Off the Record: Ensuring Privacy Protections in Free and Charitable Health Clinics

Abstract: Free and charitable clinics serve nearly two million patients annually, providing crucial medical care to underserved and uninsured community members. However, privacy laws do not automatically protect patients' health information. While the Health Insurance Portability and Accountability Act (HIPAA) and state-specific medical privacy laws require covered entities to protect sensitive health information, these standards often do not extend to free and charitable clinics that do not bill for services, leaving patients' health information vulnerable to unauthorized disclosures. The absence of uniformity with privacy protections raises concerns regarding patient confidentiality and informed consent. This prompts the question: do patients who cannot pay for medical care deserve less protection for their health information?

Existing literature on free health overlooks the gap in privacy standards in scenarios where the clinic does not bill for services and no additional safeguards are in place. In this presentation, I examine the landscape of state and federal privacy laws governing health information, shedding light on situations that fall into a legal void. I delve into the legal and ethical dilemmas free health clinics face in handling health data and their implications for individual autonomy and privacy. I argue that in the absence of formal legal protections, free health clinics should adopt internal policies that mirror HIPAA's standards, thereby extending privacy protections to entities exempt from such requirements.