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.

I. Who We Are

Hunterdon Healthcare is affiliated with multiple health care providers and has created partnerships with multiple health care providers. This notice applies to the following entities: Hunterdon Medical Center, Hunterdon Medical Center Foundation, Hunterdon Regional Community Health, Hunterdon Regional Pharmacy and Mid Jersey Corporation, Hunterdon Healthcare Partners their physicians, residents, nurses, volunteers and other personnel. To obtain an updated list of Hunterdon Healthcare affiliates and partners either visit our website at www.hunterdonhealthcare.org or contact our physician referral service at (800) 511-4462.

Hunterdon Healthcare affiliates and partners may share medical information with each other for the purposes of treatment, payment, or healthcare operations.

II. Our Privacy Obligations

We are required by law to maintain the privacy of your health information (“Protected Health Information” or “PHI”) and to provide you with this Notice of our legal duties and privacy practices with respect to your Protected Health Information. When we use or disclose your Protected Health Information, we are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure).

III. Permissible Uses and Disclosures Without Your Written Authorization

Subject to the limitations, which we will describe in Section IV below, we may use and/or disclose your protected health information without your written permission for the following purposes:

A. Uses and Disclosures For Treatment, Payment and Health Care Operations. We may use and disclose protected health information in order to treat you, obtain payment for services provided to you and conduct our “health care operations” as detailed below: Hunterdon Healthcare affiliates and partners may share medical information with each other for the purpose of treatment, payment, or healthcare operations.

• Treatment. We may use and disclose your protected health information to provide treatment and other services to you--for example, to diagnose and treat your injury or illness. As part of your treatment your medical record may be shared amongst the entities that are affiliated or has a partnership with Hunterdon Healthcare. In addition, we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also disclose protected health information to other providers involved in your treatment.

• Payment. We may use and disclose your protected health information to obtain payment for services that we provide to you--for example, disclosures to claim and obtain payment from your health insurer, HMO, or other company that arranges or pays the cost of some or all of your health care to verify that they will pay for your health care.

• Health Care Operations. We may use and disclose your protected health information for our health care operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care that we deliver to you. For example, we may use protected health information to evaluate the quality and competence of our physicians, nurses and other health care workers. We may disclose protected health information for our patient satisfaction survey process. We may disclose protected health information to our Patient Advocate in order to resolve any complaints you may have and ensure that you have a comfortable visit with us.

We may also disclose protected health information to another health care facility to which you have been transferred or referred when such protected health information is required for them to treat you, receive payment for services they render to you, or conduct certain health care operations, such as quality assessment and improvement activities, reviewing the quality and competence of health care professionals, or for health care fraud and abuse detection or compliance.

B. Use or Disclosure for Directory of Individuals in Hunterdon Healthcare. We may include your name, location in Hunterdon Healthcare, general health condition (e.g., fair, stable, etc.) and religious affiliation in a patient directory without obtaining your authorization unless you object to inclusion in the directory. Information in the directory may be disclosed to anyone who asks for you by name or members of the clergy; provided, however, that religious affiliation will only be disclosed to members of the clergy. 

C. Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your protected health information to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if we (1) obtain your agreement; (2) provide you with the opportunity to object to the disclosure and you do not object; or (3) reasonably infer from the circumstances that you do not object to the disclosure. If you are not present, or the opportunity to agree or object to a use or disclosure cannot practicably be provided because of your incapacity or an emergency circumstance, we may exercise our professional judgment to determine whether a disclosure is in your best interests. If we disclose information to a family member, other relative or a close personal friend, we would disclose only information that we believe is directly relevant to the person's involvement with your health care or payment related to your health care. We may also disclose your protected health information in order to notify (or assist in notifying) such persons of your location, general condition or death. 

D. Fundraising Communications. We may contact you to request a tax-deductible contribution to support important activities of Hunterdon Healthcare. In connection with any fundraising, we may disclose to our fundraising staff demographic information about you (e.g., your name, address and phone number) and dates we provided health care to you, without your written authorization. If you do not want to receive any fundraising requests in the future, you may contact our Privacy Office identified below. 

E. Public Health Activities. We may disclose your protected health information for the following public health activities: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to public health authorities or other government authorities authorized by law to receive such reports; (3) to report information about products and services under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance. 

F. Victims of Abuse or Neglect. If we reasonably believe you are a victim of abuse or neglect, we may disclose your protected health information to a governmental authority, including a social service or protective services agency, authorized by law to receive reports of such abuse or neglect. 

G. Health Oversight Activities. We may disclose your protected health information to a health oversight agency that oversees the health care and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid and civil rights laws. 

H. Judicial and Administrative Proceedings. We may disclose your protected health information in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.

I. Law Enforcement Officials. We may disclose your protected health information to the police or other law enforcement officials as required or permitted by law or in compliance with a court order or a grand jury or administrative subpoena.

J. Decedents. We may disclose your protected health information to a funeral director or medical examiner as authorized by law.

K. Organ and Tissue Procurement. We may disclose your protected health information to organizations that facilitate organ, eye or tissue procurement, banking or transplantation.

L. Research. We may use or disclose your protected health information for research purposes with your consent or we will ask our Institutional Review Board to approve a waiver of authorization for disclosure. A waiver of authorization will be based upon assurances from the review board that the researchers will adequately protect your protected health information.

M. Health or Safety. We may, consistent with applicable law and standards of ethical conduct, use or disclose your protected health information to prevent or lessen a threat of imminent, serious physical violence against you or another readily identifiable individual. 

N. Specialized Government Functions. We may use and disclose your protected health information to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances. 

O. Workers' Compensation. We may disclose your protected health information as authorized by and to the extent necessary to comply with state law relating to workers' compensation or other similar programs. 

P. Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution. 

Q. As required by law. We may use and disclose your protected health information when required to do so by any other law not already referred to in the preceding categories. 

lV. Uses and Disclosures Requiring Your Written Authorization

This Section IV describes when we must obtain your written permission to use or disclosure your protected health information.

A. Use or Disclosure with Your Authorization. For any purpose other than the ones described above in Section III and in this Section IV, we only may use or disclose your protected health information when you grant us your written authorization on our authorization form. For instance, you will need to complete and sign an authorization form before we can send your protected health information to your life insurance company or to the attorney representing the other party in litigation in which you are involved.

B. Marketing. We must also obtain your written authorization prior to using your protected health information to send you any marketing materials. (We can, however, provide you with marketing materials in a face-to-face encounter, or in the form of a promotional gift of nominal value, without obtaining your authorization.)

C. HIV/AIDS Related Information. Your Authorization must expressly refer to your HIV/AIDS related information in order to permit us to disclose your HIV/AIDS related information. However, there are certain purposes for which we may disclose your HIV/AIDS information, without obtaining Your Authorization: (1) your diagnosis and treatment; (2) scientific research; (3) management audits, financial audits or program evaluation; (4) medical education; (5) disease prevention and control when permitted by the New Jersey Department of Health and Senior Services; (6) pursuant to a court order under certain circumstances; and (7) when required or otherwise authorized by law, to the Department of Health and Senior Services or another entity.

D. Genetic Information. Except in certain cases (such as a paternity test for a court proceeding, anonymous research, newborn screening requirements, or pursuant to a court order), we will obtain your special written consent prior to obtaining or retaining your genetic information (for example, your DNA sample), or using or disclosing your genetic information for treatment, payment or health care operations purposes. We may use or disclose your genetic information for any other reason only when Your Authorization expressly refers to your genetic information or when disclosure is permitted under New Jersey State law (including, for example, when disclosure is necessary for the purposes of a criminal investigation, to determine paternity, newborn screening, identifying your body or as otherwise authorized by a court order.

E. Venereal Disease Information. Your Authorization must expressly refer to your venereal disease information in order to permit us to disclose any information identifying you as having or being suspected of having a venereal disease. However, there are certain purposes for which we may disclose your venereal disease information, without obtaining your Authorization, including to a prosecuting officer or the court if you are being prosecuted under New Jersey law, to the Department of Health and Senior Services, or to your physician or a health authority, such as the local board of health. Your physician or a health authority may disclose your venereal disease information only if he/she deems it necessary in order to protect the health or welfare of you, your family or the public.

F. Tuberculosis Information. Your Authorization must expressly refer to your tuberculosis information in order to permit us to disclose any information identifying you as having tuberculosis or refusing/failing to submit to a tuberculosis test if you are suspected of having tuberculosis or are in close contact to a person with tuberculosis. However, there are certain purposes for which we may disclose your tuberculosis information, without obtaining Your Authorization, including for research purposes under certain conditions, pursuant to a valid court order, or when the Commissioner of the Department of Health and Senior Services (or his/her designee) determines that such disclosure is necessary to enforce public health laws or to protect the life or health of a named person.

G. Substance Abuse Information. The confidentiality of alcohol and drug abuse patient records maintained by us is protected by federal law and regulations. Generally, we may not say to a person outside our facilities that a patient attends our facilities, or disclose any information identifying a patient as an alcohol or drug abuser unless the patient consents in writing, the disclosure is allowed by court order, or the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit or program evaluation. Accordingly, we may not disclose drug and alcohol medical records without your Authorization. 

V. Your Rights Regarding Your Protected Health Information

A. For Further Information; Complaints. If you desire further information about your privacy rights, are concerned that we have violated your privacy rights or disagree with a decision that we made about access to your protected health information, you may contact our Privacy Office, Patient Advocate or Compliance Office. You may also file written complaints with the Director, Office of Civil Rights of the U.S. Department of Health and Human Services, Jacob Javits Federal Building, 26 Federal Plaza, Suite 3312, New York, NY 10278. Also upon request, the Privacy Office can provide you with the additional contact information for the Director. We will not retaliate against you if you file a complaint with the Director or us. 

B. Right to Request Restrictions. You may request restrictions on our use and disclosure of your protected health information (1) for treatment, payment and health care operations, (2) to individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care, or (3) to notify or assist in the notification of such individuals regarding your location and general condition. While we will consider all requests for restrictions carefully, we are not required to agree to a requested restriction. If you wish to request restrictions, please obtain a request form from our Privacy Office and submit the completed form to the Privacy Office. We will send you a written response. If we agree to the requested restrictions, we will comply with your request unless protected health information is needed for emergency treatment. 

C. Right to Receive Confidential Communications. You may request and we will accommodate, any reasonable written request for you to receive your protected health information by alternative means of communication or at alternative locations. If you wish to make a request, please contact our Privacy Office in writing. 

D. Right to Revoke Your Authorization. You may revoke Your Authorization or Your Marketing Authorization, except to the extent that we have taken action in reliance upon it, by delivering a written revocation statement to the Privacy Office identified below. [A form of Written Revocation is available upon request from the Privacy Office.] 

E. Right to Inspect and Copy Your Health Information. You may request access to your medical record file and billing records maintained by us in order to inspect and request copies of the records. Under limited circumstances, we may deny you access to a portion of your records. If you desire access to your records, please obtain a record request form from the Privacy Office and submit the completed form to the Privacy Office. If you request copies, we will charge you $1.00 per page, for the first 100 pages, and $0.25 per page after that, up to a maximum of $200.00 per record. We will also charge you for our postage costs, if you request that we mail the copies to you. If you are denied access, you may request that the denial be reviewed. You should take note that, if you are a parent or legal guardian of a minor, certain portions of the minor's medical record will not be accessible to you (for example, records relating to pregnancy, abortion, sexually transmitted diseases, substance use or abuse, or contraception and/or family planning services). 

F. Right to Amend Your Records. You have the right to request that we amend Protected Health Information maintained in your medical record file or billing records. If you desire to amend your records, please obtain an amendment request form from the Privacy Office and submit the completed form to the Privacy Office. We will comply with your request unless we believe that the information that would be amended is accurate and complete or other special circumstances apply. 

G. Right to Receive An Accounting of Disclosures. Upon request, you may obtain an accounting of certain disclosures of your protected health information made by us during any period of time prior to the date of your request provided such period does not exceed six years and does not apply to disclosures that occurred prior to April 14, 2003. The accounting will not include uses or disclosures for treatment, payment, or healthcare operations, or uses or disclosures pursuant to an authorization you have already provided. If you request an accounting more than once during a twelve (12) month period, we will charge you $1.00 per page for the accounting statement. We will also charge you for our postage costs, if you request that we mail the copies to you. 

H. Right to Receive Paper Copy of this Notice. Upon request, you may obtain a paper copy of this Notice, even if you have agreed to receive such notice electronically.

VI. Effective Date and Duration of This Notice

A Effective Date. This Notice is effective on November 1, 2010.

B. Right to Change Terms of this Notice. We may change the terms of this Notice at any time. If we change this Notice, we may make the new notice terms effective for all Protected Health Information that we maintain, including any information created or received prior to issuing the new notice. If we change this Notice, we will post the new notice in our waiting areas and on our Internet site at www.hunterdonhealthcare.org. You also may obtain any new notice by contacting the Privacy Office.

VII.Privacy Office

You may contact the Privacy Office at:
Privacy Officer
Hunterdon Healthcare
Information Services
2100 Wescott Drive
Flemington, NJ 08822
Telephone Number: (908) 237-5478
E-mail: Privacy.office@hunterdonhealthcare.org

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