HomeMy WebLinkAboutCONSENT WA DOH Data Sharing 615 Sheridan Street
Port Townsend, WA 98368
c9e/ehson www.JeffersonCountyPublicHealth.org
Consent Agenda
Public HeePalitA
JEFFERSON COUNTY
BOARD OF COUNTY COMMISSIONERS
AGENDA REQUEST
TO: Board of County Commissioners
Mark McCauley, County Administrator
FROM: Apple Martine, Jefferson County Public Health Director
Ocean Mason, Jefferson County Public Health Communicable Disease Team
Lead
DATE: 4'( 7f) ' Q S
SUBJECT: Agenda item — Data Sharing Agreement Between Jefferson County Public Health
and Washington State Department of Health - upon signature until 12/31/2029
STATEMENT OF ISSUE:
Jefferson County Public Health (JCPH) seeks Board approval of a Data Sharing Agreement (DSA) with the
Washington State Department of Health (DOH). This agreement provides the framework for secure, lawful
access and use of sensitive data within the state's syringe services program (SSP) data system (REDCap).
The DSA ensures JCPH can input, store, and access potentially identifiable and confidential information
essential to its harm reduction and public health programming. The agreement spans from the date of
execution through December 31, 2029.
ANALYSIS/STRATEGIC GOALS/PROS and CONS:
This agreement strengthens JCPH's harm reduction efforts by enabling secure access to the state SSP data
system, supporting more coordinated, data-informed care. It enhances public health surveillance, improves
client services, and aligns with JCPH's strategic goals. While it requires diligent compliance with security
protocols, the benefits—expanded data capacity, confidentiality safeguards, and stronger public health
response—far outweigh the administrative burden.
FISCAL IMPACT/COST BENEFIT ANALYSIS:
There is no charge for this service. There is no fiscal impact.
RECOMMENDATION:
JCPH management requests approval of this Data Sharing Agreement from upon signature until 12/31/2029
or terminated by either party.
REVIEWED BY:
4
,v17iO4
Mark McCauley�unty Administrator Dat
Community Health Environmental Public Health
Developmental Disabilities 360-385-9444
360-385-9400 (f) 360-379-4487
360-385-9401 (f) Always working for a safer and healthier community
AD-25-018
CONTRACT REVIEW FORM clear Form
(INSTRUCTIONS ARE ON THE NEXT PAGE)
CONTRACT WITH: Washington State Department of Health Contract No: AD-25-018
Contract For: Data Share: Syringe Services Term: 1/1/2025-12/31/2029
COUNTY DEPARTMENT: Jefferson County Public Health
Contact Person: ocean mason
Contact Phone: 360-379-4480
Contact email: omason@co.jefferson.wa.us
AMOUNT: n/a PROCESS: Exempt from Bid Process
Revenue: _ Cooperative Purchase
Expenditure: Competitive Sealed Bid
Matching Funds Required: Small Works Roster
Sources(s) of Matching Funds _Vendor List Bid
Fund # _RFP or RFQ
Munis Org/Obj Other:
APPROVAL STEPS:
STEP 1: DEPARTMENT CERTIFIES C ANC. CC 3 55.080 AND CHAPTER 42.23 RCW.
CERTIFIED: t N/A:t' ' April 15, 2025
Signature Date
STEP 2: DEPARTMENT CERTIFIES THE PERSON PROPOSED FOR CONTRACTING WITH THE
COUNTY (CONTRACTOR) HAS NOT BEEN DEBARRED BY ANY FEDERAL, STATE, OR LOCAL
AGENCY.
CERTIFIED: E N/A: III April 15, 2025
Signature Date
STEP 3: RISK MANAGEMENT REVIEW(will be added electronically through Laserfiche):
Electronically approved by Risk Management on 4/16/2025.
STEP 4: PROSECUTING ATTORNEY REVIEW(will be added electronically through Laserfiche):
Electronically approved as to form by PAO on 4/16/2025.
State data share agreement.
STEP 5: DEPARTMENT MAKES REVISIONS & RESUBMITS TO RISK MANAGEMENT AND
PROSECUTING ATTORNEY(IF REQUIRED).
STEP 6: CONTRACTOR SIGNS
STEP 7: SUBMIT TO BOCC FOR APPROVAL
1
DOH Contract CLH31290
DATA SHARING AGREEMENT
FOR
CONFIDENTIAL INFORMATION OR LIMITED DATASET(S)
BETWEEN
STATE OF WASHINGTON
DEPARTMENT OF HEALTH
AND
Jefferson County Public Health
This Agreement documents the conditions under which Washington DOH shares confidential
information or limited Dataset(s) with other entities.
CONTACT INFORMATION FOR ENTITIES RECEIVING AND PROVIDING INFORMATION
INFORMATION RECIPIENT INFORMATION PROVIDER
Organization Name Washington State Department Jefferson County Public Health
of Health (DOH)
Business Contact Name Rachel Amiya Ocean Mason
Title Assessment Unit Manager Public Health Nurse
Address 101 Israel Rd SE 615 Sheridan Street, Port
Townsend, WA 98368
Telephone# 360-379-4480
Email Address Rachel.amiya@doh.wa.gov omason@co.jefferson.wa.us
IT Security Contact John Weeks Mikey Forville
Title Chief Information Security Network Foreman
Officer
Address PO Box 47890 1820 Jefferson Street, Port
Olympia, WA 98504-7890 Townsend, WA 98368
Telephone# 360-999-3454 360-385-9209
Email Address Security@doh.wa.gov mforville@co.jefferson.wa.us
Privacy Contact Name Michael Paul Veronica Shaw
Title DOH Chief Privacy Officer Deputy Director
Address P. 0. Box 47890 615 Sheridan Street, Port
Olympia, WA 98504-7890 Townsend, WA 98368
Telephone# (564) 669-9692 360-385-9409
Email Address Privacy.officer@doh.wa.gov veronica@co.jefferson.wa.us
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DEFINITIONS
Authorized user means a recipient's employees, agents, assigns, representatives, independent
contractors, or other persons or entities authorized by the data recipient to access, use or
disclose information through this agreement.
Authorized user agreement means the confidentiality agreement a recipient requires each of its
Authorized Users to sign prior to gaining access to Public Health Information.
Breach of confidentiality means unauthorized access, use or disclosure of information received
under this agreement. Disclosure may be oral or written, in any form or medium.
Breach of security means an action (either intentional or unintentional) that bypasses security
controls or violates security policies, practices, or procedures.
Confidential information means information that is protected from public disclosure by law.
There are many state and federal laws that make different kinds of information confidential. In
Washington State, the two most common are the Public Records Act RCW 42.56, and the
Healthcare Information Act, RCW 70.02.
Data storage means electronic media with information recorded on it, such as CDs/DVDs,
computers and similar devices.
Data transmission means the process of transferring information across a network from a sender
(or source),to one or more destinations.
Direct identifier Direct identifiers in research data or records include names; postal address
information ( other than town or city, state and zip code); telephone numbers, fax numbers, e-
mail addresses; social security numbers; medical record numbers; health plan beneficiary
numbers; account numbers; certificate/license numbers; vehicle identifiers and serial numbers,
including license plate numbers; device identifiers and serial numbers; web universal resource
locators ( URLs); internet protocol (IP) address numbers; biometric identifiers, including finger
and voice prints; and full face photographic images and any comparable images.
Disclosure means to permit access to or release, transfer, or other communication of
confidential information by any means including oral, written, or electronic means, to any party
except the party identified or the party that provided or created the record.
Encryption means the use of algorithms to encode data making it impossible to read without a
specific piece of information, which is commonly referred to as a "key". Depending on the type
of information shared, encryption may be required during data transmissions, and/or data
storage.
Human subjects research; human subject means a living individual about whom an investigator
(whether professional or student) conducting research obtains (1) data through intervention or
interaction with the individual, or(2) identifiable private information.
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Identifiable data or records contains information that reveals or can likely associate the identity
of the person or persons to whom the data or records pertain. Research data or records with
direct identifiers removed, but which retain indirect identifiers, are still considered identifiable.
Limited dataset means a data file that includes potentially identifiable information. A limited
dataset does not contain direct identifiers.
Potentially identifiable information means information that includes indirect identifiers which
may permit linking an individual to that person's health care information. Examples of potentially
identifiable information include:
• birth dates;
• admission, treatment or diagnosis dates;
• healthcare facility codes;
• other data elements that may identify an individual. These vary depending on factors
such as the geographical location and the rarity of a person's health condition, age,or
other characteristic.
Restricted confidential information means confidential information where especially strict
handling requirements are dictated by statutes, rules, regulations or contractual agreements.
Violations may result in enhanced legal sanctions.
State holidays State legal holidays, as provided in RCW 1.16.050.
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DOH Contract CLH31290
GENERAL TERMS AND CONDITIONS
I. USE OF INFORMATION
The Information Recipient agrees to strictly limit use of information obtained or created
under this Agreement to the purposes stated in Exhibit I (and all other Exhibits
subsequently attached to this Agreement). For example, unless the Agreement specifies
to the contrary the Information Recipient agrees not to:
• Link information received under this Agreement with any other information.
• Use information received under this Agreement to identify or contact
individuals.
The Information Recipient shall construe this clause to provide the maximum protection
of the information that the law allows.
II. SAFEGUARDING INFORMATION
A. CONFIDENTIALITY
Information Recipient agrees to:
• Follow DOH small numbers guidelines as well as dataset specific small
numbers requirements. (Appendix D)
• Limit access and use of the information:
■ To the minimum amount of information .
■ To the fewest people.
■ For the least amount of time required to do the work.
• Ensure that all people with access to the information understand their
responsibilities regarding it.
• Ensure that every person (e.g., employee or agent) with access to the
information signs and dates the "Use and Disclosure of Confidential
Information Form" (Appendix A) before accessing the information.
■ Retain a copy of the signed and dated form as long as required in Data
Disposition Section.
The Information Recipient acknowledges the obligations in this section survive
completion, cancellation, expiration or termination of this Agreement.
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B. SECURITY
The Information Recipient assures that its security practices and safeguards meet
Washington State Office of the Chief Information Officer (OCIO) security standard
141.10 Securing Information Technology Assets.
For the purposes of this Agreement,compliance with the HIPAA Security Standard and
all subsequent updates meets OCIO standard 141.10 "Securing Information
Technology Assets."
The Information Recipient agrees to adhere to the Data Security Requirements in
Appendix B. The Information Recipient further assures that it has taken steps
necessary to prevent unauthorized access, use, or modification of the information in
any form.
Note: The DOH Chief Information Security Officer must approve any changes to this
section prior to Agreement execution. IT Security Officer will send approval/denial
directly to DOH Contracts Office and DOH Business Contact.
C. BREACH NOTIFICATION
The Information Recipient shall notify the DOH Chief Information Security Officer
(security@doh.wa.gov)within one (1) business days of any suspected or actual breach of
security or confidentiality of information covered by the Agreement.
III. RE-DISCLOSURE OF INFORMATION
Information Recipient agrees to not disclose in any manner all or part of the information
identified in this Agreement except as the law requires, this Agreement permits, or with
specific prior written permission by the information provider.
If the Information Recipient must comply with state or federal public record disclosure
laws, and receives a records request where all or part of the information subject to this
Agreement is responsive to the request: the Information Recipient will notify the
information provider of the request ten (10) business days prior to disclosing to the
requestor. The notice must:
• Be in writing;
• Include a copy of the request or some other writing that shows the:
■ Date the Information Recipient received the request; and
■ The records that the Information Recipient believes are
responsive to the request and the identity of the requestor, if
known.
IV. ATTRIBUTION REGARDING INFORMATION
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Information Recipient agrees to cite the information provider or other citation as
specified, as the source of the information subject of this Agreement in all text,tables and
references in reports, presentations and scientific papers.
Information Recipient agrees to cite its organizational name as the source of
interpretations, calculations or manipulations of the information subject of this
Agreement.
V. OTHER PROVISIONS
With the exception of agreements with British Columbia for sharing health information,
all data must be stored within the United States.
VI. AGREEMENT ALTERATIONS AND AMENDMENTS
This Agreement may be amended by mutual agreement of the parties. Such amendments
shall not be binding unless they are in writing and signed by personnel authorized to bind
each of the parties
VII. CAUSE FOR IMMEDIATE TERMINATION
The Information Recipient acknowledges that unauthorized use or disclosure of the
data/information or any other violation of sections II or III, and appendices A or B, may
result in the immediate termination of this Agreement.
VIII. CONFLICT OF INTEREST
The Information Provider may, by written notice to the Information Recipient:
Terminate the right of the Information Recipient to proceed under this Agreement if it is
found, after due notice and examination by the Contracting Office that gratuities in the
form of entertainment, gifts or otherwise were offered or given by the Information
Recipient, or an agency or representative of the Information Recipient, to any officer or
employee of the Information Provider, with a view towards securing this Agreement or
securing favorable treatment with respect to the awarding or amending or the making of
any determination with respect to this Agreement.
IX. DISPUTES
Except as otherwise provided in this Agreement, when a genuine dispute arises between
the Information Provider and the Information Recipient and it cannot be resolved, either
party may submit a request for a dispute resolution to the Contracts and Procurement
Unit. The parties agree that this resolution process shall precede any action in a judicial
and quasi-judicial tribunal. A party's request for a dispute resolution must:
• Be in writing and state the disputed issues, and
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• State the relative positions of the parties, and
• State the information recipient's name, address, and his/her department
agreement number, and
• Be mailed to the DOH contracts and procurement unit, P. 0. Box 47905,
Olympia, WA 98504-7905 within thirty (30) calendar days after the party
could reasonably be expected to have knowledge of the issue which
he/she now disputes.
This dispute resolution process constitutes the sole administrative remedy available
under this Agreement.
X. GOVERNANCE
This Agreement is entered into pursuant to and under the authority granted by the laws
of the state of Washington and any applicable federal laws. The provisions of this
Agreement shall be construed to conform to those laws.
In the event of an inconsistency in the terms of this Agreement, or between its terms and
any applicable statute or rule,the inconsistency shall be resolved by giving precedence in
the following order:
• Applicable Washington state and federal statutes and rules;
• Any other provisions of the Agreement, including materials incorporated by
reference.
XI. HOLD HARMLESS
Each party to this Agreement shall be solely responsible for the acts and omissions of its
own officers,employees,and agents in the performance of this Agreement. Neither party
to this Agreement will be responsible for the acts and omissions of entities or individuals
not party to this Agreement. Information Provider and the Information Recipient shall
cooperate in the defense of tort lawsuits, when possible.
XII. LIMITATION OF AUTHORITY
Only the Authorized Signatory for DOH shall have the express, implied, or apparent
authority to alter, amend, modify, or waive any clause or condition of this Agreement on
behalf of the DOH. No alteration, modification, or waiver of any clause or condition of
this Agreement is effective or binding unless made in writing and signed by the Authorized
Signatory for DOH.
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XIII. SEVERABILITY
If any term or condition of this Agreement is held invalid, such invalidity shall not affect
the validity of the other terms or conditions of this Agreement, provided, however, that
the remaining terms and conditions can still fairly be given effect.
XIV. SURVIVORSHIP
The terms and conditions contained in this Agreement which bytheir sense and context,
g
are intended to survive the completion, cancellation, termination, or expiration of the
Agreement shall survive.
XV. TERMINATION
Either party may terminate this Agreement upon 30 days prior written notification to the
other party. If this Agreement is so terminated, the parties shall be liable only for
rendered or costs incurred in accordance with the terms of this Agreement
performanceg
prior to the effective date of termination.
XVI. WAIVER OF DEFAULT
This Agreement, or any term or condition, may be modified only by a written amendment
signed by the Information Provider and the Information Recipient. Either party may
propose an amendment.
Failure or delay on the part of either party to exercise any right, power, privilege or remedy
provided under this Agreement shall not constitute a waiver. No provision of this Agreement
may be waived by either party except in writing signed by the Information Provider or the
Information Recipient.
XVII. ALL WRITINGS CONTAINED HEREIN
This Agreement and attached Exhibit(s)contains all the terms and conditions agreed upon
by the parties. No other understandings, oral or otherwise, regarding the subject matter
of this Agreement and attached Exhibit(s) shall be deemed to exist or to bind any of the
parties hereto.
XVIII. PERIOD OF PERFORMANCE
This Agreement shall be effective from 1/1/2025 through 12/31/2029.
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IN WITNESS WHEREOF, the parties have executed this Agreement as of the date of last
signature below.
INFORMATION PROVIDER INFORMATION RECIPIENT
Jefferson County Public Health State of Washington Department of Health
Board of County Commissioners
Jefferson County, Washington
Signature Signature
Heidi Eisenhour, Chair
Print Name Print Name
Date Date
Approved as to form only:
hilip C. Hunsucker
Chief Civil Deputy Prosecuting Attorney
04/16/2025
Date
•
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EXHIBIT I
1. PURPOSE AND JUSTIFICATION FOR SHARING THE DATA
Provide a detailed description of the purpose and justification for sharing the data, including
specifics on how the data will be used.
The purpose of this agreement is to provide protections and a framework for appropriate for
data stored by syringe services programs (SSP's) within DOH's SSP data system. Syringe Services
are programs operated by a variety of organizations (to date local governments, not for profit
entities) which provide harm reduction supplies, including syringes, to the communities they
inhabit.The DOH's SSP data system is designed as a tool to assist state-funded SSP's in collecting
and storing data. It is accessed via browser and is intended to be used by SSP staff to enter and
develop reports describing program data.The DOH requires minimal aggregate data to be stored
in the SSP data system as a requirement for funding, but allows SSP's to store a variety of data in
order to meet their program needs. This can include personally identifiable information which
could cause significant harm if it were released. This agreement encompasses data that the SSP's
store in the data system beyond the minimum funding reporting requirements (CLH31013). The
data reported to DOH in the system to meet the minimum funding reporting requirements can
be used without restriction.
The DOH may use the data in the system to
-To monitor and evaluate program outcomes to inform decisions on resource planning
and allocation.
-Characterize trends in drug use and harm reduction service utilization in Washington
state
-To identify novel public health concerns related to syringe service programs
Is the purpose of this agreement for human subjects research that requires Washington State
Institutional Review Board (WSIRB) approval?
n Yes X1 No
If yes, has a WSIRB review and approval been received? If yes, please provide copy of
approval. If No, attach exception letter.
Yes EX No
2. PERIOD OF PERFORMANCE
This Exhibit shall have the same period of performance as the Agreement unless otherwise
noted below:
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Exhibit _ shall be effective from 1/1/2025 through 12/31/2029.
3. DESCRIPTION OF DATA
Information Provider will make available the following information under this Agreement:
Database Name(s): REDCap SSP Database
Data Elements being provided:
See Appendix E
The information described in this section is:
® Restricted Confidential Information (Category 4)
❑ Confidential Information (Category 3)
❑ Potentially identifiable information (Category 3)
❑ Internal [public information requiring authorized access] (Category 2)
n Public Information (Category 1)
Any reference to data/information in this Agreement shall be the data/information as
described in this Exhibit.
4. STATUTORY AUTHORITY TO SHARE INFORMATION
DOH statutory authority to obtain and disclose the confidential information or limited
Dataset(s) identified in this Exhibit to the Information Recipient:
RCW 43.70.050(2)—Collection, use,and accessibility of health-related data
RCW 43.70.070(2)-Duties of department—Analysis of health services.
RCW 43.70.130(2)and (10)- Powers and duties of secretary—General.
5. ACCESS TO INFORMATION
METHOD OF ACCESS/TRANSFER
❑ DOH Web Application (indicate application name):
❑ Washington State Secure File Transfer Service (sft.wa.gov)
❑ Encrypted CD/DVD or other storage device
Health Information Exchange(HIE)**
® Other: Redcap SSP Data System
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**NOTE: DOH Chief Information Security Officer must approve prior to Agreement
execution. DOH Chief Information Security Officer will send approval/denial directly to
DOH Contracts Office and DOH Business Contact.
FREQUENCY OF ACCESS/TRANSFER
n One time: DOH shall deliver information by (insert date)
❑ Repetitive: frequency or dates (insert dates if applicable)
• As available within the period of performance stated in Section 2.
6. REIMBURSEMENT TO DOH
Payment for services to create and provide the information is based on the actual expenses
DOH incurs, including charges for research assistance when applicable.
Billing Procedure
• Information Recipient agrees to pay DOH by check or account transfer within
30 calendar days of receiving the DOH invoice.
• Upon expiration of the Agreement, any payment not already made shall be
submitted within 30 days after the expiration date or the end of the fiscal year,
which is earlier.
Charges for the services to create and provide the information are:
❑ $
M No charge.
7. DATA DISPOSITION
Unless otherwise directed in writing by the DOH Business Contact, at the end of this
Agreement, or at the discretion and direction of DOH, the Information Recipient shall:
Immediately destroy all copies of any data provided under this Agreement
after it has been used for the purposes specified in the Agreement .
Acceptable methods of destruction are described in Appendix B. Upon
completion, the Information Recipient shall submit the attached
Certification of Data Disposition(Appendix C)to the DOH Business Contact.
Immediately return all copies of any data provided under this Agreement
to the DOH Business Contact after the data has been used for the purposes
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specified in the Agreement, along with the attached Certification of Data
Disposition (Appendix C)
n Retain the data for the purposes stated herein for a period of time not to
exceed (e.g., one year, etc.), after which Information
Recipient shall destroy the data (as described below) and submit the
attached Certification of Data Disposition (Appendix C) to the DOH
Business Contact.
M Other(Describe): Information Recipient will retain the data for 2 years,
after which Information Recipient will destroy all identifiers (names,
dates of birth, unique identifiers, addresses, phone numbers, other
contact information) and will retain the data in de-identified form.
8. RIGHTS IN INFORMATION
Information Recipient agrees to provide, if requested, copies of any research papers or
reports prepared as a result of access to DOH information under this Agreement for DOH
review prior to publishing or distributing.
In no event shall the Information Provider be liable for any damages, including, without
limitation, damages resulting from lost information or lost profits or revenue, the costs of
recovering such Information, the costs of substitute information, claims by third parties or
for other similar costs,or any special, incidental, or consequential damages, arising out of the
use of the information. The accuracy or reliability of the Information is not guaranteed or
warranted in any way and the information Provider's disclaim liability of any kind whatsoever,
including, without limitation, liability for quality, performance, merchantability and fitness
for a particular purpose arising out of the use, or inability to use the information.
n If checked, please submit the following:
• Copies of (insert list of items)
to the attention of: _(insert name of DOH employee)
at_(insert address to which material is sent)
9. ALL WRITINGS CONTAINED HEREIN
This Agreement and attached Exhibit(s)contains all the terms and conditions agreed upon by
the parties. No other understandings, oral or otherwise, regarding the subject matter of this
Agreement and attached Exhibit(s) shall be deemed to exist or to bind any of the parties
hereto.
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IN WITNESS WHEREOF, the parties have executed this Exhibit as of the date of last signature
below.
INFORMATION PROVIDER INFORMATION RECIPIENT
Jefferson County Public Health State of Washington Department of Health
Board of County Commissioners
Jefferson County, Washington
Signature Signature
Heidi Eisenhour, Chair
Print Name Print Name
Date Date
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APPENDIX A
USE AND DISCLOSURE OF CONFIDENTIAL INFORMATION
People with access to confidential information are responsible for understanding and following
the laws, policies, procedures, and practices governing it. Below are key elements:
A. CONFIDENTIAL INFORMATION
Confidential information is information federal and state law protects from public
disclosure. Examples of confidential information are social security numbers, and
healthcare information that is identifiable to a specific person under RCW 70.02. The
general public disclosure law identifying exemptions is RCW 42.56.
B. ACCESS AND USE OF CONFIDENTIAL INFORMATION
1. Access to confidential information must be limited to people whose work
specifically requires that access to the information.
2. Use of confidential information is limited to purposes specified elsewhere in this
Agreement.
C. DISCLOSURE OF CONFIDENTIAL INFORMATION
1. An Information Recipient may disclose an individual's confidential information
received or created under this Agreement to that individual or that individual's
personal representative consistent with law.
2. An Information Recipient may disclose an individual's confidential information,
received or created under this Agreement only as permitted under the Re-
Disclosure of Information section of the Agreement, and as state and federal laws
allow.
D. CONSEQUENCES OF UNAUTHORIZED USE OR DISCLOSURE
An Information Recipient's unauthorized use or disclosure of confidential information is
the basis for the Information Provider immediately terminating the Agreement. The
Information Recipient may also be subject to administrative, civil and criminal penalties
identified in law.
E. ADDITIONAL DATA USE RESTRICTIONS: (if necessary)
Signature:
Date:
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APPENDIX B
DATA SECURITY REQUIREMENTS
Protection of Data
The storage of Category 3 and 4 information outside of the State Governmental Network requires
organizations to ensure that encryption is selected and applied using industry standard
algorithms validated by the NIST Cryptographic Algorithm Validation Program. Encryption must
be applied in such a way that it renders data unusable to anyone but authorized personnel, and
the confidential process, encryption key or other means to decipher the information is protected
from unauthorized access. All manipulations or transmissions of data within the organizations
network must be done securely.
The Information Recipient agrees to store information received under this Agreement(the data)
within the United States on one or more of the following media, and to protect it as described
below:
A. Passwords
1. Passwords must always be encrypted. When stored outside of the authentication
mechanism, passwords must be in a secured environment that is separate from the data
and protected in the same manner as the data. For example passwords stored on mobile
devices or portable storage devices must be protected as described under section F. Data
storage on mobile devices or portable storage media.
2. Complex Passwords are:
• At least 8 characters in length.
• Contain at least three of the following character classes: uppercase letters,
lowercase letters, numerals, special characters.
• Do not contain the user's name, user ID or any form of their full name.
• Do not consist of a single complete dictionary word but can include a passphrase.
• Do not consist of personal information (e.g., birthdates, pets' names, addresses,
etc.).
• Are unique and not reused across multiple systems and accounts.
• Changed at least every 120 days.
B. Hard Disk Drives/Solid State Drives— Data stored on workstation drives:
1. The data must be encrypted as described under section F. Data storage on mobile devices
or portable storage media. Encryption is not required when Potentially Identifiable
Information is stored temporarily on local workstation Hard Disk Drives/Solid State Drives.
Temporary storage is thirty (30) days or less.
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2. Access to the data is restricted to authorized users by requiring logon to the local
workstation using a unique user ID and Complex Password, or other authentication
mechanisms which provide equal or greater security, such as biometrics or smart cards.
Accounts must lock after 5 unsuccessful access attempts and remain locked for at least
15 minutes, or require administrator reset.
C. Network server and storage area networks (SAN)
1. Access to the data is restricted to authorized users through the use of access control
lists which will grant access only after the authorized user has authenticated to the
network.
2. Authentication must occur using a unique user ID and Complex Password, or other
authentication mechanisms which provide equal or greater security, such as
biometrics or smart cards. Accounts must lock after 5 unsuccessful access attempts,
and remain locked for at least 15 minutes, or require administrator reset.
3. The data are located in a secured computer area, which is accessible only by
authorized personnel with access controlled through use of a key, card key, or
comparable mechanism.
4. If the servers or storage area networks are not located in a secured computer area or
if the data is classified as Confidential or Restricted it must be encrypted as described
under F. Data storage on mobile devices or portable storage media.
D. Optical discs(CDs or DVDs)
1. Optical discs containing the data must be encrypted as described under F. Data
storage on mobile devices or portable storage media.
2. When not in use for the purpose of this Agreement, such discs must be locked in a
drawer, cabinet or other physically secured container to which only authorized users
have the key, combination or mechanism required to access the contents of the
container.
E. Access over the Internet or the State Governmental Network(SGN).
1. When the data is transmitted between DOH and the Information Recipient, access is
controlled by the DOH, who will issue authentication credentials.
2. Information Recipient will notify DOH immediately whenever:
a) An authorized person in possession of such credentials is terminated or
otherwise leaves the employ of the Information Recipient;
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b) Whenever a person's duties change such that the person no longer requires
access to perform work for this Contract.
3. The data must not be transferred or accessed over the Internet by the Information
Recipient in any other manner unless specifically authorized within the terms of the
Agreement.
a) If so authorized the data must be encrypted during transmissions using a key
length of at least 128 bits. Industry standard mechanisms and algorithms,such
as those validated by the National Institute of Standards and Technology
(NIST) are required.
b) Authentication must occur using a unique user ID and Complex Password (of
at least 10 characters). When the data is classified as Confidential or
Restricted, authentication requires secure encryption protocols and multi-
factor authentication mechanisms, such as hardware or software tokens,
smart cards, digital certificates or biometrics.
c) Accounts must lock after 5 unsuccessful access attempts, and remain locked
for at least 15 minutes, or require administrator reset.
F. Data storage on mobile devices or portable storage media
1. Examples of mobile devices are: smart phones, tablets, laptops, notebook or netbook
computers, and personal media players.
2. Examples of portable storage media are:flash memory devices(e.g. USB flash drives),and
portable hard disks.
3. The data must not be stored by the Information Recipient on mobile devices or portable
storage media unless specifically authorized within the terms of this Agreement. If so
authorized:
a) The devices/media must be encrypted with a key length of at least 128 bits, using
industry standard mechanisms validated by the National Institute of Standards and
Technologies (NIST).
• Encryption keys must be stored in a secured environment that is separate from
the data and protected in the same manner as the data.
b) Access to the devices/media is controlled with a user ID and a Complex Password (of
at least 6 characters), or a stronger authentication method such as biometrics.
c) The devices/media must be set to automatically wipe or be rendered unusable after
no more than 10 failed access attempts.
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d) The devices/media must be locked whenever they are left unattended and set to lock
automatically after an inactivity activity period of 3 minutes or less.
e) The data must not be stored in the Cloud. This includes backups.
f) The devices/ media must be physically protected by:
• Storing them in a secured and locked environment when not in use;
• Using check-in/check-out procedures when they are shared; and
• Taking frequent inventories.
4. When passwords and/or encryption keys are stored on mobile devices or portable storage
media they must be encrypted and protected as described in this section.
G. Backup Media
The data may be backed up as part of Information Recipient's normal backup process
provided that the process includes secure storage and transport, and the data is encrypted
as described under F. Data storage on mobile devices or portable storage media.
H. Paper documents
Paper records that contain data classified as Confidential or Restricted must be protected by
storing the records in a secure area which is only accessible to authorized personnel. When
not in use, such records is stored in a locked container, such as a file cabinet, locking drawer,
or safe, to which only authorized persons have access.
I. Data Segregation
1. The data must be segregated or otherwise distinguishable from all other data. This is to
ensure that when no longer needed by the Information Recipient, all of the data can be
identified for return or destruction. It also aids in determining whether the data has or
may have been compromised in the event of a security breach.
2. When it is not feasible or practical to segregate the data from other data, then all
commingled data is protected as described in this Exhibit.
J. Data Disposition
If data destruction is required by the Agreement, the data must be destroyed using one or
more of the following methods:
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Data stored on: Is destroyed by:
Hard Disk Drives/Solid State Using a "wipe" utility which will overwrite the data at
Drives least three (3) times using either random or single
character data, or
Degaussing sufficiently to ensure that the data cannot
be reconstructed, or
Physically destroying the disk, or
Delete the data and physically and logically secure data
storage systems that continue to be used for the
storage of Confidential or Restricted information to
prevent any future access to stored information. One
or more of the preceding methods is performed before
transfer or surplus of the systems or media containing
the data.
Paper documents with On-site shredding, pulping, or incineration, or
Confidential or Restricted Recycling through a contracted firm provided the
information Contract with the recycler is certified for the secure
destruction of confidential information.
Optical discs (e.g. CDs or DVDs) Incineration, shredding, or completely defacing the
readable surface with a course abrasive.
Magnetic tape Degaussing, incinerating or crosscut shredding.
Removable media (e.g. floppies, Using a "wipe" utility which will overwrite the data at
USB flash drives, portable hard least three (3) times using either random or single
disks, Zip or similar disks) character data.
Physically destroying the disk.
Degaussing magnetic media sufficiently to ensure that
the data cannot be reconstructed.
K. Notification of Compromise or Potential Compromise
The compromise or potential compromise of the data is reported to DOH as required in
Section II.C.
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APPENDIX C
CERTIFICATION OF DATA DISPOSITION
Date of Disposition
n All copies of any Datasets related to agreement DOH# have been deleted from
all data storage systems. These data storage systems continue to be used for the storage
of confidential data and are physically and logically secured to prevent any future access
to stored information. Before transfer or surplus, all data will be eradicated from these
data storage systems to effectively prevent any future access to previously stored
information.
All copies of any Datasets related to agreement DOH# have been eradicated from
all data storage systems to effectively prevent any future access to the previously stored
information.
❑ All materials and computer media containing any data related to agreement DOH
have been physically destroyed to prevent any future use of the materials and
media.
All paper copies of the information related to agreement DOH # have been
destroyed on-site by cross cut shredding.
I I All copies of any Datasets related to agreement DOH # that have not been
disposed of in a manner described above, have been returned to DOH.
II Other
The data recipient hereby certifies, by signature below, that the data disposition requirements
as provided in agreement DOH # , Section J, Disposition of Information, have been
fulfilled as indicated above.
Signature of data recipient Date
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APPENDIX D
DOH SMALL NUMBERS GUIDELINES
• Aggregate data so that the need for suppression is minimal. Suppress all non-zero
counts which are less than ten.
• Suppress rates or proportions derived from those suppressed counts.
• Assure that suppressed cells cannot be recalculated through subtraction, by using
secondary suppression as necessary. Survey data from surveys in which 80%or more of
the eligible population is surveyed should be treated as non-survey data.
• When a survey includes less than 80%of the eligible population, and the respondents
are unequally weighted, so that cell sample sizes cannot be directly calculated from the
weighted survey estimates, then there is no suppression requirement for the weighted
survey estimates.
• When a survey includes less than 80%of the eligible population, but the respondents
are equally weighted, then survey estimates based on fewer than 10 respondents
should be "top-coded" (estimates of less than 5%or greater than 95%should be
presented as 0-5%or 95-100%).
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APPENDIX E
LIST OF DATA ELEMENTS BEING PROVIDED
Form Question Field Type
registration Record ID text
registration First 2 letters of last name text
registration First letter of first name text
registration First letter of mother's first name text
registration 2 digit day of the month you were born text
registration Unique ID text
registration tiebreaker field for duplicate unique ID's text
registration Notes or messages for all staff: notes
ssp_intake SSP Intake Date text
ssp_intake Intake Site dropdown
ssp_intake Provider name dropdown
ssp_intake How do you identify your gender? checkbox
ssp_intake What is your age? radio
ssp_intake Race/ethnicity checkbox
ssp_intake In the last 30 days,where did you sleep most frequently? radio
ssp_intake Zip code(if applicable) text
ssp_intake Are you exchanging today for yourself,others,or both? checkbox
ssp_intake In the last 7 days,which drugs have you used? checkbox
ssp_intake What do you consider to be your primary drug? radio
ssp_intake On a typical day, how many times do you inject(if at all)? radio
ssp_intake On a typical day, how many smoking sessions do you have(if at all)? radio
ssp_intake Routes of administration in past 30 days checkbox
In the last 30 days,have you had to do any of the following because
ssp_intake you didn't have a new,sterile syringe? checkbox
In the last 30 days,have you had to do any of the following because
ssp_intake you didn't have access to smoking supplies(e.g.pipe,foil,tooter) checkbox
ssp_intake Health behavior in the past 90 days: checkbox
ssp_intake Do you currently have health insurance? yesno
ssp_intake What type of health insurance do you have? checkbox
ssp_intake How did you hear about us? dropdown
ssp_intake Notes notes
ssp_encounter Encounter date text
ssp_encounter Site name dropdown
ssp_encounter Provider dropdown
ssp_encounter Delivery zip code text
ssp_encounter First encounter? checkbox
ssp_encounter How many people are you exchanging or getting supplies for today? radio
ssp_encounter In the past 30 days, have you shared needles/works? yesno
ssp_encounter In the past 30 days,have you reused syringes? yesno
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ssp_encounter Syringes returned text
ssp_encounter Sharps containers returned text
ssp_encounter Syringes returned checkbox
ssp_encounter Were any supply items requested but unavailable? checkbox
ssp_encounter Unavailable supplies checkbox
ssp_encounter Basic needs provided checkbox
ssp_encounter Syringes distributed text
ssp_encounter HRT kit text
ssp_encounter Boofing kit text
ssp_encounter Snorting kit text
ssp_encounter Plan B text
ssp_encounter Pregnancy tests text
ssp_encounter Bubbles/meth pipe text
ssp_encounter Stem/crack pipe text
ssp_encounter Hammer pipe text
ssp_encounter Foil text
ssp_encounter Mouthpiece text
ssp_encounter Chore/brillo text
ssp_encounter External condoms text
ssp_encounter Lube text
ssp_encounter Internal condoms distributed text
ssp_encounter Dental dams text
ssp_encounter Fentanyl test strips text
ssp_encounter Xylazine test strips text
ssp_encounter Wound care kit text
ssp_encounter Hygiene kit text
ssp_encounter Biohazard bin(1 quart) text
ssp_encounter Biohazard bin(2 gallon) text
ssp_encounter Nasal naloxone kits text
ssp_encounter Injectable naloxone kits text
ssp_encounter Naloxone kits(any type) text
ssp_encounter Naloxone training provided? checkbox
ssp_encounter Have you used naloxone since your last visit? checkbox
How many overdoses have you responded to since your last visit to
ssp_encounter this ssp? text
How many overdoses have you successfully reversed since your last
ssp_encounter visit to this ssp? text
1 ssp_encounter For the most recent reversal,how many doses were administered? text
ssp_encounter What type of naloxone was used? checkbox
ssp_encounter Where did the overdose occur? radio
What happened to the person that overdosed after they were given
ssp_encounter naloxone? radio
ssp_encounter Did you receive the naloxone kit that was used from this SSP? radio
ssp_encounter Routes of administration in past 30 days checkbox
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In the last 30 days,have you had to do any of the following because
ssp_encounter you didn't have a new,sterile syringe? checkbox
ssp_encounter Education provided checkbox
ssp_encounter Services provided checkbox
ssp_encounter Referrals checkbox
ssp_encounter Referrals: Infectious disease testing type checkbox
ssp_encounter Referrals: Infectious disease treatment type checkbox
ssp_encounter Referred facility name(s) text
ssp_encounter Notes notes
hrcn_participant_
profile Enrollment Date text
hrcn_participant_
profile Consent and confidentiality form signed checkbox
hrcn_participant_
profile Active in Harm Reduction Care Navigation? checkbox
hrcn_participant_
profile First name text
hrcn_participant_
profile Last name text
hrcn_participant_
profile (optional)What do you like to be called?(Nickname/Alias) text
hrcn_participant_
profile Date of Birth text
hrcn_participant_
profile Gender Identity checkbox
hrcn_participant_
profile Race/Ethnicity checkbox
hrcn_participant_
profile Other Race/Ethnicity text
hrcn_participant_
profile Housing status radio
hrcn_participant_
profile Do you have health insurance? checkbox
hrcn_participant_
profile Other health insurance text
hrcn_participant_ Health Insurance information
profile (e.g.,ID number, Medicaid MCO,etc.) notes
hrcn_participant_
profile Permission to contact via: checkbox
hrcn_participant_
profile Phone number(s) notes
hrcn_participant_
profile Address and/or places we can find you notes
hrcn_participant_
profile Alternate Contact(s) notes
hrcn_participant_
profile Notes: notes
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hrcn_form_uploa
ds Form Type dropdown
hrcn_form_uploa
ds Form description text
hrcn_form_uploa
ds Upload File file
hrcn_goals Goal Label text
hrcn_goals Goal start date text
hrcn_goals Summary notes
hrcn_goals Resources notes
hrcn_goals Barriers notes
hrcn_goals action step#1 notes
hrcn_goals action step#2 notes
hrcn_goals action step#3 notes
hrcn_goals action step#4 notes
hrcn_goals action step#5 notes
hrcn_goals Role/responsibility#1 notes
hrcn_goals Role/responsibility#2 notes
hrcn_goals Role/responsibility#3 notes
hrcn_goals Role/responsibility#4 notes
hrcn_goals Role/responsibility#5 notes
hrcn_goals Action item goal completion date text
hrcn_goals Action item goal completion date text
hrcn_goals Action item goal completion date text
hrcn_goals Action item goal completion date text
hrcn_goals Action item goal completion date text
hrcn_goals Goal Notes notes
hrcn_goals Date goal completed text
hrcn_encounter Date text
hrcn_encounter Encounter Duration dropdown
hrcn_encounter Contact Method radio
hrcn_encounter Other Contact Method text
hrcn_encounter Where was encounter initiated? radio
hrcn_encounter Other encounter location text
hrcn_encounter Did you make contact with the client? radio
hrcn_encounter Encounter Type checkbox
hrcn_encounter Services directly provided by SSP staff or Care Navigator checkbox
hrcn_encounter Housing Services checkbox
hrcn_encounter Infectious disease checkbox
hrcn_encounter HCV Services checkbox
hrcn_encounter HCV Testing checkbox
hrcn_encounter HIV Services checkbox
hrcn_encounter HIV Testing checkbox
hrcn_encounter Other HIV Test text
hrcn_encounter Other STI checkbox
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hrcn_encounter Chlamydia Services checkbox
hrcn_encounter Gonorrhea Services checkbox
hrcn_encounter Syphilis Services checkbox
hrcn_encounter Public Benefits checkbox
hrcn_encounter Substance Use Treatment checkbox
hrcn_encounter MOUD checkbox
hrcn_encounter Data notes
hrcn_encounter Assessment notes
hrcn_encounter Plan notes
hrcn_referral Referral date text
hrcn_referral External Referral Organization/Agency text
hrcn_referral Referral category dropdown
hrcn_referral Housing Services checkbox
hrcn_referral Infectious disease checkbox
hrcn_referral HCV Services checkbox
hrcn_referral HCV Testing checkbox
hrcn_referral HIV Services checkbox
hrcn_referral HIV Testing checkbox
hrcn_referral Other HIV Test text
hrcn_referral Other STI checkbox
hrcn_referral Chlamydia Services checkbox
hrcn_referral Gonorrhea Services checkbox
hrcn_referral Syphilis Services checkbox
hrcn_referral Public Benefits checkbox
hrcn_referral Substance Use Treatment checkbox
hrcn_referral MOUD checkbox
hrcn_referral Referral notes notes
hrcn_referral Linkage successful? yesno
hrcn_referral Linkage date text
hrcn_referral Linkage notes notes
hrcn_test_results Date text
hrcn_test_results Test Result Source checkbox
hrcn_test_results Test radio
hrcn_test_results Test other type text
hrcn_test_results Type of Test(eg,brand) text
hrcn_test_results Test Result radio
hrcn_test_results Notes notes
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