System Name: Health Resources Utilization Statistics, HHS/OASH/NCHS.
Security Classification: None.
System Location(s): National Center for Health Statistics, Centers for Disease Control, Presidential Building, Rm. 1140, 6525 Belcrest Road, Hyattsville, Maryland 20782.
Categories of Individuals Covered by the System: Recipients of medical care included in statistical surveys and reports of the National Center for Health Statistics (NCHS), including but not limited to: (1) Staff and residents of nursing homes selected by random sampling techniques to be representative of nursing homes in the U.S.; (2) physicians providing medical care and patients visiting such physicians; (3) patient medical records from selected short-stay hospitals.
Categories of Records in the System: Records containing information on: (1) The utilization of long-term care and nursing home care through data on clients and residents (demographic and social characteristics, health status and charges paid for care) and the facility (general characteristics, certification, services offered and expense); (2) the demographic characteristics, medical and other problems of persons visiting physicians, and the physicians' diagnosis, treatment, and disposition decisions made during such visits as obtained from physicians during randomly assigned one- week survey periods; (3) the demographic characteristics administrative information (admission and discharge dates, discharge status, and medical record number), and medical information (diagnosis and surgical procedures) abstracted from the face sheet of short-stay hospital medical records.
In many cases, these records do not contain individual identifiers when they come under control of the National Center for Health Statistics; they carry only sequence numbers, which only the originating agency would be able to translate into a personal identifier-- and even then, not in all cases. Names of residents and staff of nursing homes and patients of physicians are listed on separated forms for sampling purposes only and are not included in the final statistical records.
Authority for Maintenance of the System: Public Health Service Act, Section 306(b) (42 U.S.C. 242k).
Purpose(s): The data are used for statistical purposes only, as specified by statute, section 308(d) of 42 U.S.C. 242m. Uses within the Department include the preparation of aggregated data in the form of statistical tables for publication, analysis and interpretation to meet the legislative mandates of 42 U.S.C. 242k, i.e., collection of statistics on the utilization of health services, including the utilization of: (1) Long-term care services and nursing home facilities to determine levels of illness and disability, effects on the serviced population, and the costs of care; (2) ambulatory health services by specialties and types of practice of the health professionals providing such services; and (3) short-stay hospitals to determine characteristics of patients, length of stay, diagnosis and surgical operations, and utilization patterns of care in hospitals of different size and ownership.
Routine Uses of Records Maintained in the System, Including Categories of Users and the Purposes of such Uses: The data are disseminated in forms which do not permit the identification of individuals, such as publications of statistical tables, special requested tabulations, and public use computer tapes. These are communicated to interested persons outside DHHS, such as members of Congress and their staffs, other executive branch agencies, universities and medical schools, state and local health planning agencies, private foundations, etc. The findings are used by demographers, sociologists, health statisticians, epidemiologists, medical educators, health planners, other scholars, and concerned citizens, to evaluate health matters, make determinations on needs for legislation, appropriations, new service programs, and the like.
Records may be disclosed to student volunteers, individuals working under a personal services contract, and other individuals performing functions for PHS who do not technically have the status of agency employees, if they need the records in the performance of their agency functions.
Policies and Practices for Storing, Retrieving, Accessing, Retaining, and Disposing of Records in the System—
Storage: Paper files and magnetic tapes.
Retrievability: Data are retrieved by individual identifier only in the editing stage of data processing and only for the purpose of correcting errors in the recording of information. Original survey records are reviewed for accuracy and edited, then data (without personal identifiers such as name or Social Security Number) are transferred to magnetic tape.
Safeguards: Measures to prevent unauthorized disclosures are implemented as appropriate for the particular records maintained. NCHS and its contractors implement personnel, physical, and procedural safeguards as follows:
1. Authorized users: Persons authorized and needing to use the records, including project directors, contract officers, interviewers, analysts, statisticians, statistical clerks, and data entry personnel on the staffs of the Center and the contractors.
2. Physical safeguards: The manual portions of the records are stored in locked files or offices when not in use. (The automated portions of the records do not contain individually identifiable data. Because they are not subject to the Privacy Act, descriptions of the computer safeguards used are not included in this notice.) Access to the buildings in which the manual records are stored is controlled by special entry devices and 24-hour security guards.
3. Procedural safeguards: All employees of NCHS and contractor personnel with access to NCHS records are required, as a condition of employment, to sign an affidavit binding them to nondisclosure of individually identifiable information; periodic training sessions are conducted to reinforce the confidentiality restrictions.
Contractors who maintain records in the system are instructed to make no further disclosure of the records. Privacy Act requirements are specifically included in contracts for survey and research activities related to this system. The HHS project directors, contract officers, and project officers oversee compliance with these requirements.
These safeguards are in accordance with chapter 45-13, "Safeguarding Records Contained in Systems of Records," of the HHS General Administration Manual; supplementary chapter PHS.hf: 45-13; the National Bureau of Standards Federal Information Processing Standards (FIPS Pub. 41 and FIPS Pub. 312); and the NCHS Staff Manual on Confidentiality.
Retention and Disposal: The original records are retained in office files of NCHS or NCHS contractors for two years. The procedure for family planning records differs in that the original documents are retained in office files for only two months. In all instances, the original records are then sent to the Federal Records Center where they are stored for five years.
System Manager(s) and Address(es): Director, National Center for Health Statistics, Centers for Disease Control, Presidential Building, Rm. 1140, 6525 Belcrest Road, Hyattsville, Maryland 20782.
Notification Procedure: To determine if a record exists, write to the System Manager at the above address.
Record Access Procedures: Access to record systems which have been granted an exemption from the Privacy Act access requirement may be made at the discretion of the System Manager. Positive identification is required from anyone seeking access. Appeal of access refusal may be made to the Director, Office of Management, Public Health Service. An individual may also request an accounting of disclosures of his/her record, if any.
Contesting Record Procedures: If access has been granted, contact the System Manager and reasonably identify the record, specify the information being contested, and state the corrective action sought, with supporting information to show how the record is inaccurate, incomplete, untimely, or irrelevant.
Record Source Categories: Hospitals, physicians, clinics, nursing homes, and other providers of health care.
System Exempted from Certain Provisions of the Act: With respect to this system of records, exemption has been granted from the requirements contained in subsections 552(a)(3), (d)(1) through (4), and (e)(4)(G) and (H), in accordance with provisions of subsections 552a (k)(4) of the Privacy Act of 1974. The reason for this exemption is that this system contains only records required by statute to be maintained and used solely as statistical records. The exemption was published in the Federal Register, September 11, 1978, page 40229.