HIPAA Notice of Privacy Practices

Effective Date: August 1, 2026    Last Updated: August 1, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Our Commitment to Your Privacy

Ohana Mental Health is required by law to maintain the privacy of your protected health information (PHI), to provide you with this notice describing our legal duties and privacy practices, and to follow the terms currently in effect.

How We May Use and Disclose Your Health Information

Without your written authorization, for:

• Treatment: to provide, coordinate, or manage your care. Under Minnesota law, which is more protective than federal HIPAA law, we generally may not share your health record with another treating provider without your signed, dated consent, except in a medical emergency or as otherwise specifically permitted by Minnesota law (Minn. Stat. §§ 144.291 to 144.298). We will ask for that consent as part of care coordination.
• Payment: to bill and collect payment for services, including working with your insurance company
• Health Care Operations: for quality improvement, staff training, and other activities necessary to run our practice

Other permitted uses, in limited circumstances, without your authorization:

• As required by law, including Minnesota’s mandatory reporting laws: suspected maltreatment of a minor (Minn. Stat. ch. 260E), suspected maltreatment of a vulnerable adult (Minn. Stat. § 626.557), and the duty to warn or take reasonable precautions when a patient poses a clear danger to a specific, identifiable person (Minn. Stat. § 148.975)
• For public health activities
• For health oversight activities
• For judicial or administrative proceedings, in response to a court order
• For law enforcement purposes, as required by law
• To avert a serious and imminent threat to health or safety
• For workers’ compensation, as authorized by law

Disclosures where you have the opportunity to agree or object:

• To a family member, friend, or other person involved in your care or payment for care, unless you object
• To notify a family member or other person responsible for your care of your location, general condition, or, in the event of your death, that information, unless you object

Where you are not present or able to agree or object, we will use professional judgment to determine whether a disclosure of this kind is in your best interest.

Uses and Disclosures Requiring Your Written Authorization

The following require your specific written authorization, which you may revoke at any time:

• Psychotherapy notes, where separately maintained
• Marketing communications
• Sale of your health information

Substance use disorder treatment records: If you receive treatment through our Medication-Assisted Treatment program, or any other service that creates, receives, or maintains substance use disorder treatment records, those records are protected under federal law, 42 CFR Part 2, in addition to HIPAA. Information that would identify you, directly or indirectly, as having a substance use disorder may not be disclosed or used in any civil, criminal, administrative, or legislative proceeding against you unless you provide written consent, or a court issues an order after notice and an opportunity for you to be heard. This protection applies to care coordination and referrals as well as treatment records themselves.

Any other use or disclosure not described in this notice will only be made with your written authorization.

Your Rights Regarding Your Health Information

• Right to inspect and obtain a copy of your health record, including an electronic copy if we maintain your record electronically
• Right to request an amendment to your health record
• Right to request an accounting of certain disclosures we’ve made
• Right to request restrictions on certain uses and disclosures. If you pay for a service in full, out of pocket, and request that we not disclose information about that service to your health plan, we are required to grant that request, except where disclosure is otherwise required by law
• Right to request confidential communications by an alternative means or location
• Right to a paper copy of this notice upon request, even if you have agreed to receive it electronically
• Right to be notified in the event of a breach involving your unsecured health information

Minors and Confidentiality

Minnesota law includes specific rules about when a minor may consent to mental health treatment independently, and when a parent or guardian may be informed. In general:

• A person 16 or older may consent to certain voluntary mental health services without parental consent (Minn. Stat. § 253B.04)
• Minors may consent to certain services related to alcohol or drug use, and a minor living apart from their parents and managing their own financial affairs may consent to broader services (Minn. Stat. § 144.343)
• Minnesota law governs the circumstances under which a provider may inform a parent of treatment the minor consented to independently (Minn. Stat. § 144.346)

These rules affect who can access a minor patient’s records and client portal. We are happy to walk through how this applies to your family’s situation.

Requesting Your Records

Minnesota law sets specific limits on the fees we may charge and the timeline for responding to a request for your health record (Minn. Stat. § 144.292), including circumstances where a copy must be provided free of charge. Contact us using the information below to start a records request.

Our Duties

We are required to maintain the privacy of your health information, provide you with this notice, and abide by its terms. We reserve the right to change this notice and to make the revised notice effective for health information we already have as well as information we receive in the future. Prior versions of this notice, with their effective dates, are archived and available on request.

Changes to This Notice

A copy of the current notice will be available at our office and on this website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our practice using the contact information below, or with the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201, or online at hhs.gov/ocr/complaints. Filing a complaint will not affect your care with us.

Privacy Officer and Contact Information

[Privacy Officer Name], Privacy Officer

Ohana Mental Health

7201 Metro Blvd, Suite 550, Edina, MN 55439

(612) 567-2633  |  info@suprtapp.com