HILL COUNTRY MHDD CENTERS
819 Water Street, Suite 300
Kerrville, Texas 78028
Web Site: www.hillcountry.org
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.
When you receive treatment or
benefits (such as Medicaid) from Hill Country MHDDC, we will obtain
and/or create health information about you. Health information includes
any information that relates to (1) your past, present, or future
physical or mental health or condition; (2) the health care provided to
you; and (3) the past, present, or future payment for your health care.
The following notice tells you about our duty to protect your health
information, your privacy rights, and how we may use or disclose your
Hill Country MHDDC’s Duties:
- The law requires us to protect the privacy of
your health information. This means that we will not use or let other
people see your health information without your permission except in
the ways we tell you in this notice. We will safeguard your health
information and keep it private. This protection applies to all health
information we have about you, no matter when or where you received or
sought services. When you are in a Hill Country MHDDC facility, we will
not allow any unauthorized person to interview, photograph, film, or
record you without your written permission. We will not tell anyone if
you sought, are receiving, or have ever received services from Hill
Country MHDDC, unless the law allows us to disclose that information.
- We will ask you for your written permission
(authorization or consent) to use or disclose your health information.
There are times when we are allowed to use or disclose your health
information without your permission, as explained in this notice. If
you give us your permission to use or disclose your health information,
you may take it back (revoke it) at any time. If you revoke your
permission, we will not be liable for using or disclosing your health
information before we knew you revoked your permission. To revoke your
permission, send a written statement, signed by you, to the Hill
Country MHDDC facility where you gave your permission, providing the
date and purpose of the permission and saying that you want to revoke
- We are required to give you this notice of our
legal duties and privacy practices, and we must do what this notice
says. We can change the contents of this notice and, if we do, we will
have copies of the new notice at our facilities and on our website,
www.hillcountry.org. The new notice will apply to all health
information we have, no matter when we got or created the information.
- Our employees must protect the privacy of your
health information as part of their jobs. We do not let our employees
see your health information unless they need it as part of their jobs.
We will punish employees who do not protect the privacy of your health
- We will not disclose information about you
related to HIV/AIDS without your specific written permission, unless
the law allows us to disclose the information.
- If you are also being treated for alcohol or
drug abuse, your records are protected by federal law and regulations
found in the Code of Federal Regulations at Title 42, Part 2. Violation
of these laws that protect alcohol or drug abuse treatment records is a
crime, and suspected violations may be reported to appropriate
authorities in accordance with federal regulations. Federal law will
not protect any information about a crime committed by you either at
Hill Country MHDDC or against any person who works for Hill Country
MHDDC or about any threat to commit such a crime. Federal laws and
regulations do not protect any information about suspected child abuse
or neglect from being reported under state law to appropriate state or
Your Privacy Rights at Hill Country MHDDC
- You can look at or get a copy of the health
information that we have about you. There are some reasons why we will
not let you see or get a copy of your health information, and if we
deny your request we will tell you why. You can appeal our decision in
some situations. You can choose to get a summary of your health
information instead of a copy. If you want a summary or a copy of your
health information, you may have to pay a reasonable fee for it.
- You can ask us to correct information in your
records if you think the information is wrong. We will not destroy or
change our records, but we will add the correct information to your
records and make a note in your records that you have provided the
- You can get a list of when we have given health
information about you to other people in the last six years. The list
will not include disclosures for treatment, payment, health care
operations, national security, law enforcement, or disclosures where
you gave your permission. The list will not include disclosures made
before April 14, 2003. There will be no charge for one list per year.
- You can ask us to limit some of the ways we use
or share your health information. We will consider your request, but
the law does not require us to agree to it. If we do agree, we will put
the agreement in writing and follow it, except in case of emergency. We
cannot agree to limit the uses or sharing of information that are
required by law.
- You can ask us to contact you at a different
place or in some other way. We will agree to your request as long as it
- You can get a copy of this notice any time you
ask for it.
Treatment, Payment, and Health Care Operations
We may use or disclose your health information to provide care to you,
to obtain payment for that care, or for our own health care operations.
Health information about you may be exchanged
between Hill Country MHDDC facilities, other HHSC facilities, local
mental health or developmental disabilities authorities, other
community centers, and contractors of mental health and developmental
disabilities services, for purposes of treatment, payment, or health
care operations, without your permission.
Treatment: We can 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, we can use your health
information to prescribe medication for you. Unless you ask us not to,
we may also contact you to remind you of an appointment or to offer
treatment alternatives or other health-related information that may
Payment: We can use or disclose your
health information to obtain payment for providing health care to you
or to provide benefits to you under a health plan such as the Medicaid
program. For example, we can use your health information to bill your
insurance company for health care provided to you.
Notice to applicants and recipients of financial
assistance or payments under federal benefit programs: any information
provided by you may be subject to verification through matching
Health Care Operations: We can also use
your health information for health care operations:
- Activities to improve health care, evaluating
programs, and developing procedures;
- Case management and care coordination;
- Reviewing the competence, qualifications,
performance of health care professionals and others;
- Conducting training programs and resolving
- Conducting accreditation, certification,
licensing, or credentialing activities;
- Providing medical review, legal services, or
auditing functions; and
Engaging in business planning and management or
For example, we can use your health information to develop procedures
for providing care to people in our facilities.
Unless you are receiving treatment for alcohol or
drug abuse, Hill Country MHDDC is permitted to use or disclose your
health information without your permission for the following purposes.
- When required by law. We may use or
disclose your health information as required by state or federal law.
- To report suspected child abuse or neglect.
We may disclose your health information to a government authority if
necessary to report abuse or neglect of a child.
- To address a serious threat to health or
safety. We may use or disclose your health information to medical
or law enforcement personnel if you or others are in danger and the
information is necessary to prevent physical harm.
- For research. We may use or disclose
your health information if a research board says it can be used for a
research project, or if information identifying you is removed from the
health information. Information that identifies you will be kept
- To a government authority if Hill Country
MHDDC thinks that you are a victim of abuse. We may disclose your
health information to a person legally authorized to investigate a
report that you have been abused or have been denied your rights.
- To Advocacy, Inc. We may disclose your
health information to Advocacy, Inc., in accordance with federal law,
to investigate a complaint by you or on your behalf.
- For public health and health oversight
activities. We will disclose your health information when we are
required to collect information about disease or injury, for public
health investigations, or to report vital statistics.
- To comply with legal requirements. We
may disclose your health information to an employee or agent of a
doctor or other professional who is treating you, to comply with
statutory, licensing, or accreditation requirements, as long as your
information is protected and is not disclosed for any other reason.
- For purposes relating to death. If you
die, we may disclose health information about you to your personal
representative and to coroners or medical examiners to identify you or
determine the cause of death.
- To a correctional institution. If you
are in the custody of a correctional institution, we may disclose your
health information to the institution in order to provide health care
- To locate you if you are missing from a
facility. We may disclose some information about you to law
enforcement personnel so that they can find you and return you to the
facility if you are missing.
- For government benefit programs. We may
use or disclose your health information as needed to operate a
government benefit program, such as Medicaid.
- To your legally authorized representative
(LAR). We may share your health information with a person appointed
by a court to represent your interests.
- If you are receiving services for
developmental disabilities, we may give health information about
your current physical and mental condition to your parent, guardian,
relative, or friend.
- In judicial and administrative proceedings. We
your health information in any criminal or civil
proceeding if a court or administrative judge has issued an order or
subpoena that requires us to disclose it. Some types of court or
administrative proceedings where we may disclose your health
- commitment proceedings for
involuntary commitment for court-ordered treatment or services.
- court-ordered examinations for a
mental or emotional condition or disorder.
- proceedings regarding abuse or neglect of
of an institution.
- license revocation proceedings
against a doctor or other professional.
To the Secretary of Health and Human Services. We
your health information to the United States Department
of Health and Human Services when requested in order to enforce the
If you are also being treated for alcohol or drug
abuse, Hill Country MHDDC will not tell any unauthorized person outside
of Hill Country MHDDC that you have been admitted to a Hill Country
MHDDC facility or that you are being treated for alcohol or drug abuse,
without your written permission. We will not disclose any information
identifying you as an alcohol, drug, or substance user, except as
allowed by law.
Hill Country MHDDC may only disclose
information about your treatment for alcohol or drug abuse without your
permission in the following circumstances:
- pursuant to a special court order that complies
with 42 Code of Federal Regulations Part 2 Subpart E;
- to medical personnel in a medical emergency;
- to qualified personnel for research, audit, or
- to report suspected child abuse or neglect;
- to Advocacy, Inc. and/or the Texas Department
of Protective and Regulatory Services, as allowed by law, to
investigate a report that you have been abused or have been denied your
Federal and State laws prohibit redisclosure of
information about alcohol or drug abuse treatment without your
If you believe that Hill Country MHDDC has violated your privacy
rights, you have the right to file a complaint. You may complain by
contacting the following local or state offices:
|Hill Country MHDDC Consumer
(830) 792-3300 (Kerrville)
(888) 393-3609 (toll free)
819 Water Street, Suite 300
Kerrville, Texas 78028
(512) 206-5670 (Austin) or
(800) 252-8154 (toll free)
P.O. Box 12668
Austin, Texas 78711
|You may also file
a complaint with either of the following federal or states agencies:
|U.S. Department of Health and
200 Independence Avenue, S.W.
Washington, D.C. 20201
(800) 368-1019 (toll free)
|Office of Attorney General
P. O. Box 12548
Austin, Texas 78711
(800) 463-2100 (toll free)
You must file your complaint within 180 days of
when you knew or should have known about the event that you think
violated your privacy rights.
Hill Country MHDDC will not retaliate against you if you file a
For Further Information: Contact the Hill
Country MHDDC Privacy Officer by calling (830) 792-3300, writing to 819
Water Street, Kerrville, Texas 78028, or via internet at
Effective Date: April 14, 2003. Last Revision: 4/1/2011