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Privacy Practices
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.
This notice applies to all of the records of your care generated by the Community Health Centers (CHCs), whether made by the CHC or an associated provider. Our policies on protecting your health information extend to all professional authorized persons who have a need to know in order to provide care to you.
CHC associated providers include the CHC Dental Clinic (RBJ, South Austin, Northeast), Del Valle CHC, David Powell Clinic, A. K. Black CHC, East Austin CHC, Manor CHC, Montopolis CHC, Northeast Austin CHC, Oak Hill CHC, Rosewood Zaragosa CHC, Pflugerville CHC, CHC Homeless Clinics, South Austin CHC, and the Seton Healthcare Network.
YOUR PROTECTED HEALTH INFORMATION
We are legally required to protect the privacy of your health information. We are required by law to make sure your protected health information is kept private, to provide you with this Notice of Privacy Practices (NPP), and make sure your legal rights are protected within the law.
We reserve the right to change this notice at any time. The CHC must approve in advance any material changes to the uses or disclosures of your personal health information, CHC’s legal duties regarding your personal health information, or a privacy practice stated in the NPP. If any such change is approved, you may request a copy of the current NPP each time you visit the CHC for services, or by calling the CHC and requesting the current NPP be sent to you in the mail.
HOW WE MAY USE AND DISCLOSE YOUR PERSONAL HEALTH INFORMATION
Treatment. We use information about you to provide you with current or future health care treatment. We will disclose your information to doctors, nurses, and other health care personnel who are involved in your care.
Payment. We may use and disclose medical information about you concerning services and procedures that may be billed and collected from you, your insurance company, or a third party reimbursement entity.
Operational Uses. We may use and disclose medical information about you in order to operate the CHCs efficiently and make sure our patients receive quality care. We may share your information with other agencies providing health care and other services to you.
Appointment and Patient Recall Reminders. We may use and disclose your health information to contact you to remind you regarding appointments for medical care that you are to receive.
External Entities. In an emergency, we may disclose information about you to an entity assisting in disaster relief so that your family can be notified about your condition and location.
Research. We may participate in research concerning the use of certain treatments that have proper governmental and CHC approval. In that case, we would secure your informed consent that will identify all aspects of your involvement, risks and benefits, and possible disclosures.
Required by Law. We will disclose medical information about you when required to do so by federal, state, or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose your health information to persons who need to know when necessary to prevent a serious threat to either your health or the health and safety of others. For example, infectious disease outbreaks.
Public Health Issues and Risks. We may report your health information as required by law or by your authorization concerning certain health conditions to prevent or control disease, to track and access the risk of spreading disease, injury or disability, births and deaths, child or elder abuse or neglect, reactions to medications or products, recalls of products, and notice of exposure to a condition.
Victims of Abuse, Neglect, or Domestic Violence. We may disclose your health information to law enforcement, social services, or other government agencies authorized to receive the report if we have reason to believe you are a victim of abuse, neglect, or domestic violence.
Investigations and Government Activities. We may disclose your health information to a local, state, or federal agency for oversight activities authorized by law that may concern inspections, licensure, illegal conduct, or compliance with other laws and regulations including civil rights laws.
Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose your health information in response to a court order, discovery request, or other lawful process by someone else involved in the dispute.
Law Enforcement. We may release your health information to law enforcement officials in response to a court order or similar process to identify or locate a suspect witness or missing person, a victim of a crime, or in response to a death we believe may involve criminal actions, crimes on CHC premises, or emergency situations to report the details of a crime.
Coroners, Medical Examiners, and Funeral Directors. We may release your health information to a coroner, medical examiner, or funeral director as necessary for them to carry out their duties.
Military and National Security. If you currently serve in the military or are a veteran, we may disclose your health information to the military upon proper request. We may also disclose your information to federal officials conducting national security and intelligence activities.
Workers’ Compensation. We may disclose your information if required by workers’ compensation laws and other similar laws and regulations.
YOUR PRIVACY RIGHTS—You have the right to:
• Inspect and copy your health information.
• Amend your health information, if you feel it is wrong or not complete.
• Request a limit to the health information we disclose.
• Request a list of disclosures we have made of your health information.
• Request confidential communications from us.
• Receive a copy of this notice from us.
YOUR RIGHT TO COMPLAIN
If you believe that your privacy rights have been violated, you may file a complaint with the CHC Privacy Representative or the Department of Health and Human Services Regional Manager, as listed below. All complaints, which must be in writing, will be investigated.
Community Care Services Department
Claudia Lindenberg, CHC Privacy Representative 1111 E. Cesar Chavez,
Austin, TX 78702
Tel: (512) 972-4097, Fax: (512) 972-5375
U.S. Dept. of Health and Human Services
Ralph Rouse, Regional Manager
1301 Young Street, Ste. 1169
Dallas, Texas 75202
Tel: (214) 767-4056, Fax: (214) 767-0432
TDD: (214) 767-8940
PRIVACY CONTACT INFORMATION
For more detailed information, please consult the CHC HP60.0 Notice of Privacy Practices.
If you have further questions about this notice or wish to submit a request, please contact the CHC Privacy Representative, listed above.
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Patient Rights & Responsibilities
Welcome to the Community Health Centers
Our Goal is to provide quality health care to qualified persons in this community, regardless of their ability to pay. If the CHCs are enrolling new patients, you may be eligible to become our patient. As a patient, you have rights and responsibilities. The CHCs also have rights and responsibilities. We want you to understand these rights and responsibilities so you can help us provide better health care to you.
Human Rights
You have a right to be treated with respect and dignity regardless of race, religion, sex, national origin, sexual orientation, political affiliation, or ability to pay for services.
Payment for Services
• You are responsible for giving us accurate information about your present financial status and any changes in your financial status. The CHCs need this information to decide how much to charge you and/or bill private insurance, Medicaid, Medicare or other benefits for which you may be eligible. If your income is less than the federal poverty guidelines, you will be charged a discounted fee according to our policy.
• You have a right to receive explanations of your bill. You must pay, or arrange to pay, all agreed fees for medical services or dental services, as provided by our policies. If you cannot pay right away, please let us know so the CHCs can provide care for you now and work out a payment plan.
• Federal law prohibits us from denying you medically necessary primary health care services solely because you cannot pay for these services.
Privacy
You have a right to have your interview, examinations, and treatment in privacy. Your medical records are also private. Only legally authorized persons may see your records, unless you request in writing for us to show them to someone else. A complete discussion of your privacy rights is available in the “Notice of Privacy Practices”. This notice details the various rights granted to you under the Health Insurance Portability and Accountability Act (HIPAA).
Health Care
• You are responsible for providing the CHCs complete and current information about your health or illness, so we can provide you proper health care. You have a right to, and are encouraged to participate in decisions about your treatment.
• You have the right to information and explanations in the language you normally speak and in words you understand. You have a right to information about your health or illness, treatment plan (including risk), and expected outcomes, if known, and information regarding Advance Directives. If you do not wish to receive this information, or if it is not medically advisable to share that information with you, the CHCs will provide it to a legally authorized person.
• You are responsible for appropriate use of our services, which includes following our staff’s instructions, making and keeping scheduled appointments, and only requesting a “walk in “ appointment when absolutely necessary. If you do not understand or cannot follow the staff’s instructions, please tell us so the CHCs can help you.
• If you are an adult, you have a right to refuse treatment to the extent permitted by law, and to be informed of the risks of refusing such care. You are
responsible for the outcome of refusing treatment.
• You have the right to health care and treatment that is reasonable for your condition and within our capability. You have a right to be transferred or referred to another facility for services that the CHCs cannot provide. However, the CHCs do not pay for services that you get elsewhere. Note: the CHCs are not emergency facilities.
• If you are in pain, you have a right to receive an appropriate assessment and management, as necessary.
CHC Rules
• You have a right to receive information on how to appropriately use CHC services. You are responsible for using CHC services in an appropriate manner. If you have questions about using these services, please ask us.
• You are responsible for the supervision of children you bring with you to the CHCs. You are responsible for their safety and the protection of other clients and our property.
• You have a responsibility to keep your scheduled appointment. Missed scheduled appointments cause delay in treating you and other patients. If you do not keep scheduled appointments for three (3) consecutive times you will be asked to meet with a staff member to discuss the reason for your missed appointments and whether you may continue as a patient of the CHC.
Complaints
If you are not satisfied with our services, please tell us. The CHCs want suggestions so we can improve our services. CHC staff will tell you how to file a complaint. If you are not satisfied with how the CHC handles your complaint, you may file a complaint with the CHC Board of Directors. The CHCs will not punish you for filing a complaint and will continue to see you as a patient.
Termination
The CHCs can decide to stop treating you as a patient. If the CHCs stop treating you as a patient, you have a right to advance notice that explains the reason for the decision, and you will be given 30 days to attempt to find other health services. After notice of termination, the CHCs will only provide care for immediate, serious heath conditions for a 30-day period while you find a new provider. The CHCs can decide to stop treating you immediately and without notice if the CHC has determined that you have created a threat to the safety of the staff and/or other clients. You also have a right to receive a copy of the CHC’s termination policy. (Please see AD10.6, Terminating a Patient From CHC Services).
Reasons for which the CHCs may stop seeing you include:
1. Failure to follow CHC rules and requirements
2. Failure to keep scheduled appointments three (3) consecutive times
3. Intentional failure to report accurate information concerning your health
4. Intentional failure to follow the health care program, such as instructions about taking medications, personal health
practices, or follow-up appointments, as recommended by your doctor
5. Creating a threat to the safety of the staff and/or other clients
6. Intentional failure to accurately report your financial status
If the CHCs have given you a notice of termination, you have the right to appeal the decision to the CHC Board of Directors. However, unless you have a serious health concern that requires immediate medical attention, we will not continue to see you as a patient while you are appealing the decision.
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