2300, Client Rights

Body

Revision 24-2; Effective Sept. 20, 2024

2310 Confidentiality

Revision 26-3; Effective Sept. 1, 2026

All grantees must comply with the U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA) standards for protection of privacy.

A BCCS provider must maintain all health care information as confidential to the extent required by law. 

HIPAA requires grantees to develop and distribute a notice that provides a clear explanation of privacy rights and practices. 

This Notice of Privacy Practices must be given to clients:

  • at the first appointment, 
  • on request, 
  • at a minimum, every three years.

The notice must be posted in a clear and easy to find location for clients to review. It must be on the organization’s website. 

Grantees must make sure all employees and volunteers receive training about client confidentiality during orientation. Grantees also must make them aware that violation of the law about confidentiality may result in civil damages and criminal penalties. All employees, volunteers, subrecipients, board members and advisory board members must sign a confidentiality statement during orientation.

Grantees must monitor client records to make sure only appropriate staff and HHSC may access the records. 

Grantees must document the client’s preferred method of communication, such as cell phone, email, work phone or text, and preferred language in the client’s record. 

Each client must receive verbal assurance of confidentiality, an explanation of what confidentiality means, and any applicable exceptions, such as abuse reporting. Grantees must also provide clients with a copy of their signed confidentiality policy or agreement and the grantee must maintain a copy in the client's record.

2320 Nondiscrimination and Limited English Proficiency

Revision 26-3; Effective Sept. 1, 2026

HHSC contracts require grantees to comply with state and federal antidiscrimination laws including state rules in Texas Administrative Code (TAC) Title 1, Part 15, Chapter 395, Subchapter B, Section 395.11.

Find more information about nondiscrimination laws and regulations on the HHSC Civil Rights Office webpage and the Requirements for Contractors webpage.

Grant Terms and Conditions

To ensure compliance with nondiscrimination laws, regulations and policies, grantees must:

  • sign a written assurance to comply with applicable federal and state nondiscrimination laws and regulations;
  • have a written policy that states the agency does not discriminate based on:
    • race;
    • color;
    • national origin including limited English proficiency (LEP);
    • sex;
    • age;
    • religion; or
    • disability;
  • have a policy that addresses client rights and responsibilities that is applicable to all people who request services;
  • have procedures to notify the HHSC Civil Rights Office of any program- or service-related discrimination allegation or complaint within 10 calendar days after the allegation or complaint;
  • make sure all grantee staff are trained in the grantee's nondiscrimination policies;
  • notify all people who apply for services of the grantee's nondiscrimination policies and complaint procedures; and
  • prominently display Civil Rights Posters in English and Spanish as applicable in common areas, including lobbies and waiting rooms, the front reception desk and locations where clients apply for services. 

More information about nondiscrimination laws and regulations is on the HHSC Civil Rights Office.

Limited English Proficiency – LEP

To comply with civil rights requirements related to LEP, grantees must:

  • take reasonable steps to make sure people with LEP have meaningful access to its programs and services;
  • not require a person with LEP to use friends or family members as interpreters;
    • a family member or friend may serve as a person’s interpreter if the person requests it; and
    • the family member or friend does not compromise the effectiveness of the service or violate client confidentiality; and
  • make people with language service needs, including people with LEP and disabilities, aware that the grantee will provide an interpreter free of charge.

2330 Termination of Services

Revision 26-3; Effective Sept. 1, 2026 

Grantees must never deny services to an eligible client because of an inability to pay. 

Grantees have the right to terminate services to a client if:

  • the client is disruptive, unruly, threatening or uncooperative to the extent the client seriously impairs the grantee’s ability to effectively and safely provide services; or
  • the client’s behavior jeopardizes their own safety, or the safety of clinic staff or others.

A termination of services policy must be included in the grantee’s policy.

If a grantee denies, modifies, suspends or terminates services to a client, an explanation must be documented in the client’s record. A client has the right to appeal the denial, modification, suspension or termination of services by following the Resolution of Complaints process.

2340 Resolution of Complaints

Revision 26-3; Effective Sept. 1, 2026 

Grantees must make sure clients can express concerns about the care they’ve received and ensure any complaints or concerns are handled in a consistent and timely manner. A grantee’s policy must explain the process clients may follow if they are not satisfied with the care received, including:

  • Grantees must investigate and resolve a complaint or concern within 30 business days, beginning on the day they are notified by the aggrieved client.
  • Clients may contact a grantee during and after the resolution of an investigation to receive more information on the grantee's decision or to help correct the issue.
  • Grantees must provide the client with contact information to the HHS Office of the Ombudsman. If a client has requested more help from the Ombudsman, a grantee must not terminate services to that client until a final decision is rendered by HHSC, unless there is a viable risk to the safety of the aggrieved client, clinic staff or others.
  • All complaints and concerns must be documented in the client’s record.

2350 Freedom of Choice

Revision 26-3; Effective Sept. 1, 2026

Clients have the right to choose health care providers without coercion or intimidation. Acceptance of health care services does not preclude eligibility for, or receipt of, any other service or assistance.

2360 Research, Human Subject Clearance

Revision 26-3; Effective Sept. 1, 2026

To participate in proposed research that would involve the use of BCCS clients as subjects, the use of BCCS client records or any data collected from clients, BCCS grantees must get prior approval from their own internal Institutional Review Board (IRB) and from HHSC. For information about the process, grantees should visit the Institutional Review Board Home.

Grantees must have a policy in place that shows approval will be obtained from the HHSC BCCS program, as well as the IRB, before instituting any research activities. The grantee must also make sure all staff are made aware of this policy through training. Documentation of training on this topic must be maintained. Federal BCCS funds may not be used for research.