This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. This Notice of Privacy Practices only applies to persons receiving healthcare treatment or services at the CSC affiliates listed in this Notice.

Center of Special Care is required by law to maintain the privacy of your health information. This Notice describes the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information. We must provide you with this Notice of our legal duties and privacy practices. We must follow the terms of the Notice that is currently in effect.

If you have questions about this Notice, please call our Security and Privacy Officer at (860)827-4822.

Who Will Follow This Notice: This Notice will be followed by all employees, medical staff, students, departments, volunteers and healthcare professionals at our healthcare provider sites. This includes:

• Hospital for Special Care
• Brittany Farms Health Center
• Special Care Dental Services

These provider sites may share medical information with each other for treatment, payment and healthcare operations as described below. Although some doctors and healthcare professionals at these sites are not employees of the Center of Special Care, they will also follow this Notice when caring for you. However, medical care and treatment given by these practitioners is given as independent professionals and Center of Special Care accepts no legal responsibility for their actions. Any medical information you give during a visit at a private doctor's office or clinic is not covered by this Notice. Those offices and clinics will have their own privacy notices and policies.

This Notice does not apply to the Special Care Research & Education Center, sports and community programs of HSC Community Services, and community members of the Aquatic Rehabilitation Center.

How We May Use and Disclose Your Medical Information:

For Treatment
We may use your medical information to provide you with medical treatment or services. We may give your medical information to doctors, nurses, technicians, healthcare students, clergy, or others who care for you. For example, a doctor treating you for a broken bone may need to know if you have diabetes because diabetes may slow the healing process. The doctor may tell the dietitian if you have diabetes so that we can give you the proper meals. Other departments of the facility also may share medical information about you in order to provide you with the different services you need such as medication, lab work, and x-rays. We also may disclose medical information about you to people outside the facility who may be involved in your medical care during or after you leave the facility, such as physician offices, home care agencies, or other providers of services that are part of your care.

For Payment
We may use and disclose medical information about you so that the treatment and services you receive at the facility may be billed to an insurance company or a third party. For example, we may need to give your health plan information about physical therapy you receive so your health plan will pay us or reimburse you for the therapy. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. We may also share your medical information with other providers, such as ambulance companies, so that they can obtain payment for services provided to you.

For healthcare Operations
own operations. These uses and disclosures are necessary to run the facility and make sure that our patients receive quality care. For example, you may receive a patient satisfaction survey that helps us to review our treatment and services and to evaluate the performance of our staff in caring for you. We may combine medical information about many patients to decide what additional services are needed, and whether certain new treatments are effective. We may also combine the medical information we have with medical information from other facilities to compare how we are doing and see where we can make improvements.

We may also use or disclose your medical information for the following reasons:

• to remind you of an upcoming appointment,
• to tell you about possible treatment options or alternatives that may be of interest to you, and
• to tell you about health-related benefits and services, or medical education classes that may be of interest to you.

Unless you object, we may also share your medical information for the following reasons:

To Others Involved in Your Care: Your medical information may be shared with family members, friends, personal caregivers or others that are involved in your care or payment for your care.

Disaster Relief: Your medical information may also be shared with other healthcare providers or disaster relief agencies in the event of a disaster to coordinate care and assist in notifying your family of your condition or location.

Patient Directory: While you are a patient at Hospital for Special Care or Brittany Farms Health Center, we may include limited information about you in the Patient Directory. This information includes your name, location (such as room number), your general condition (fair, stable, etc.) and your religious affiliation. This Directory gives basic information for your family, friends, and clergy so they can visit you and know how you are doing. This information will only be given to callers and visitors that ask for you by name. A member of the clergy, such as a priest or rabbi, may also be given your religious affiliation, even if they do not ask for you by name. You may object to this Directory information being given to callers or visitors by notifying the Admissions staff. However, please keep in mind that if your name is not in the Directory, we cannot tell family members, friends, or others, such as florists and deliverymen, where your room is, or that you are even here. Flowers and other packages will be returned to the sender.

Fundraising: We may share limited information about you with the Foundation of Special Care for its fundraising efforts on our behalf. We only release contact information (name, address and phone number) and the dates you received treatment or services. If you do not want to be contacted for fundraising purposes, you must notify the Foundation of Special Care in writing at: 2150 Corbin Avenue, New Britain, CT 06053

We may use or disclose your medical information without your express permission for the following reasons:

As Required by Law:
We will disclose medical information about you when required to do so by federal, state, or local law.

Public Health Activities: We may disclose medical information about you for public health activities. For example,

• to report infectious disease, injury or disability;
• to report birth and deaths;
• to report suspected child abuse or neglect;
• to report problems with medical products or assist in recalls of medical products; or
• to notify a person who may have been exposed to a disease or may be at risk for contacting or spreading a disease or condition.

Abuse:
We may disclose medical information to notify the appropriate government authority if we believe that a patient has been the victim of abuse, neglect or domestic violence.

Healthcare Oversight:
We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigation, inspections, and the licensure process. These activities are necessary for the federal and state government to monitor the healthcare system, government programs, and compliance with civil rights laws.

Judicial and Administrative Proceedings:
We may release your medical information in response to a court order, or other lawful process.

Law Enforcement:
We may release medical information, if asked to do so by law enforcement officials,

• in response to a court order, subpoena, warrant, summons or similar process,
• to identify or locate a suspect, fugitive, material witness, or missing person,
• about the victim of a crime, criminal conduct at the facility, a death we believe may be the result of criminal conduct, and
• in emergency circumstances, to report a crime, the location of the crime or victims or the identity, description or location of the person who committed the crime.

Coroners, Medical Examiners, and Funeral Directors:
We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the hospital to funeral directors as necessary to carry out their duties.

Organ and Tissue Donation:
We may release medical information to organizations that handle organ donation and transplants as required by law. This does not effect your rights to consent to or refuse to be an organ donor. If you are an organ donor, we will release your medical information as necessary to facilitate the donation or transplantation process.

Research:
Under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who receive one medication to those who received another medication for the same condition. All research projects, however, are subject to a special approval process. We may also use or disclose medical information from which some or all of the information that identifies you has been removed.

To Avert a Serious Threat to Safety:
We may release medical information to authorized agencies when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person, as required or permitted by law.

Specialized Government Functions: Military, National Security, Intelligence and Protective Services Activities:
If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority. We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state.

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. The release would be necessary for the institution to provide you with healthcare; to protect your health and safety or the health and safety of others; for the safety and security of personnel or others at the correctional institution; or for the administration of the correctional institution.

Worker's Compensation:
We may release medical information about you for workers' compensation or similar programs, to the extent authorized by law. These programs provide benefits for work-related injuries or illness.

Special Restrictions under State or Federal Law:
There also may be special considerations under state or federal law in some circumstances to further protect your medical information. For disclosures or access to certain health information, such as HIV-related information, substance abuse treatment or certain records regarding psychiatric care, special restrictions may apply under federal or state law. For example, your specific written authorization is required to release information regarding HIV test results.

Access by parents to records related to treatment of minors may also be restricted in certain circumstances, including treatment for venereal disease, HIV testing, HIV-related counseling or treatment, and abortion and related counseling. Access to records of emancipated minors and children of a minor may also be restricted without the minor's consent.

Your Rights Regarding Your Medical Information:
You have the following rights regarding medical information we maintain about you

Right to Inspect and Copy:
You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. To inspect and copy your medical information, you must submit your request in writing to the medical record department at the facility where you were treated. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed.

Right to Amend:
If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the hospital. To request an amendment, your request must be made in writing and submitted to the Security and Privacy Officer at Center of Special Care. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

• was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
• is not part of the medical information kept by or for the hospital;
• is not part of the information which you would be permitted to inspect and copy; or
• is accurate and complete.

Right to an Accounting of Disclosures:
You have the right to request an "accounting of disclosures." This is a list of the disclosures we made of your medical information. This list will not include disclosures made for purposes of treatment, payment or operations, disclosures made to you, to others involved in your care, to law enforcement or correctional institutions in some circumstances, for national security purposes or disclosures authorized by you. To request this list, you must submit your request in writing to the Security and Privacy Officer at Center of Special Care. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions:
You have the right to request a restriction or limitation on the medical information about you that we use or disclose for treatment, payment or healthcare operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a procedure you had. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to Security and Privacy Officer at Center of Special Care. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure to others, or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

Right to Request Confidential Communications:
You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to the Security and Privacy Officer at Center of Special Care. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted..

Right to a Paper Copy of This Notice:
You have the right to a paper copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, www.hfsc.org, or by contacting the Security and Privacy Officer at Center of Special Care at (860)827-4822.

Changes to This Notice:
We reserve the right to change this Notice. We reserve the right to make the new Notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in each service delivery site and on our website, and will make a copy available to you on request.

Other Uses of Medical Information:
Other uses and disclosures of your medical information not covered by this Notice or permitted by laws that apply to us will be made only with your written permission. Your written permission tells us what health information you want to disclose, the reason for its disclosure, and to whom you are asking the information be sent. Your permission will have an expiration date, and you may revoke that permission at any time, by writing to the Security and Privacy Officer at Center of Special Care. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written permission. You understand that we are unable to take back any disclosures we have already made before your revocation, and that we are required to retain our records of the care that we provided to you.

Complaints:
If you believe your privacy rights have been violated, you may file a written complaint with the Center of Special Care Security and Privacy Officer at 2150 Corbin Avenue, New Britain, CT 06053, or Office for Civil Rights, U.S. Department of Health and Human Services, Government Center, J.F. Kennedy Federal Building-Room 1875, Boston, Massachusetts 02203. Voice phone (617) 565-1340. FAX (617) 565-3809. TDD (617) 565-1343. You will not be retaliated against for filing a complaint.

Date of first publication 4/14/2003
Revised: 9/1/2003
Revised: 2/7/2007