About This Notice

This notice tells you about your privacy rights, HCPHES’ duty to protect the health information that identifies you, and how HCPHES may use or disclose health information that identifies you without your written permission. This notice does not apply to health information that does not identify you or anyone else.

Your Rights

You have the right to:

· Request a restriction on certain uses and disclosures of your information. However, HCPHES is not required to agree to a requested restriction.

· Receive confidential communications of protected health information.

· Inspect and obtain a copy of your health record. HCPHES may charge a reasonable fee to cover costs.

· Request changes to your health record. Requests for changes must be in writing.

· Obtain an accounting of disclosures of your health information.

· Request communications of your health information by alternative means or at alternative locations. For example, only send appointment messages by mail, no telephone messages.

· Revoke your authorization to use or disclose health information except to the extent that action has already been taken. Revocations must be in writing.

HCPHES’ Duty to Protect Your Health Information

* HCPHES is required by law to protect the privacy of your health information. This means that HCPHES will not use or disclose your health information without your authorization except in the ways we explain to you in this notice. We must abide by this notice.

* HCPHES will ask you for a written authorization to use or disclose your health information in ways other than those stated in this notice. If you give such an authorization, you may revoke it at any time, but HCPHES will not be liable for uses or disclosures made before you revoked your authorization.

* If HCPHES changes the content of this notice, the new notice will be made available at our facilities and on our website. www.hcphes.org within 30 days of the effective date of the changed notice. The new notice will apply to all health information maintained by HCPHES, no matter when we received or created the information.

How HCPHES Uses and Discloses Your Information

1. Treatment

HCPHES may use or disclose your health information to provide, coordinate, or manage health care or related services. This includes providing care to you, consulting with another health care provider about you, and referring you to another health care provider. For example, HCPHES can disclose your health information to refer you to a high-risk clinic or a hospital for services. HCPHES may also contact you to remind you of an appointment or to tell you about other health-related information that may be of interest to you.

2. Payment

HCPHES may use or disclose health information about you to pay or collect payment for your health care. For example, HCPHES can use or disclose your health information to bill your insurance company, Medicaid, or other funding sources such as The Texas Department of Health, for health care provided to you.

3. Health Care Operations

HCPHES may use or disclose health information about you for health care operations. Health care operations include:

· Conducting quality assessment, improvement activities, training health-care professionals; and

· The general administrative activities of HCPHES.

4. Family Member, Other relative, or Close Personal Friend

HCPHES may disclose health information about you to a family member, other relative or close personal friend when the health information is related to that person’s involvement with your care or payment for your care and you have had an opportunity to stop or limit the disclosure before it happens.

5. Health Oversight Activities

HCPHES may sometimes use or disclose health information about you for health oversight activities. Health oversight activities include audits, inspections, and investigations of possible fraud.

6. Public Health

HCPHES may disclose health information about you to a public health authority for purposes of preventing or controlling disease, injury, or disability, or to report vital statistics; and problems with FDA-regulated products or activities.

7. Victims of Abuse, Neglect, or Domestic Violence

If HCPHES believes you are the victim of abuse, neglect, or domestic violence we may disclose health information about you to a governmental agency that requires reports of abuse, neglect, or domestic violence as mandated by Texas law.

8. Serious Threat to Health or Safety

HCPHES may use or disclose health information about you if we believe the use or disclosure is needed to prevent or lessen a serious and immediate threat to the health and safety of a person or the public.

9. As Required by Texas Law

HCPHES may use or disclose health information about you when a law requires the use or disclosure.

10. Contractors

HCPHES may disclose health information about you to a contractor if the contractor needs the information to perform services for us and agrees to protect the privacy of your information.

11. Purposes Relating to Death

HCPHES may disclose health information about you to hospitals for the purpose of organ transplants, coroners, medical examiners, and funeral directors.

12. Research

HCPHES may use or disclose health information about you for research if the HCPHES Research Review Committee approves the use. The committee will ensure that your privacy is protected when your health information is used in research.

13. HCPHES Does Not Use Your Information For Marketing Purposes.

Complaint Process

If you believe that HCPHES has violated your privacy rights, you have the right to file a complaint within 180 days of when you learned of the violation. Complaints can be filed with any of the agencies listed below.

· HCPHES Privacy Officer at 2223 West Loop So. RM 643, Houston, Texas 77027, telephone 713/439-6168;

· Harris County Privacy Officer at 1310 Prairie, Suite 200 Houston, Texas 77002, telephone 713/755-5349;

· Region VI, Office of Civil Rights, U.S. Department of Health & Human Services 1301 Young Street , Suite 1169, Dallas, Texas 75202, telephone 214/767-4056

You can also file a complaint on-line at OCRComplaint@hhs.gov.