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V|h[&l׳H,k4lm])"Vmƥ-9*(2 pxJsS΢ Wég 'W|g~y<ζH 퀁SLV?EeK͟YN*.fɕ#YrQ;z3tWۜo$tfzA{=Vi[b5_&dD3 y 9Ds̏EY%i ]6JdYlXEs(75IP**|U7T R!!;'p%_3%V ‡]ߖm>,S77F+qSK-ƅi9bu@$#Rhḇ ߰g<^Z$歧TnUWBNznHD! kpMoU9abj1kTA8+ b*= }3SP߰âVf[#U$N % 0: 0VI ^ w 4   m N 1u 72b 0c 0 w 0 n 0 0 0 L 0  0  0 D 1! 72 0U 0G 0* 0  0 0 0 0l 0= 0C  0N 0 0 0 0 0E 0 0 0@ 0 0 0Y! 0!" 0" 0# 0g$ 0#% 1% 72e& 0,& 0('* 0+ 0NM, 0<,U:>, 0U-j-:p./ 0Up0 0U0 0(1 D+B1 AQm11y6);R+<R}<}<<~=HS>S>S>S>S>S>S>S>S>S> 06?\\oswdc06\OCR-HP8150-508F36E0(9 Z6Times New Roman RegularX($USUS.,(.3$ !USUS.,  m.s uz.8-tBackup3|xU3#37=CIQYag1.a.i.(1)(a)(i)1)a) i)(;3$2#  0  .3  0  (O;$0  2#  a  .3  0` (#(#(b$0  0` (#(#2#   .3  0 ` (#` (#(xir$0  0` (#(#0 ` (#` (#2#(  0  )3  0 (# (#($0  0` (#(#0 ` (#` (#0 (# (#2#(  a  )3  0h(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#2#(   )3  0h(#h(#($0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#2#  0  )3  0(#(#({$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#2#  a  )3  0p(#(#(F$0  0` (#(#0 ` (#` (#0 (# (#0h(#(#0h(#h(#0(#(#0p(#(#2#     )3  0p(#p(# xAGaeimquy}Bullet ListBullets List  HRSA*+ (_2623  ..*D+J (_25   ," <DL,23  ..  2( 4 <DL2  *A+J (_24   ) <DL)23  ..  2( 4 <DL2  *>+J (_23  ` &<<DL&23  ..  2( 4 <DL2  *;+J (_22   #DL#23  ..  2( 4 <DL2  *8+J (_21    DL 23  ..  2( 4 <DL2  *5+J (_20  h DDL23  ..  2( 4 <DL2  *2+J (_19   L23  ..  2( 4 <DL2  */+J (_18    L23  ..  2( 4 <DL2  * (_1723  Ԁ*DJ (_16   ," <DL,23  Ԁ  2( 4 <DL2  *AJ (_15   ) <DL)23  Ԁ  2( 4 <DL2  *>J (_14  ` &<<DL&23  Ԁ  2( 4 <DL2  *;J (_13   #DL#23  Ԁ  2( 4 <DL2  *8J (_12    DL 23  Ԁ  2( 4 <DL2  *5J (_11  h DDL23  Ԁ  2( 4 <DL2  *2J (_10   L23  Ԁ  2( 4 <DL2  (/J &_9    L23  Ԁ  2( 4 <DL2  ( &_823  (DJ &_7   ," <DL,23   2( 4 <DL2  (AJ &_6   ) <DL)23   2( 4 <DL2  (>J &_5  ` &<<DL&23   2( 4 <DL2  (;J &_4   #DL#23   2( 4 <DL2  (8J &_3    DL 23   2( 4 <DL2  (5J &_2  h DDL23   2( 4 <DL2  (2J &_1   L23   2( 4 <DL2  &/J $_    L23   2( 4 <DL2  xCcgkosw{TrianglesTriangle Bullet6<D!:QuickFormat1XXX  cb  ! ! (Axy6XXX  cb  ! ! (Axy6<D:QuickFormat2XXX  cb   (Ax3 XXX  cb   (Ax3   'USUS.,  _&&:(# 8XXOCRHIPAAPrivacy  NN;(#December3,2002 r   RevisedApril3,2003#XDX8R# 6)&4Hyperlink            (O$<:Default Para\  `&Times New Roman(-2$ !USUS.,  Ahttp://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.php?p_sid=K6SCZJFg&p_lva=&p_li=&p_page=1&p_cat_lvl1=7&p_cat_lvl2=56&http://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.php?p_sid=K6SCZJFg&p_lva=&p_li=&p_page=1&p_cat_lvl1=7&p_cat_lvl2=56&p_search_text=&p_new_search=1 Level 1 Level 2 Level 3 Level 4 Level 5(-2$ !USUS.,  (-2$ !USUS.,  ($'dxdBCDEFC<< c  'USUS.,  _ @ 8XX>88 %#X#>XDX>8H##XDXX>XDg#>XDXXXD##9%#>8X>XD#8>8#>88 #>XDX>8#>8X>XDO#>XDX>8#>8X>XDCRHI#>XDX>8#>8X>XDPAA#>XDX>8,#>8X>XDPrivacy   @  @ #>XDX>8r#>8X>XDKK:%##>XDX>8#>8X>XDDecember3,2002 r  @  @  @   #>XDX>8>#>8X>XDRevisedApril3,2003 4  @  @   ?+ ` hp x %#?#>XDX>8##XDXX>XD]#>XDXXXD o ?) (#(#(#(#USUS.,  _8XX>88#>XDX>8X##XDXX>XDw#>XDXXXD>8X>XD#8>8#>88GKWGCz h p @X@E'##!  (#(#    (#(##>XDX>8##XDXX>XD=#>XDXXXD>8X>XD#8>8#>88#>XDX>8##XDXX>XD#>XDXXXD @ >8X>XD#8>8\#>88GLQA=x h p @XE! http://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.php?p_sid=UFo3G3Eg&p_lva=&p_li=&p_page=1&p_cat_lvl1=7&p_cat_lvl2=56&p H C"USUS.,  _ @  H C"USUS.,  _ @ Phttp://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.php?p_sid=f47XY6Gg&p_lva=&p_li=&p_page=1&p_cat_lvl1=7&p_cat_lvl2=%7Ehttp://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.phphttp://answers.hhs.gov/cgi-bin/hhs.cfg/php/enduser/std_alp.php?p_sid=f47XY6Gg&p_lva=&p_li=&p_page=1&p_cat_lvl1=7&p_cat_lvl2=%7Eany%7E&p_search_text=&p_new_search=1&$""  !USUS.,  _ :8DXXdd8@  DISCLOSURESFORPUBLICHEALTHACTIVITIES   @![45CFR164.512(b)]   Background      TheHIPAAPrivacyRulerecognizesthelegitimateneedforpublichealthauthoritiesand Z  othersresponsibleforensuringpublichealthandsafetytohaveaccesstoprotectedhealth F  informationtocarryouttheirpublichealthmission.TheRulealsorecognizesthatpublichealth 2t reportsmadebycoveredentitiesareanimportantmeansofidentifyingthreatstothehealthand ` safetyofthepublicatlarge,aswellasindividuals.Accordingly,theRulepermitscovered  L  entitiestodiscloseprotectedhealthinformationwithoutauthorizationforspecifiedpublichealth 8  purposes. $  Ѐ    HowtheRuleWorks      GeneralPublicHealthActivities.ThePrivacyRulepermitscoveredentitiestodisclose   protectedhealthinformation,withoutauthorization,topublichealthauthoritieswhoarelegally ~ authorizedtoreceivesuchreportsforthepurposeofpreventingorcontrollingdisease,injury,or j disability.Thiswouldinclude,forexample,thereportingofadiseaseorinjury;reportingvital V events,suchasbirthsordeaths;andconductingpublichealthsurveillance,investigations,or B interventions.See45CFR164.512(b)(1)(i).Also,coveredentitiesmay,atthedirectionofa .p publichealthauthority,discloseprotectedhealthinformationtoaforeigngovernmentagencythat \ isactingincollaborationwithapublichealthauthority.See45CFR164.512(b)(1)(i).Covered H entitieswhoarealsoapublichealthauthoritymayuse,aswellasdisclose,protectedhealth 4 informationforthesepublichealthpurposes.See45CFR164.512(b)(2).     A publichealthauthorityisanagencyorauthorityoftheUnitedStatesgovernment,a  State,aterritory,apoliticalsubdivisionofaStateorterritory,orIndiantribethatisresponsible   forpublichealthmattersaspartofitsofficialmandate,aswellasapersonorentityactingunder ! agrantofauthorityfrom,orunderacontractwith,apublichealthagency.See45CFR164.501. z" ExamplesofapublichealthauthorityincludeStateandlocalhealthdepartments,theFoodand f# DrugAdministration(FDA),theCentersforDiseaseControlandPrevention,andthe R$ OccupationalSafetyandHealthAdministration(OSHA). >%      Generally,coveredentitiesarerequiredreasonablytolimittheprotectedhealth 'X" informationdisclosedforpublichealthpurposestotheminimumamountnecessaryto (D # accomplishthepublichealthpurpose.However,coveredentitiesarenotrequiredtomakea (0!$ minimumnecessarydeterminationforpublichealthdisclosuresthataremadepursuanttoan )"% individualsauthorization,orfordisclosuresthatarerequiredbyotherlaw.See45CFR *#& 164.502(b).Fordisclosurestoapublichealthauthority,coveredentitiesmayreasonablyrelyon +#' aminimumnecessarydeterminationmadebythepublichealthauthorityinrequestingthe  protectedhealthinformation.See45CFR164.514(d)(3)(iii)(A).Forroutineandrecurring  publichealthdisclosures,coveredentitiesmaydevelopstandardprotocols,aspartoftheir   minimumnecessarypoliciesandprocedures,thataddressthetypesandamountofprotected   healthinformationthatmaybedisclosedforsuchpurposes.See45CFR164.514(d)(3)(i). n    OtherPublicHealthActivities.ThePrivacyRulerecognizestheimportantrolethat F  personsorentitiesotherthanpublichealthauthoritiesplayincertainessentialpublichealth 2t activities.Accordingly,theRulepermitscoveredentitiestodiscloseprotectedhealth ` information,withoutauthorization,tosuchpersonsorentitiesforthepublichealthactivities  L  discussedbelow. 8   (Ax3 "3"  0  3d2A3  0` (#(#  Childabuseorneglect.Coveredentitiesmaydiscloseprotectedhealth3d݌ ` (#` (# Ќ  0  0` (#(#informationtoreportknownorsuspectedchildabuseorneglect,ifthereportis   madetoapublichealthauthorityorotherappropriategovernmentauthoritythatis   authorizedbylawtoreceivesuchreports.Forinstance,thesocialservices   departmentofalocalgovernmentmighthavelegalauthoritytoreceivereportsof ~ childabuseorneglect,inwhichcase,thePrivacyRulewouldpermitacovered j entitytoreportsuchcasestothatauthoritywithoutobtainingindividual V authorization.Likewise,acoveredentitycouldreportsuchcasestothepolice B departmentwhenthepolicedepartmentisauthorizedbylawtoreceivesuch .p reports.See45CFR164.512(b)(1)(ii).Seealso45CFR512(c)forinformation \ regardingdisclosuresaboutadultvictimsofabuse,neglect,ordomesticviolence.H` (#` (# "3"    32A3  0 `   Quality,safetyoreffectivenessofaproductoractivityregulatedbytheFDA.   Coveredentitiesmaydiscloseprotectedhealthinformationtoapersonsubjectto   FDAjurisdiction,forpublichealthpurposesrelatedtothequality,safetyor  effectivenessofanFDA-regulatedproductoractivityforwhichthatpersonhas   responsibility.Examplesofpurposesoractivitiesforwhichsuchdisclosuresmay ! bemadeinclude,butarenotlimitedto:3݌z"` (#` (# Ќ   6(yx"3"    0 ` 323  0 ` (#` (#  Collectingorreportingadverseevents(includingsimilarreportsregarding R$ foodanddietarysupplements),productdefectsorproblems(including >%  problemsregardinguseorlabeling),orbiologicalproductdeviations;3?݌*&l! (# (# Ќ  "3"    0 ` 323  0 ` (#` (#  TrackingFDA-regulatedproducts;3݌'X" (# (# Ќ  "3"    0 ` 323  0 ` (#` (#  Enablingproductrecalls,repairs,replacementorlookback(whichincludes (D # locatingandnotifyingindividualswhoreceivedrecalledorwithdrawn (0!$ productsorproductsthatarethesubjectoflookback);and3 ݌)"% (# (# Ќ  "3"    0 ` 3 23  0 ` (#` (#  Conductingpost-marketingsurveillance.3 ݌*#& (# (# Ќ   +#' 0  0` (#(#See45CFR164.512(b)(1)(iii).The personsubjecttothejurisdictionofthe  FDAdoesnothavetobeaspecificindividual.Rather,itcanbeanindividualor  anentity,suchasapartnership,corporation,orassociation.Coveredentitiesmay   identifythepartyorpartiesresponsibleforanFDAregulatedproductfromthe   productlabel,fromwrittenmaterialthataccompaniestheproduct(knowas n  labeling),orfromsourcesoflabeling,suchasthePhysiciansDeskReference.Z ` (#` (# Z    Z3$" `   Personsatriskofcontractingorspreadingadisease.AcoveredentitymayZ3$Z$݌ 2t Ќ  0  0` (#(#discloseprotectedhealthinformationtoapersonwhoisatriskofcontractingor ` spreadingadiseaseorconditionifotherlawauthorizesthecoveredentityto  L  notifysuchindividualsasnecessarytocarryoutpublichealthinterventionsor 8  investigations.Forexample,acoveredhealthcareprovidermaydisclose $  protectedhealthinformationasneededtonotifyapersonthat(s)hehasbeen   exposedtoacommunicablediseaseifthecoveredentityislegallyauthorizedto   dosotopreventorcontrolthespreadofthedisease.See45CFR   164.512(b)(1)(iv). ` (#` (# Z    Z(" `   Workplacemedicalsurveillance.Acoveredhealthcareproviderwhoprovides j 0  0` (#(#ahealthcareservicetoanindividualattherequestoftheindividualsemployer, V orprovidestheserviceinthecapacityofamemberoftheemployersworkforce, B maydisclosetheindividualsprotectedhealthinformationtotheemployerforthe .p purposesofworkplacemedicalsurveillanceortheevaluationofworkrelated \ illnessandinjuriestotheextenttheemployerneedsthatinformationtocomply H withOSHA,theMineSafetyandHealthAdministration(MSHA),orthe 4 requirementsofStatelawshavingasimilarpurpose.Theinformationdisclosed   mustbelimitedtotheprovidersfindingsregardingsuchmedicalsurveillanceor   workrelatedillnessorinjury.Thecoveredhealthcareprovidermustprovidethe  individualwithwrittennoticethattheinformationwillbedisclosedtohisorher   employer(orthenoticemaybepostedattheworksiteifthatiswheretheservice ! isprovided).See45CFR164.512(b)(1)(v).Z(7(݌z"` (#` (# Ќ    ->XDXXX-FrequentlyAskedQuestionsi. R$ #XDXX>XD-#:.>XDXXXD .0  ToseePrivacyRuleFAQs,clickthedesiredlinkbelow:6Y*&l!(#(# #XDXX>XD.#>XDXXXD X#XDXX>XD}/# 4Js<O  5  <O  '/<O/   6/<  7&0>XDXXXDd4@ <O  5  FAQsonPublicHealthUsesandDisclosures6=1<OQ1  7 1#XDXX>XD1#d>XDXXXD p  (D #  X#XDXX>XD;2#d>XDXXXDd#XDXX>XD2# X9%4 4 <DLX94N <O  5  <O  d>XDXXXDFAQsonALLPrivacyRuleTopics d<O\3   #XDXX>XD3#>XDXXXD6H3<O  7 3d>8X>XDԀ )"%   *#& #>XDX>84##XDXX>XDn4#mH:FI8>D>XXdXXd8<( ` hp x 44X<>XDXXXD>8X>XD(Y#>XDX>8o6##XDXX>XDP6#>XDXXXDoucanalsogotod#XDXX>XD6#4O 2 <O  5  <O  >XDXXXDhttp://_answers.hhs.gov_/cgibin/_hhs.cfg_/_php_/_enduser_/_std_alp.php_<D7  #XDXX>XD7#>XDXXXD607<  7 !r7d>8X>XD,#>XDX>8|9##XDXX>XD9#>XDXXXDthen  select"PrivacyofHealthInformation/HIPAA"fromtheCategorydropdownlistand  clicktheSearchbutton.d#XDXX>XD9#>XDXXXD)>8X>XD#8>8:#>88     #8>8$;##XDX8:#>XDXXXD #XDXX>XD;#;  `     h      p