Records are maintained on each student/patient. All information is confidential but can be released with written permission or under special legal exceptions. Records are maintained electronically and are accessible only by health service and counseling staff. Student employees only have access to the scheduling and demographic data in the record.
Notice of Privacy Practices
We will ask you to acknowledge receipt of the following information, please review it carefully.
This notice explains how the BSU Student Center for Health uses and discloses your personal health information and the rights that you, as a consumer, have to access this information and keep it private. We are required by federal and state law to protect the privacy of your personal health information and to provide you with this notice. If state law provides you with greater protection for your information or greater access to your records than the federal law, we will abide by state law.
We reserve the right to change our privacy practices and the terms of this notice. Before we make a significant change in our privacy practices, we will distribute a new notice to you and obtain your consent for new uses and disclosures, if required by law. To the extent applicable, any changes in our privacy policy will affect information we receive or create after the effective date of the new policy.
Exceptions to Confidentiality
There are legal and ethical exceptions to confidentiality which require that we take responsible action. They include:
- When there is a clear and present danger of harm to yourself or another person. In these circumstances we are legally required to take action to protect your safety. Thus, our actions in these circumstances may include arranging for voluntary or involuntary hospitalization, as well as notifying law enforcement authorities and/or family/friends/individuals at risk.
- In the case of suspected child abuse or abuse of a vulnerable adult. In these circumstances we are legally required to report the abuse to Child Protection Services or other appropriate county and/or state authorities.
- In the event of a court order for information.
- In the case of an emergency which poses a serious health threat to the client or another person(s).
- We may disclose your health information to the appropriate persons in order to comply with the laws related to workers’ compensation or other similar programs. These programs may provide benefits for work-related injuries or illness.
- Under certain circumstances, and only after a special approval process, we may use and disclose your health information to help conduct research. Such research might try to find out whether a certain treatment is effective in curing an illness.
- When allowed or required under state or federal data privacy laws including the Minnesota Data Privacy Act, HIPPA or FERPA.
Your Right to Privacy
You are not legally required to provide us information. However, our services may be limited by how much information you choose to disclose.
We will use your personal information only to the extent necessary to conduct or support treatment, payment or other health care operations on your behalf or as authorized by you or by law.
Some examples are:
- To tell you apart from other people with the same or similar name.
- To support treatment purposes such as care coordination.
- To collect money from insurers or others, if they should pay for your care.
Unless you are incapacitated, we will give you an opportunity to object to the following uses or disclosures of your information:
- Family and Other Individuals Involved in Your Care – We may disclose to family members, friends and persons you indicate are involved with your care, personal information that is directly relevant to their involvement in your care.
- Disaster Relief Efforts – We may release your health information to organizations authorized to handle disaster relief efforts so those who care for you can receive information about your location or health status.
- Treatment Options -We may look at your medical information and decide to tell you about another treatment or a new service we offer.
Your Right to Your Health Information
You have several rights with regard to your health information. Specifically, you have the right to:
- Inspect and copy your health information. With a very few exceptions, you have the right to inspect and obtain a copy of your health information. Please use the Release of Information form to make your request in writing. We will respond immediately or within 10 working days, unless an extension is necessary. If you request copies, we may charge you a reasonable fee as permitted by law. If we deny your request, you may be entitled to a review of that denial.
- Request to amend your health information. If you believe your health information is incorrect, you may ask us to correct the information. You may be asked to make such requests in writing and to give a reason as to why your health information should be changed. However, if we did not create the health information that you believe is incorrect or if we disagree with you and believe your health information is correct, we may deny your request. You may be entitled to a review of that denial. You may respond with a statement of disagreement to be included in your records.
- Request restrictions on certain uses and disclosures. You have the right to ask for certain restrictions on how your health information is used or to whom your information is disclosed, even if the restriction affects your treatment or our payment or health care operation activities. We are not required to agree in all circumstances to your requested restriction.
- As applicable, receive confidential communication of health information. You have the right to ask that we communicate your health information to you in different ways or places. For example, you may want us to contact you only at work or through a written letter sent to a private address. You must make your request in writing and specify how or where you wish to be contacted. We will accommodate reasonable requests.
- Receive a record of disclosures of your health information. You have the right to request and obtain a list of the disclosures we have made of your health information. This right does not apply to disclosures made to you or with your consent or authorization, for purposes of treatment, payment or health care operations and a few other limited exceptions. This list must include the date of each disclosure, who received the disclosed health information, a brief description of the health information disclosed and why the disclosure was made. We may not charge you for the list, unless you request such a list more than once per year.
- Obtain a paper copy of this notice. Upon your request, you may at any time receive a paper copy of this notice, even if you earlier agreed to receive this notice electronically.
- Complain. If you believe your privacy rights have been violated, you or your legal representative, may file a complaint with us or with the U.S. Department of Health and Human Services. We will not retaliate against you for filing such a complaint. To file a complaint with either entity:
Jennifer Fraik, Interim Director of The Student Center for Health and Counseling
1500 Birchmont Dr. NE, Box 42
Bemidji, MN 56601
(218) 755-2053
Office of Civil Rights Medical Privacy, Complaint Division
US Department of Health and Human Services
200 Independence Ave. SW
Washington,DC 20201
1-(866) 627-7748
Release of Information
If you wish to have your medical or counseling records transferred, you may click on the link below to download a form. Once form is completed you can email it to healthservices@bemidjistate.edu, fax it to (218) 755-2750 or send it through the mail.
Release of Information form (PDF)
Bemidji State University Student Center for Health and Counseling Services Consent Forms
Counseling Informed Consent form (PDF)
Students under the age of 18 cannot be treated for health related services without consent. Exceptions to this are governed by Minnesota Statutes, Chapter 144. Please click on the link below to access our consent form. When you have completed the form you can fax it to (218) 755-2750 or mail it to the Student Center for Health and Counseling 1500 Birchmont Drive NE #42, Bemidji MN 56601