Notice of Privacy Practices

Notice of Privacy Practices Texas State Student Health Center

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSEDAND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Purpose: The Texas State Student Health Center (SHC) is providing you with this notice to comply with federal and state privacy laws. All SHC staff, including student employees, will follow the privacy practices described in this notice.

ATTENTION: Texas State Students The privacy of your health information and medical record is protected by various state laws and a federal law entitled the Family Educational Rights and Privacy Act of 1974 (FERPA). FERPA sets out requirements to protect the privacy of your education records and gives you certain rights. You can learn more about FERPA on the TX State website. Some of the state laws we comply with include, but are not limited to Occupations Code, Title 3, Chapter 159; Texas Medical Board Rules, Chapter 165; and Health & Safety Code, Title 7, Chapter 611. Your health information will not be disclosed without your written permission unless permitted or required by law. Electronic Communications: The SHC may use Online Student Health (OSH), a secure patient website, e-mail and encrypted e-mail to communicate with patients and to send appointment reminders. Special/Emergency Situations: In a health or safety emergency, we may use or disclosure your health information to notify medical and law enforcement personnel, and appropriate parties of threat of harm to self or others, appropriate parties may include parents, significant other, Dean of Students, and law enforcement.

ATTENTION: Staff, Faculty, Summer Campers, TX State Program Attendees When Can the SHC Use and Disclose My Health Information? The SHC may be permitted or required by law to use your health information without your authorization for the following reasons. You will have an opportunity to refuse some of these communications as indicated by. ***  Health Care Treatment, Payment, and Operations Functions by: SHC staff for the purpose of providing you with care during a scheduled appointment or to refer you to another medical provider; to send you a bill, if necessary, or to file an insurance claim on your behalf, and/or to perform quality improvement studies or to make decisions about the services we provide. SHC business associates for the purpose of performing the jobs we have asked them to do, such as, but not limited to providing after hours nurse advice services or providing optional student insurance claims processing.  To Contact You for the purpose of providing you with appointment reminders, information about treatment alternatives or other health-related benefits and services that may be of interest to you, or for SHC fundraising activities.***  In certain circumstances where we disclose directory information about you to others, e.g., state whether or not you visited the SHC and your general condition.***  Family members or close friends involved in your care or payment for treatment***  To inform you of treatment alternatives or benefits or services related to your health.***  Workers’ Compensation for the purpose of reporting and processing claims for your Texas State work-related injuries and illnesses.  Public Health Activities for the purpose of preventing disease, injury or disability; reporting deaths; reporting reactions to medications or product problems; providing notification of recalls, conducting public health investigation and intervention, notifying public health authority or other appropriate government authority of suspected abuse, neglect, or domestic violence; infectious disease control; to report findings concerning a Texas State work-related illness or injury or a Texas State workplace-related medical surveillance;  Health Oversight Activities for the purpose of audits, investigations, inspections, and licensure.  Judicial and Administrative Proceedings for the purpose of responding to an order of a court or administrative tribunal; subpoena, discovery request, or lawful process.  Law Enforcement for the purpose of reporting certain types of wounds and injuries; in response to a request for information about a victim of a crime; to alert of a death that may have resulted from criminal conduct; to provide evidence of criminal conduct that occurred at the SHC; and to report crime in emergencies.  Coroner and Medical Examiners for the purpose of identifying a deceased person, determining a cause of death, or other duties.  Research Activities for the purpose of conducting or participating in a study. But please note, individually identifying information about you would not be included in the report of any study.  Prevent Serious Threat to Health or Safety of a person, public, or to the target of the threat.  National Security and Intelligence Activities and Protective Services to the President to authorized federal officials for the purpose of conducting security investigations and providing protective services.

Privacy Complaints If you believe your privacy rights have been violated, you may file a written complaint with the Secretary of Health and Human Services. There will be no retaliation taken against you for filing a complaint. Submit written complaints to the Office for Civil Rights, U.S. Department of Health & Human Services,1301 Young Street – Suite 1169, Dallas, TX 75202. (214) 767-4056; (214) 767- 8940 (TDD); (800) 368-1019; FAX (214) 767-0432

We Must Have Your Authorization for Other Disclosures By law, we may be allowed to or required to use or disclose your protected health information without your written consent or authorization for those purposes listed above. In all other instances, use or disclosure of your protected health information would be made only with your written authorization and you would be able to revoke such authorization.

ATTENTION: All Patients Requirements Regarding This Notice: The Student Health Center is required by law to maintain the privacy of your health information and to provide you with a notice of our legal duties and privacy practices with respect to your protected health information. We are required to follow the terms of this notice currently in effect. We have the right to change this notice and to make the new changes effective for all protected health information we maintain. A new notice will be posted on our website, in our clinic, and made available to you upon request.

Your Privacy Rights Although your health record is the physical property of the SHC, the information belongs to you. You have the right to:  Request a Restriction on certain uses and disclosures related to treatment, payment or health care operations; although we are not legally required to comply. Restrictions for disclosures to health plans must be observed in some cases.  Request Confidential Communications of your health information by alternative means or at an alternative location, but you must tell us how or where you wish to be contacted.  Access your health record to inspect and obtain a copy in paper or electronic format. We may charge a fee for copying and mailing. There may be instances when your request may be denied. You may request review of the denial by another licensed health care professional who is designated by the SHC. The SHC will agree to the outcome of the review.  Request Amendment to your health record if you believe it is incomplete or inaccurate; however we are not legally required to comply.  Obtain an Accounting of Disclosures of your health information for purposes other than treatment, payment, or health care operations within the past six (6) years of your request, but not prior to April 14, 2003. There may be a charge after the first request.  A Copy of This Notice by requesting a copy of a paper notice. You may ask for this at any time during our regular hours of operation. You may also obtain a copy of this notice at our website, www.healthcenter.txstate.edu. You must submit a written request to the Privacy Officer to exercise your rights.

Questions? The Student Health Center wants you to understand the information we are giving you. If you have questions, would like additional information, or would like to file a written complaint, you may contact the SHC Privacy Officer at (512) 245-2161 or [email protected].

Effective Date of Notice: December 5, 2005 Revised 10/19/11