Notice of Privacy Practices

We may use health information about you to provide you with medical treatment or services.  We may disclose health information about you to doctors, nurses, technicians, students, or other Center personnel who are involved in taking care of you at the Center.  For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process.  Additionally, the doctor may need to tell the social worker if you have diabetes so we can arrange for appropriate follow up.  Different areas of the Center also may share health information about you in order to coordinate the different care you need, such as medications, lab work and x-rays.  We also may disclose health information about you to people outside the Center who may be involved in your healthcare after you leave the Center, such as nurses, social workers, family members, or clergy. We may also use and disclose health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

The Facility participates in electronic Health Information Exchange (HIE) networks through its electronic health record system, eClinicalWorks, including the PRISMA network. These networks allow us to securely share and receive your health information electronically with other participating healthcare providers, hospitals, laboratories, pharmacies, and health plans across regional and national networks for treatment, payment, and healthcare operations purposes, as permitted by law.

Participation in HIE helps improve the quality, safety, and coordination of your care by allowing authorized providers to access important medical information such as diagnoses, medications, allergies, lab results, and treatment history. This may reduce duplication of tests, avoid medication conflicts, and support more informed medical decision-making.

Your health information shared through these networks may include sensitive information, such as information related to HIV/AIDS, behavioral health, genetic testing, and substance use treatment, to the extent permitted by applicable federal and state law.

You have the right to opt out of participation in electronic Health Information Exchange. If you choose to opt out, your information will not be shared through HIE networks except as otherwise permitted or required by law (such as for public health reporting or medical emergencies). Choosing to opt out will not affect your ability to receive treatment at this Facility.

To request an opt-out form or obtain more information about your HIE choices, please contact our front desk or Privacy Officer.

By signing this Notice of Privacy Practices acknowledgment, you acknowledge that this Facility participates in electronic Health Information Exchange and that you understand your right to opt out.

We may use and disclose health information about you so that the treatment and services you receive at the Center may be billed to and payment may be collected from you, an insurance company or a third party such as Workers Compensation. For example, we may need to give your health plan information about a procedure you received at the Center so your health plan will pay us or reimburse you for the procedure or encounter. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your health plan will cover the treatment. We may also use and disclose health information about you via Med-IT or Cerner database as part of the services through Breast and Cervical Cancer Services (BCCS) or Family Planning Services as defined by federal laws and regulations.

We may use and disclose health information about you for our health care operations activities.  These uses and disclosures are necessary to operate the Center efficiently and make sure that all of our patients receive quality care.  For example, we may use health information to review the safety and the quality of our treatment and services and to evaluate the performance of our staff in caring for you.  We may also combine and analyze health information about many Center patients to decide what additional services the Center should offer, what services are not needed, and whether certain new treatments are effective.  We may also disclose information to doctors, nurses, technicians, students, volunteers and other Center personnel for review and learning purposes.  Additionally, we may combine the health information we have with health information from other Centers to compare how we are doing and to see where we can make improvements in the care and services we offer.  We may remove information that identifies you from this set of health information so others may use it to study health care and health care delivery without learning who the specific patients are.

We may include certain limited information about you in the Center directory while you are a patient at the Center.  This information may include your name, location at our facility, general condition, and religious affiliation to clergy.  Unless there is a specific written request from you to the Privacy Officer listed herein to the contrary, this directory information may also be released to people who ask for you by name.

We may use and disclose health information about you by having you sign in when you arrive at the Center.  We may also call out your name when you are ready to be seen.

 We may use and disclose your health information to contact you to remind you regarding appointments or for health care that you are to receive through the following method of communication: email, voice call, patient portal and secure text messaging. By signing below, you acknowledge that GCHC will by default set up all methods of communication on your account unless you Opt-Out of a specific method of communication or all practice communication.

We understand you may prefer to limit how we contact you. You can choose to opt out of certain communication methods or all practice communications by filling out a Patient Privacy Opt-Out Form, available at our front desk or from our clinical team. However, please keep in mind that opting out could delay you receiving important updates about your health.

 Some of our functions are accomplished through contracted services provided by Business Associates.  A Business Associate may include any individual or entity that receives your health information from us in the course of performing services for the Center.  Such services may include, without limitation, legal, actuarial, accounting, consulting, data aggregation, management, administrative, accreditation or financial services.  When these services are contracted, we may disclose your health information to our Business Associates so that they can perform the job we have asked them to do.  To protect your health information, however, we require the Business Associate to appropriately safeguard your information.

We may disclose information about you to an entity assisting in disaster relief so that your family can be notified about your condition, status and location.

We may contact you for fundraising efforts, but you can tell us not to contact you again. If you do not want the Center to contact you for fundraising efforts, you must notify the Center’s Executive Director or Compliance Officer at: (956) 625-3036.

 We may use and disclose health information to tell you about our health-related products or services that may be of interest to you.

We may disclose your health information to notify or assist in notifying a family member, your personal representative, or another individual involved in or responsible for your health care about your location at the Center, your general condition, or in the event of your death.  We may also disclose information to someone who helps arrange for payment for your care.  If you are able and available to agree or to object, we will give you the opportunity to agree or object prior to making these disclosures, although we may disclose this information in the case of a disaster even over your objection if we believe it is necessary to respond to the disaster or emergency situation.  If you are unable or unavailable to agree or object, we will use our best judgment in any communication with your family, personal representative, and other involved individuals.

Under certain circumstances, we may use and disclose health information about you for research purposes.  For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition.  All research projects, however, are subject to a special approval process.  This process evaluates a proposed research project and its use of health information, trying to balance the research needs with patients’ need for privacy of their health information.  Before we use or disclose health information for research, the project will have been approved through this research approval process.  However, we may also disclose health information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the health information they review does not leave the Center.

We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.  For example, we may notify emergency response personnel about a possible exposure to Acquired Immune Deficiency Syndrome (AIDS) and/or the Human Immunodeficiency Virus (HIV).  Any such disclosure, however, would only be to the extent required or permitted by federal, state or local laws and regulations.

 In the event that the Center is sold or merged with another organization, your health information/medical record will become the property of the new owner, although you will maintain the right to request that copies of your health information be transferred to another Center, medical group, physician or other healthcare provider.

We may disclose your health information to a health oversight agency for activities authorized by federal, state or local laws and regulations.  These oversight activities include, for example, audits, inspections, licensure reviews, investigations into illegal conduct, and compliance with other laws and regulations.  These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

 If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose health information about you to the institution or law enforcement official, if the disclosure is necessary (a) for the institution to provide you with health care; (b) to protect your health and safety or the health and safety of others; or (c) for the safety and security of the correctional institution.

We may release your health information if asked to do so by a law enforcement official in the following circumstances:  (a) in response to a court order, subpoena, warrant, summons or similar process; (b) to identify or locate a suspect fugitive, material witness, or missing person; (c) about the victim of a crime, if, under certain limited circumstances, we are unable to obtain the person’s agreement; (d) about a death we believe may be the result of criminal conduct; (e) about criminal conduct at the Center; or (f) in emergency situations to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

However, in many situations we are prohibited from sharing, and will not share, your health information for investigations or legal actions concerning reproductive health care access and services where that care is lawful as provided. For example, the law prohibits us from using or disclosing your reproductive health care information in many instances to: (a) respond to investigation requests, court orders, or subpoenas seeking information about or imposing liability on any person for seeking, obtaining, providing, or facilitating lawfully provided reproductive health care; or (b) identify any person that is subject to a criminal, civil, or administrative investigation or legal action, including any in law enforcement investigations, criminal prosecutions, family law proceedings, or state licensure proceedings, for seeking, obtaining, providing, or facilitating lawfully provided reproductive health care.

Some examples of seeking, obtaining, providing, or facilitating reproductive health care include: using reproductive health care; performing, furnishing, or paying for reproductive health care; providing information about reproductive health care; arranging, insuring, administering, providing coverage for, approving, or counseling about reproductive health care; or attempting any of these activities.

If you are involved in a lawsuit or a dispute, we may disclose your health information to the extent expressly authorized by a court or administrative order.  We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if reasonable efforts have been made to notify you of the request (which may include written notice to you) and you have not objected, or to obtain an order protecting the information requested.

[For Centers receiving or maintaining Part 2 Substance Abuse Treatment Records: In a civil, criminal, administrative, or legislative proceeding against an individual, we will not use or share information about your substance abuse treatment records unless a court order requires us, or you give us your written permission.]

If you are a member of the armed forces, we may release health information about you as required by military authorities.  We may also release health information about foreign military personnel to the appropriate foreign military authority.

We may release health information about you to authorize federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.

If you are an organ donor, we may disclose health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary, to facilitate organ or tissue donation and transplantation.

We may disclose health information about you to authorize federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state or to conduct special investigations.

We may disclose health information about you for public health activities.  We will only make this disclosure if you agree or when required or authorized by law.  These activities generally include the following:  (a) to prevent or control disease, injury or disability; (b) to report births and deaths; (c) to report the abuse or neglect of children, elders and dependent adults; (d) to report reactions to medications or problems with products; (e) to notify people of recalls of products they may be using; and (f) to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

 We may disclose your health information to notify the appropriate government authority if we believe that a patient has been the victim of abuse, neglect, or domestic violence.  We will only make this disclosure when required or authorized by law.

We may disclose health information about you for workers’ compensation or similar programs.  These programs provide benefits for work-related injuries or illnesses.

We may use medical information about you to make decisions regarding your medical suitability for a security clearance or service abroad.  We may also release your medical suitability determination to the officials in the Department of State who need access to that information for these purposes.

We may disclose health information to a state or local government agency or a multidisciplinary personnel team relevant to the prevention, identification, management or treatment of an abused child and the child’s parents, or elder abuse and neglect.

In some circumstances, your health information may be subject to additional restrictions that may limit or preclude some uses or disclosures described in this Notice or Privacy Practices. For example, there are special restrictions on the use and/or disclosure of certain categories of health information such as: (a) AIDS treatment information and HIV tests results; (b) treatment for mental health conditions and psychotherapy notes; (c) alcohol, drug abuse and chemical dependency treatment information: (d) genetic information; and/or (e) reproductive health care information, are all subject to special restrictions.  In addition, Government health benefit programs, such as Medicare or Medicaid, may also limit the disclosure of patient information for purposes unrelated to the program.

We may share your reproductive health care information for health oversight agency audits or inspections, civil or criminal investigations or proceedings, or licensure actions.

 We may share your reproductive health care information in response to a court or administrative order, subpoena, or discovery request.

 We may share your reproductive health care information for law enforcement purposes, including in response to a court-ordered warrant or a law enforcement official’s request for information about a victim of a crime.

We may share your reproductive health care information in some situations to a coroner or medical examiner to identify a deceased person, determine cause of death, or other duties as authorized by law.

You have the right to inspect and copy health information that may be used to make decisions about your care.  Usually this includes medical and billing records but may not include some mental health information. You may obtain an electronic copy of your medical records. You may also instruct us in writing to send an electronic copy of your medical records to a third party.  If you request a copy of your health information that may be used to make decisions about your care, we may charge a fee for the costs of copying, mailing or other supplies associated with your request.  To inspect and copy health information that may be used to make decisions about you, you must submit your request in writing or fill out a Requesting Access to Health Information Form obtainable from the Medical Records Department or the Center’s Privacy Office and mailed to: 

Gateway Community Health Center, Inc.

1515 Pappas St.

Laredo, TX 78041

Attention: Daniel Cabrera, Privacy Officer

We may deny your request to inspect and copy in specific circumstances.  If you are denied access to your health information, you may request that the denial be reviewed.  Another licensed health care professional chosen by the Center will review your request and the denial.  The person conducting the review will not be the person who denied your request.  The Center will comply with the outcome of the review.

You have the right to request a restriction or limitation on the health information the Center uses or discloses about you for treatment, payment or health care operations.  You can also request a restriction or limitation on the health information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.  For example, you could ask that we not use or disclose information about a surgery you had.

 If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.  We will notify you if we do not agree to a requested restriction.  To request restrictions, you must submit a written request to the Center at the above address.  In your request, you must state: (a) what information you want to limit; (b) whether you want to limit its use, disclosure or both; and (c) to whom you want the limits to apply; for example, no disclosures to your spouse.

 You have the right to restrict the disclosure of your health information to a health plan if the health information pertains to health care services for which you paid in full directly to the Center and the disclosure is not otherwise required by law.

If you feel that the health information, we have about you is incorrect or incomplete, you may ask us to amend the information.  You have the right to request an amendment to your health information for as long as the information is kept by or for the Center. You must make your request to amend your health information, in writing, and submit it to the Center at the above address.  You must include a reason that supports your request.  In addition, we may deny your request if you ask us to amend information that: 

1. Was not created by us, unless the person or entity that created the information is no longer available to make the amendment.
2. Is not part of the health information kept by or for the Center.
3. Is not part or the information which you would be permitted to inspect and copy; or
4. Is accurate and complete.

The law permits us to deny your request for an amendment if it is not in writing or does not include a reason to support the request.

Even if the Center denies your request for amendment, you have the right to submit a written addendum, not to exceed 250 words, with respect to any item or statement in your record you believe is incomplete or incorrect.  If you clearly indicate in writing that you want the addendum to be made part of your medical record, we will attach it to your records and include it whenever we make a disclosure of the item or statement you believe to be incomplete or incorrect.

You have the right to request an “accounting of disclosures.”  Such accounting is a list of the disclosures we made of health information about you other than our own uses for treatment, payment, and health care operations (as those functions are described above) and with other expectations pursuant to law. To request this list or accounting of disclosures, you must submit your request in writing to the Center at the above address. Your request must state a time period that may not be longer than six (6) years.  Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free.  For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. You must make your request for confidential communications in writing to the Center at the address noted above. We will not ask you for the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

You have the right to receive a paper copy of this Notice. You may request a copy of this Notice at any time.  Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice.

You have the right to be notified if we or one of our Business Associates becomes aware of an improper disclosure of your health information.