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System of Record Notice 09-15-0002
 

 

 

 

 

System number:  09-15-0002

System name:  Record of Patients’ Personal Valuables and Monies, HHS/HRSA/BPHC.

Security classification:  None.

System location:
National Hansen’s Disease Program
1770 Physician’s Park Drive
Baton Rouge, Louisiana 70816

Categories of individuals covered by the system:  Individuals admitted to the National Hansen’s Disease Program (NHDP).

Categories of records in the system:  Information regarding personal valuables such as watches or rings, and monies checked in by the patients for safe-keeping.

Authority for maintenance of the system:  Section 321 of the Public Health Service Act.

Purpose(s):  The purpose of the system is to provide for the safekeeping of patients’ valuables.  Records may also be used by the HHS Audit Agency for audit purposes.

Routine uses of records maintained in the system, including categories of users and the purposes of such uses:

  1. Disclosure may be made to a congressional office from the record of an individual in response to a verified inquiry from the congressional office made at the written request of that individual.

  2. The Department may disclose information from this system of records to the Department of Justice, or to a court or other tribunal, when

    1. HHS, or any component thereof; or

    2. Any HHS employee in his or her official capacity; or

    3. Any HHS employee in his or her individual capacity where the Department of Justice (or HHS, where it is authorized to do so) has agreed to represent the employee; or

    4. The United States or any agency thereof where HHS determines that the litigation is likely to affect HHS or any of its components, is a party to litigation or has an interest in such litigation, and HHS determines that the use of such records by the Department of Justice, the court or other tribunal is relevant and necessary to the litigation and would help in the effective representation of the governmental party, provided, however, that in each case, HHS determines that such disclosure is compatible with the purpose for which the records were collected.

  3. To appropriate Federal agencies and Department contractors that have a need to know the information for the purpose of assisting the Department’s efforts to respond to a suspected or confirmed breach of the security or confidentiality of information maintained in this system of records, and the information disclosed is relevant and necessary for that assistance.

Policies and practices for storing, retrieving, accessing, retaining, and disposing of records in the system:

  • Storage:  Valuables and monies (contents verified by the patient and a witness) are placed in an envelope by the patient.  Name, hospital number, and list of contents are written on the envelope and on flap.  It is sealed and receipt flap is given to the patient.  The envelope is then placed in locked cabinet or safe.  Actions are documented in the patient’s medical record.

  • Retrievability:  Presentation of receipt flap, name, and hospital number.  Return of valuables is documented in the medical record.

  • Safeguards:

    1. Authorized Users:  DNHDP personnel responsible for the security of valuables and monies.

    2. Physical Safeguards:  All documents are protected during lunch hours and nonworking hours in locked file cabinets or locked storage areas.

    3. Procedural Safeguards:  All users of personal information in connection with the performance of their jobs protect information from public view and from unauthorized personnel entering an unsupervised office.  Access to records is strictly limited to those staff members trained in accordance with the DHHS Chapter 45-13 and Chapter PHS.hf: 45-13 of the General Administration Manual.

Retention and disposal:  Documentation within the medical record is retained indefinitely until authority to destroy medical records is received.

How destroyed:  Incinerator or shredding.

System manager(s) and address:
Medical Records Coordinator
National Hansen’s Disease Program
1770 Physician’s Park Drive
Baton Rouge, Louisiana   70816

Notification procedure:  Write to the National Hansen’s Disease Program, Medical Records Coordinator, 1770 Physician’s Park Drive, Baton Rouge, Louisiana 70816.  Individual must provide positive identification such as driver’s license, passport, voter registration card, union card, or a written certification verifying his or her identity.  Requesters should also reasonably specify the record contents being sought.

Record access procedures:  Same as notification procedures.

Contesting record procedures:  Write to the official at the address specified in the notification procedures above, and reasonably identify the record, specify the information to be contested, and state the corrective action sought, with supporting justification.

Record source categories:  Patient and admission record.

Systems exempted from certain provisions of the act:  None.