NOTICE OF PRIVACY PRACTICES
STATE OF SOUTH DAKOTA DEPARTMENT OF HEALTH
Effective April 14, 2003
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.
If you have any questions about this notice,
please contact our Compliance Officer at (605) 773-3361 or doh.sd.gov.
We are required to provide you with this Notice o
f Privacy Practices and to explain our legal
duties under the federal Health Insurance Portability and Accountability Act (HIPAA).
We are the public health agency in South Dakota that prevents and controls the spread of
infectious diseases, promotes health through education and the provision of specified health
care services and screenings, provides laboratory testing, maintains the state's vital records
systems, and administers regulatory programs related to health care facilities and health
protection. To provide some of these services, we must collect certain information about you
that may be considered “protected health information". We are required by law to maintain the
privacy of any protected health information that we collect and maintain.
“Protected health information” is defined as individually identifiable health information. This
includes demographic information, for example, age, address, and account numbers, and
information that relates to your past, present, or future physical or mental health or condition
and related health care services.
This notice explains:
• How we may use or disclose your protected health information.
• When we must get your permission to use or disclose your protected health information.
• Your rights regarding your protected health information.
• That you will be asked to sign an acknowledgement of receipt of this notice.
• That we may make changes to this notice.
• That you may file a complaint if you believe your privacy rights have been violated.
HOW WE MAY USE OR DISCLOSE YOUR PROTECTED HEALTH INFORMATION
This section describes permitted uses and disclosures of your protected health information and
contains examples. All situations are not described.
For Treatment. We may use or disclose your protected health care information to provide,
coordinate, or manage your health care and related services. This includes the coordination or
management of your health care with a third party. For example, information from your medical
record (i.e., weight, blood pressure, certain test results, etc.) may be shared with another health
care provider for further diagnosis and treatment of your condition.
For Payment. We may use or disclose your protected health care information to obtain
payment or to pay for the health care services you receive. For example, information from your
medical record (i.e., weight, blood pressure, certain test results, etc.) may be shared with your
insurance company for reimbursement purposes.
For Health Care Operations. We may use or disclose your protected health care information
in order to manage our agency programs and activities. For example, information from your
medical record (i.e., weight, blood pressure, certain test results, etc.) may be shared between
Department of Health programs in order to more efficiently manage your care.
As Required by Law. We may use or disclose your protected health information when required
by federal or state law.
As Required for Law Enforcement. We may use or disclose your protected health information
when required by court order, subpoena, warrant, summons, or similar legal process.
Public Health Activities. We may use and disclose your protected health information for public
health activities, such as vital statistics and disease control, and may disclose it to other public
health agencies for public health activities.
Public Health Oversight Activities. We may use or disclose your protected health information
for public health oversight activities, such as inspecting health care providers.
Abuse Reports and Investigations. We are required by law to receive and investigate reports
of abuse.
To Avert a Serious Threat to Health or Safety. We may use or disclose your protected health
information when necessary to prevent a serious threat to the health or safety of you or other
individuals.
For Research. We may use or disclose your protected health information for research studies
and to develop research reports. However, the results of the studies and reports do not identify
specific people.
For Appointments & Other Health Information. We may send you reminders for medical
care or checkups. We also may use or disclose your protected health information as needed to
provide you with information about treatment alternatives or other health-related benefits and
services that might interest you. For example, we may use your name and address to send
information to you about our programs and services or about other products or services that we
believe might benefit you. You have the right to limit our use and disclosure for this purpose.
Disclosures to Family, Friends, & Others. We may disclose your protected health
information to your family or other persons involved in your medical care. You have the right to
limit our use and disclosure for this purpose.
WHEN WE NEED YOUR PERMISSION TO USE OR DISCLOSE YOUR PROTECTED
HEALTH INFORMATION
Except for the purposes identified in the section above, we will not use or disclose your
protected health information unless we have your specific written authorization. You have the
right to revoke a written authorization at any time as long as you do so in writing.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have certain rights regarding your protected health information, as listed below. To
exercise these rights, you must submit a written request on a form that you can obtain from our
Compliance Officer. In some instances, we may charge you for the costs associated with
providing you with the information you request.
Our Compliance Officer can answer your questions and give you guidance in pursuing these
rights. Please be aware that we may deny your requests under certain circumstances
authorized by law. You also may seek a review of our denial under certain circumstances as
authorized by law.
Right to Access, Inspect, and Copy. You may access, inspect, and obtain a copy of your
protected health information for as long as we maintain the protected health information. This
right does not include access to the following records: psychotherapy notes; information
compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or
proceeding; and protected health information that is subject to law that prohibits access to
protected health information.
Right to Request Amendment. If you believe that the information we have about you is
incorrect or incomplete, you may request an amendment to your protected health information as
long as we maintain this information. However, we may deny your request for certain reasons
authorized by law.
Right to an Accounting of Disclosures. You may request that we provide you with an
accounting of the disclosures we have made of your protected health information. However, we
may deny your request for certain reasons authorized by law.
Right to Request Restrictions. You may ask us to not use or disclose any part of your
protected health information for treatment, payment, or health care operations. However, we
may deny your request for certain reasons authorized by law.
Right to Request Confidential Communications. You may request that our communications
with you remain confidential and that we communicate with you using alternative means or an
alternative location. We will not ask you the reason for your request. We will accommodate
reasonable requests, when possible.
Right to Obtain a Copy of this Notice. You have the right to ask for a paper copy of this
notice at any time.
ACKNOWLEDGEMENT OF RECEIPT OF THIS NOTICE
You will be asked to provide a signed acknowledgment of receipt of this notice. The delivery of
your health care services or your participation in any of our programs will in no way be
discontinued if you decline to sign an acknowledgement. Even if you decline, we may use and
disclose your protected health information for treatment, payment, health care operations, and
other program activities when necessary and authorized by law.
CHANGES TO THIS NOTICE & HOW TO GET A COPY
We will abide by the terms of this notice, including any future revisions that we may make to this
notice as re
quired or au
thorized by law. This no
tice is effective in its entirety as of April 14,
2003. We reserve the right to change this notice and to make the revised or changed notice
effective for health information we already have about you as well as any information we receive
in the future.
You may obtain a copy of our current Notice of
Privacy Pra
c
tices by accessing our website at
doh.sd.gov, calling our Compliance Officer at (605) 773-3361 or asking for
a printed copy at
any of our offices.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a written complaint with our
Compliance Officer or the Secretary of the U.S. Department of Health and Human Services. No
retaliation will occur against you for filing a complaint.
CONTACT INFORMATION
You may contact our Compliance Officer for further information about the complaint process, or
for further explanation of this document. Our Compliance Officer may be contacted at:
South Dakota Department of Health
Attn: HIPAA Compliance Officer
600 East Capitol Avenue
Pierre, South Dakota 57501-2536
(605) 773-3361
doh.sd.gov
This notice is effective in its entirety as of April 14, 2003.
