VISITING THE HOSPITAL
Notice of privacy practices

Visiting the hospital Preparing for a stay Clinic visits & outpatient surgery Emergency care Admission & billing Insurance accepted Parking Contact information Patient rights & responsibilities Notice of privacy practices Medical team Virtual tour of the hospital

Effective date: April 14, 2003

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.

Texas Children’s Hospital Integrated Delivery System has developed this Notice of Privacy Practices (“Notice”) to comply with the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA was enacted by Congress to establish standards for protecting the confidentiality and security of your health information.
This document is available in pdf format and in Spanish.

Purpose
Texas Children’s Hospital Integrated Delivery System (TCH IDS), which includes Texas Children’s Hospital, Texas Children’s Pediatric Associates, Texas Children’s International, and Texas Children’s Health Plan and its professional staff, employees, volunteers, and Medical Staff follow the privacy practices described in this Notice. This Notice describes the general ways your protected health information may be used and disclosed in order for TCH IDS to provide you with medical treatment, to collect payment for the services rendered to you by TCH IDS, and to facilitate TCH IDS health care operations.

Forms also available
Notice of Privacy Practices (pdf)
Notice of Privacy Practices in Spanish
Authorization for Disclosure (pdf)
Patient Request for Access to Protected Health Information (pdf)
Request for Amendment (pdf)
Restriction of Protected Health Information (pdf)
Revocation of Authorization (pdf)

Protected health information, as defined by HIPAA, means your personal health information which is found in your medical and billing records and which relates to your past, present, or future physical or mental health conditions or the provision of payment for services related to those health conditions. During the course of treatment, payment and health care operations activities, this may include information created or received by health care providers, insurance companies, and/or your employer.

Your Health Information Rights
As a patient receiving health care at Texas Children’s Hospital Integrated Delivery System (TCH IDS), you have the following rights regarding your health information. To exercise any of the following rights, you must submit a written request on a form provided by TCH IDS. The forms can be found on our Web site, www.texaschildrenshospital.org, or by contacting the TCH IDS Privacy Office at 832-824-2091.

• Right to a copy of this Notice. You may obtain a paper copy of this Notice at any time, even if you have been provided with an electronic copy. Paper copies of this Notice may be obtained from any registration or admissions desk. You may obtain an electronic copy of this Notice at our Web site, www.texaschildrenshospital.org. You do not have to submit a written request to obtain the Notice.
• Right to inspect and copy. You have the right to inspect and/or receive a copy of your protected health information maintained by TCH IDS. TCH IDS may charge you a reasonable fee for copying your information.
• Right to request amendment. If you believe that your protected health information maintained by TCH IDS is incorrect or incomplete, you may request an amendment to your information. TCH IDS is not required to accept the amendment.
• Right to request restriction. You may request limitations on how TCH IDS uses and/or discloses your protected health information. For example, you may ask us not to disclose that you have had a particular surgery. TCH IDS is not required to agree to your request. If TCH IDS agrees to your request, TCH IDS will comply with your request unless the use or disclosure is necessary in order to provide you with emergency treatment or is otherwise required by law.
• Right to receive confidential communications. You may request that communications from TCH IDS regarding your protected health information be provided to you in a certain way or at a certain location. For example, you may prefer to get mail regarding your protected health information at an address other than your usual mailing address. You must specify how or where you wish to be contacted.
• Right to accounting of disclosures. You may request a list of the disclosures by TCH IDS of your protected health information that have been made to persons or entities other than for the purposes of health care treatment, payment or operations or pursuant to your specific authorization. This list will contain each disclosure TCH IDS has made for the past six (6) years, but not prior to April 14, 2003. If you make more than one request in a 12 month period, TCH IDS may charge you a reasonable fee to cover costs.

TCH IDS Responsibilities
Texas Children’s Hospital Integrated Delivery System (TCH IDS) is required by law to:

• Make sure that protected health information that identifies you is kept private in accordance with federal and state law; and
• Provide you with this Notice of TCH IDS’ legal duties and privacy practices with respect to your protected health information; and
• Follow the terms of this Notice as long as it is in effect. If TCH IDS revises this Notice, TCH IDS will follow the terms of the revised Notice as long as it is in effect.

Use and Disclosure of Your Protected Health Information 
The following is a list of ways that Texas Children’s Hospital Integrated Delivery System (TCH IDS) may use and disclose your protected health information. Each bold-faced section provides you with examples of how your information will be used and/or disclosed. Not every possible use or disclosure in any given section is listed. However, all of the ways TCH IDS is permitted to use and disclose information will fall within one of the bold-faced print sections below.

• Treatment. TCH IDS may use your protected health information to provide you with medical treatment or services. TCH IDS may disclose your protected health information to doctors, nurses, technicians, medical students or other members of your health care team at TCH IDS. For example, a doctor treating you for diabetes may need to tell the dietitian that you have diabetes so that appropriate meals can be arranged. TCH IDS also may disclose your protected health information to people outside TCH IDS who may be involved in your medical care, such as health care providers who will provide follow-up care after hospitalization, physical therapy organizations, medical equipment suppliers, or laboratories.
• Payment. TCH IDS may use and disclose your protected health information to obtain payment from your insurance company or a third party. For example, TCH IDS may need to provide your health plan with information about treatment you received for an ear infection so that your health plan will pay us or reimburse you for the treatment. Also, TCH IDS may disclose your protected health information to your other health care providers to assist those providers in obtaining payment from your insurance company or a third party.
• Health Care Operations. TCH IDS may use and disclose your protected health information for routine health care operations. Health care operations at TCH IDS include, but are not limited to, reviewing the quality of care provided by health care professionals; obtaining health insurance or stop-gap insurance; conducting legal services and auditing services; conducting business planning and development activities; risk management activities and investigations; and managing the business and general administrative activities of TCH IDS. TCH IDS may also disclose your protected health information to your other health care providers to assist them in their health care operations.
• Appointments and Alternatives. TCH IDS may use and disclose your health care information to contact you to provide appointment reminders or information about disease management, wellness programs, prescription refill reminders, and other communications regarding your case management or health care coordination.
• Business Associates. TCH IDS may disclose your protected health information to TCH IDS business associates in order to carry out treatment, payment, or health care operations. For example, TCH IDS may disclose your protected health information to a company who bills insurance companies on TCH IDS’ behalf in order to enable that company to help TCH IDS obtain payment for the health care services TCH IDS provides.
• Coroners, Medical Examiners and Funeral Directors. TCH IDS may disclose protected health information to a coroner or medical examiner to identify a deceased person or to determine the cause of death, or as otherwise permitted by law. TCH IDS may also disclose protected health information about patients of TCH IDS to funeral directors as necessary to carry out their duties.
• Correctional Institutions. If you are an inmate of a correctional institution or under the custody of a law enforcement official, TCH IDS may disclose your protected health information to the correctional institution or law enforcement official. This disclosure may be necessary for the institution to provide you with health care, to protect your health and safety or the health and safety of others or for the safety and security of the correctional institution.
• Fundraising Activities. TCH IDS uses certain portions of your protected health information, including your name, address, phone number and the dates you received treatment or services at TCH IDS to contact you regarding efforts to raise funds to support hospital programs and operations. If you do not want TCH IDS to contact you about a contribution or fundraising programs, please contact the Development Office at 832-824-6806 or submit your request in writing to:

Texas Children's Hospital
Development Office
P. O. Box 300630, MC 4-4483
Houston, TX 77230-0630
Fax number 832-825-2162

• Group Health Plans. TCH IDS maintains a group health plan for its employees, and may disclose protected health information of individuals covered under this plan to the sponsor of the group health plan, as permitted by law.
• Health Oversight Activities. TCH IDS may disclose your protected health information to a health oversight agency or entity for activities authorized by law, such as audits, investigations, inspections, and licensure.
• Health-Related Benefits and Services. TCH IDS may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you. TCH IDS may also use and disclose your protected health information to provide you a promotional gift of nominal value.
• Hospital Directory. TCH IDS may use your protected health information to maintain a hospital directory while you are a patient in Texas Children’s Hospital. This information includes your name, your location in the Hospital, your general condition, and your religious affiliation (“Directory Information”). Directory Information, except for your religious affiliation, may also be disclosed to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if the clergy member does not ask for you by name. In the event that you do not wish your Directory Information to be available, you may notify the Hospital at the time of your admission.
• Individuals Involved in Your Care or Payment for Your Care. TCH IDS may disclose your protected health information to a family member, other relative, or close personal friend who is involved in your medical care if the protected health information disclosed is directly relevant to such person’s involvement with your care, unless you tell us otherwise. TCH IDS also may disclose information to someone who helps pay for your care.
• Law Enforcement. TCH IDS may disclose your protected health information for law enforcement purposes, as required by law or in response to a valid subpoena.
• Lawsuits and Disputes. TCH IDS may disclose your protected health information in response to a court or administrative order. In addition, TCH IDS may disclose your protected health information in response to a valid subpoena, discovery request, or other lawful process provided that efforts have been made to tell you about the request or to obtain an order protecting the information requested, as required by law.
• Organ and Tissue Donation. TCH IDS may disclose protected health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank to facilitate organ or tissue donation and transplantation.
• Public Health Activities. As required by law, TCH IDS may disclose your protected health information for public health activities, including, but not limited to, the prevention of disease, injury, or disability; reporting births and deaths; reporting child abuse or neglect; reporting reactions to medications or product problems; notification of recalls; infectious disease control; notifying government authorities of suspected abuse, neglect or domestic violence. For example, TCH IDS may disclose portions of your protected health information to local, state, and/or federal registry programs, such as the Houston/Harris County Immunization Registry, for monitoring health care systems and government programs.
• Registration and Scheduling. To improve our scheduling and registration operations, Texas Children’s Hospital, The Methodist Hospital, Baylor College of Medicine and TCH IDS participating organizations have developed a centralized database that allows us to share your demographic (i.e., name, address, etc.,) and insurance eligibility information among our institutions. TCH IDS may use your protected health information in relation to this database in an effort to reduce the time you spend registering at any of these facilities.
• Research. TCH IDS may disclose your protected health information to researchers when their research has been legally approved and protocols have been established to ensure the privacy of your protected health information.
• Serious Threat to Health or Safety. TCH IDS may use and disclose your protected health information when TCH IDS deems it necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
•  Workers' Compensation. TCH IDS may disclose your protected health information to workers' compensation or similar programs to the extent necessary to comply with laws relating to worker’s compensation or similar programs.

Written Authorization. 
Except as described above, Texas Children’s Hospital Integrated Delivery System (TCH IDS) will not use or disclose your protected health information unless you authorize such disclosure to TCH IDS in writing, on the form provided by TCH IDS. You may revoke such authorization by providing a written Revocation of Authorization form to TCH IDS.

A written revocation will not apply to any previous use or disclosure of protected health information made in good faith under a prior authorization. TCH IDS has an Authorization Form and a Revocation of Authorization form available for your use at www.texaschildrenshospital.org or from the TCH IDS Privacy Office at (832) 824-2091.

Changes to This Notice
Texas Children’s Hospital Integrated Delivery System (TCH IDS) reserves the right to change this Notice from time to time. TCH IDS reserves the right to make the revised Notice effective for protected health information TCH IDS already has about you as well as any information TCH IDS receives in the future. A copy of the current Notice or a summary of the current Notice will be posted at patient service locations throughout TCH IDS and on our Web site at www.texaschildrenshospital.org. The effective date of the Notice will appear on the first page of the Notice or summary. In addition, each time you register at or are admitted to any TCH IDS entity for treatment or health care services as an inpatient or outpatient, TCH IDS will have available for you, at your request, a copy of the current Notice in effect.

Complaints
If you believe your privacy rights have been violated, you may file a complaint with Texas Children’s Hospital Integrated Delivery System (TCH IDS) or with the Secretary of the United States Department of Health and Human Services. You will not be penalized or retaliated against in any way for making a complaint to TCH IDS or the United States Department of Health and Human Services.

If you wish to file a complaint with TCH IDS, you may contact the TCH IDS Privacy Office at 832-824-2091.

If you wish to file a complaint with the Secretary of the United States Department of Health and Human Services, you may write to:

U.S. Department of Health and Human Services (DHHS)
200 Independence Ave. S.W.
Washington, D.C. 20201
hhsmail@os.dhhs.gov

Contact
If you have any questions about this Notice or your privacy rights, or wish to obtain a form to exercise your rights as described above, you may contact the TCH IDS Privacy Office at
832-824-2091 or write to:
Privacy Office
Texas Children's Hospital
6621 Fannin, MC 3-4221
Houston, TX 77030

See also:
Notice of privacy practices in pdf or in Spanish
Patient rights and responsibilities
Financial arrangements