THIS NOTICE OF PRIVACY PRACTICES (“Notice”) DESCRIBES HOW HEALTH 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 from Integral Care, we will obtain and/or create health information (protected health information) about you. Health information includes any information that relates to your physical or mental health or condition, the health care provided to you, the payment for your health care, and individually identifiable information, such as your name, address, telephone number, or social security number.
This Notice tells you about our duty to protect your health information, your privacy rights, and how we may use or disclose your health information. It is effective beginning August 15, 2017. Integral Care, its employees, contractors and agents, and each of its programs will follow this Notice.
Who Must Comply with this Notice
˜Integral Care providers and employees
˜Integral Care subcontractors and agents
Integral Care participates in a regional arrangement of health care organizations, the Integrated Care Collaborative (“ICC”), who work with each other to facilitate access to health information that may be relevant to your care. For example, if you are admitted to a hospital on an emergency basis and cannot provide important information about your health condition, the ICC will allow us to make your health information available to other providers who participate in the ICC to treat you at the hospital.
Integral Care also participates in an Organized Health Care Arrangement (“OHCA”) with Central Health, Seton and CommUnityCare to improve quality of care and reduce cost for our patients. We will share your information with other OHCA participants, as necessary to carry out treatment, payment, or health care operations relating to the OHCA.
- 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. We will not give permission to any person to interview, photograph, film, or record you without your written agreement. We will not tell anyone if you sought, are receiving, or have ever received services from Integral Care, unless the law allows us to disclose that information.
- We will ask you for your written permission (authorization) to use or disclose your health information, except when we are allowed or required 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 Integral Care office where you gave your permission, providing the date and purpose of the permission and saying that you want to revoke it.
- We are required to give you notice of our legal duties and privacy practices at the first non-crisis service delivery. If the first non-crisis service delivery is by telephone, a copy of this Notice will be mailed to you on the same day as the service. 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 offices and on our website, www.integralcare.org. The new Notice will apply to all health information we have, no matter when we received or created the information.
- We are required to notify you and the Secretary of HHS of any breach of your unsecured protected health information without unreasonable delay and in no event more than 60 days of our discovery of the breach.
- Our employees must protect the privacy of your health information as part of their jobs. We instruct our employees not to look at your health information unless they need it as part of their jobs. We will discipline employees who do not protect the privacy of your health information.
- We reserve the right to change our practices and make the new provisions effective for all health information we maintain. Should our information practices change, we will post the amended Notice in our office and our website. You may request that a copy be provided to you by contacting the Privacy Officer at (512)440-4076, 5225 N. Lamar Blvd., Austin, Texas, 78751.
- We may use and disclose your health information electronically. For example, if another provider requests a copy of your medical record for treatment purposes, we may forward such record electronically. Under Texas law we are required to obtain your written authorization before we disclose your PHI, except to another covered entity for treatment, payment and permissible health care operations, .or where authorized or required by law.
- If you or your legally authorized representative (a person who is legally authorized to represent your interests through court appointment, power of attorney or otherwise) (“LAR”) request that we disclose your health information we will disclose it to the person you or your LAR authorize in writing to receive it. We will first obtain your or your LAR’s written authorization prior to disclosing your health information electronically.
- Access. You can look at or get a copy of the health information that we have about you as soon as possible but no later than 15 days from the date of your request. If you want a copy or summary of your health information, you may have to pay a reasonable fee for it. We will post on our website a fee schedule for copies and/or summaries of your health information. We will also notify you of such fees in advance when you ask for copies.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. To inspect or request a copy of your health information, please send your request in writing to Integral Care, P.O. Box 3548, Austin, Texas 78764-3548, Attention: Medical Records.
- Amend. You can ask us to amend information in your records if you think the information is wrong. We will not destroy or change our records, but we can put the new information in an addendum to your records and indicate that you requested the amendment. Sometimes we may not amend your information, for example, if we disagree that the information is incorrect, but will make a note of your request in your records. In order to request an amendment, please submit your written request to Integral Care, P.O. Box 3548, Austin, Texas 78764-3548, Attention: Medical Records. You must provide a reason that supports your request.
- Accounting. You can get a list of when we have given health information about you to other people for a time period not longer than 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 (unless specifically required by law). There will be no charge for one list per calendar year. To request this list, you must submit your request in writing to Integral Care, P.O. Box 3548, Austin, Texas 78764-3548, Attention: Medical Records.
- Confidential Communications. 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 is reasonable. You must make your request to Integral Care, P.O. Box 3548, Austin, Texas 78764-3548, Attention: Medical Records. Your request must specify how or where you wish to be contacted.
- Restrictions. You have the right to request a restriction or limitation on the health information Integral Care uses or discloses about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information Integral Care discloses about you to someone who is involved in your care or the payment of your care. We will consider your request, but the law does not require us to agree to it, except when the request pertains solely to a healthcare item or service for which Integral Care has been paid out of pocket in full and: (i) the restriction pertains to payment or a healthcare operation and (ii) the disclosure is not otherwise required by law. If we do agree to your request to restrict, 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. To request a restriction, please make your request in writing to Integral Care, P.O. Box 3548, Austin, Texas 78764-3548, Attention: Medical Records, and indicate: (i) that you want to limit Integral Care’s use and/or disclosure of your medical information you want to limit; (ii) the health information to which your requested limitation applies and; (iii) to whom you want the limits to apply.
- Right to Revoke an Authorization. There are certain types of uses or disclosures that require your express authorization. For example, Integral Care may not sell your information to a third party for marketing purposes without first obtaining your authorization. If you provide authorization for a particular use or disclosure of your information, you may revoke such authorization in writing sent to Integral Care’s Privacy Officer, 5225 N. Lamar Blvd., Austin, Texas 78751. We will honor your revocation except to the extent that we have already taken action in reliance of the specific authorization.
- Right to Receive a Copy of this Document. You can get a copy of this Notice any time you ask for it.
- If you have received substance use disorder services from us, you can request and receive a list of individuals/entities to whom your information about substance use disorder services has been disclosed pursuant to a consent that generally designates a recipient or type of recipient that is not an individual. We will provide this list to you within 30 days of your request.
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 Integral Care, funding sources of mental health and intellectual/developmental disabilities and/or substance use disorder services, Integral Care programs, local mental health or mental retardation authorities, community MHMR centers, Texas Department of State Health Services (TDSHS) facilities, Texas Department of Aging and Disability Services (TDADS) facilities and other health care providers, for purposes of treatment, payment, or health care operations, without your permission. Substance use disorder information will only be released as allowed by law.
- 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 interest you.
- 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.
- Health Care Operations. We can also use or disclose your health information for health care operations. For example, we may use or disclose health information for:
- Activities to improve health care, evaluate programs, and develop procedures;
- Case management and care coordination;
- Reviewing the competence, qualifications, performance of health care professionals and others;
- Conducting training programs and resolving internal disputes;
- Conducting accreditation, certification, licensing, or credentialing activities;
- Providing medical review, legal services, or auditing functions;
- Engaging in business planning and management or general administration; and
- Managing software and databases in Integral Care’s operations.
- Psychotherapy Notes. Psychotherapy notes where your mental health professional documents and analyzes the contents of a conversation during a counseling session may not be shared without your authorization, except in the following circumstances:
- The mental health professional may use them to provide you with further treatment;
- The mental health professional may disclose them :
- To students, trainees or practitioners in mental health who are learning under supervision to practice or improve their skills in group, joint, family, or individual counseling
- As necessary to defend himself or herself or Integral Care in a legal proceeding initiated by you or your personal representative;
- As required/allowed by law;
- To government authorities to avert a serious and imminent threat to the health or safety of you or another person;
- To the United States Department of Health and Human Services when that agency requests them; and
- To medical examiners and coroners, if necessary, to determine your cause of death.
All other uses and disclosures of psychotherapy notes require your written authorization. You have the right to revoke such authorization in writing sent to Integral Care’s Privacy Officer at 5225 N. Lamar Blvd., Austin, Texas 78751.
- Fundraising: Integral Care engages in certain fundraising activities. For example, Integral Care may work with Integral Care Foundation, Inc. to perform fundraising activities. Information used and disclosed for fundraising is generally limited to your name, race, age, gender, birthday, address, and dates of service with Integral Care. Prior to using any of your health information for a fundraising activity, we will get your written authorization unless otherwise permitted by law.
All other uses and disclosures of your information for fundraising purposes require your written authorization. You have the right to revoke such authorization in writing.
- Marketing. Marketing generally includes a communication made to describe a health-related product or service that may encourage you to purchase or use the product or service. If we receive any money for the communication, we will first get your authorization unless we communicate with you face-to-face, or to give you a promotional gift of nominal value, or as otherwise permitted by law.All other uses and disclosures of your information for marketing purposes require your written authorization. You have the right to revoke such authorization in writing sent to Integral Care’s Privacy Officer at 5225 N. Lamar Blvd., Austin, Texas 78751.
- Sale of your Health Information. We will not sell your health information for marketing purposes without first obtaining your written authorization. You have the right to revoke such authorization in writing sent to Integral Care’s Privacy Officer at 5225 N. Lamar Blvd., Austin, Texas 78751.
Integral Care is permitted to use or disclose your health information (except information about substance use disorder services) without your permission for the following additional purposes:
- When required by law. We may use or disclose your health information as required by state or federal law.
- To report suspected abuse or neglect or denial of rights. We may disclose your health information to a government authority if necessary to report abuse, neglect or denial of rights, or as allowed by law to provide information in an investigation about alleged abuse, neglect or denial of rights.
- 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 waives the requirement that we obtain your authorization for a research project, or if information identifying you is removed from the health information.
- To Disability Rights Texas We may disclose your health information to Disability Rights Texas, in accordance with federal law, at their request.
- 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 and/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 you.
- 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 LAR.
- In judicial and administrative proceedings. We may disclose 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. For example, some types of court or administrative proceedings where we may disclose your health information are:
- Proceedings related to parole or probation
- 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 a protected individual such as a child, elderly person, or resident of a mental health facility.
- License revocation proceedings against a doctor or other professional.
- To the Secretary of Health and Human Services. We must disclose your health information to the United States Department of Health and Human Services when requested in order to enforce the privacy laws.
- Crimes. We will report any information about a crime committed by you either at Integral Care or against any person who works for Integral Care or about any threat to commit such a crime unless law prevents it.
- Appointment Reminders. We may use and disclose your health information to remind you of an appointment. For example, Integral Care may use telephone and/or text message reminders. If you receive an appointment reminder through telephone or text message, the message may be like the following, “This is an appointment reminder. The appointment is at ___(time) on ____(day) ____(date) at ____(program name). If you have questions, call ____(front desk telephone number of program name). We look forward to seeing you.”
- Other Uses and Disclosures. Any other use or disclosure of your health information will be made only upon your or your LAR’s individual written authorization. You may revoke an authorization at any time provided that it is in writing and we have not already relied on the authorization.
- We will not disclose information about you related to HIV/AIDS without your or your LAR’s specific written permission, unless the law allows us to disclose the information.
If you have received substance use disorder services, we will only disclose your health information related to those services as follows:
- With your consent and in accordance with the term of your consent form
- In a Medical emergency to medical personnel to meet a “bona fide medical emergency in which prior consent cannot be obtained”
- With a subpoena and a Court order after the Court has made a finding that there is good cause for the information to be disclosed
- For research with your written consent.
We are prohibited from disclosing information about any substance use disorder services that you have received for criminal investigation or prosecution unless the crime involved is extremely serious and causes or directly threatens loss of life or serious bodily injury, and certain other requirements of federal law have been met.
If you believe that Integral Care has violated your privacy rights, you have the right to file a complaint. Integral Care will not retaliate against you if you file a complaint. You may complain by contacting:
Integral Care Ombudsman
(512) 440-4086 (Austin)
P.O. Box 3548
Austin, Texas 78764-3548
You may also file a complaint with:
TDSHS Consumer Services and Rights Protection/Ombudsman Office
(800) 252-8154 (toll free)
P.O. Box 12668
Austin, Texas 78711
TDADS Consumer Rights and Services
(800) 458-9858 (toll free)
Mail Code E-249
PO Box 149030-78714
Austin, Texas 78751
*Region VI, Office for Civil Rights
U.S. Department of Health and Human Services
Hotline (800) 368-1019 (toll free)
1301 Young Street, Suite 1169
Dallas, Texas 75202
Office of Attorney General
P.O. Box 12548
Austin, Texas 78711
(800) 463-2100 (toll free)
For complaints against substance use disorder treatment programs, contact the United States Attorney’s Office for the judicial district in which the activity complained about occurred. To locate this office, consult the blue pages in your telephone book.
*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. All complaints should be submitted in writing.