Federal Register Extracts

Agency: " Department of State."

SUMMARY: The information of the Bureau of Medical Services (MED) system is used and reviewed by medical and administrative personnel to provide health care to the individuals eligible to participate in the medical program, make clearance decisions for individuals eligible to participate in the health care program and for applicants to the Department of State, and as a reference for local medical capabilities. The system also serves to record and monitor the status of the professional credentials of Department of State Foreign Service, Civil Service and Locally Employed Staff healthcare providers.

DATES: In accordance with 5 U.S.C. 552a(e)(4) and (11), this modified system of records will be effective upon publication, except for the routine uses (u), (v), and (w) that are subject to a 30-day period during which interested persons may submit comments to the Department. Please submit any comments by June 5, 2023. Unless comments are received that would require a revision, this system of records will become effective on June 5, 2023.

ADDRESSES: Questions can be submitted by mail, email, or by calling Eric F. Stein, the Senior Agency Official for Privacy, on (202) 485-2051. If mail, please write to: U.S Department of State; Office of Global Information Systems, A/GIS; Room 4534, 2201 C St. NW, Washington, DC 20520. If email, please address the email to the Senior Agency Official for Privacy, Eric F. Stein, at [email protected]. Please write "Medical Records, State-24" on the envelope or the subject line of your email.

FOR FURTHER INFORMATION CONTACT: Eric F. Stein, Senior Agency Official for Privacy; U.S. Department of State; Office of Global Information Services, A/GIS; Room 4534, 2201 C St. NW, Washington, DC 20520 or by calling (202) 485-2051.

SUPPLEMENTARY INFORMATION: The purpose of this modification is twofold: (1) to consolidate two existing records systems (State-71--Post Capabilities Database and State-24--Medical Records) into a single modified State-24, to accurately reflect the scope of Department medical records; and (2) to reflect the expansion of Medical Records to FedRAMP-authorized Cloud environments. The proposed merged System of Records will include substantive modifications to the following sections: Routine Uses, Categories of Records, Storage, Retrievability, and Record Access Procedures. In addition, the Department is taking this opportunity to make minor administrative updates to the notice in the Security Classification and System Location sections.

SYSTEM NAME AND NUMBER:

Medical Records, State-24.

SECURITY CLASSIFICATION:

Sensitive but unclassified.

SYSTEM LOCATION:

The Enterprise Server Operations Center (ESOC WEST) in Denver, Colorado. Some records may be stored within a government cloud provided system (Amazon Web Services and Microsoft Azure Gov) and within a FedRAMP authorized government cloud system provided, implemented, and overseen by the Department's Enterprise Server Operations Center (ESOC), 2201 C Street NW, Washington, DC 20520.

SYSTEM MANAGER(S):

Director for Medical Informatics, Bureau of Medical Services, 2401 E Street NW, Washington, DC 20522, [email protected].

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

Foreign Service Act of 1980, Sec. 904 (22 U.S.C. 4084); and 5 CFR part 792 (Federal Employees' Health, Counseling, and Work/Life Programs).

PURPOSE(S) OF THE SYSTEM:

The records maintained in the systems include Personally Identifiable Information (PII) and Protected Health Information (PHI) and are used to enable MED's practitioners to provide the best medical care possible to a globally dispersed patient population. Records include patients' medical history/records, which are used to provide medical care, adjudicate medical clearances, and support medical evacuations. Additionally, the system describes the medical capabilities available at each Post to support employees under Chief of Mission authority. Moreover, the system also serves to provide medical clearances of applicants to the Department of State. The system also serves to record and monitor the current status of the professional credentials of Department of State Foreign Service, Civil Service and Locally Employed Staff healthcare providers.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:

Applicants to the Department of State and their family members, U.S. Government employees and their family members, Locally Employed Staff, and any other individuals eligible to participate in the medical program of the U.S. Department of State as authorized by either section 904 of the Foreign Service Act of 1980 (22 U.S.C. 4084) or other applicable legal authority. The Privacy Act defines an individual at 5 U.S.C. 552a(a)(2) as a United States citizen or lawful permanent resident.

CATEGORIES OF RECORDS IN THE SYSTEM:

Categories of records include full name; Social Security number (Department of State Employees and applicants only); date of birth; address; email address; phone number; State Global Identifier (SGID); reports of medical examinations and related documents, images, and other items; reports of treatments and other health services rendered to individuals; immunization records; narrative summaries of hospital treatments; personal medical histories; reports of on-the-job injuries or illnesses; reports on medical evacuation; and/or any other types of individually identifiable health information generated or used in the course of conducting health care operations. This system includes records that contain protected health information and does not include records maintained by the Department of State and/or other employers in their capacity as employers.

This system also includes certain records maintained as part of the Department's Employee Assistance Program pursuant to 5 CFR part 792. The system also includes a directory of MED staff, and professional credentials of MED providers. The directory may include addresses, emails, and phone numbers for direct-hire Foreign Service, Civil Service, and Locally Employed Staff medical personnel. The credentials that are maintained include copies of licenses and certifications (Professional, Clinical, Drug Enforcement Administration (DEA), clinical privileges information, and National Provider Identifier (NPI)). For use by MED clinical staff, the system maintains directories and high-level assessments of the location and quality of medical resources offered in the areas surrounding most Post locations. This system also includes the medical clearance records of applicants to the Department of State who are in the final stages of their application process and may further include the medical clearance records of their family members.

RECORD SOURCE CATEGORIES:

Information contained in these records comes from applicants, patients, hospitals, clinics, laboratories, private medical providers, employers, and medical professionals employed by the Department of State.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS AND PURPOSES OF SUCH USES:

Medical Records may be disclosed:

A. To another health care provider, a group health plan, a health insurance issuer, or a health maintenance organization for purposes of carrying out treatment, payment, or health care operations;

B. To a parent, guardian or other person acting in loco parentis with respect to the subject of the information;

C. To a health oversight agency or public health authority authorized by law to investigate or otherwise oversee the relevant conduct or conditions of the Department of State's medical program, or for such oversight activities as audits; civil, administrative, or criminal proceedings or actions; inspections; and licensure or disciplinary action;

D. To a public health authority (domestic or foreign) that is authorized by law to collect or receive protected health information for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions;

E. To the U.S. Department of Health and Human Services (HHS), when required by the Secretary of HHS;

F. To a public health authority or other appropriate government authority (domestic or foreign) authorized by law to receive reports of child abuse or neglect;

G. To a person subject to the jurisdiction of the Food and Drug Administration (FDA) with respect to an FDA-regulated product or activity for which that person has responsibility, for the purpose of activities related to the quality, safety, or effectiveness of such FDA-regulated product or activity;

H. To a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition, to the extent MED is authorized by law to notify such person and as necessary in the conduct of a public health intervention or investigation;

I. To a government authority (domestic or foreign), including a social service or protective services agency, authorized by law to receive reports of abuse, neglect or domestic violence (1) to the extent such a disclosure is required by law; (2) where in the exercise of professional judgment, the disclosure is necessary to prevent serious harm to the individual or other potential victims; or (3) where, if the subject of the information is incapacitated, a law enforcement, or other public official authorized to receive the report, represents that the information sought is not intended to be used against the individual and that an immediate enforcement activity that depends upon the disclosure would be adversely affected by waiting until the individual is able to agree to the disclosure;

J. To the Department of Justice, as required by law, for the purpose of submitting information to the National Instant Criminal Background Check System;

K. In the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal;

--This is a summary of a Federal Register article originally published on the page number listed below--

Notice of a modified system of records.

Citation: "88 FR 29171"

Document Number: "Public Notice: 12065"

Federal Register Page Number: "29171"

"Notices"