4854479 Human Services, Department of - Notice of Proposed Rulemaking - To promulgate rules for implementing the Data-sharing Act of 2010, which allows District agencies and service providers to share health and human services information (HHSI) for ...
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DEPARTMENT OF HUMAN SERVICES
NOTICE OF PROPOSED RULEMAKING
The Director of the District of Columbia Department of Human Services (DHS), pursuant to authority set forth in Section 108 of the Data-Sharing and Information Coordination Amendment Act of 2010 (Act), effective December 4, 2010 (D.C. Law 18-273; D.C. Official Code § 7-248)(2012 Repl.)), and Mayor’s Order 2011-169, dated October 5, 2011, hereby gives notice of its intent to amend Title 29 (Public Welfare) of the District of Columbia Municipal Regulations (DCMR) by creating a new Chapter 30 entitled “Data-Sharing.”
The purpose of the rulemaking is to promulgate rules for implementing the Act. The Act allows District of Columbia (District) agencies and service providers to share health and human services information (HHSI) for specified purposes. These rules will mandate (1) the purposes for using or disclosing information; (2) the requirements for sharing HHSI between District agencies; (3) the requirements District agencies and service providers must follow when sharing HHSI with other service providers; and (4) the penalties for not complying with the Act.
The Director gives notice of the intent to take final rulemaking action to adopt the amendments in not less than thirty (30) days from the date of publication of this notice in the D.C. Register. In accordance with Section 108(b) of the Act, these rules will be submitted to the Council for the District of Columbia for a thirty (30)-day period of review.
Title 29 (Public Welfare) is amended by creating a new Chapter 30 (Data-Sharing) to read as follows:
CHAPTER 30: DATA-SHARING
3000 SCOPE AND APPLICABILITY
3000.1 These rules shall apply to the sharing of health and human services information (HHSI) between District of Columbia (District) agencies (Agency or Agencies) and the Agency’s service providers (Provider) in accordance with the Data-Sharing and Information Coordination Amendment Act of 2010, effective December 4, 2010, as amended (D.C. Law 18-273; D.C. Official Code §§ 7-241, et seq.)(Act).
3001 USE AND DISCLOSURE OF HEALTH AND HUMAN SERVICES INFORMATION
3001.1 An Agency or Provider shall disclose HHSI referencing or related to an identified individual client or customer (Individual) upon request from another Agency or Provider for the following purposes, unless disclosure is precluded by District or federal law:
(a) To establish the Individual’s eligibility for, or determine his or her amount of:
(1) Treatment;
(2) Services;
(3) Benefits;
(4) Support; or
(5) Assistance;
(b) To coordinate for the Individual, his or her:
(1) Treatment;
(2) Benefits;
(3) Services;
(4) Support; or
(5) Assistance;
(c) To conduct oversight activities, including:
(1) Management;
(2) Financial and other audits;
(3) Program evaluations;
(4) Planning;
(5) Investigations;
(6) Examinations;
(7) Inspections;
(8) Quality reviews;
(9) Licensure;
(10) Disciplinary actions; or
(11) Civil, administrative, or criminal proceedings or actions; and
(d) To conduct research related to treatments, benefits, services, support, or assistance provided that:
(1) Information referencing or relating to an Individual shall not be disclosed in a manner that would permit the Individual’s identity to be reasonably inferred by either direct or indirect means; and
(2) The Agency or Provider receiving HHSI shall affirm in writing that any individually identifiable health information shall be treated in accordance with the Health Insurance Portability and Accountability Act of 1996, approved August 21, 1996, as amended (110 Stat. 1936; 42 U.S.C. §§ 1320d, et seq.) (HIPAA) and its implementing regulations.
3001.2 Neither an Agency nor a Provider requesting or disclosing HHSI referencing or related to an Individual pursuant to § 3001.1 of this chapter has to obtain the person’s prior consent to using or disclosing HHSI unless required by § 3004 of this chapter.
3001.3 An Agency or Provider shall use or disclose HHSI in accordance with this chapter.
3001.4 Notwithstanding any other provision in this chapter, Agencies and Providers shall comply with any applicable Agency or Provider HIPAA policies and procedures, and Agencies shall comply with the District-wide HIPAA Policy.
3001.5 An Agency or Provider using or disclosing HHSI shall make reasonable efforts to limit the use or disclosure of HHSI to the minimum extent necessary to accomplish its intended purpose.
3001.6 An Agency or Provider that discloses HHSI shall designate a person within the Agency or Provider’s staff who shall, in coordination with any person that the Agency or Provider has designated as its HIPAA privacy officer and/or security officer, be responsible for:
(a) Responding to requests for HHSI from another Agency or Provider; and
(b) Ensuring that any HHSI disclosed pursuant to this chapter is limited to the minimum amount of HHSI necessary to accomplish the purpose of the disclosure.
3001.7 The individual designated by an Agency or Provider pursuant to § 3001.6 shall:
(a) Respond to a request within forty-eight (48) hours;
(b) Not unreasonably deny a request; and
(c) Within five (5) business days of the date of the request, supply the requested information to the extent such request was approved.
3001.8 If an Agency or Provider is unable to provide the requested HHSI within five (5) business days pursuant to § 3001.7(c), it shall notify the requesting Agency or Provider immediately and provide a reasonable timeline for fulfilling the request to the extent possible.
3002 DATA-SHARING AGREEMENT BETWEEN AGENCIES
3002.1 A District Agency seeking to use another District Agency’s HHSI or seeking to disclose HHSI to another District Agency shall, consistent with the District-wide HIPAA Policy, enter into a data-sharing agreement (Agreement). Any Agency or Provider seeking to enter into an Agreement must follow any applicable Agency or Provider HIPAA policies and procedures.
3002.2 At a minimum, the Agreement shall include the following information:
(a) The legal authority which authorizes the sharing of HHSI between the two Agencies including the Act’s legal citation;
(b) A listing of the specific HHSI each Agency is requesting from the other along with a statement of the Agency’s purpose for requesting each piece of HHSI on that list, which shall be limited to the minimum amount of HHSI necessary to accomplish the purpose of the disclosure;
(c) A provision stating that the requested HHSI shall be safeguarded and protected from improper access, use, or dissemination in accordance with the Act, and any other applicable District and Federal laws;
(d) A provision stating that any unlawful use or disclosure of HHSI shall be subject to penalties outlined in the Act, and any other applicable District and Federal laws;
(e) Procedures for notifying an Agency of an actual or suspected unauthorized access, use, or dissemination of the HHSI.
3003 A PROVIDER OR AGENCY DISCLOSING HEALTH AND HUMAN SERVICES INFORMATION TO SERVICE PROVIDERS
3003.1 A Provider or Agency seeking to request or disclose HHSI to a Provider shall do so in accordance with their applicable contract, grant, or similar agreement with the Provider which shall contain provisions governing the sharing of HHSI.
3003.2 A Provider seeking to obtain HHSI from an Agency or another Provider shall submit a written request to the Agency or Provider in possession of the HHSI describing in detail the HHSI sought and the purpose for the HHSI being requested.
3003.3 An Agency or Provider that receives a request for HHSI from another Provider shall maintain an accurate record, for a reasonable period of time:
(a) Of the date and purpose for any request for the HHSI;
(b) The date which the HHSI was disclosed; and
(c) A record of whom the HHSI was disclosed to.
3003.4 For purposes of this § 3003.3, the term “reasonable period of time” incorporates any applicable document retention requirements imposed by District or federal law.
3004 PRIOR WRITTEN CONSENT
3004.1 Unless Federal law states otherwise, an Agency or Provider disclosing HHSI in response to a request from another Agency or Provider pursuant to § 3000.1 shall obtain the Individual’s prior written consent to disclose the HHSI requested if it involves:
(a) Alcohol and drug abuse patient records governed by 42 C.F.R. Part 2;
(b) Psychotherapy notes governed by 45 C.F.R. § 164.508(a)(2); and
(c) Any other HHSI requiring prior consent for disclosure as required by Federal law.
3004.2 Unless District or Federal law states otherwise, an Agency or Provider disclosing HHSI in response to a request from another Agency or Provider pursuant to § 3000.1 shall obtain the Individual’s prior written consent to disclose the HHSI requested if it involves:
(a) Records governed by Section 1 of An Act To authorize the Commissioners of the District of Columbia to make regulations to prevent and control the spread of communicable and preventable diseases, approved August 11, 1939 (53 Stat. 1408; D.C. Official Code § 7-131);
(b) Records which are incident to a case of HIV infection or AIDS as required by Section 6 of the AIDS Health-Care Response Act of 1986, effective June 10, 1986 (D.C. Law 6-121; D.C. Official Code § 7-1605);
(c) Records incident to a reported case of cancer as required by Section 2 of the Preventive Health Services Amendments Act of 1985 (D.C. Law 6-83; D. C. Official Code § 7-302);
(d) Substance abuse records governed by Section 7 of the Choice in Drug Treatment Act of 2000, effective July 18, 2000 (D.C. Law 13-146; D.C. Official Code § 7-3006);
(e) Registration and other records of a detoxification center governed by Section 4(c) of An Act To establish a program for the rehabilitation of alcoholics, promote temperance, and provide for the medical and scientific treatment of persons found to be alcoholics by the courts of the District, and for other purpose, approved August 4, 1947 (61 Stat. 745; D.C. Official Code § 24-604(c)).
(f) Information provided to a Domestic Violence counselor governed by Section 3 of the Domestic Violence Amendment Act of 2006, effective March 2, 2007 (D.C. Law 16-204; D.C. Official Code § 14-310);
(g) Information provided to a Human Trafficking counselor governed by Section 203 of the Prohibition Against Human Trafficking Amendment Act of 2010, effective October 23, 2010 (D. C. Law 18-239; D.C. Official Code § 14-311); and
(h) Any other HHSI requiring prior written consent for disclosure as required by District law.
3004.3 The prior written consent required by § 3004.1 and § 3004.2 shall comply with all applicable laws and regulations, and with any applicable District-wide, Agency, or Provider HIPAA policies and procedures, and shall use plain language.
3005 CIVIL AND CRIMINAL PENALTIES FOR UNLAWFUL USE OR DISCLOSURE OF INFORMATION IN ACCORDANCE WITH THE ACT
3005.1 A person who negligently uses or discloses HHSI in a manner not authorized by the Act or other District law shall be liable in an amount of five hundred dollars ($500) for each violation.
3005.2 For purposes of this section, “negligently” means that a person guided by ordinary considerations should have known, and by exercising reasonable diligence would have known, that the use or disclosure was not authorized.
3005.3 A person who willfully uses or discloses HHSI in a manner not authorized by the Act or other District law shall be liable in an amount of one thousand dollars ($1,000) for each violation.
3005.4 A person who knowingly obtains, uses, or discloses HHSI in a manner not authorized by the Act or other District law shall be guilty of a misdemeanor, and upon conviction, shall be fined not more than two thousand five hundred dollars ($2,500), imprisoned not more than sixty (60) days, or both. If the offense is committed through deception or theft, the person shall be guilty of a misdemeanor and shall be fined not more than five thousand dollars ($5,000), imprisoned for not more than one hundred eighty (180) days, or both.
3005.5 If a civil or criminal penalty imposed by another law applies to an action that is also subject to a civil or criminal penalty under the Act, the greater penalty shall apply.
3099 DEFINITIONS
3099.1 The following terms shall have the meanings ascribed:
Act – Data-Sharing and Information Coordination Amendment Act of 2010, effective December 4, 2010 (D.C. Law 18-273; D.C. Official Code §§ 7-241, et seq.).
Agency – an agency, department, unit, or instrumentality of the District of Columbia government.
Department – District of Columbia Department of Human Services.
Disclosure – the release, transfer, provision of access to, or distribution of information in any manner by an entity holding the information to a person outside of the entity.
District-wide HIPAA Policy – the set of HIPAA policies and procedures issued by the District as a hybrid entity in accordance with 45 C.F.R. § 164.105(a)(2)(iii)(D). The District-wide HIPAA Policy applies to any District agency, and any subdivision of a District agency, that is subject to HIPAA as part of the District’s hybrid entity.
Health and human services information (HHSI) – any information that relates to:
(a) The past, present, or future physical or mental health of an Individual or family;
(b) The provision of health care or human services, including benefits or supports, to an Individual or family;
(c) The past, present, or future payment for the provision of health care or human services to an Individual.
HIPAA – the Health Insurance Portability and Accountability Act of 1996, approved August 21, 1996 (110 Stat. 1936; 42 U.S.C. §§ 1320d, et seq.), as amended; 45 C.F.R Parts 160, 162, and 164, as amended.
Identified individual – a natural person to whom health and human services information pertains.
Individually identifiable health information – shall have the same meaning as it does in HIPAA.
Person – a natural person, firm, company, association, corporation, service provider, or government instrumentality or agency authorized to receive HHSI in accordance with the Act.
Service provider (Provider) – an entity that provides health or human services to District residents pursuant to a contract, grant, or other similar agreement with an Agency.
Use – the sharing, employment, application, utilization, examination, or analysis of health and human services information.
All persons who desire to comment on these proposed rules should submit their comments in writing to David A. Berns, Director, DHS, 64 New York Avenue, N.E., Washington, D.C. 20002, Attn: Deborah A. Carroll, Administrator, Economic Security Administration (formerly known as the Income Maintenance Administration). All comments must be received by DHS not later than thirty (30) days after publication of this notice in the D.C. Register. Copies of these rules and related information may be obtained by writing to the above address, by calling the DHS Economic Security Administration at (202) 698-3900, or by sending an e-mail to deborah.carroll@dc.gov.