FAQs: How to secure medical information from a county jail

Disclosure of an Inmate’s Medical Information by Texas County Jails to Inmate’s Family

This document provides answers to common questions regarding the right of inmates’ family members to obtain an inmate’s medical records and information from county jails in Texas.  For questions regarding the information in this document, please contact the Texas Jail Project at texasjailproject@gmail.com or (512) 469-7665. 

  • Is a county jail legally permitted to release medical records and information about an inmate to family members?

    Yes, if the inmate provides to the jail a signed form authorizing the release of the inmate’s medical information and records to family members.

  1. After an inmate submits an authorization form to the county jail, the jail is permitted to release and discuss (in person and by phone) all of the information and records covered by the form.
  • What are the required elements of an authorization form?

    A valid authorization form is required to contain the names of the inmate and recipient(s), a description of the information disclosed and the purpose of disclosure, an expiration date, a dated signature, and certain statements.

    A valid authorization form is required to contain the following: (i) a description of the information to be disclosed, (ii) the name of the inmate, (iii) the name of the recipient of information and/or records, (iv) a description of each purpose of the requested information (for example, to confirm that my relative is given the medication that he or she requires), (v) an expiration date, and (vi) a dated signature.  The authorization form must also contain certain required statements addressing the individual’s right to revoke the authorization, the ability or inability to condition treatment on the signing of the authorization, and the potential for re-disclosure of the information by the recipient.  A valid authorization form is provided on the Texas Jail Project’s website at:
    http://texasjailproject.org/wp-content/uploads/2013/02/Sample-request-letter-TEXAS-PUBLIC-INFORMATION-ACT.pdf.

  • Is a county jail required to respond to every request by an inmate for medical records?

    Yes, the county jail must either provide access to the records or provide the inmate with a written denial, explaining the basis for denial, within 30 days.

  1. The county jail must either provide access to or copies of the records or send to the requesting individual a written denial within 30 days.  If the county jail issues a written denial, the denial must specify in plain language the basis for denial, provide a statement of the individual review rights (including a description as to how to exercise such review rights), and describe how the requesting individual may complain to the jail or to the U.S. Department of Health and Human Services (including the name, title, and telephone number of the contact person or office designated to receive complaints).
  • Is a county jail required to provide medical records or information to an inmate’s family member?

    Generally, yes, if the request is made by the inmate.  However, there are certain exceptions.    

  1. Upon an inmate’s request, the jail must provide the access requested by the inmate, including inspection and/or obtaining a copy of the inmate’s medical records.  If an inmate requests that a copy be sent to another person, such as to a family member, the jail must comply with the request.There are certain specific instances in which a jail can deny an inmate’s request for access to the medical records, such as when releasing a copy of the records to the inmate would jeopardize the health, safety, security, custody, or rehabilitation of the requesting inmate or of other inmates, or the safety of any officer, employee, or other person at the jail responsible for the transporting of the inmate. In this circumstance, the inmate maintains the right to inspect the medical records in person.A jail may also deny access to psychotherapy notes and information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding. Blanket refusals to provide records are not permitted.  Justifications such as “embarrassment” or the existence of an open investigation are not valid bases for denial of the request.  As noted above, if a jail denies an inmate’s request to a copy of the medical records, the jail must provide an explanation for the denial within 30 days of the request.
  • Is a county jail required to provide medical records of a deceased inmate to a requesting family member?

    Yes, if the family member is an executor, administrator, or otherwise has authority to act on behalf of a deceased inmate or of the inmate’s estate.

  1. The executor, administrator, or other person that has authority to act on behalf of a deceased inmate or the inmate’s estate must be treated by the jail as the inmate for purposes of providing access to medical records. Thus, if such person requests a copy of the deceased inmate’s medical records or to inspect the medical records, the jail must provide the records.
  • What if the jail does not provide adequate access to an inmate’s medical records?

    The inmate or the inmate’s family can file a complaint with the U.S. Department of Health and Human Services, Office of Civil Rights.  

  1. The inmate’s right to access and receive a copy of the inmate’s medical records is established in the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).  If a jail does not provide adequate access to the medical records as required by HIPAA, the inmate or the inmate’s family can file a complaint with the U.S. Department of Health and Human Services, Office of Civil Rights.  The online complaint form is located here:
    https://www.hhs.gov/hipaa/filing-a-complaint/index.html.
  • Is the release of autopsy records restricted by privacy laws?

    No, the release of autopsy records is not restricted by privacy laws. Moreover, Texas law expressly prohibits withholding of autopsy records (including the report and detailed findings findings) except photographs or x-rays of a body taken during an autopsy.

  1. Autopsy records may be requested under the Texas Public Information Act by submitting a written request to the county holding the records.  Medical examiners in some counties (for example, Travis County) have an online process for requesting autopsy records.

[1]
 The analysis in this document applies to county jails that are “covered entities” under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”).
[1] 45 C.F.R. § 164.508(a); 2 Texas Health & Safety Code § 181.154(b).
[1] 45 C.F.R. § 164.508(c).
[1] 45 C.F.R. § 164.524(b)(2).
[1] 45 C.F.R. § 164.524(d)(1).
[1] 45 C.F.R. § 164.524(3)(ii).
[1] 45 C.F.R. § 164.524(c)(1).
[1] Additionally, if a record is generated or held by a physician, the inmate has a right to access the record within 15 days unless the physician determines that access would be harmful to the physical, mental, or emotional health of the inmate.  3 Tex. Occ. Code § 159.006.
[1] 45 C.F.R. § 164.524(c)(3)(ii).
[1] 45 C.F.R. § 164.524(a)(1).
[1] 45 C.F.R. §§ 164.524(g)(1), (g)(4).
[1] Tex. Code Crim. Proc. art. § 49.25.