Health Insurance Portability and Accountability Act(HIPAA) Privacy Notice 

This information describes how medical information about you may be used and disclosed and how you can get access to this information.

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.  

Downloads
HIPAA privacy notice

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. 
  • 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. 
  • 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 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 31
Little Rock, AR 72205 
501-661-2878 

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 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.