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Medical Records and Your Rights

The Health Information Management Department (Medical Records) helps people who receive services from MHMR and their families by maintaining and protecting your MHMR medical records. MHMR’s Rights Department advocates for the rights and protection of MHMR patients.

Understand your rights:

  • Abuse – physical, sexual, emotional, verbal
  • Neglect
  • Exploitation
  • Patient rights, privacy & HIPAA

Connect and work better with:

  • Protective and Family Services
  • Texas Department of State Health Services
  • Texas Department of Human Services
  • Other licensing authorities

Register to vote in local, state and national elections.

Obtain handbooks to explain your rights in detail:

Call 817-569-4417 if you have questions about your medical records. 

Health Information Management Department (Medical Records) helps people who receive services from MHMR and their families by maintaining and protecting patients’ MHMR medical records. We provide authorized access to patients’ medical record information.  We also provide general assistance in answering questions about medical record privacy, security and HIPAA requirements.

Your medical record is an important, private document. It contains recorded information about your visits to your health care providers, tests you may have had (such as lab work), and other information about program admissions.  It is the road map for your health and the health care your have received from MHMR.  Should you need emergency care or care elsewhere, your medical record helps ensure that the person helping you is aware of your medical history, conditions and previous treatments.

Privacy with your medical records (Also see Frequently Asked Questions)

There are many rules and guidelines to make sure your records remain private or confidential, such as:

  • We can release records to other physicians or health care facilities without your consent for follow-up care or if it is a medical emergency. When records are released, we take reasonable precautions that the physician is providing follow-up care to you.
  • Generally, a spouse or other family member cannot get a copy of a patient’s records unless he or she signs a form giving us permission.
  • We require identification before we will release your records even to you.
  • We do not release confidential information over the phone.

Getting Copies of Your Medical Records (release form)
If you would like a copy of your record, we will be glad to help you complete a written request. If you are unable to come to the agency to fill out the form, we will accept a signed letter from the patient or legal guardian indicating whose records are to be sent, where they are to be sent and the dates of service. We will mail the records as soon as possible. By state law, we are allowed to charge fees for making copies of the records under certain circumstances. The standard fee we charge a patient requesting copies of records is $1 per page (1-10 pages) or a $10 flat fee for record copies that exceed 10 pages.

Authorization form to release your records

Abuse – Physical, Sexual, Sexual Exploitation

What is Physical Abuse?

Examples of physical abuse include:

  • Physical injury or death performed knowingly, recklessly, or intentionally; physical abuse may also be caused by a failure to act, that results in injury or death
  • Inappropriate or excessive force or corporal punishment, regardless of whether the act results in a physical injury
  • The use of chemical or bodily restraints on a person served, not in compliance with federal and state laws and regulations

What is Sexual Abuse?

Sexual abuse is sexual activity that occurs by an employee, agent, or contractor with a person served. That includes but is not limited to:

  • Kissing, hugging, stroking, fondling with sexual intent
  • Engaging in obscene activity
  • Requesting, soliciting or compelling a person to engage in sexual or obscene activity
  • Committing sexual exploitation
  • Committing sexual assault or aggravated sexual assault
  • Engaging in, allowing or encouraging obscene photos or videos

What is Sexual Exploitation?
Sexual exploitation is conduct that may include sexual contact by an employee, agent or contractor for the purpose of arousal or gratification or sexual abuse.

Obtaining information about a patient’s sexual history, within standard accepted clinical practice, is not defined as sexual exploitation.

Patient abuse at MHMR is governed by The Texas Administrative Code – Title 40 – Part 19 – Chapter 711.

Also refer to the Texas Penal Code 22.011, 22.021, 43.01 and 43.21 for more information.

This code directs that Provider Investigations (PI) has the authority to investigation all allegations of physical and sexual abuse involving Child and Family Services, Mental Health and Intellectual Developmental Disabilities programs at MHMR.

The state of Texas works to protect minors, the elderly and adults with disabilities from: MHMR employees, contractors, volunteers, interns and agents are trained to recognize and report abuse, neglect, and the exploitation of minors, the elderly and adults with disabilities. Investigations of allegations of abuse, neglect and exploitation, are handled by:
  • Provider Investigations – Child and Family Services, Mental Health, Intellectual and Developmental Disabilities
  • Texas Department of State Health Services – Substance Abuse Division – Addiction Services
State laws include: Texas Family Code – Minors (17 years and younger) Texas Human Resources Code – Elderly and adults with disabilities FAQs

MHMR wants to ensure that you are provided services in a professional and confidential manner. 

If you have a complaint, question or concern about services, contact:

MHMR Reporting Line:
1-800-500-0333 (toll-free)

Your rights representative will document your complaint or concern, investigate it and respond to you within five days.

Confidentiality rules may limit information that may be shared with anyone other than the primary patient.

Call the MHMR Reporting Line to report issues of compliance:
1-800-500-0333

This 24/7 hotline is available to report suspected instances of noncompliance.  The hotline is answered by third-party personnel to ensure anonymity.

These reports are investigated, and the results are then reviewed by a Compliance Committee, which makes recommendations to improve controls within MHMR.

The Compliance Program, directed by Compliance Officer Paul Duncan, seeks to ensure that MHMR employees provide ethical services and comply with MHMR’s Standards of Conduct.

The compliance efforts include a full-time auditing staff that reviews billings for compliance with Medicaid rules and regulations.  Examples of noncompliance would include:

  • Using an incorrect billing code
  • Billing for services not provided
  • Billing for services with inadequate or missing documentation

A compliance program is intended to identify and reduce risk, and improve internal controls. We believe it is the duty of every employee or contractor of MHMR to assist in the prevention, detection and correction of any instances

You can file an Americans with Disabilities Act (ADA) complaint alleging disability discrimination against a State or local government or a public accommodation. A complaint can be filed online using the link below, by mail, or by facsimile.

File an ADA complaint online

To file an ADA complaint by mail, send the completed ADA complaint form to:

MHMR
ADA Coordinator
3840 Hulen St.
Fort Worth, TX 76107

To file an ADA complaint by facsimile, fax the completed ADA complaint form to: (817) 810-3250

Keep a copy of your complaint and the original documents for your own records.


Paperwork Reduction Act Statement

This request is in accordance with the Paperwork Reduction Act of 1995, 44 U.S.C. § 3507.  This information collection is for the purpose of allowing the MHMR Emergency Management (EMD) to engage in authorized civil rights compliance and enforcement activities. Providing the information is voluntary, except that failure to provide such information may result in EMD being unable to process your complaint. The estimated average burden associated with this collection is 45 minutes per response, depending on individual circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden may be sent by email at: Emergency.Management@mhmrtc.org.  An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.

Privacy Act Statement

The Americans with Disabilities Act of 1990, 42 U.S.C. §§ 12131-12134, and Section 504 of the Rehabilitation Act of 1973, 29 U.S.C. § 794, authorize the solicitation of the information for this form. Providing the information is voluntary, except that failure to provide such information may result in the MHMR Emergency Management (EMD) being unable to process your complaint. The principal purpose of collecting information from you is for EMD’s authorized civil rights compliance and enforcement activities. EMD will not disclose your name or other identifying information about you unless it is necessary for enforcement activities against an entity alleged to have violated federal law, required to be disclosed under the Freedom of Information Act, 5 U.S.C. § 552, disclosure is permitted pursuant to the Privacy Act, or is otherwise required by law. 

What is Verbal and Emotional Abuse?

Emotional abuse is any act or use of verbal or other communication, including gestures, by an employee, agent, or contractor to:

  • Curse, vilify or degrade a person served
  • Threaten a person served with physical or emotional harm

The act or communication must:

  • Result in observable distress or harm to the person served
  • Be of such a serious nature that a reasonable person would consider it harmful or causing distress

Patient abuse at MHMR is governed by The Texas Administrative Code – Title 40 – Part 19 – Chapter 711.

This code directs that Provider Investigations (PI) has the authority to investigation all allegations of physical and sexual abuse involving Child and Family Services, Mental Health and Intellectual Developmental Disabilities programs at MHMR.

What is Exploitation?

Exploitation is the illegal or improper act of using a person or their resources for monetary or personal benefit, profit or gain, by an employee, agent or contractor.
Examples include:

  1. A patient performing a job function for the staff
  2. A patient purchasing items for the staff
  3. Staff using a patient’s money for staff’s personal use
  4. Staff receiving a valuable item from the patient
  5. Staff using a patient’s identity for personal gain

Provider Investigations (PI) has the authority to investigate all allegations of physical and sexual abuse involving Child and Family Services, Mental Health and Intellectual Developmental Disabilities programs at MHMR.

Patient abuse at MHMR is governed by The Texas Administrative Code – Title 40 – Part 19 – Chapter 711.

In ECI, IDD and MH programs, all allegations of patient exploitation must be reported to:

Provider Investigations
1-800-647-7418
www.txabusehotline.org

Substance Use (Addiction) Services programs should report allegations of patient exploitation to:

MHMR
Director of Patient Rights
817-569-4429

or

Department of State Health Services – Substance Abuse Complaint Line
1-512-834-6650 (Option 8)

Required Disclosure of PHI

MHMR may not use or disclose protected health information (PHI), except in certain situations, governed by the Privacy Rule. MHMR is required to disclose protected health information to:
  • An individual (patient) who requests their PHI medical records in writing
  • Health and Human Services (HHS) for investigation of HIPAA compliance (without authorization)
MHMR is permitted to disclose protected health information without an authorization, for:
  • Treatment: to provide, coordinate or manage the care and treatment of patients among providers
  • Payment for services
  • Health Care Operations: Administrative, financial, legal and quality improvement activities necessary to run business and support core functions of treatment and payment.
  • Public Health Authorities: to report vital statistics, e.g. death to the Department of Health or to prevent or control disease, e.g. report TB, HIV/AIDS to Public Health Department
  • Public Health Authorities
  • To report abuse/neglect of a child or adult (APS or CPS)
    • If reporting abuse of an adult patient to APS, the patient needs to know that a report was made on his/her behalf
    • If reporting child abuse, no information about the parent can be disclosed (if the parent is a patient) without an authorization or a court order.
Other:
  • To medical or law enforcement personnel if it is determined that there is a probability of physical injury to the patient or others or if there is a probability of immediate mental or emotional injury to the patient
  • For judicial and administrative proceedings – upon receipt of subpoena or court order
  • To a correctional facility (jail, prison) where patient is detained for the purpose of providing treatment
  • To coroners and medical examiners on deceased individuals for the purpose of identifying the person or determining cause of death
  • In emergency situations when information is necessary for treatment
  • For national security and intelligence activities – to FBI or CIA
  • For protective services for the president/others – to Secret Service when threats have been made to the president
  • Information on special needs offenders may be released to the parole officer, juvenile probation, and parole office to monitor needs of patient
Exception to Permitted Disclosures: We cannot disclose a patient’s substance use diagnosis, etc. without an authorization for treatment purposes or in the following instances:
  • TCOOMMI / Department of Corrections
  • APS for investigation of abuse/neglect of an adult
  • External doctor/hospital for treatment purposes.
Information on patients with a substance use diagnosis cannot be disclosed unless we have a specific authorization or in the following instances:
  • To medical personnel to meet a medical emergency
  • For audits and evaluations
  • To Provider Investigations to report child/adult abuse/neglect
  • Upon receipt of a subpoena and court order.

Under HIPAA, consumers have the right to:

  • Notice that Privacy Practices will be:
    • Given on the first day of services
    • Posted at all service locations and on the Website
    • Signed for acknowledgment of receipt; the notice should be filed in the patient’s record
  • Request restrictions on how their information (PHI) is used and disclosed
  • Request access to (inspect or copy) their medical records unless it is determined it will endanger the life of physical safety of the patient or others
  • Request amendments (corrections) to their medical records; however we can never remove anything that is corrected from the record
  • Request special accommodations (considerations) on how their health information is communicated (e.g., alternate addresses and phone numbers)
  • Request an accounting of to whom PHI has been disclosed
  • File a complaint with MHMR of Tarrant County, HHS, Texas Attorney General, and/or to the Federal Department of Health and Human Services

All requests to access, for an accounting, to amend, or to restrict information must be in writing.

For Copies of Medical Records, Call:
817-569-4416 or  817-569-4410

HIPAA questions or complaints, call:
817-569-4382

MHMR HIPAA Privacy Notice

MHMR Health Information Management
3840 Hulen St, Ste #400
Fort Worth TX 76107

If you receive services at MHMR, you may register to vote by contacting your assigned staff and requesting a registration form.

You may vote in all local, state and national elections if:

  • You are a U.S. citizen
  • You are 18 years old (you may register at 17 years, 10 months)
  • You are a resident of the county
  • You have not been convicted of a felony (unless you have completed the sentence, including probation or parole)
  • You have not been declared mentally incapacitated by a court of law.

If you do not receive services at MHMR:
You may register to vote by contacting:
Texas Secretary of State
Elections Division

P.O. Box 12060
Austin, Texas 78711-2060
1-800-252-VOTE (8683) OR (512) 463-5650

How can I reach the Rights officer at MHMR?
Call the MHMR Reporting Line at 1-800-500-0333

How can I report physical, emotional abuse or exploitation of a patient?
Call 1-800-647-7418
Provider Investigators
(for Mental Health, Child and Family Services and Disability Services programs)

Call 817-569-4429 or 1-512-834-6650 (Option 8) (HHSC Substance Abuse Complaint Line)

(for Substance Use (Addiction) Services programs)

How can I get a copy of the MHMR Handbook of Rights and Responsibilities?
Your service provider must provide a handbook for you when you first enter into the program and each time that you request one. View Handbook of Rights and Responsibilities (Spanish)

How can I get assistance outside of the MHMR system?
For assistance with advocacy throughout the state of Texas call Disability Rights Texas: 1-800-252-9108

How can I find out what state and federal laws can protect me?
Contact the agencies listed above.

How can I get a copy of my medical record?
Call 817-569-4416 or 817-569-4410 to request your records.
or complete and return an Authorization for Disclosure Form to:

Health Information Management, MHMR
3840 Hulen St, Suite #400
Fort Worth, TX 76107

Our office hours are:
Monday – Thursday: 8 a.m. – 4 p.m.,
Friday: 8 a.m. – 12 p.m.
(Excluding Holidays)

Who else can get copies of my medical records?
Anyone authorized by you in writing may receive copies of your medical records. If you change your mind, you may revoke your consent at any time.
Some others in law enforcement may receive your Protected Health Information (PHI) without an authorization.

What is HIPAA and what rights do I have under HIPAA?
HIPAA, the Health Insurance Portability and Accountability Act, is a federal law to protect the privacy of your medical information. It gives individuals rights regarding access and control of their Protected Health Information and also includes security regulations to govern the electronic use of that information.

What is PHI?
Protected Health Information, or any information that identifies a patient.  This information includes:

  • Demographic information
  • Any health information that relates to the past, present or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to our patients.
  • Health information maintained by MHMR in any form – verbal, paper and electronic, which may be found in:
    • Medical records
    • Computer systems / electronic records
    • Photographs, videos, audiotapes
    • Reports / minutes
    • Billing records

What is Individually Identifiable Health Information?
Any information that might identify someone or connect our patients to their personal health information:

  • Name
  • Date of Birth
  • Address
  • Telephone / fax number, e-mail address
  • Social Security, driver’s license, or insurance policy number
  • Pictures / fingerprints
  • Names of relatives and employers
  • Medical record number

To report violations, contact the MHMR Rights Officer,
817-569-4429
ClientRights@mhmrtc.org

Notice Under the ADA

You also may contact:

Mental Health Services/Addiction Services Department of State Health Services Consumer Rights and Services
1-800-252-8154

Intellectual Developmental Disability (IDD) Services
Department of Aging and Disability Services Consumer Rights and Services
1-800-458-9858

Early Childhood Intervention
Department of Assistive and Rehabilitative Services
1-800-628-5115

You also may contact:
Disability Rights Texas
1-800-252-9108

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