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35052 Federal Register / Vol. 72, No.

122 / Tuesday, June 26, 2007 / Notices

The Commission has determined that DEPARTMENT OF HEALTH AND CAPT Balingit-Wines can be contacted
it is not necessary to include a ‘‘cease HUMAN SERVICES by telephone at 202–205–8088, or e-mail
and desist’’ provision that directly at anamarie.balingit-wines@hhs.gov for
prohibits the Board from resuming the Office of the Assistant Secretary for issues related to the SOR.
conduct challenged in the complaint. Preparedness & Response, Office of
Preparedness & Emergency SUPPLEMENTARY INFORMATION: NDMS
This conclusion rests on various factors operates pursuant to Section 2812 of the
particular to this case. A key factor is Operations; Privacy Act of 1974;
Report of a New System of Records Public Health Service Act (42 U.S.C.
the experience in South Carolina since 300hh–11), and currently resides in
the 2003 changes to the South Carolina AGENCY: Department of Health and HHS under ASPR in accordance with
Dental Practice Act. The new statutory Human Services (HHS), Office of the the Pandemic and All Hazards
scheme has now been in place for nearly Assistant Secretary for Preparedness Preparedness Act (PAHPA), Public Law
four years. Throughout this period, and Response (ASPR), Office of 109–417. With the passage of PAHPA,
dental hygienists have been providing Preparedness and Emergency (OPEO). ASPR has been designated as the agency
preventive services in schools under an ACTION: Notice of a new System of responsible for medical response to
agreement with the health department— Records (SOR). include the deployment of NDMS and
without an initial examination by a Field Medical Station assets as well as
dentist—and the Board has not SUMMARY: In accordance with the the management of the officers of the
reimposed its previous dentist requirements of the Privacy Act of 1974, Public Health Service Commissioned
examination requirement. Thus, we are proposing to establish a new Corps deployed during a response.
although the 2003 amendments have not system titled, ‘‘The National Disaster ASPR medical components, in
eliminated the need for relief in this Medical System (NDMS) Patient particular NDMS, function in a
case, they are a relevant consideration Treatment and Tracking Records coordinated effort with DHS, DoD, and
System,’’ System Number 09–90–0040. the VA. In a disaster situation, NDMS
in determining the nature and scope of
The primary purpose of the NDMS and other ASPR components will
that relief.
Patient Treatment and Tracking Records augment the public health and health
Accordingly, the proposed order takes System is to collect data from care activities of State and local
the statutory change into account. First, individuals using the medical care governments.
requiring the Board to distribute the capabilities provided by NDMS.
The Privacy Act embodies fair
announcement set forth in Appendix A EFFECTIVE DATES: NDMS filed a new information principles in a statutory
to all dentists, dental hygienists, and SOR report with the Chair of the House framework governing the means by
school districts will ensure that Committee on Oversight and which the United States Government
interested parties know that the Board Government Reform; the Chair of the collects, maintains, uses, and
has formally acknowledged that it is Senate Committee on Homeland disseminates personally identifiable
legally barred from resuming the Security and Governmental Affairs; and information. The Privacy Act applies to
conduct challenged in the Commission’s the Administrator, Office of Information information that is maintained in a SOR,
complaint. Second, the notice and Regulatory Affairs, Office of which is a group of any records under
requirement of Paragraph II addresses Management and Budget (OMB) on June the control of an agency from which
the possibility that the Board might 18, 2007. The proposed SOR will be information is retrieved by the name of
attempt to restrain competition in the effective 30 days from the publication of the individual or by some identifying
provision of dental hygienist services in the notice or 40 days from the date number, symbol, or other identifying
public health settings in ways not mailed to ensure that all parties have particular, such as property address,
addressed by the 2003 amendments. adequate time in which to comment. mailing address, assigned to the
This notice provision will increase the However, a request has been submitted individual. As a component of
Commission’s ability to monitor the to the OMB to grant HHS a 10 day Emergency Support Function (ESF) #8,
Board’s future conduct and is likely to waiver of the review period due to the NDMS has shared medical records with
help deter the Board from imposing impending start of the hurricane season. the other agencies and departments that
We may defer implementation of this comprise ESF #8, due to the Function’s
restraints on public health preventive
system and retrieve the request for shared statutory authority over the
dental care that are not grounded in the
waiver should we receive comments collection of medical information.
policies articulated by the South that are contrary and requires the
Carolina legislature. NDMS has three key functions to which
document to be altered. each of the ESF partners contribute and
As is standard in Commission orders, require the collection of medical
ADDRESSES: You may submit comments,
the proposed order contains certain identified by one of the following information: medical response, patient
reporting and other provisions that are methods: The Federal e-Rulemaking evacuation, and definitive medical care.
designed to assist the Commission in Portal at http://www.regulations.gov and The medical response function of
monitoring compliance with the order. following the instructions for submitting NDMS is related to the activation and
The proposed order would expire in comments, or send to the NDMS Chief deployment of NDMS response teams,
ten years. Medical Officer, National Disaster comprised of medical and logistical
By direction of the Commission. Medical System, 330 Independence personnel, to assess the health and
Avenue, SW., Room G–644, medical needs of disaster victims. In
Donald S. Clark, Washington, DC 20201. response to the overall needs of the
Secretary. FOR FURTHER INFORMATION CONTACT: patients, NDMS teams are activated to
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[FR Doc. E7–12323 Filed 6–21–07: 8:45 am] CAPT Ana Marie Balingit-Wines, Chief provide physical and mental health, as
BILLING CODE 6750–01–S Nurse, NDMS Electronic Medical well as evacuation during a public
Records Project Officer, ASPR/OPEO/ health emergency as cause for activation
NDMS, 330 Independence Avenue, SW., as defined in 42 U.S.C. 300hh–
Room G–644, Washington, DC 20201. 11(a)(3)(A).

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Federal Register / Vol. 72, No. 122 / Tuesday, June 26, 2007 / Notices 35053

The patient evacuation function of laboratory tests performed, diagnosis, create a separate and distinct system of
NDMS relates to the establishment of treatment provided, medications records. Below is the description of the
communications, transportation, and a prescribed, referrals, and any treatment NDMS Patient Treatment and Tracking
medical regulating system to evacuate advice provided by the medical Records System.
and move patients from a staging center professional to the patient. Pursuant to Dated: June 14, 2007.
near a disaster site to patient reception 5 U.S.C. 552a(b)(1), information
Kevin Yeskey,
sites known as Federal Coordinating collected would be disclosed to other
Deputy Assistant Secretary, Office of
Centers (FCCs). The DoD and VA have Department of Health and Human
Preparedness and Emergency Operations.
the prime responsibility for activating Services (HHS) agencies such as the
and managing the FCCs. In turn, upon Centers for Disease Control and SYSTEM NO. 09–90–0040
receiving the patients, the FCCs have Prevention (CDC), the Centers for
the authority to arrange for necessary Medicare and Medicaid Services (CMS), SYSTEM NAME:
referrals and admissions or NDMS and the Agency for Health Care ‘‘National Disaster Medical System
evacuated patients. Research and Quality (AHRQ), for the (NDMS) Patient Treatment and
CMS is responsible for establishing purpose of research, evaluation or Tracking,’’ HHS/ASPR/OPEO.
and administering the reimbursement epidemiologic and longitudinal SECURITY CLASSIFICATION:
process for health care rendered to surveillance studies related to health
patients provided under the umbrella of care, which may impact the care Unclassified.
NDMS in accordance with Section 2812 provided to disaster victims. SYSTEM LOCATION:
of the Public Health Service Act, 42 Information in this system will be For a specified period and in
U.S.C. 300hh–11, for ‘‘definitive care.’’ disclosed as ‘‘routine uses’’ to the accordance with the archiving rules, the
The SOR for the collection of following entities: paper records will be resident at NDMS
information for the purpose of 1. Emergency Support Function #8
headquarters, located at 409 3rd Street
reimbursement has been filed separately (ESF #8) is a coordinated effort between
SW., Suite 330, Washington, DC 20024.
and was published on November 23, the Department of Health and Human
The electronic copy of the record will be
2005, under 70 FR 70849. NDMS health Service (HHS), the Department of
resident at the data center at the Unisys
care providers, in the course of Homeland Security (DHS), the
Corporation, 11720 Plaza America
providing health care, collect data that Department of Defense (DoD), and the
Drive, Reston, VA 20190.
identifies the patient’s name, address, Department of Veterans Affairs (VA). As
contact information, gender, insurance such, the medical treatment and CATEGORIES OF INDIVIDUALS COVERED BY THE
information, prior medical history, and evacuation of patients is a shared SYSTEM:
all treatment information to include, but responsibility between these agencies The individuals covered by the
not limited to, symptoms, vital signs, and disclosure of health related system are all persons and owners of
diagnosis, and medications prescribed information is necessary to adequately animals treated by NDMS medical
through the health care continuum. manage the overall care of the patient. personnel when the NDMS Disaster
NDMS veterinary providers, in the 2. Disclosure to a member of Congress Medical Assistance Teams (DMATs) and
course of providing care to animals, may on behalf of a constituent’s inquiry. Veterinary Medical Assistance Teams
collect contact information from the 3. Disclosure to the Department of (VMATs) are activated to respond to
animal’s owner. The medical records Justice (DOJ), court or adjudicatory body emergency situations, or as a response
could also include x-rays, lab results, when the agency is involved in to any other situation for which they are
and providers’ comments relative to litigation or has an interest in litigation. activated.
their observations about the patient. 4. Disclosure to agency contractors,
NDMS has a need for the collection of consultants, or grantees engaged in the CATEGORIES OF RECORDS IN THE SYSTEM:
information for health care, patient performance of service related to this All records pertaining to treatment
movement, and tracking, as well as for collection and who may need to have and movement of patients to include the
reimbursement of health care rendered. access to the records in order to perform following (both in hard copy and
The collection of the data as a result the activity. electronic format):
of illness or injury from a disaster or 5. To assist another Federal or State Category A: Completed Patient
other event mandating the deployment agency, agency of a state government, an Treatment Record form that includes:
of NDMS medical personnel is agency established by State law, or its 1. NDMS Team Identification.
accomplished through a combination of fiscal agent to assess the location or the 2. Chart Number.
paper and electronic records. The status of their beneficiary. 3. Time and Date Patient seeks
patient data collected will also be used 6. Disclosure to family members of a treatment.
for tracking the patient through the patient about the location or the status 4. Triage Category and health status.
continuum. The collection of of the patient. 5. Location where Patient is seen and
information during an event such as a The Privacy Act requires each agency transferred.
patient evacuation will assist NDMS in to publish in the Federal Register a 6. Patient Identification—Name,
quickly tracking and sending the patient description denoting the type and Address, City, State, Zip, Date of Birth,
and the medical information from the character of each system of records that Phone Number, Employment, Weight,
casualty collection site to the designated the agency maintains, and the routine Next of Kin.
FCC. The system will also allow NDMS uses that are contained in each system 7. Complaints/Symptoms.
to track how many patients are sent to in order to make agency recordkeeping 8. Vital Signs/Treatment
each FCC along with their discharge and practices transparent, to notify Recommended and/or Prescribed.
location status. The information will individuals regarding the uses to which 9. Discharge—Time, Date,
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include but not be limited to name, personally identifiable information is Disposition, Recommendations.
address, phone numbers, ethnic annotated, and to assist individuals to 10. Patient Authorization—Requires
background, and other contact and/or easily find such files within the agency. Patient Signature in Front of Witness
identifying information as well as NDMS, as a component of the OPEO, and Witness Verification through
medical information including which resides within ASPR, intends to Signature.

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35054 Federal Register / Vol. 72, No. 122 / Tuesday, June 26, 2007 / Notices

11. Any potential attachments such as 1. ESF #8 is a coordinated effort Records in this system will be
X-rays and laboratory reports showing between HHS, DHS, DoD, and the VA. retained in accordance with the records
test results. As such, the medical treatment and disposition authority approved by the
Category B: Veterinarian Treatment movement of patients is a shared National Archives and Records
Records on animals: responsibility between the ESF #8 Administration (NARA) for the Office of
1. Privacy Act Data such as the name, partnership agencies. The medical and Public Health and Emergency
address and telephone contact demographic information collected Preparedness (OPHEP) in compliance
information of owners of animals will during the treatment of a patient is with N1–468–07–1. The Pandemic and
be maintained to be associated with the shared with the partners to ensure that All Hazards Preparedness Act (Pub. L.
animal patient. However, animal patients treated through NDMS receive 109–417), established the ASPR to serve
treatment records themselves are not the maximum level of health care in a similar capacity as OPHEP for
subject to the Privacy Act protections. possible. medical disaster response. The records
2. Disclosure to a member of Congress disposition authority used for these
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
or a Congressional staff member in records will N1–468–07–1.
NDMS Statute, 42 U.S.C. 300hh–11; response to an inquiry from the
Title VI of the Civil Rights Act of 1964; Disposition authority:
Congressional office made at the behest Patient Care Forms or other Medical
and Section 504 of the Rehabilitation of the constituent about whom the Records regulated under the Health
Act of 1973. Records disposition of this record is maintained. Insurance Portability and
medical SOR is determined under laws 3. Disclosure to the Department of Accountability Act (HIPAA), created by
governing federal records through the Justice (DOJ), court, or adjudicatory the Federal Medical Station(s) or by any
National Archives, 44 U.S.C. 3303a. body when the following situations component of HHS/ASPR during a
PURPOSE(S): arise: response to an event while caring for
Medical and demographic a. The agency or any component victims of that event. Disposition: Cutoff
information is collected on all patients thereof, or is at the end of the response activity by
b. Any employee of the agency the Federal Medical Station(s) for a
seen and/or treated by NDMS or ASPR
whether in his/her official or individual particular event. Retire to the
personnel. This SOR will also provide
capacity, where DOJ has agreed to Washington National Records Center 2
the location, time, and date the patient
represent the employee, or years after cutoff. Destroy 75 years after
was transported during an evacuation. c. The United States government is a
The information collected will include cutoff. This disposition instruction is
party to litigation or has an interest in
but not be limited to the patient’s (1) media neutral; it applies regardless of
such litigation and after careful review,
Medical treatment history, (2) their pre- media or format of the records.
the agency deems that the records
existing conditions, (3) their described Category B—The information
requested are relevant and necessary to
symptoms, (4) any medical opinion collected on animals and their owners
the litigation and that the use of such
rendered by an attending medical will not be destroyed until NARA
records by DOJ, court, or adjudicatory
professional(s), (5) medications that approves a disposition schedule for
body is compliant with the purpose for
were prescribed, or (6) any other those records.
which the agency collected the records.
medical advice provided. The collection 4. Disclosure to agency contractors, STORAGE:
of data contained in medical records consultants, or grantees who have been
provides a mechanism by which teams Paper records from this system are
engaged by the agency to assist in the stored in the NDMS headquarters at 409
can have the ability to conduct medical performance of a service related to this
quality assurance and establish a quality 3rd Street, SW., Suite 330, Washington,
collection and who need to have access DC 20024. The electronic database or
improvement process (QIP). Through to the records in order to perform the
QIP, teams can analyze and judge their server where information is entered and
activity. stored is maintained at the HHS data
performance on a specific deployment 5. To assist another Federal and/or
and if necessary enable them to better center located at Unisys Corporation,
State agency, agency of a state 11720 Plaza America Drive, Reston, VA
plan for future deployments. These government, an agency established by
patient records are also important 20190. During deployments, NDMS
State law, or its fiscal agent: stores the records securely in their
sources of information to be used for a. To establish the benefit entitlement
research projects related to the deployed location, the electronic data is
of the patient.
prevention of disease or disability as a stored in a secured server, and all
b. To establish the relationship
result of a disaster. Most importantly, procedures required for protection of
between the existing state benefit and
these patient records document medical Privacy Act documents are
the benefit funded in whole or part with
treatment rendered, especially if implemented as identified in
Federal funds, such as the one
questions of liability arise about the ‘‘Safeguards’’ section below.
associated with the NDMS definitive
treatment or the subsequent condition of care. RETRIEVABILITY:
the patient while he/she is under the c. To collaborate with the state and NDMS Patient Treatment and
care of NDMS. state agencies on behalf of family Tracking Records in electronic and
ROUTINE USES OF RECORDS MAINTAINED IN THE
members regarding the current location paper copy are organized by event,
SYSTENM, INCLUDING CATEGORIES OF USERS AND and placement of their evacuated family location, and date of treatment. Data
THE PURPOSES OF SUCH USES: member or patient population. from the records are stored in an
In addition to those disclosures 6. Disclosure to family members of a electronic database enabling data from
generally permitted under 5 U.S.C. patient about the location or the status the records to be retrievable by name
552a(b) of the Privacy Act, all or a of the patient. and other demographic information
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portion of the records or information POLICIES AND PRACTICES FOR STORING, provided by the patient (or for
contained in this system may be RETRIEVING, ACCESSING, RETAINING, AND veterinary records, by pet owner), as
disclosed outside HHS as a routine use DISPOSING OF RECORDS IN THE SYSTEM: well as by location of treatment,
pursuant to 5 U.S.C. 552a(b)(3) as Category A: Patient Care Forms or diagnosis, and other data fields within
follows: other Medical Records: the database.

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Federal Register / Vol. 72, No. 122 / Tuesday, June 26, 2007 / Notices 35055

SAFEGUARDS: CONTESTING RECORD PROCEDURES: Method for the Direct Detection and
NDMS has safeguards in place for Same as the Notification Procedure Quantitation of Asparagine Synthetase
authorized users and monitors such above. The letter should state clearly in Biological Samples
users to ensure against unauthorized and concisely what information you are Description of Technology: Acute
use. Personnel having access to the contesting, the reasons for contesting it, lymphoblastic leukemia (ALL) is a fast-
system have been trained in the Privacy and the proposed amendment to the growing cancer that targets immature
Act and information security information that you seek pursuant to cells of the blood and bone marrow.
requirements for both paper copies and HHS Privacy Act regulations, 45 CFR Clinical treatments of ALL use enzyme-
electronically stored information. 5b.7. based methods, such as L-asparaginase
Information in this system is (ASNase), for depletion of cellular
safeguarded in accordance with RECORD SOURCE CATEGORIES: asparagine in combination with
applicable laws, rules and policies, standard chemotherapeutic agents.
Sources for providing data for NDMS Although ASNase can be used to treat
including the HHS Information
Patient Treatment Records will only be both childhood and adult forms of ALL,
Technology Security Program
provided by patients, medical personnel its use is limited because patients can
Handbook, all pertinent National
treating the patients or by accessing often develop resistance to ASNase
Institutes of Standards and Technology
their personal health records (PHR). In therapy. Studies have shown a
publications and OMB Circular A–130,
the case of minors or other individuals correlation between ASNase resistance
Management of Federal resources. All
unable to explain symptoms, and increased expression levels of
records are protected from unauthorized
information may be sought from a asparaginase synthetase (ASNS)
access through appropriate
parent or guardian. For animals, enzyme, which catalyzes the
administrative, physical, and technical
information will be gathered by NDMS biosynthesis of cellular L-asparagine
safeguards. These safeguards include
veterinary personnel and/or owners or from L-aspartate in an ATP-dependent
restricting access to authorized
caretakers of animals. reaction. At present, measurement of
personnel who have a need-to-know,
using physical locks in the office ASNS expression levels are based on
EXEMPTIONS CLAIMED FOR THE SYSTEM: mRNA or antibody based assays;
environment, and the process of
authentication using user IDs and None. however, these methods are not suitable
passwords function as protection [FR Doc. 07–3097 Filed 6–25–07; 8:45 am] for direct quantitation of protein in
identification features. HHS file areas biological samples. Thus, new and
BILLING CODE 4150–37–M
are locked after normal duty hours and improved methods that directly measure
the facilities are protected from the ASNS protein levels are needed.
outside by security personnel. Researchers at the NCI have
DEPARTMENT OF HEALTH AND
developed novel methods for
HUMAN SERVICES
SYSTEM MANAGER AND ADDRESS: quantitating ASNS protein in biological
National Institutes of Health samples using isotope-labeled standard
The NDMS Chief Medical Officer peptides and mass spectrometry. The
located at 409 3rd Street, SW., current technology describes methods of
Government-Owned Inventions;
Washington, DC 20024. Mailing address: identifying a patient with cancer or
Availability for Licensing
330 Independence Avenue, SW., Room chemoresistant cancer, monitoring the
G–644, Washington, DC 20201. AGENCY: National Institutes of Health, treatment regimen of a patient with
Public Health Service, HHS. cancer, as well as methods for detecting
NOTIFICATION PROCEDURES:
modulators and their ability to affect
Requests for Privacy Act protected ACTION: Notice. ASNS expression levels. Further
information generally are governed by described are novel pharmaceutical
HHS regulations found at 45 CFR, Part SUMMARY: The inventions listed below compositions with potential use as
5b. They must be made in writing and are owned by an agency of the U.S. chemotherapeutic agents.
clearly marked as a ‘‘Privacy Act Government and are available for Applications: Diagnostic assay for
Request’’ on the envelope and letter. licensing in the U.S. in accordance with leukemia or chemoresistant cancer; Use
Inquiries regarding this SOR should be 35 U.S.C. 207 to achieve expeditious in screening or identifying potential
addressed to the System Manager. commercialization of results of chemotherapeutic agents; Use in
Inquiries related to patient medical federally-funded research and measuring a patient’s sensitivity to
records should include the full name of development. Foreign patent ASNase therapy.
the individual, the appropriate personal applications are filed on selected Market: Approximately 5,200 people
identification, and the current address, inventions to extend market coverage are diagnosed with ALL each year in the
and should be sent to the Chief Medical for companies and may also be available United States; ALL is the most common
Officer, NDMS, 330 Independence for licensing. type of cancer in children in developed
Avenue, SW., Room G–644, countries.
ADDRESSES: Licensing information and Development Status: Early stage.
Washington, DC 20201. The name of the copies of the U.S. patent applications Inventors: Thomas P. Conrads (NCI/
requester, the nature of the record listed below may be obtained by writing SAIC) et al.
sought, and the verification of identify to the indicated licensing contact at the Patent Status: International
must be clearly indicated, as required by Office of Technology Transfer, National Application No. PCT/US06/28965 filed
HHS regulations at 45 CFR 5b.5. Institutes of Health, 6011 Executive 25 Jul 2006 (HHS Reference No. E–189–
Requests may also be sent to: HHS Boulevard, Suite 325, Rockville, 2006/0–PCT–01).
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Privacy Act Officer 200 Independence Maryland 20852–3804; telephone: 301– Licensing Status: Available for
Avenue, SW., Washington, DC 20201. 496–7057; fax: 301–402–0220. A signed exclusive and non-exclusive licensing.
Confidential Disclosure Agreement will Licensing Contact: Robert M. Joynes,
RECORD ACCESS PROCEDURES:
be required to receive copies of the J.D., M.S.; 301–594–6565;
Same as Notification Procedure above. patent applications. joynesr@mail.nih.gov.

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