|
Arkansas
Department of Health
PRIVACY
NOTICE
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.
The Arkansas
Department of Health (ADH) is committed to protecting your health
information. This Notice
is to inform you about our privacy practices and legal duties related
to the protection of the privacy of your medical/health records that
we create or receive.
HOW WE MAY USE AND DISCLOSE
MEDICAL INFORMATION ABOUT YOU
ADH staff will only
use your health information when doing their jobs.
The purposes of the use and sharing of health information are
for treatment, payment for services and for Agency operations.
Treatment:
Caregivers, such as nurses, doctors, therapists, nutritionists
and social workers, may use your health information to determine your
plan of care. Individuals
and programs within the ADH may share health information about you in
order to coordinate the services you may need, such as clinical
examinations, therapy, nutritional services, medications,
hospitalization, or follow-up care.
For
Payment: The ADH
may release information about you to Medicaid, Medicare, your health
plan or health insurance carrier to obtain payment for our services.
For example, we may need to give your health plan information
about a clinical exam or vaccinations that you or your child received
so your health plan or Medicaid or Medicare will pay us for treatment
or services.
For
Operations: The
ADH may use and release information about you to ensure that the
services and benefits provided to you are appropriate and are high
quality. For example, we
may use your information to evaluate our treatment and service
programs (quality assurance). We
may combine health information about many individuals to research
health trends, to determine what services and programs should be
offered, or whether new treatments or services are useful.
We may share your health information with business partners who
perform functions on behalf of the ADH.
For example, our business partners may use your information to
perform case management, coordination of care, or other assessment
activities. The ADH requires that our business partners abide by the same
level of confidentiality and security as ADH when handling your health
information.
Other uses,
sharing of health information or disclosures of health information
required or allowed by law include:
To
Other Government Agencies Providing Benefits or Services:
The ADH may release your health information to other government
agencies that are providing you with benefits or services when the
information is necessary for you to receive those benefits and
services.
To
Keep You Informed: The
ADH may contact you about reminders for treatment, medical care or
health check-ups. We may
also contact you to tell you about health related benefits or services
that may be of interest to you.
For
Public Health: The
ADH may release your health information to other programs within the
ADH as it relates to public health, subject to the provisions of
applicable state and federal law, for the following kinds of
activities:
-
To
prevent or control disease, injury or disability or to keep vital
statistics records such as births and deaths.
-
To
notify social services agencies that are authorized by law to
receive reports of abuse, neglect or domestic violence.
-
To
report reactions to medications or problems with products to the
Food and Drug Administration (FDA).
For
Health Oversight Activities:
The ADH may share your health information with other programs
within the ADH and with other agencies for oversight activities as
required by law. Examples
of these oversight activities include audits, inspections,
investigations, and licensure.
For
Law Enforcement:: The
ADH may release health information to a law enforcement official,
subject to applicable federal and state law and regulations, for
purposes that are required by law or in response to a court order or
subpoena.
For
Research: The ADH
may release your health information for research projects that have
been reviewed and approved by an institutional review board or privacy
board to ensure the continued privacy and protection of the health
information.
Lawsuits
and Disputes: If
you are involved in a lawsuit or a dispute, the ADH may release health
information about you in response to a court or administrative order.
We may also release health information about you in response to
a subpoena, discovery request, or other lawful process by someone else
involved in the dispute, but only if efforts have been made to tell
you about the request or to obtain an order protecting the information
requested.
To
Coroners, Medical Examiners and Funeral Directors:
The ADH may release health information to a coroner, medical
examiner or funeral director, as necessary to carry out duties as
authorized by law.
For
Organ Donations: If
you are an organ donor, the ADH may release your health information to
an organization that procures, banks, or transports organs for the
purpose of an organ, eye or tissue donation and transplantation.
To
Avert A Serious Threat to Health or Safety:
The ADH may release your health information if it is necessary
to prevent a serious threat to your health and safety or to the health
and safety of the public or another person.
For
National Security and Protection of the President:
The ADH may release your heath information to an authorized
federal official or other authorized persons for purposes of national
security, for providing protection to the President, or to conduct
special investigations, as authorized by law.
To
a Correctional Institution:
If you are an inmate of a correctional institution or under the
custody of a law enforcement officer, the ADH may release your health
information to the correctional institution or law enforcement
officer. The information
released must be necessary for the institution to provide you with
health care, protect your health and safety or the health and safety
of others, or for the safety and security of the correctional
institution.
To
the Military: If
you are a veteran or a current member of the armed forces, the ADH may
release your health information as required by military command or
Veteran Administration authorities.
If you do
not object and the situation is not an emergency and disclosure is
not otherwise prohibited by stricter laws,
the ADH is permitted to release your information under the following
circumstances:
To Individuals
Involved In Your Care: The
ADH may release your health information to a family member, other
relative, friend, or other person whom you have identified to be
involved in your health care or the payment of your health care.
To Family:
The ADH may use your information to notify a family member, a
personal representative, or a person responsible for your care, of
your location, general condition, or death.
To Disaster
Relief Agencies: The ADH may release your health information to an agency
authorized by law to assist in disaster relief efforts.
YOUR HEALTH INFORMATION
RIGHTS
Release of your
information outside of the boundaries of ADH-related treatment,
payment, or operations, or as otherwise permitted by state or federal
law, will be made only with your specific written
authorization. Your
specific written authorization is required to release the following
types of information: Drug and Alcohol Abuse, Family Planning,
HIV/AIDS, Mental Illness, Sexually Transmitted Diseases, and Women,
Infants and Children (WIC) Program.
You may revoke specific authorizations to release your
information, in writing, at any time.
If you revoke an authorization, we will no longer release your
health information to the authorized recipient(s), except to the
extent that the ADH has already used or released that information in
reliance of the original authorization.
In addition, you
have the following rights regarding the health information that the
ADH has about you:
Right to
Inspect and Copy: You may request to inspect or have a copy of any part of your
health record. We may
charge a fee for the costs of copying, mailing, or other supplies
associated with your request.
Right to
Request Amendment: If you feel that the health information the ADH has created
about you is incorrect or incomplete, you may ask us to amend that
information. The ADH may
deny your request if you ask to amend information that: 1) was not
created by the ADH; 2) is not part of the health information kept by
the ADH; 3) is not part of the information
which you would be permitted to
inspect or copy; or 4) the information is determined to be accurate
and complete.
Right to
Request an Accounting of Health Information Releases:
You may request an accounting of disclosures of your health
information. The
accounting does not include disclosures for purposes of treatment,
payment, health care operations; disclosures required by law for
purposes of national security; disclosures to jails or correctional
facilities, authorized disclosures, and any disclosures made prior to
April 14, 2003.
Right to
Request Restrictions: You
may request ADH to limit the use or disclosure of your health
information except for treatment, payment, and health care operations.
ADH is not required by law to agree to your request.
Right to
Request Confidential Communication:
You may request, in writing, that ADH communicate with you in a
different way or to a different location, for example, using a
different mailing address or calling you at a different phone number.
Right to a
Paper Copy of this Privacy Notice:
You may request a paper copy of this Privacy Notice from ADH at
any time.
All requests for
inspecting, copying, amending, making restrictions, or obtaining an
accounting of your health information and any questions regarding this
Privacy Notice must be directed to the Local Health Unit Hometown
Health Leader.
COMPLAINTS
If you believe your
privacy rights have been violated, you may file a complaint:
- With
the ADH by contacting:
Privacy
Officer
4815 West Markham, Slot 41
Little Rock, AR 72205
(501) 661-2000
- Or
with the Secretary of the Department of Health and Human Services
by calling them at 877-696-6775 or writing them at 200
Independence Ave. S.W., Washington, DC, 2020l.
- Or
with the Office of Civil Rights by calling 866-OCR-PRIV
(866-627-7748), or 886-788-4989 TTY.
CHANGES TO THIS PRIVACY NOTICE
The ADH reserves the
right to revise this Privacy Notice effective for health information
the ADH already has about you as well as any information received in
the future. We will
provide you with a copy of the revised Privacy Notice at your next
visit following the effective date of the revised Privacy Notice.
In addition, you may ask for a copy of our current Privacy
Notice any time you visit an ADH facility for treatment or health care
services.
You may request
translation or reading of this Privacy Notice.
When possible, a written translation will be provided.
|
