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SORN 09-90-0005

System name: Safety Management Information System (HHS Accident, Injury and Illness Reporting System), HHS/OS/ASMB/OFE/OSOH.

Security classification: None.

System location: At Departmental, Regional and Headquarters facilities (see Appendix. Categories of individuals covered by the system:

1. HHS employees, including both civilian and commissioned corps personnel, who are involved in an accident which arises out of and in the course of their employment whether occurring on HHS premises or not and results in:

a. A fatality.

b. Lost workdays beyond the day in which the accident occurred.

c. Nonfatal injuries which result in transfer to another job, termination of employment, medical treatment other than first aid,   loss of consciousness or restriction of work or motion.

d. A possible tort claim.

e. A claim for compensation.

f. Property damage in excess of 50.00 dollars..

g. Interrupts or interferes with the orderly progress of work of other employees.

h. Radiation over exposure.

i. Biological exposure resulting in lost time of accidental release of biologicals where the public may be over-exposed.

2. Visiting scientists, contractor personnel, hospitalized patients, out-patients, employees of other Federal agencies, state or    local governments or members of the public who suffer injury, illness or property damage on or in HHS premises or as a result of HHS activities.

Categories of records in the system:

This system consists of a variety of information and supporting documentations resulting from the reporting and investigation of accidents which have resulted in injury, illness, property damage or the interruption or interference with the orderly progress of work. The records contain information about individuals involved in or experiencing accidents including but not limited to the severity of the injury, whether consciousness was lost, the type of injury, culmination of any injury, days lost from work if any, the nature of the injury, illness or disease, the body part affected, causal factors, weather factors, agency of accident, whether unsafe mechanical, physical, or personal acts or factors were involved, the accidents area of origin and if fire was involved, the type and form of materials involved. Property damage (both public and private) is noted through the property sequence number, who owned the property involved, property damage and actual or estimated monetary loss, the   HHS installation number if appropriate and the year of manufacture or construction if appropriate. Identifiers relating to a particular accident include the organization, case number assigned, date and time of occurrence, state or territory, site, type and classification of accident, estimated amount of tort claims if appropriate, name of individual(s) involved, the social security number, sex, age, grade series and level, CSC series, address, other Departments notified of accident, duty status, activity at time of accident and time on duty before accident. Management's evaluation and corrective action taken or proposed is also noted.

Authority for maintenance of the system:

Section 19 of the Occupational Safety and Health Act of 1970 (Pub. L. 91-596); U.S.C. 7902; 29 CFR part 1960; Executive Order No. 12196.

Purpose(s):

The purpose of the system is to comply with the reporting and statistical analyses requirements of section 19 of the Occupational Safety and Health Act of 1970 (Pub L. 91-596) as amended (29 U.S.C. 668); U.S.C. 7902; 29 CFR part 1960; Executive Order 12196 and such other purposes as are described under routine uses of this system notice. The Safety Management Information System is a Department-wide system utilized by all organizational components of the Department.    Thus in addition to the routine uses subsequently noted in this system notice there may be other ad hoc disclosures within the Department on an official business ``need to know'' basis.

a. Establish a written record of the causes of accidents.

b. Provide information to initiate and support corrective or preventive action.

c. Provide statistical information relating to accidents resulting in occupational injuries, illnesses, and/or property damage.

d. Provide management with information with which to evaluate the effectiveness of safety management programs.

e. Provide the means for complying with the reporting requirements of Section 19 of the Occupational Safety and Health Act    of 1970 and such other reporting requirements as may be required by legislative or regulative requirements.

f. Provide such other summary descriptive statistics and analytical studies as necessary in support of the function for which   the records are collected and maintained including general requests for statistical information without personal identification of  individuals.

g. Information in these records is used by or may be disclosed to:

a. The Office of Safety and Occupational Health, Office of the Secretary, HHS in the review of accident experience data to determine the adequacy of corrective actions, the effect of codes, standards and guides, the consolidation, summarization and dissemination of accident experience data throughout HHS and other Government Departments and agencies as needed or required.

b. The supervisor, administrative officer or other official initiating and accident report, including each succeeding reviewing official in the chain of command through which the report passes to insure that corrective action, as needed and appropriate, is taken.

c. Appropriately appointed Safety Directors, Officers, or others with safety responsibilities within the Department in the verifying, assembling, analyzing, summarizing and disseminating data concerning the accident experience in their areas of responsibility and the initiation of appropriate corrective action. Routine uses of records maintained in the system, including    categories of users and the purposes of such uses:

A. To request from a Federal, state, local agency or private sources information relevant to the investigation of an accident and/ or corrective action.

B. To respond to an inquiry from a member of Congress made on behalf of a constituent.

C. In the event of litigation where the defendant is (a) the Department, any component of the Department, or any employee of the Department in his or her official capacity; (b) the United States where the Department determines that the claim if successful, is likely to directly affect the operations of the Department of any of its components; or (c) any Department employee in his or her individual capacity where the Justice Department has agreed to represent such employee, the Department may disclose such records as it deems desirable or necessary to the Department of Justice to enable that Department to present an effective defense, provided such disclosure is compatible with the purpose for which the records were collected. Disclosure may be made to a congressional office from the record of an individual in response to an inquiry from the congressional office made at the request of that individual.

D. In the event that a system of records maintained by this agency to carry out its functions indicates a violation or potential   violation of law, whether civil, criminal or regulatory in nature, and whether arising by general statute or particular program statute, or by regulation, rule or order issued pursuant thereto, the relevant records in the system of records may be referred, as a routine use, to the appropriate agency, whether federal, or foreign, charged with the responsibility of investigating or prosecuting such violation or charged with enforcing or implementing the statute, or rule, regulation or order issued pursuant thereto.

E. In the event that a system of records maintained by this agency to carry out its function indicates a violation or potential  violation of law, whether civil, criminal or regulatory in nature, and whether arising by general statute or particular program statute, or by regulation, rule or order issued pursuant thereto, the relevant records in the system of records may be referred, as a routine use to the appropriate agency, whether state or local charged with the responsibility of investigating or prosecuting such violation or charged with enforcing or implementing the statute, or rule, regulation or order issued pursuant thereto.

F. Records may be disclosed to student volunteers, individuals working under a personal services contract, and other individuals performing functions for the Department but technically not having the status of agency employees, if they need access to the records in order to perform their assigned agency functions.

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

Storage: Records are or may be maintained on magnetic tapes, punchcards, lists, forms, discs, computer storage, in file folders, binders and index cards.

Retrievability:

1. At the Department level, the system is completely computerized with no other records normally maintained or retained in the Office of Safety and Occupational Health. Since individual indentifiers such as name, case number, and social security number are not within the computer storage banks, special programming would be required to extract individual records based on case number. Normal output consists of statistical reports and surveys including those required by the Department of Labor and Statistical Analysis in support of the Department occupational safety and health program for dissemination  to the Principal Operating Components, Regions and Staff Offices.

2. The Principal Operating Components of the Department, their sub-components, Regional Offices and Staff Offices may maintain original or copies of the accident reports and supporting documentation by name, social security number, case number or cross reference.

Safeguards:  Access to and use of those records is made available to those personnel having a legitimate need for the information (those whose duties require review or access) including inspecting or evaluating personnel. Records, which under the law, may not be disclosed such as information pertinent to national security or trade secrets are maintained separately, adequately safeguarded and released only in accordance with the law. When there is doubt regarding the release of   information, the matter will be referred, in advance of release, to the Office of the General Counsel, HHS.

Retention and disposal: All accident reports, records, logs, and other information relating to an accident are retained by the Principal Operating Components and their agencies, the Regional Offices and the Office of the Secretary for at least five years following the end of the calendar year in which the accident occurred. Specific occupational safety and health standards (such as the standards, covering the handing of carcinogenic chemicals) may be required to be kept for up to twenty years. Records may be retained indefinitely.

System manager(s) and address: Director, Office of Safety and Occupational Health, Department of Health and Human Services, 330 Independence Avenue, SW, Washington, DC 20201.

Notification procedure: Individuals wishing to inquire whether this system of records contains information about them should address their inquiries to one of the following as appropriate:

1. If employed or formerly employed in a HHS Regional Office, the Regional Occupational Safety and Health Manager of the Region involved (see list and addresses under appendix).

2. If employed or formerly employed in a HHS Principal Operating Component or sub-agency, a staff office or the Office of the Secretary, the Occupational Safety and Health Manager of the component where employed with the exception of the Food and Drug Administration (see list and addresses under appendix).

The contact for the Food and Drug Administration is:  Privacy Act Coordinator, Food and Drug Administration, 5600   Fishers Lane, Rockville, Maryland 20857.

Individuals requesting information about this system of records should provide their full name, social security number, name and address of office and agency in which currently or formerly employed and the accident(s) case number if known.

Record access procedures: Individuals wishing to gain access to or contest their records should contact the following in person or writing as appropriate; with the exception of Food and Drug Administration. See "Notification" above.

1. If employed or formerly employed in an HHS Regional Office, the Regional Occupational and Health Manager of the Region involved (see list and addresses under appendix).

2. If employed or formerly employed in an HHS Principal Operating Component or sub-agency, a staff office or the Office of the Secretary, the Occupational Safety and Health Manager of the component where employed. (See list and addresses under appendix.) Individuals requesting information in this system of records should provide their full name, social security number (on a purely voluntary basis), case number if known, time and brief description of the accident in which they were involved and the name and address of office in which employed. (Access procedures are in accordance with Department Regulations (45 CFR 5b.5(a)(2)), Federal Register, October 8, 1975, page 47410.)

Contesting record procedures: Contact the official at the address specified under notification procedures above, and reasonably identify the record and specify the information to be contested and corrective action sought with supporting justification. (These procedures are in accordance with Department Regulations (45 CFR 5b.7), Federal Register, October 8,   1975, page 47411.)

Record source categories: The information in this system is obtained from the following sources: (1) The individual to whom the record pertains; (2) witnesses to the accident; (3) investigation officials (Federal, state, local); (4) medical personnel seeing the individual as a result of the accident; (5) supervisory personnel; (6) reviewing officials; (7) personnel offices; (8) investigative material furnished by Federal, state, or local agencies; (9) on site observations.

Systems exempted from certain provisions of the act: None.

Appendix

 Region I, HHS Regional Safety and Occupational Health Manager, John F. Kennedy Federal Building--Room 1503, Government Center, Boston, Massachusetts 02203.

Region II, HHS Regional Safety and Occupational Health Manager, Federal Building--Room 3835, 26 Federal Plaza, New York, New York 10007.

Region III, HHS Regional Safety and Occupational Health Manager, 3535 Market Street, Philadelphia, Pennsylvania 19101.

Region IV, HHS Regional Safety and Occupational Health Manager, Suite 1503--101 Marietta Tower, Atlanta, Georgia 30323.

Region V, HHS Regional Safety and Occupational Health Manager, 300 South Wacker Drive--35th Floor, Chicago, Illinois 60606.

Region VI, HHS Regional Safety and Occupational Health Manager, 1200 Main Tower Bldg., Dallas, Texas 75202.

Region VII, HHS Regional Safety and Occupational Health Manager, 601 East 12th Street--Room 566, Kansas City, Missouri 64106.

Region VIII, HHS Regional Safety and Occupational Health Manager, 1961 Stout Street--Room 11037, Denver, Colorado 80202.

Region IX, HHS Regional Safety and Occupational Health Manager, Federal Office Building--Room 8, 50 United Nations Plaza, San Francisco, California 94102.

Region X, HHS Regional Safety and Occupational Health Manager, Arcade Plaza--Room 6003, 1321 Second Avenue, Seattle, Washington 98101.

Health Care Financing Administration: Safety Officer, A-1 Gwynn Oak Building, 1710 Gwynn Oak Avenue, Woodlawn, Md. 21207.

Social Security Administration: Director, Occupational Health Management, Rm. 8, Second Floor, Link Bldg., 6401 Security Boulevard, Baltimore, Maryland 21235.

Office of the Secretary, HHS Safety Officer, 1073 HHS-N, Department of Health and Human Services, 330 Independence Avenue SW, Washington, DC 20201.

Public Health Service: Director, Division of Health Facilities Planning, Room 18-42--Parklawn Building, 5600 Fishers Lane,    Rockville, Maryland 20857.

Alcohol, Drug Abuse, and Mental Health Administration: Safety Officer, Room 12C26--Parklawn Building, 5600 Fishers Lane, Rockville, Maryland 20857.

Center for Disease Control: Chief, Office of Biosafety, Bldg. 4--Room 232, 1600 Clifton Road NE., Atlanta, Georgia 30333.

Food and Drug Administration: Privacy Act Coordinator, Rockville, Maryland 20857.

Health Resources Administration: Safety Officer, Rm. 129, Federal Center Bldg. 2, 3700 East-West Highway, Hyattsville, Md. 20782.

National Institutes of Health: Chief, Occupational Safety and Health Branch, DS, ORS, Building 13, Room 3K04, 9000 Rockville Pike, Bethesda Maryland 20205.