Privacy Policy

PRIVACY PRACTICES AND CONSENT FOR TREATMENT AND USE OF HEALTH INFORMATION 

Aloha Kona Healthcare Services (AKHS) |  Effective Date: June 11, 2026 

PLEASE REVIEW CAREFULLY: NOTICE OF PRIVACY PRACTICES 

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. 

Aloha Kona Healthcare Services is required by law to protect the privacy of your protected health information, provide this notice, follow the terms of this notice, and notify you if a breach occurs that may have compromised the privacy or security of your information. 

We may use and disclose your health information without a separate written authorization for treatment, payment, and health care operations, including: 

• Treatment, including coordination of care among providers. 
• Payment, including billing and insurance processing. 
• Health care operations, including quality improvement, training, and audits. 

We may also use or disclose your information when permitted or required by law, including for public health reporting, health oversight activities, workers’ compensation, law enforcement when legally required, court or administrative orders, coroners or medical examiners, organ and tissue donation purposes, and to prevent or lessen a serious and imminent threat to health or safety. 

We may use or disclose health information for research permitted by law, including when an institutional review board or privacy board has approved a waiver of authorization or when you have provided written authorization. We may also disclose information to business associates that perform services for AKHS when they agree to protect the information as required by law. 

Uses and disclosures not described in this notice will be made only with your written authorization when required by law. This includes most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and disclosures that constitute a sale of protected health information. You may revoke an authorization in writing at any time, except to the extent we have already relied on it. 

AKHS may change the terms of this notice and make the new notice apply to health information we already have as well as information we receive in the future. The current notice will be available upon request and through AKHS’s usual patient communication channels. 

YOUR RIGHTS 

You have the right to: 

• Access, inspect, and obtain a copy of your medical record, including an electronic copy when available. 
• Request corrections or amendments to information you believe is incorrect or incomplete. 
• Request restrictions on certain uses or disclosures, including a restriction on disclosure to a health plan when you pay out of pocket in full for the related service and the disclosure is for payment or health care operations. 
• Request confidential communications by alternative means or at an alternative location. 
• Receive an accounting of certain disclosures as required by law. 
• Receive a paper copy of this notice upon request, even if you agreed to receive it electronically. 
• Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person may exercise your rights and make choices about your health information. We will verify that the person has this authority before taking action for you. 
• File a complaint with Aloha Kona Healthcare Services or with the U.S. Department of Health and Human Services Office for Civil Rights without retaliation. 

You may file a privacy complaint with the AKHS Privacy Officer using the contact information below. You may also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the OCR Complaint Portal or by mail to: U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201. AKHS will not retaliate against you for filing a complaint. 

If AKHS contacts you for fundraising, you may tell us not to contact you again for fundraising purposes. 

We will obtain your written authorization before using or disclosing your information for marketing purposes, selling your information, or using or disclosing most psychotherapy notes, unless an exception permitted by law applies. 

YOUR CHOICES 

For certain health information, you may tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, tell us what you want us to do. We will follow your instructions when permitted by law. 

You may tell us whether to share information with your family, close friends, or others involved in your care, or share information in a disaster-relief situation. If you are unable to tell us your preference, we may share information when we believe it is in your best interest or when needed to lessen a serious and imminent threat to health or safety, as permitted by law. 

OUR DUTIES 

We are required by law to: 

• Maintain the privacy of your information. 
• Provide this notice. 
• Notify you of a breach. 
• Follow the terms of this notice. 

CONTACT: PRIVACY OFFICER 

Aloha Kona Healthcare Services
5995 Kuakini Hwy, Suite 513
Kailua-Kona, Hawaii 96740
Phone: 808-365-2297  |  Email: office@thnhawaii.org 

I voluntarily consent to receive medical evaluation, diagnostic testing, and treatment from Aloha Kona Healthcare Services. I authorize AKHS and its providers to use and disclose my health information for treatment, payment, and health care operations. This consent remains in effect until revoked by the patient in writing, except to the extent AKHS has already acted in reliance on it. 

INTEGRATED CARE 

I understand that AKHS provides coordinated care, including primary care, behavioral health, and substance use disorder services. Authorized members of my care team may share information for care coordination, referrals, medication management, and follow-up care, as permitted by applicable law. 

SUBSTANCE USE DISORDER SERVICES 

Aloha Kona Healthcare Services provides substance use disorder (SUD) services. Certain records related to substance use disorder treatment may receive additional protections under federal law, including 42 CFR Part 2. Patients who receive substance use disorder services may be asked to review and sign additional consent forms and authorizations that apply specifically to those services. Aloha Kona Healthcare Services will use and disclose substance use disorder treatment information only as permitted by applicable law and any valid consent or authorization provided by the patient. To the extent AKHS maintains or receives substance use disorder patient records subject to 42 CFR Part 2, AKHS will not use or disclose those records for investigations or civil, criminal, administrative, or legislative proceedings against the patient without the patient’s specific written consent or a court order accompanied by a subpoena or other legal mandate as required by law. 

TELEHEALTH SERVICES 

Aloha Kona Healthcare Services may provide certain health care services through telehealth, including secure phone, video, or other electronic communication methods. Telehealth may be used for evaluation, consultation, follow-up care, medication management, behavioral health services, care coordination, or other services when appropriate. I understand that telehealth allows me to receive care without being physically present in the clinic, but it may not be appropriate for every medical concern. I understand that possible risks include technology problems, interruptions, limits on the provider’s ability to examine me in person, and privacy or security risks despite reasonable safeguards. I understand that AKHS will take reasonable steps to protect my privacy and health information during telehealth visits. I may ask questions about telehealth, request an in-person visit when appropriate, or decline telehealth services, except when telehealth is the only available or clinically appropriate option. 

SPECIAL PROTECTIONS FOR SENSITIVE INFORMATION 

My records may include sensitive information such as: 

• Mental health treatment. 
• Substance use disorder services. 
• HIV/AIDS or sexually transmitted infections. 
• Reproductive health services. 

Certain information may receive additional protections under federal or state law. AKHS will use or disclose sensitive information only as permitted by law or with required written consent or authorization. AKHS will not use or disclose reproductive health information for a prohibited purpose when federal or state law prohibits such use or disclosure. 

 Aloha Kona Healthcare Services complies with applicable federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, disability, sex, pregnancy or related condition, religion, sexual orientation, gender identity, or any other status protected by applicable law. 

AKHS provides free aids and services when needed for effective communication and meaningful access, including: 

• Free language assistance services, including qualified interpreter services and translated materials when required. 
• Free auxiliary aids and services for people with disabilities, such as accessible formats or communication assistance when required. 
• Timely assistance without requiring patients to provide their own interpreter or rely on a minor child except in limited emergency circumstances permitted by law. 

To request language assistance, disability-related aids or services, or help filing a grievance, contact the Civil Rights Coordinator / Privacy Officer at Aloha Kona Healthcare Services, Phone: 808-365-2297, Email: office@thnhawaii.org. If you believe AKHS has failed to provide these services or discriminated in another way, you may file a grievance with the Civil Rights Coordinator / Privacy Officer. You may also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights. 

PATIENT PAYMENT POLICY 

INSURANCE 

We accept most major insurance plans. Patients are responsible for ensuring that AKHS is in network with their insurance provider. Verification of insurance coverage, eligibility, or benefits is not a guarantee of payment by the insurance plan. Co-payments, deductibles, and coinsurance amounts are due at the time of service. Patients remain responsible for charges not paid by their insurance plan, subject to applicable financial assistance, payment arrangement, or access-to-care policies. 

SELF-PAY 

Patients without insurance are responsible for payment at the time services are provided unless prior arrangements are made. Patients who have difficulty paying may request information about available financial assistance, sliding fee options, payment arrangements, or other programs for which they may qualify. No patient will be denied medically necessary services due to inability to pay, where required by applicable law or AKHS policy. AKHS will apply any applicable financial assistance or access-to-care policies consistently and in accordance with law. 

BILLING 

AKHS will submit claims to your insurance on your behalf. Any remaining balance after insurance processing is the patient’s responsibility. Statements will be provided for any outstanding balance. 

NON-PAYMENT 

AKHS will work with patients regarding outstanding balances and available payment arrangements. Collection activity may occur for unpaid balances after reasonable notice. Financial policies will be applied consistently and will not be used to discriminate or deny access to services in a manner prohibited by law. 

PATIENT RESPONSIBILITY 

I understand that I am financially responsible for all charges not covered by my insurance, subject to applicable financial assistance, payment arrangement, or access-to-care policies.