Confidential information about your past, present, or future health or condition, the services provided to you and the past, present, or future payment for services is considered "Protected
Healthcare Information". We understand that information about you and services you receive from Texana are personal and confidential. We are committed to protecting this information.
This notice will tell you about our duty to protect your information, your privacy rights, and how we may use or disclose your confidential information.
Texana's Duty Regarding Your Confidential Information
The law requires us to protect the privacy of your information. This means that we will not use or let other people see your confidential information without your permission except in
the ways we tell you in this notice. We will safeguard your confidential information and keep it private. This protection applies to all information we have about you, no matter when or
where you received or sought services. We will not tell anyone if you sought, are receiving, or have ever received services from us, unless the law allows us to disclose that information.
We will ask you for your written permission (authorization) to use or disclose your information. There are times when we are allowed to use or disclose your information without your
permission, as explained in this notice. If you give us your permission to use or disclose your 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 information before we knew you revoked your permission. To revoke your permission, send a written statement, sigh by you to Texana's
Privacy Officer, providing the date and purpose of the permission and saying that your want to revoke it.
We are required to give you this notice of our legal duties and privacy practices, and we must do what this notice says. We will ask you to sign an acknowledgement that you have received
this notice. We can change the contents of this notice and, if we do, we will have copies of the new notice at our service sites and administrative offices and on our website
www.texanacenter.com. The new notice will apply to all confidential information we have, no mater when we received or created the information.
Texana employees must protect the privacy of your confidential information as part of their jobs. We do not let our employees see your confidential information unless they need it as
part of their jobs. We will punish employees who do not protect the privacy of your confidential information.
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 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 Texana or against any person who works for Texana or about any threat to commit such a crime. Federal
law and regulations do not protect any information about suspected child abuse or neglect from being reported under state law to appropriate state or local authorities.
Your Privacy Rights Regarding Your Confidential Information
Right To Inspect and Copy: Your have the right to inspect and copy information that may be used to make decisions about your care. Usually, this includes information about your past,
present, or future health or condition, services, the provision of health care to you, and financial / billing information. If you want copies of your confidential information, you may
have to pay a reasonable fee for it.
Right To Request Amendment: If you feel that information that we have about you is incorrect or incomplete, you may request, in writing, an amendment to your information. Your request must
be submitted to Texana's Privacy Officer. While we will accept all requests for amendment, we are not required to agree to the amendment.
Right To Request Restrictions. You have the right to ask us to limit or restrict how we use or disclose your information. To request restrictions, you must make your request in writing and
submit it to Texana's Privacy Officer. Your written request must explain (1) what information you want to limit; (2) to whom you want the limits to apply. We will consider your request,
but are not legally bound to agree to the restriction. To the extent that we do agree to any restrictions on our use/disclosure of your information, we will put the agreement in writing
and abide by it except in emergency situations. We cannot agree to limit uses/disclosures that are required by law.
To choose how we contact you. You have the right to ask that we send you information at an alternative address or by an alternative means. We must agree to your request as long as it is
reasonably easy for us to do so.
Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures". This is a list of the disclosures we made of information about you that was not for
treatment, payment, and/or operations. To request an accounting of disclosures, you must submit your request in writing to Texana's Privacy Officer. Your request must state a time period,
which may not be longer that six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free.
To receive this notice. You have a right to receive a copy of this Notice any time you request one.
How Texana May Use and Disclose Your Confidential
Information Following are examples of permitted uses and disclosure of your confidential information. Not every use or disclosure will be listed. However, all of the ways we are permitted
to use and disclose information will fall within one of the following categories. Information may be disclosed in writing, orally, or electronically.
For Treatment: We may use information about you to provide treatment or services to you. We may disclose your confidential information to doctors, nurses, therapist,
service coordinators and other Texana personnel who are involved in services provided to you within Texana. For example, your information will be shared among members of your treatment
For Payment: We may use and disclose information about you so that the treatment and services you receive at Texana may be billed to you, an insurance company, or a third
party. For example, we may need to give your insurance company information about services you received at Texana, so they will pay us or reimburse you for the services. We may also tell
them about a service you are going to receive to obtain prior approval or to determine whether your plan will cover the services.
For Healthcare Care Operations: We may use and disclose information about you for organizational operations. These uses and disclosures are necessary to run the organization
and make sure that individuals receive quality care. For example, members of the medical staff or management teams may use your identifiable information to review our treatment and
services and to evaluate the performance of our staff in caring for you.
Texas Department of Behavioral Healthcare Developmental Disability
Texana Center, as a part of the MHMR service delivery system, may disclose information between MHMR facilities, local mental health or mental retardation authorities, community MHMR centers,
and their respective contract provider for the purpose of treatment, payment, or health care operations.
Appointment reminders unless you provide Texana Center with alternative instructions in writing, we may use your identifiable information to contact and remind you of appointments.
Uses and Disclosures Requiring Authorization
For uses and disclosures to any third parties we are required to have your written authorization, unless the use or disclosure falls within one of the exceptions described below.
Authorizations can be revoked at any time to stop future uses/disclosures except to the extent that we have already undertaken an action in reliance upon your authorization.
Unless you are receiving treatment for alcohol or drug abuse, Texana is permitted to use and disclose your confidential information without your permission or authorization for the following
When required by law: We may use or disclose your confidential information as required by state or federal law.
To report suspected child abuse or neglect: We may disclose your confidential information to a government authority if necessary to report abuse or neglect of a child.
To a government authority if Texana 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.
For public health and health oversight activities: We may disclose confidential information about you when we are required to collect information about disease or injury,
for public health investigations, or to report vital statistics.
To Advocacy, Inc.: We may disclose your confidential information to Advocacy, Inc., in accordance with federal law, to investigate a complaint by your or one your behalf.
For worker's compensation: We may release information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or
To comply with legal requirements: We may disclose your confidential 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 reasons.
If you are receiving services for mental retardation. We give confidential information about your current physical and mental condition to your parents, guardian,
relative or friend.
To a correctional institution. If you are in the custody of a correctional institution, we may disclose your confidential information to the institution in order to
provide health care to you.
Coroners, Medical Examiners and Funeral Directors: We may disclose information relating to an individual's death to coroners, medical examiners or funeral directors, and
to organ procurement organizations relating to organ, eye, or tissue donations or transplants.
For research. In certain circumstances, and under supervision of a privacy board, we may use and disclose information about you for research purposes.
National security and intelligence activities: We may release information about you to authorized federal officials for intelligence, counterintelligence, and other
national security activities authorized by law.
Protection services for the President and others: We may disclose information about you to authorized federal officials so they may provide protection to the President of
the United States, other authorized persons or foreign heads of state or conduct special investigations.
To avert a serious threat to health or safety: We may use or disclose your confidential information to medical, law enforcement personnel or other persons who can
reasonably prevent or lessen the threat of harm, if you or others are in danger and the information is necessary to prevent physical harm.
In judicial and administrative proceedings. We may disclose your confidential 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.
To the Secretary of Healthcare and Human Services. We must disclose your confidential information to the United States Department of Healthcare and Human Services when requested
in order to enforce the HIPAA privacy laws.
If you are being treated for alcohol or drug abuse, Texana will not tell any unauthorized person outside of Texana 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.
Complaints About Privacy Practices
If you believe your privacy rights have been violated, or you disagree with a decision we made about access to your confidential information, you may file a complaint with:
4910 Airport Avenue, Bldg. B.
Rosenberg, Texas 77471
You may also file a complaint with Consumer Services and Rights Protection/Ombudsman Office by calling 1-800-252-8154 or writing to P.O. Box 12668, Austin, TX, 78711. You may also file a
written complaint with the Secretary of the U.S. Department of Healthcare and Human Services by calling 877-696-6775 or writing to 200 Independence Ave. SW, Washington, D.C. 20201. We will take
no retaliatory action against you if you make such complaints.
If you have questions, need further explanation or would like additional information regarding this document or Texana's Privacy Practices, you may contact
4910 Airport Avenue, Bldg. B.
Rosenberg, Texas 77471