Revision 19-0; Effective July 1, 2019


4100 Confidentiality

Revision 19-0; Effective July 1, 2019


All contracting agencies must be in compliance with the U.S. Health Insurance Portability and Accountability Act of 1996 (HIPAA) established standards for protection of privacy.

A contractor must document the individual’s preferred method of follow-up for clinic services (cell phone, email, work phone) and the individual’s preferred language. Contractor must verbally assure everyone the right to confidentiality. Contractors must comply with adult and child abuse and neglect reporting laws in Texas. An FPP health care provider may not require consent for family planning services from the spouse of a married client. (1 TAC §382.125)

Contractors must ensure that all employees and volunteers receive training about client confidentiality during orientation and be made aware that violation of the law regarding confidentiality may result in civil damages and criminal penalties. An FPP health care provider’s staff (paid and unpaid) must be informed during orientation of the importance of keeping client information confidential. (1 TAC §382.125(c)). All employees, volunteers, subcontractors, board members and/or advisory board members must sign a confidentiality statement during orientation.


4110 Minors and Confidentiality

Revision 19-0; Effective July 1, 2019


A provider is required to maintain the confidentiality of care provided to a minor and may not disclose confidential information without the documented consent of the minor’s legally authorized representative, or the minor when allowed by law. A provider may only disclose confidential information without consent as required by law, such as to report abuse, and with appropriate safeguards for confidentiality.

The HIPAA privacy rule requires a covered entity to treat a “personal representative” the same as the individual with respect to uses and disclosures of the individual’s protected health information. [45 Code of Federal Regulations (CFR) §164.502(g)(1)] In most cases, parents are legally considered to be the personal representatives for their minor children, and they can exercise individual rights, such as access to medical records, on behalf of their minor children. [45 CFR §164.502(g)(2) and (3)]


4200 Nondiscrimination and Limited English Proficiency

Revision 19-0; Effective July 1, 2019


HHSC contractors must comply with state and federal anti-discrimination laws. These laws are contained in the HHSC Uniform Terms and Conditions – Grant Version 2.15, Article IX, Section 9.21 (a-f) Civil Rights, the HHSC Special Conditions Version 1.1, Article V, Section 5.06 Services, and Information for Persons with Limited English Proficiency, which are part of a contractor’s contract with the state.

Information about nondiscrimination laws and regulations can be found on the HHS Civil Rights website.


4210 Contract Terms and Conditions

Revision 19-0; Effective July 1, 2019


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

  • Sign a written assurance to comply with applicable federal and state non- discrimination 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, disability or sexual orientation;
  • Have a policy that addresses individual rights and responsibilities that is applicable to all individuals requesting family planning services;
  • Have procedures for notifying the HHSC Civil Rights Office of any program or service-related discrimination allegation or complaint no more than ten calendar days of the allegation or complaint;
  • Ensure that all contractor staff are trained in the contractor’s nondiscrimination policies, including policies for serving individuals with LEP and individuals with disabilities, and HHSC complaint procedures;
  • Notify all individuals who are applying for family planning services of the contractor’s nondiscrimination policies and complaint procedures; and
  • Prominently display civil rights posters in common areas, including lobbies and waiting rooms, front reception desk and locations where individuals apply for services. Posters can be found on the Civil Rights Office website.

Questions concerning this section and civil rights matters can be directed to the HHSC Civil Rights Office.


4300 Important Information for Former Military Service Members

Revision 19-0; Effective July 1, 2019


Women and men who served in any branch of the United States Armed Forces, including Army, Navy, Marines, Air Force, Coast Guard, Reserves or National Guard, may be eligible for benefits and services under other HHSC programs. For more information, visit the Texas Veterans Portal.


4400 Termination of Services

Revision 19-0; Effective July 1, 2019


A qualifying individual seeking family planning services must not be denied services due to an inability to pay. Contractors have the right to terminate services for an individual if the individual is disruptive, unruly, threatening or uncooperative to the extent that the individual seriously impairs the contractor’s ability to effectively and safely provide services, or if the individual’s behavior jeopardizes his or her own safety, clinic staff or others. An individual has the right to appeal the denial, suspension or termination of services. See appeal rights: Denial, Suspension, or Termination of Services and Client Appeals (1 TAC §382.111).

Any policy related to termination of services must be included in the contractor’s policy manual.


4500 Resolution of Complaints

Revision 19-0; Effective July 1, 2019


Contractors must ensure that individuals can express concerns about care received and to further ensure that those complaints are handled in a consistent manner. Contractors’ policy manuals must explain the process when individuals request a hearing. A contractor shall not terminate services to the individual until a final decision is rendered by HHSC (1 TAC §357.13). Any complaint must be documented in the individual’s record.


4600 Freedom of Choice

Revision 19-0; Effective July 1, 2019


HHSC FPP clients are guaranteed the right to voluntarily choose qualified family planning providers and methods without coercion or intimidation. Acceptance of family planning services must not be a prerequisite to eligibility for, or receipt of, any other service or assistance from the entity or individual that provided the service or assistance.


4700 Research (Human Subject Clearance)

Revision 19-0; Effective July 1, 2019


An HHSC FPP contractor that wishes to participate in any proposed research that would involve the use of HHSC FPP clients as subjects, the use of HHSC FPP clients’ records or any data collection from FPP clients, must obtain prior approval from their own internal Institutional Review Board (IRB) and HHSC. For information about the process, contractors should contact the Department of State Health Services IRB at The IRB will review the materials and approve or deny the application.

The contractor must have a policy in place that indicates that prior approval will be obtained from HHSC, prior to instituting any research activities. The contractor must also ensure that all staff are made aware of this policy through staff training. Documentation of training on this topic must be maintained.