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.

Purpose of This Notice of Privacy Practices. Each health care service provider under common ownership or control by East Texas Medical Center Regional Healthcare System (including each ETMC hospital, hospital-based clinic, physician organization, physician office, delivery site, ETMC Home Services and ETMC EMS), each referred to as the “ETMC Service Provider”, and its departments, sections, divisions, units, medical staff, professional staff, employees, and volunteers follow the privacy practices described in this Notice. The ETMC Service Provider maintains your medical information in a confidential manner as required by law; however, each ETMC Service Provider must use and disclose your medical information to the extent necessary to provide you with quality health care. To do this, the ETMC Service Provider must share your medical information as necessary for treatment, payment and health care operations. The ETMC Service Providers and other covered entities participating in an organized health care arrangement will also share medical information with each other as necessary to carry out treatment, payment or health care operations relating to the organized health care arrangement.
What Are Treatment, Payment, and Health Care Operations? Treatment includes sharing information among health care providers involved in your care. For example, your physician may share information about your condition with pharmacists to discuss appropriate medications or with radiologists or other consultants in order to make a diagnosis. The ETMC Service Provider may use your medical information as required by your insurer or HMO to obtain payment for your treatment, transport and/or hospital stay. We also may use and disclose your medical information to improve the quality of care, for example, for review and training purposes.
How Will the ETMC Service Provider Use or Disclose My Medical Information? In addition to uses and disclosures for treatment, payment and certain health care operations, your medical information may be used or disclosed, unless you ask for restrictions on a specific use or disclosure, for the following purposes, as applicable:
- Appointment reminders.
- Family members or close friends involved in your care or payment for your treatment.
- American Red Cross (or a government disaster relief agency) if you are involved in a disaster relief effort.
- To inform you of treatment alternatives or benefits or services related to your health that may be of interest to you.
- As required by law.
- Public health activities, including disease prevention, 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.
- Health oversight activities (e.g., audits, inspections, investigations, and licensure).
- Lawsuits and disputes.
- Law enforcement (e.g., in response to a court order or subpoena).
- To coroners, medical examiners and funeral directors.
- Organ and tissue donation.
- Certain research projects approved by an Institutional Review Board.
- To prevent a serious threat to health or safety.
- To military command authorities if you are a member of the armed forces.
- National security and intelligence activities.
- Protection of the President or other authorized persons or foreign heads of state, or to conduct special investigations.
- Inmates. (Medical information about inmates of correctional institutions may be released to the institution.)
- Workers’ Compensation. (Medical information regarding benefits for work-related illnesses may be released as appropriate.)
- To carry out health care treatment, payment, and health care operations functions through business associates, e.g., to install a new computer system.
ETMC Service Providers that provide hospital or hospital-related services may also use or disclose your medical information for the following purposes (unless you ask for restrictions on a specific use or disclosure):
- Hospital Directory, which may include your name, general condition, and your location in the Hospital.
- Religious affiliation, to a hospital chaplain or member of the clergy.
- To contact you regarding your interest in supporting the services and programs provided for the community through the fund raising activities of the hospital and/or hospital district foundation.
Certain types of information may be subject to additional restrictions on disclosure, such as substance abuse treatment records, AIDS test results, and psychotherapy notes.
Your Authorization Is Required for Other Disclosures. Except as described above, we will not use or disclose your medical information unless you authorize (permit) the ETMC Service Provider in writing to disclose your information. You may revoke your permission, which will be effective only after the date of your written revocation.
You Have Rights Regarding Your Medical Information. You have the following rights regarding your medical information, provided that you make a written request to invoke the right on the form provided by the ETMC Service Provider:
- Right to request restriction. You may request limitations on your medical information we use or disclose for health care treatment, payment, or operations, but we are not required to agree to your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
- Right to confidential communications. You may request communications in a certain way or at a certain location, but you must specify how or where you wish to be contacted.
- Right to inspect and copy. You have the right to inspect and copy your medical information regarding decisions about your care. Under limited circumstances, your request may be denied; however, you may request review of the denial by another licensed health care professional chosen by the ETMC Service Provider. The ETMC Service Provider will comply with the outcome of the review. Access to certain information is prohibited by the Clinical Laboratory Improvement Amendments.
- Right to request amendment. If you believe that the medical information we have about you is incorrect or incomplete, you may request an amendment on the form provided by the ETMC Service Provider, which requires certain specific information. The ETMC Service Provider is not required to accept the amendment.
- Right to accounting of disclosures. You may request a list of the disclosures of your medical information that have been made to persons or entities in the past six (6) years, but not prior to April 14, 2003. Such list will not include certain disclosures, including disclosures made (i) to you; (ii) pursuant to an authorization; or (iii) for treatment, payment, and health care operations. After the first request, there may be a charge.
- Right to a copy of this Notice. You may request a paper copy of this Notice at any time, even if you have been provided with an electronic copy. You may also obtain an electronic copy of this Notice at our web site, www.etmc.org.
Requirements Regarding This Notice. Some of the ETMC Service Providers are required by law to provide you with this Notice. We will be governed by this Notice for as long as it is in effect. The ETMC Service Provider may change this Notice, and these changes will be effective for medical information we have about you as well as any information we receive in the future. Each time you receive health care services at or by an ETMC Service Provider, you may receive a copy of the Notice in effect at the time.
Complaints. If you believe your privacy rights have been violated, you may file a complaint with the ETMC Service Provider 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 the ETMC Service Provider or the Department of Health and Human Services.
Contact: Call the ETMC Privacy Office at 903-596-3388 or the Privacy Hotline at 800-688-3144 if:
- you have a privacy complaint;
- you have any questions about this Notice;
- you wish to request restrictions on uses and disclosures for health care treatment, payment, or operations; or
- you wish to obtain a form to exercise your individual rights described in paragraph 5.

Notice of Privacy Practices