Office of the Assistant Secretary for Preparedness & Response, Office of Preparedness & Emergency Operations; Privacy Act of 1974; Report of a New System of Records, 35052-35055 [07-3097]
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35052
Federal Register / Vol. 72, No. 122 / Tuesday, June 26, 2007 / Notices
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The Commission has determined that
it is not necessary to include a ‘‘cease
and desist’’ provision that directly
prohibits the Board from resuming the
conduct challenged in the complaint.
This conclusion rests on various factors
particular to this case. A key factor is
the experience in South Carolina since
the 2003 changes to the South Carolina
Dental Practice Act. The new statutory
scheme has now been in place for nearly
four years. Throughout this period,
dental hygienists have been providing
preventive services in schools under an
agreement with the health department—
without an initial examination by a
dentist—and the Board has not
reimposed its previous dentist
examination requirement. Thus,
although the 2003 amendments have not
eliminated the need for relief in this
case, they are a relevant consideration
in determining the nature and scope of
that relief.
Accordingly, the proposed order takes
the statutory change into account. First,
requiring the Board to distribute the
announcement set forth in Appendix A
to all dentists, dental hygienists, and
school districts will ensure that
interested parties know that the Board
has formally acknowledged that it is
legally barred from resuming the
conduct challenged in the Commission’s
complaint. Second, the notice
requirement of Paragraph II addresses
the possibility that the Board might
attempt to restrain competition in the
provision of dental hygienist services in
public health settings in ways not
addressed by the 2003 amendments.
This notice provision will increase the
Commission’s ability to monitor the
Board’s future conduct and is likely to
help deter the Board from imposing
restraints on public health preventive
dental care that are not grounded in the
policies articulated by the South
Carolina legislature.
As is standard in Commission orders,
the proposed order contains certain
reporting and other provisions that are
designed to assist the Commission in
monitoring compliance with the order.
The proposed order would expire in
ten years.
By direction of the Commission.
Donald S. Clark,
Secretary.
[FR Doc. E7–12323 Filed 6–21–07: 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Office of the Assistant Secretary for
Preparedness & Response, Office of
Preparedness & Emergency
Operations; Privacy Act of 1974;
Report of a New System of Records
Department of Health and
Human Services (HHS), Office of the
Assistant Secretary for Preparedness
and Response (ASPR), Office of
Preparedness and Emergency (OPEO).
ACTION: Notice of a new System of
Records (SOR).
AGENCY:
SUMMARY: In accordance with the
requirements of the Privacy Act of 1974,
we are proposing to establish a new
system titled, ‘‘The National Disaster
Medical System (NDMS) Patient
Treatment and Tracking Records
System,’’ System Number 09–90–0040.
The primary purpose of the NDMS
Patient Treatment and Tracking Records
System is to collect data from
individuals using the medical care
capabilities provided by NDMS.
EFFECTIVE DATES: NDMS filed a new
SOR report with the Chair of the House
Committee on Oversight and
Government Reform; the Chair of the
Senate Committee on Homeland
Security and Governmental Affairs; and
the Administrator, Office of Information
and Regulatory Affairs, Office of
Management and Budget (OMB) on June
18, 2007. The proposed SOR will be
effective 30 days from the publication of
the notice or 40 days from the date
mailed to ensure that all parties have
adequate time in which to comment.
However, a request has been submitted
to the OMB to grant HHS a 10 day
waiver of the review period due to the
impending start of the hurricane season.
We may defer implementation of this
system and retrieve the request for
waiver should we receive comments
that are contrary and requires the
document to be altered.
You may submit comments,
identified by one of the following
methods: The Federal e-Rulemaking
Portal at https://www.regulations.gov and
following the instructions for submitting
comments, or send to the NDMS Chief
Medical Officer, National Disaster
Medical System, 330 Independence
Avenue, SW., Room G–644,
Washington, DC 20201.
FOR FURTHER INFORMATION CONTACT:
CAPT Ana Marie Balingit-Wines, Chief
Nurse, NDMS Electronic Medical
Records Project Officer, ASPR/OPEO/
NDMS, 330 Independence Avenue, SW.,
Room G–644, Washington, DC 20201.
ADDRESSES:
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CAPT Balingit-Wines can be contacted
by telephone at 202–205–8088, or e-mail
at anamarie.balingit-wines@hhs.gov for
issues related to the SOR.
NDMS
operates pursuant to Section 2812 of the
Public Health Service Act (42 U.S.C.
300hh–11), and currently resides in
HHS under ASPR in accordance with
the Pandemic and All Hazards
Preparedness Act (PAHPA), Public Law
109–417. With the passage of PAHPA,
ASPR has been designated as the agency
responsible for medical response to
include the deployment of NDMS and
Field Medical Station assets as well as
the management of the officers of the
Public Health Service Commissioned
Corps deployed during a response.
ASPR medical components, in
particular NDMS, function in a
coordinated effort with DHS, DoD, and
the VA. In a disaster situation, NDMS
and other ASPR components will
augment the public health and health
care activities of State and local
governments.
The Privacy Act embodies fair
information principles in a statutory
framework governing the means by
which the United States Government
collects, maintains, uses, and
disseminates personally identifiable
information. The Privacy Act applies to
information that is maintained in a SOR,
which is a group of any records under
the control of an agency from which
information is retrieved by the name of
the individual or by some identifying
number, symbol, or other identifying
particular, such as property address,
mailing address, assigned to the
individual. As a component of
Emergency Support Function (ESF) #8,
NDMS has shared medical records with
the other agencies and departments that
comprise ESF #8, due to the Function’s
shared statutory authority over the
collection of medical information.
NDMS has three key functions to which
each of the ESF partners contribute and
require the collection of medical
information: medical response, patient
evacuation, and definitive medical care.
The medical response function of
NDMS is related to the activation and
deployment of NDMS response teams,
comprised of medical and logistical
personnel, to assess the health and
medical needs of disaster victims. In
response to the overall needs of the
patients, NDMS teams are activated to
provide physical and mental health, as
well as evacuation during a public
health emergency as cause for activation
as defined in 42 U.S.C. 300hh–
11(a)(3)(A).
SUPPLEMENTARY INFORMATION:
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The patient evacuation function of
NDMS relates to the establishment of
communications, transportation, and a
medical regulating system to evacuate
and move patients from a staging center
near a disaster site to patient reception
sites known as Federal Coordinating
Centers (FCCs). The DoD and VA have
the prime responsibility for activating
and managing the FCCs. In turn, upon
receiving the patients, the FCCs have
the authority to arrange for necessary
referrals and admissions or NDMS
evacuated patients.
CMS is responsible for establishing
and administering the reimbursement
process for health care rendered to
patients provided under the umbrella of
NDMS in accordance with Section 2812
of the Public Health Service Act, 42
U.S.C. 300hh–11, for ‘‘definitive care.’’
The SOR for the collection of
information for the purpose of
reimbursement has been filed separately
and was published on November 23,
2005, under 70 FR 70849. NDMS health
care providers, in the course of
providing health care, collect data that
identifies the patient’s name, address,
contact information, gender, insurance
information, prior medical history, and
all treatment information to include, but
not limited to, symptoms, vital signs,
diagnosis, and medications prescribed
through the health care continuum.
NDMS veterinary providers, in the
course of providing care to animals, may
collect contact information from the
animal’s owner. The medical records
could also include x-rays, lab results,
and providers’ comments relative to
their observations about the patient.
NDMS has a need for the collection of
information for health care, patient
movement, and tracking, as well as for
reimbursement of health care rendered.
The collection of the data as a result
of illness or injury from a disaster or
other event mandating the deployment
of NDMS medical personnel is
accomplished through a combination of
paper and electronic records. The
patient data collected will also be used
for tracking the patient through the
continuum. The collection of
information during an event such as a
patient evacuation will assist NDMS in
quickly tracking and sending the patient
and the medical information from the
casualty collection site to the designated
FCC. The system will also allow NDMS
to track how many patients are sent to
each FCC along with their discharge and
location status. The information will
include but not be limited to name,
address, phone numbers, ethnic
background, and other contact and/or
identifying information as well as
medical information including
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laboratory tests performed, diagnosis,
treatment provided, medications
prescribed, referrals, and any treatment
advice provided by the medical
professional to the patient. Pursuant to
5 U.S.C. 552a(b)(1), information
collected would be disclosed to other
Department of Health and Human
Services (HHS) agencies such as the
Centers for Disease Control and
Prevention (CDC), the Centers for
Medicare and Medicaid Services (CMS),
and the Agency for Health Care
Research and Quality (AHRQ), for the
purpose of research, evaluation or
epidemiologic and longitudinal
surveillance studies related to health
care, which may impact the care
provided to disaster victims.
Information in this system will be
disclosed as ‘‘routine uses’’ to the
following entities:
1. Emergency Support Function #8
(ESF #8) is a coordinated effort between
the Department of Health and Human
Service (HHS), the Department of
Homeland Security (DHS), the
Department of Defense (DoD), and the
Department of Veterans Affairs (VA). As
such, the medical treatment and
evacuation of patients is a shared
responsibility between these agencies
and disclosure of health related
information is necessary to adequately
manage the overall care of the patient.
2. Disclosure to a member of Congress
on behalf of a constituent’s inquiry.
3. Disclosure to the Department of
Justice (DOJ), court or adjudicatory body
when the agency is involved in
litigation or has an interest in litigation.
4. Disclosure to agency contractors,
consultants, or grantees engaged in the
performance of service related to this
collection and who may need to have
access to the records in order to perform
the activity.
5. To assist another Federal or State
agency, agency of a state government, an
agency established by State law, or its
fiscal agent to assess the location or the
status of their beneficiary.
6. Disclosure to family members of a
patient about the location or the status
of the patient.
The Privacy Act requires each agency
to publish in the Federal Register a
description denoting the type and
character of each system of records that
the agency maintains, and the routine
uses that are contained in each system
in order to make agency recordkeeping
practices transparent, to notify
individuals regarding the uses to which
personally identifiable information is
annotated, and to assist individuals to
easily find such files within the agency.
NDMS, as a component of the OPEO,
which resides within ASPR, intends to
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35053
create a separate and distinct system of
records. Below is the description of the
NDMS Patient Treatment and Tracking
Records System.
Dated: June 14, 2007.
Kevin Yeskey,
Deputy Assistant Secretary, Office of
Preparedness and Emergency Operations.
SYSTEM NO. 09–90–0040
SYSTEM NAME:
‘‘National Disaster Medical System
(NDMS) Patient Treatment and
Tracking,’’ HHS/ASPR/OPEO.
SECURITY CLASSIFICATION:
Unclassified.
SYSTEM LOCATION:
For a specified period and in
accordance with the archiving rules, the
paper records will be resident at NDMS
headquarters, located at 409 3rd Street
SW., Suite 330, Washington, DC 20024.
The electronic copy of the record will be
resident at the data center at the Unisys
Corporation, 11720 Plaza America
Drive, Reston, VA 20190.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:
The individuals covered by the
system are all persons and owners of
animals treated by NDMS medical
personnel when the NDMS Disaster
Medical Assistance Teams (DMATs) and
Veterinary Medical Assistance Teams
(VMATs) are activated to respond to
emergency situations, or as a response
to any other situation for which they are
activated.
CATEGORIES OF RECORDS IN THE SYSTEM:
All records pertaining to treatment
and movement of patients to include the
following (both in hard copy and
electronic format):
Category A: Completed Patient
Treatment Record form that includes:
1. NDMS Team Identification.
2. Chart Number.
3. Time and Date Patient seeks
treatment.
4. Triage Category and health status.
5. Location where Patient is seen and
transferred.
6. Patient Identification—Name,
Address, City, State, Zip, Date of Birth,
Phone Number, Employment, Weight,
Next of Kin.
7. Complaints/Symptoms.
8. Vital Signs/Treatment
Recommended and/or Prescribed.
9. Discharge—Time, Date,
Disposition, Recommendations.
10. Patient Authorization—Requires
Patient Signature in Front of Witness
and Witness Verification through
Signature.
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11. Any potential attachments such as
X-rays and laboratory reports showing
test results.
Category B: Veterinarian Treatment
Records on animals:
1. Privacy Act Data such as the name,
address and telephone contact
information of owners of animals will
be maintained to be associated with the
animal patient. However, animal
treatment records themselves are not
subject to the Privacy Act protections.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
NDMS Statute, 42 U.S.C. 300hh–11;
Title VI of the Civil Rights Act of 1964;
and Section 504 of the Rehabilitation
Act of 1973. Records disposition of this
medical SOR is determined under laws
governing federal records through the
National Archives, 44 U.S.C. 3303a.
PURPOSE(S):
Medical and demographic
information is collected on all patients
seen and/or treated by NDMS or ASPR
personnel. This SOR will also provide
the location, time, and date the patient
was transported during an evacuation.
The information collected will include
but not be limited to the patient’s (1)
Medical treatment history, (2) their preexisting conditions, (3) their described
symptoms, (4) any medical opinion
rendered by an attending medical
professional(s), (5) medications that
were prescribed, or (6) any other
medical advice provided. The collection
of data contained in medical records
provides a mechanism by which teams
can have the ability to conduct medical
quality assurance and establish a quality
improvement process (QIP). Through
QIP, teams can analyze and judge their
performance on a specific deployment
and if necessary enable them to better
plan for future deployments. These
patient records are also important
sources of information to be used for
research projects related to the
prevention of disease or disability as a
result of a disaster. Most importantly,
these patient records document medical
treatment rendered, especially if
questions of liability arise about the
treatment or the subsequent condition of
the patient while he/she is under the
care of NDMS.
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ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTENM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:
In addition to those disclosures
generally permitted under 5 U.S.C.
552a(b) of the Privacy Act, all or a
portion of the records or information
contained in this system may be
disclosed outside HHS as a routine use
pursuant to 5 U.S.C. 552a(b)(3) as
follows:
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1. ESF #8 is a coordinated effort
between HHS, DHS, DoD, and the VA.
As such, the medical treatment and
movement of patients is a shared
responsibility between the ESF #8
partnership agencies. The medical and
demographic information collected
during the treatment of a patient is
shared with the partners to ensure that
patients treated through NDMS receive
the maximum level of health care
possible.
2. Disclosure to a member of Congress
or a Congressional staff member in
response to an inquiry from the
Congressional office made at the behest
of the constituent about whom the
record is maintained.
3. Disclosure to the Department of
Justice (DOJ), court, or adjudicatory
body when the following situations
arise:
a. The agency or any component
thereof, or
b. Any employee of the agency
whether in his/her official or individual
capacity, where DOJ has agreed to
represent the employee, or
c. The United States government is a
party to litigation or has an interest in
such litigation and after careful review,
the agency deems that the records
requested are relevant and necessary to
the litigation and that the use of such
records by DOJ, court, or adjudicatory
body is compliant with the purpose for
which the agency collected the records.
4. Disclosure to agency contractors,
consultants, or grantees who have been
engaged by the agency to assist in the
performance of a service related to this
collection and who need to have access
to the records in order to perform the
activity.
5. To assist another Federal and/or
State agency, agency of a state
government, an agency established by
State law, or its fiscal agent:
a. To establish the benefit entitlement
of the patient.
b. To establish the relationship
between the existing state benefit and
the benefit funded in whole or part with
Federal funds, such as the one
associated with the NDMS definitive
care.
c. To collaborate with the state and
state agencies on behalf of family
members regarding the current location
and placement of their evacuated family
member or patient population.
6. Disclosure to family members of a
patient about the location or the status
of the patient.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
Category A: Patient Care Forms or
other Medical Records:
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Records in this system will be
retained in accordance with the records
disposition authority approved by the
National Archives and Records
Administration (NARA) for the Office of
Public Health and Emergency
Preparedness (OPHEP) in compliance
with N1–468–07–1. The Pandemic and
All Hazards Preparedness Act (Pub. L.
109–417), established the ASPR to serve
in a similar capacity as OPHEP for
medical disaster response. The records
disposition authority used for these
records will N1–468–07–1.
Disposition authority:
Patient Care Forms or other Medical
Records regulated under the Health
Insurance Portability and
Accountability Act (HIPAA), created by
the Federal Medical Station(s) or by any
component of HHS/ASPR during a
response to an event while caring for
victims of that event. Disposition: Cutoff
is at the end of the response activity by
the Federal Medical Station(s) for a
particular event. Retire to the
Washington National Records Center 2
years after cutoff. Destroy 75 years after
cutoff. This disposition instruction is
media neutral; it applies regardless of
media or format of the records.
Category B—The information
collected on animals and their owners
will not be destroyed until NARA
approves a disposition schedule for
those records.
STORAGE:
Paper records from this system are
stored in the NDMS headquarters at 409
3rd Street, SW., Suite 330, Washington,
DC 20024. The electronic database or
server where information is entered and
stored is maintained at the HHS data
center located at Unisys Corporation,
11720 Plaza America Drive, Reston, VA
20190. During deployments, NDMS
stores the records securely in their
deployed location, the electronic data is
stored in a secured server, and all
procedures required for protection of
Privacy Act documents are
implemented as identified in
‘‘Safeguards’’ section below.
RETRIEVABILITY:
NDMS Patient Treatment and
Tracking Records in electronic and
paper copy are organized by event,
location, and date of treatment. Data
from the records are stored in an
electronic database enabling data from
the records to be retrievable by name
and other demographic information
provided by the patient (or for
veterinary records, by pet owner), as
well as by location of treatment,
diagnosis, and other data fields within
the database.
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Federal Register / Vol. 72, No. 122 / Tuesday, June 26, 2007 / Notices
SAFEGUARDS:
CONTESTING RECORD PROCEDURES:
NDMS has safeguards in place for
authorized users and monitors such
users to ensure against unauthorized
use. Personnel having access to the
system have been trained in the Privacy
Act and information security
requirements for both paper copies and
electronically stored information.
Information in this system is
safeguarded in accordance with
applicable laws, rules and policies,
including the HHS Information
Technology Security Program
Handbook, all pertinent National
Institutes of Standards and Technology
publications and OMB Circular A–130,
Management of Federal resources. All
records are protected from unauthorized
access through appropriate
administrative, physical, and technical
safeguards. These safeguards include
restricting access to authorized
personnel who have a need-to-know,
using physical locks in the office
environment, and the process of
authentication using user IDs and
passwords function as protection
identification features. HHS file areas
are locked after normal duty hours and
the facilities are protected from the
outside by security personnel.
Same as the Notification Procedure
above. The letter should state clearly
and concisely what information you are
contesting, the reasons for contesting it,
and the proposed amendment to the
information that you seek pursuant to
HHS Privacy Act regulations, 45 CFR
5b.7.
SYSTEM MANAGER AND ADDRESS:
The NDMS Chief Medical Officer
located at 409 3rd Street, SW.,
Washington, DC 20024. Mailing address:
330 Independence Avenue, SW., Room
G–644, Washington, DC 20201.
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NOTIFICATION PROCEDURES:
Requests for Privacy Act protected
information generally are governed by
HHS regulations found at 45 CFR, Part
5b. They must be made in writing and
clearly marked as a ‘‘Privacy Act
Request’’ on the envelope and letter.
Inquiries regarding this SOR should be
addressed to the System Manager.
Inquiries related to patient medical
records should include the full name of
the individual, the appropriate personal
identification, and the current address,
and should be sent to the Chief Medical
Officer, NDMS, 330 Independence
Avenue, SW., Room G–644,
Washington, DC 20201. The name of the
requester, the nature of the record
sought, and the verification of identify
must be clearly indicated, as required by
HHS regulations at 45 CFR 5b.5.
Requests may also be sent to: HHS
Privacy Act Officer 200 Independence
Avenue, SW., Washington, DC 20201.
RECORD ACCESS PROCEDURES:
Same as Notification Procedure above.
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RECORD SOURCE CATEGORIES:
Sources for providing data for NDMS
Patient Treatment Records will only be
provided by patients, medical personnel
treating the patients or by accessing
their personal health records (PHR). In
the case of minors or other individuals
unable to explain symptoms,
information may be sought from a
parent or guardian. For animals,
information will be gathered by NDMS
veterinary personnel and/or owners or
caretakers of animals.
EXEMPTIONS CLAIMED FOR THE SYSTEM:
None.
[FR Doc. 07–3097 Filed 6–25–07; 8:45 am]
BILLING CODE 4150–37–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Government-Owned Inventions;
Availability for Licensing
National Institutes of Health,
Public Health Service, HHS.
AGENCY:
ACTION:
Notice.
SUMMARY: The inventions listed below
are owned by an agency of the U.S.
Government and are available for
licensing in the U.S. in accordance with
35 U.S.C. 207 to achieve expeditious
commercialization of results of
federally-funded research and
development. Foreign patent
applications are filed on selected
inventions to extend market coverage
for companies and may also be available
for licensing.
Licensing information and
copies of the U.S. patent applications
listed below may be obtained by writing
to the indicated licensing contact at the
Office of Technology Transfer, National
Institutes of Health, 6011 Executive
Boulevard, Suite 325, Rockville,
Maryland 20852–3804; telephone: 301–
496–7057; fax: 301–402–0220. A signed
Confidential Disclosure Agreement will
be required to receive copies of the
patent applications.
ADDRESSES:
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35055
Method for the Direct Detection and
Quantitation of Asparagine Synthetase
in Biological Samples
Description of Technology: Acute
lymphoblastic leukemia (ALL) is a fastgrowing cancer that targets immature
cells of the blood and bone marrow.
Clinical treatments of ALL use enzymebased methods, such as L-asparaginase
(ASNase), for depletion of cellular
asparagine in combination with
standard chemotherapeutic agents.
Although ASNase can be used to treat
both childhood and adult forms of ALL,
its use is limited because patients can
often develop resistance to ASNase
therapy. Studies have shown a
correlation between ASNase resistance
and increased expression levels of
asparaginase synthetase (ASNS)
enzyme, which catalyzes the
biosynthesis of cellular L-asparagine
from L-aspartate in an ATP-dependent
reaction. At present, measurement of
ASNS expression levels are based on
mRNA or antibody based assays;
however, these methods are not suitable
for direct quantitation of protein in
biological samples. Thus, new and
improved methods that directly measure
ASNS protein levels are needed.
Researchers at the NCI have
developed novel methods for
quantitating ASNS protein in biological
samples using isotope-labeled standard
peptides and mass spectrometry. The
current technology describes methods of
identifying a patient with cancer or
chemoresistant cancer, monitoring the
treatment regimen of a patient with
cancer, as well as methods for detecting
modulators and their ability to affect
ASNS expression levels. Further
described are novel pharmaceutical
compositions with potential use as
chemotherapeutic agents.
Applications: Diagnostic assay for
leukemia or chemoresistant cancer; Use
in screening or identifying potential
chemotherapeutic agents; Use in
measuring a patient’s sensitivity to
ASNase therapy.
Market: Approximately 5,200 people
are diagnosed with ALL each year in the
United States; ALL is the most common
type of cancer in children in developed
countries.
Development Status: Early stage.
Inventors: Thomas P. Conrads (NCI/
SAIC) et al.
Patent Status: International
Application No. PCT/US06/28965 filed
25 Jul 2006 (HHS Reference No. E–189–
2006/0–PCT–01).
Licensing Status: Available for
exclusive and non-exclusive licensing.
Licensing Contact: Robert M. Joynes,
J.D., M.S.; 301–594–6565;
joynesr@mail.nih.gov.
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]]>Agencies
[Federal Register Volume 72, Number 122 (Tuesday, June 26, 2007)]
[Notices]
[Pages 35052-35055]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 07-3097]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Assistant Secretary for Preparedness & Response,
Office of Preparedness & Emergency Operations; Privacy Act of 1974;
Report of a New System of Records
AGENCY: Department of Health and Human Services (HHS), Office of the
Assistant Secretary for Preparedness and Response (ASPR), Office of
Preparedness and Emergency (OPEO).
ACTION: Notice of a new System of Records (SOR).
-----------------------------------------------------------------------
SUMMARY: In accordance with the requirements of the Privacy Act of
1974, we are proposing to establish a new system titled, ``The National
Disaster Medical System (NDMS) Patient Treatment and Tracking Records
System,'' System Number 09-90-0040. The primary purpose of the NDMS
Patient Treatment and Tracking Records System is to collect data from
individuals using the medical care capabilities provided by NDMS.
EFFECTIVE DATES: NDMS filed a new SOR report with the Chair of the
House Committee on Oversight and Government Reform; the Chair of the
Senate Committee on Homeland Security and Governmental Affairs; and the
Administrator, Office of Information and Regulatory Affairs, Office of
Management and Budget (OMB) on June 18, 2007. The proposed SOR will be
effective 30 days from the publication of the notice or 40 days from
the date mailed to ensure that all parties have adequate time in which
to comment. However, a request has been submitted to the OMB to grant
HHS a 10 day waiver of the review period due to the impending start of
the hurricane season. We may defer implementation of this system and
retrieve the request for waiver should we receive comments that are
contrary and requires the document to be altered.
ADDRESSES: You may submit comments, identified by one of the following
methods: The Federal e-Rulemaking Portal at https://www.regulations.gov
and following the instructions for submitting comments, or send to the
NDMS Chief Medical Officer, National Disaster Medical System, 330
Independence Avenue, SW., Room G-644, Washington, DC 20201.
FOR FURTHER INFORMATION CONTACT: CAPT Ana Marie Balingit-Wines, Chief
Nurse, NDMS Electronic Medical Records Project Officer, ASPR/OPEO/NDMS,
330 Independence Avenue, SW., Room G-644, Washington, DC 20201. CAPT
Balingit-Wines can be contacted by telephone at 202-205-8088, or e-mail
at anamarie.balingit-wines@hhs.gov for issues related to the SOR.
SUPPLEMENTARY INFORMATION: NDMS operates pursuant to Section 2812 of
the Public Health Service Act (42 U.S.C. 300hh-11), and currently
resides in HHS under ASPR in accordance with the Pandemic and All
Hazards Preparedness Act (PAHPA), Public Law 109-417. With the passage
of PAHPA, ASPR has been designated as the agency responsible for
medical response to include the deployment of NDMS and Field Medical
Station assets as well as the management of the officers of the Public
Health Service Commissioned Corps deployed during a response. ASPR
medical components, in particular NDMS, function in a coordinated
effort with DHS, DoD, and the VA. In a disaster situation, NDMS and
other ASPR components will augment the public health and health care
activities of State and local governments.
The Privacy Act embodies fair information principles in a statutory
framework governing the means by which the United States Government
collects, maintains, uses, and disseminates personally identifiable
information. The Privacy Act applies to information that is maintained
in a SOR, which is a group of any records under the control of an
agency from which information is retrieved by the name of the
individual or by some identifying number, symbol, or other identifying
particular, such as property address, mailing address, assigned to the
individual. As a component of Emergency Support Function (ESF)
8, NDMS has shared medical records with the other agencies and
departments that comprise ESF 8, due to the Function's shared
statutory authority over the collection of medical information. NDMS
has three key functions to which each of the ESF partners contribute
and require the collection of medical information: medical response,
patient evacuation, and definitive medical care.
The medical response function of NDMS is related to the activation
and deployment of NDMS response teams, comprised of medical and
logistical personnel, to assess the health and medical needs of
disaster victims. In response to the overall needs of the patients,
NDMS teams are activated to provide physical and mental health, as well
as evacuation during a public health emergency as cause for activation
as defined in 42 U.S.C. 300hh-11(a)(3)(A).
[[Page 35053]]
The patient evacuation function of NDMS relates to the
establishment of communications, transportation, and a medical
regulating system to evacuate and move patients from a staging center
near a disaster site to patient reception sites known as Federal
Coordinating Centers (FCCs). The DoD and VA have the prime
responsibility for activating and managing the FCCs. In turn, upon
receiving the patients, the FCCs have the authority to arrange for
necessary referrals and admissions or NDMS evacuated patients.
CMS is responsible for establishing and administering the
reimbursement process for health care rendered to patients provided
under the umbrella of NDMS in accordance with Section 2812 of the
Public Health Service Act, 42 U.S.C. 300hh-11, for ``definitive care.''
The SOR for the collection of information for the purpose of
reimbursement has been filed separately and was published on November
23, 2005, under 70 FR 70849. NDMS health care providers, in the course
of providing health care, collect data that identifies the patient's
name, address, contact information, gender, insurance information,
prior medical history, and all treatment information to include, but
not limited to, symptoms, vital signs, diagnosis, and medications
prescribed through the health care continuum. NDMS veterinary
providers, in the course of providing care to animals, may collect
contact information from the animal's owner. The medical records could
also include x-rays, lab results, and providers' comments relative to
their observations about the patient. NDMS has a need for the
collection of information for health care, patient movement, and
tracking, as well as for reimbursement of health care rendered.
The collection of the data as a result of illness or injury from a
disaster or other event mandating the deployment of NDMS medical
personnel is accomplished through a combination of paper and electronic
records. The patient data collected will also be used for tracking the
patient through the continuum. The collection of information during an
event such as a patient evacuation will assist NDMS in quickly tracking
and sending the patient and the medical information from the casualty
collection site to the designated FCC. The system will also allow NDMS
to track how many patients are sent to each FCC along with their
discharge and location status. The information will include but not be
limited to name, address, phone numbers, ethnic background, and other
contact and/or identifying information as well as medical information
including laboratory tests performed, diagnosis, treatment provided,
medications prescribed, referrals, and any treatment advice provided by
the medical professional to the patient. Pursuant to 5 U.S.C.
552a(b)(1), information collected would be disclosed to other
Department of Health and Human Services (HHS) agencies such as the
Centers for Disease Control and Prevention (CDC), the Centers for
Medicare and Medicaid Services (CMS), and the Agency for Health Care
Research and Quality (AHRQ), for the purpose of research, evaluation or
epidemiologic and longitudinal surveillance studies related to health
care, which may impact the care provided to disaster victims.
Information in this system will be disclosed as ``routine uses'' to
the following entities:
1. Emergency Support Function 8 (ESF 8) is a
coordinated effort between the Department of Health and Human Service
(HHS), the Department of Homeland Security (DHS), the Department of
Defense (DoD), and the Department of Veterans Affairs (VA). As such,
the medical treatment and evacuation of patients is a shared
responsibility between these agencies and disclosure of health related
information is necessary to adequately manage the overall care of the
patient.
2. Disclosure to a member of Congress on behalf of a constituent's
inquiry.
3. Disclosure to the Department of Justice (DOJ), court or
adjudicatory body when the agency is involved in litigation or has an
interest in litigation.
4. Disclosure to agency contractors, consultants, or grantees
engaged in the performance of service related to this collection and
who may need to have access to the records in order to perform the
activity.
5. To assist another Federal or State agency, agency of a state
government, an agency established by State law, or its fiscal agent to
assess the location or the status of their beneficiary.
6. Disclosure to family members of a patient about the location or
the status of the patient.
The Privacy Act requires each agency to publish in the Federal
Register a description denoting the type and character of each system
of records that the agency maintains, and the routine uses that are
contained in each system in order to make agency recordkeeping
practices transparent, to notify individuals regarding the uses to
which personally identifiable information is annotated, and to assist
individuals to easily find such files within the agency. NDMS, as a
component of the OPEO, which resides within ASPR, intends to create a
separate and distinct system of records. Below is the description of
the NDMS Patient Treatment and Tracking Records System.
Dated: June 14, 2007.
Kevin Yeskey,
Deputy Assistant Secretary, Office of Preparedness and Emergency
Operations.
SYSTEM NO. 09-90-0040
SYSTEM NAME:
``National Disaster Medical System (NDMS) Patient Treatment and
Tracking,'' HHS/ASPR/OPEO.
SECURITY CLASSIFICATION:
Unclassified.
SYSTEM LOCATION:
For a specified period and in accordance with the archiving rules,
the paper records will be resident at NDMS headquarters, located at 409
3rd Street SW., Suite 330, Washington, DC 20024. The electronic copy of
the record will be resident at the data center at the Unisys
Corporation, 11720 Plaza America Drive, Reston, VA 20190.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
The individuals covered by the system are all persons and owners of
animals treated by NDMS medical personnel when the NDMS Disaster
Medical Assistance Teams (DMATs) and Veterinary Medical Assistance
Teams (VMATs) are activated to respond to emergency situations, or as a
response to any other situation for which they are activated.
CATEGORIES OF RECORDS IN THE SYSTEM:
All records pertaining to treatment and movement of patients to
include the following (both in hard copy and electronic format):
Category A: Completed Patient Treatment Record form that includes:
1. NDMS Team Identification.
2. Chart Number.
3. Time and Date Patient seeks treatment.
4. Triage Category and health status.
5. Location where Patient is seen and transferred.
6. Patient Identification--Name, Address, City, State, Zip, Date of
Birth, Phone Number, Employment, Weight, Next of Kin.
7. Complaints/Symptoms.
8. Vital Signs/Treatment Recommended and/or Prescribed.
9. Discharge--Time, Date, Disposition, Recommendations.
10. Patient Authorization--Requires Patient Signature in Front of
Witness and Witness Verification through Signature.
[[Page 35054]]
11. Any potential attachments such as X-rays and laboratory reports
showing test results.
Category B: Veterinarian Treatment Records on animals:
1. Privacy Act Data such as the name, address and telephone contact
information of owners of animals will be maintained to be associated
with the animal patient. However, animal treatment records themselves
are not subject to the Privacy Act protections.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
NDMS Statute, 42 U.S.C. 300hh-11; Title VI of the Civil Rights Act
of 1964; and Section 504 of the Rehabilitation Act of 1973. Records
disposition of this medical SOR is determined under laws governing
federal records through the National Archives, 44 U.S.C. 3303a.
PURPOSE(S):
Medical and demographic information is collected on all patients
seen and/or treated by NDMS or ASPR personnel. This SOR will also
provide the location, time, and date the patient was transported during
an evacuation. The information collected will include but not be
limited to the patient's (1) Medical treatment history, (2) their pre-
existing conditions, (3) their described symptoms, (4) any medical
opinion rendered by an attending medical professional(s), (5)
medications that were prescribed, or (6) any other medical advice
provided. The collection of data contained in medical records provides
a mechanism by which teams can have the ability to conduct medical
quality assurance and establish a quality improvement process (QIP).
Through QIP, teams can analyze and judge their performance on a
specific deployment and if necessary enable them to better plan for
future deployments. These patient records are also important sources of
information to be used for research projects related to the prevention
of disease or disability as a result of a disaster. Most importantly,
these patient records document medical treatment rendered, especially
if questions of liability arise about the treatment or the subsequent
condition of the patient while he/she is under the care of NDMS.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTENM, INCLUDING CATEGORIES
OF USERS AND THE PURPOSES OF SUCH USES:
In addition to those disclosures generally permitted under 5 U.S.C.
552a(b) of the Privacy Act, all or a portion of the records or
information contained in this system may be disclosed outside HHS as a
routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:
1. ESF 8 is a coordinated effort between HHS, DHS, DoD,
and the VA. As such, the medical treatment and movement of patients is
a shared responsibility between the ESF 8 partnership
agencies. The medical and demographic information collected during the
treatment of a patient is shared with the partners to ensure that
patients treated through NDMS receive the maximum level of health care
possible.
2. Disclosure to a member of Congress or a Congressional staff
member in response to an inquiry from the Congressional office made at
the behest of the constituent about whom the record is maintained.
3. Disclosure to the Department of Justice (DOJ), court, or
adjudicatory body when the following situations arise:
a. The agency or any component thereof, or
b. Any employee of the agency whether in his/her official or
individual capacity, where DOJ has agreed to represent the employee, or
c. The United States government is a party to litigation or has an
interest in such litigation and after careful review, the agency deems
that the records requested are relevant and necessary to the litigation
and that the use of such records by DOJ, court, or adjudicatory body is
compliant with the purpose for which the agency collected the records.
4. Disclosure to agency contractors, consultants, or grantees who
have been engaged by the agency to assist in the performance of a
service related to this collection and who need to have access to the
records in order to perform the activity.
5. To assist another Federal and/or State agency, agency of a state
government, an agency established by State law, or its fiscal agent:
a. To establish the benefit entitlement of the patient.
b. To establish the relationship between the existing state benefit
and the benefit funded in whole or part with Federal funds, such as the
one associated with the NDMS definitive care.
c. To collaborate with the state and state agencies on behalf of
family members regarding the current location and placement of their
evacuated family member or patient population.
6. Disclosure to family members of a patient about the location or
the status of the patient.
Policies and Practices for Storing, Retrieving, Accessing, Retaining,
and Disposing of Records in the System:
Category A: Patient Care Forms or other Medical Records:
Records in this system will be retained in accordance with the
records disposition authority approved by the National Archives and
Records Administration (NARA) for the Office of Public Health and
Emergency Preparedness (OPHEP) in compliance with N1-468-07-1. The
Pandemic and All Hazards Preparedness Act (Pub. L. 109-417),
established the ASPR to serve in a similar capacity as OPHEP for
medical disaster response. The records disposition authority used for
these records will N1-468-07-1.
Disposition authority:
Patient Care Forms or other Medical Records regulated under the
Health Insurance Portability and Accountability Act (HIPAA), created by
the Federal Medical Station(s) or by any component of HHS/ASPR during a
response to an event while caring for victims of that event.
Disposition: Cutoff is at the end of the response activity by the
Federal Medical Station(s) for a particular event. Retire to the
Washington National Records Center 2 years after cutoff. Destroy 75
years after cutoff. This disposition instruction is media neutral; it
applies regardless of media or format of the records.
Category B--The information collected on animals and their owners
will not be destroyed until NARA approves a disposition schedule for
those records.
Storage:
Paper records from this system are stored in the NDMS headquarters
at 409 3rd Street, SW., Suite 330, Washington, DC 20024. The electronic
database or server where information is entered and stored is
maintained at the HHS data center located at Unisys Corporation, 11720
Plaza America Drive, Reston, VA 20190. During deployments, NDMS stores
the records securely in their deployed location, the electronic data is
stored in a secured server, and all procedures required for protection
of Privacy Act documents are implemented as identified in
``Safeguards'' section below.
Retrievability:
NDMS Patient Treatment and Tracking Records in electronic and paper
copy are organized by event, location, and date of treatment. Data from
the records are stored in an electronic database enabling data from the
records to be retrievable by name and other demographic information
provided by the patient (or for veterinary records, by pet owner), as
well as by location of treatment, diagnosis, and other data fields
within the database.
[[Page 35055]]
Safeguards:
NDMS has safeguards in place for authorized users and monitors such
users to ensure against unauthorized use. Personnel having access to
the system have been trained in the Privacy Act and information
security requirements for both paper copies and electronically stored
information. Information in this system is safeguarded in accordance
with applicable laws, rules and policies, including the HHS Information
Technology Security Program Handbook, all pertinent National Institutes
of Standards and Technology publications and OMB Circular A-130,
Management of Federal resources. All records are protected from
unauthorized access through appropriate administrative, physical, and
technical safeguards. These safeguards include restricting access to
authorized personnel who have a need-to-know, using physical locks in
the office environment, and the process of authentication using user
IDs and passwords function as protection identification features. HHS
file areas are locked after normal duty hours and the facilities are
protected from the outside by security personnel.
SYSTEM MANAGER AND ADDRESS:
The NDMS Chief Medical Officer located at 409 3rd Street, SW.,
Washington, DC 20024. Mailing address: 330 Independence Avenue, SW.,
Room G-644, Washington, DC 20201.
NOTIFICATION PROCEDURES:
Requests for Privacy Act protected information generally are
governed by HHS regulations found at 45 CFR, Part 5b. They must be made
in writing and clearly marked as a ``Privacy Act Request'' on the
envelope and letter. Inquiries regarding this SOR should be addressed
to the System Manager. Inquiries related to patient medical records
should include the full name of the individual, the appropriate
personal identification, and the current address, and should be sent to
the Chief Medical Officer, NDMS, 330 Independence Avenue, SW., Room G-
644, Washington, DC 20201. The name of the requester, the nature of the
record sought, and the verification of identify must be clearly
indicated, as required by HHS regulations at 45 CFR 5b.5. Requests may
also be sent to: HHS Privacy Act Officer 200 Independence Avenue, SW.,
Washington, DC 20201.
RECORD ACCESS PROCEDURES:
Same as Notification Procedure above.
CONTESTING RECORD PROCEDURES:
Same as the Notification Procedure above. The letter should state
clearly and concisely what information you are contesting, the reasons
for contesting it, and the proposed amendment to the information that
you seek pursuant to HHS Privacy Act regulations, 45 CFR 5b.7.
RECORD SOURCE CATEGORIES:
Sources for providing data for NDMS Patient Treatment Records will
only be provided by patients, medical personnel treating the patients
or by accessing their personal health records (PHR). In the case of
minors or other individuals unable to explain symptoms, information may
be sought from a parent or guardian. For animals, information will be
gathered by NDMS veterinary personnel and/or owners or caretakers of
animals.
EXEMPTIONS CLAIMED FOR THE SYSTEM:
None.
[FR Doc. 07-3097 Filed 6-25-07; 8:45 am]
BILLING CODE 4150-37-M
