Date: 11/4/2019 3:43:39 PM
STATE OF FLORIDA)
AFFIDAVIT OF RONALD W. CLARK JR
COUNTY OF UNION)

AFFIDAVIT IN SUPPORT OF HIPAA VIOLATION
I Ronald Wayne Clark Jr duly declare under the penalty of perjury that the below statement/facts are true and correct. On Tuesday October 29, 2019 at approximately 9:00 am Co Brown served me a disciplinary report, DR log #213-191416 which contained a medical procedure and part of my medical history. I drew up a Formal complaint and sent it in an email to my girlfriend Claudine Verplanken, see attached as exhibit (A). These people realizing that I had identified their mistake, where they have now violated State and Federal laws under HIPAA, to correct it they rewrote the DR on October 31, 2019 at 1:00 PM. They also deleted my letter #14 from my sent box where my girlfriend would not receive it. So not only did they violate HIPAA, but they infringed on my First Amendment Constitutional Right to get this Formal complaint out there. The rewrite DR log #213-191436 has the HIPAA violation corrected. But by doing so, they've admitted and acknowledged the fact that staff clearly and unequivocally violated the laws under HIPAA. Otherwise they would not have tried to correct this egregious mistake, where they placed confidential medical information into a document that is open to public record request. Now Sgt Wood has sat in on my doctor clinics, so he had first-hand knowledge of my medical procedure. Word is classification wrote this DR, to try to make it stick, and "they" went into the emails, and did all the research. Fact is who ever authored it, and who ever typed it was both entities who are subject to HIPAA, and therefore violated this law. These facts support that an investigation into this matter needs to be conducted.
OATH/VERIFICATION
Under penalty of perjury, I, Ronald Wayne Clark Jr. do hereby certify that I have read the forgoing affidavit and that the facts and matter set forth therein are true and correct. And I will support all these facts with a polygraph exam.
_Ronald Wayne Clark Jr_ #812974. November 4, 2019

CC. Senator Randolph Bracy, Senator Gary Farmer, Representative Kionne McGhee, Representative Anna Eskamani, Representative Carlos Guillermo Smith, Representative Susan Valdes. Chief Inspector General's office, Office of the Governor, Inspector Heather Robinson. Secretary Mark Inch, The Office for Civil Rights of the U.S. Department of Health and Human Services.

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