Common use of Individual Authorization and Control Clause in Contracts

Individual Authorization and Control. 1. North Coast Care Connect brings together Participants that serve their Individuals in different ways and that are subject to different legal frameworks affecting how they may use and disclose their Individuals’ personal information. For example, Participants that are health care providers must comply with the HIPAA Privacy Rule, among others, while other Participants such as housing counselors do not. Therefore, North Coast Care Connect allows Individuals to choose whether or not to have their information (beyond what State and Federal laws allow Participant to share without authorization for some sharing of information) accessible through North Coast Care Connect. North Coast Care Connect permits information sharing without the Individual’s authorization when applicable laws and regulations permit that sharing without authorization. Individuals may choose to authorize that expanded data sharing among Participants by completing the North Coast Care Connect Authorization Form. NCHIIN has developed this form and will be responsible for revising this form as necessary to comply with new laws, regulations, or changes to existing laws and regulations that apply the use and disclosure of Individuals’ personal information by Participants. NCHIIN will notify all Participants if and when the forms are revised. 2. Each Participant is responsible, at the time of first contact, to notify Individuals of their right to choose to authorize expanded information sharing among Participants and to offer the opportunity to sign this form (available online and on paper). Other forms of authorization are not sufficient (for example, authorizations given by telephone or on other forms). The Participant is to discuss the authorization with the Individual and if necessary, help that Individual to make necessary selections and sign the document properly. At that time, the Participant will share with the Individual the current list of Participants who may receive the Individual’s information as a result of that authorization. NCHIIN will maintain a current copy of this list at [insert webpage] and will notify Participants by e-mail when the list changes. a) Online authorization forms are available within North Coast Care Connect. Participant sends a link to the form electronically to an Individual’s email or smartphone for electronic signature. Individual makes selections on data sharing and “signs” electronically at which point the form is available for printing. North Coast Care Connect automatically populates record consistent with Individual data sharing choices and is effective immediately. The completed PDF form is available in the Individual's North Coast Care Connect record containing Individual's choices and electronic signature. b) Paper versions of the forms may be provided to Individuals to sign and a copy will be provided to the Individual. The executed form is uploaded into North Coast Care Connect by Participant and selections entered into the system. North Coast Care Connect automatically populates record with Individual data sharing choices and is effective immediately. Participant must ensure that the paper is uploaded and legible before destroying or storing according to Participant Policy. North Coast Care Connect will maintain a record for each Individual of the authorizations they have given and will only permit Individuals’ expanded data to be shared throughout North Coast Care Connect if the Individual has a current, legally compliant authorization on file.

Individual Authorization and Control. ‌ 1. North Coast Care Connect The SHIE brings together Participants that serve their Individuals in different ways and that are subject to different legal frameworks affecting how they may use and disclose their Individuals’ personal information. For example, Participants that are health care providers must comply with the HIPAA Privacy Rule, among others, while other Participants such as housing counselors do not. Therefore, North Coast Care Connect the SHIE allows Individuals to choose whether or not to have their information (beyond what State and Federal laws allow Participant to share without authorization for some sharing of information) accessible through North Coast Care Connectthe SHIE. North Coast Care Connect The SHIE permits information sharing without the Individual’s authorization when applicable laws and regulations permit that sharing without authorization. Individuals may choose to authorize that expanded data sharing among Participants by completing the North Coast Care Connect Alameda County Information Sharing Authorization Form(ISA) Form and Substance Use Disorder (“SUD”) Release of Information (ROI) Form as applicable. NCHIIN HCSA has developed this form these forms and will be responsible for revising this form those forms as necessary to comply with new laws, regulations, or changes to existing laws and regulations that apply the use and disclosure of Individuals’ personal information by Participants. NCHIIN HCSA will notify all Participants if and when the forms are revised. 2. Each Participant is responsible, at the time of first contact, to notify Individuals of their right to choose to authorize expanded information sharing among Participants and to offer the opportunity to sign this form these forms (available online and on paper). Other forms of authorization are not sufficient (for example, authorizations given by telephone or on other forms). The Participant is to discuss the authorization ISA and/or SUD ROI, as the case may be, with the Individual and if necessary, help that Individual to make necessary selections and sign the document properly. At that time, the Participant will share with the Individual the current list of Participants who may receive the Individual’s information as a result of that authorization. NCHIIN HCSA will maintain a current copy of this list at [insert webpage] ▇▇▇.▇▇▇▇▇▇▇▇▇▇▇▇▇.▇▇▇/▇▇▇▇▇▇▇▇▇▇▇▇▇, and will notify Participants by e-mail when the list changeschanges There are two means of capturing an Individual authorization (unless the Individual declines). a) Online authorization consent forms are available within North Coast Care Connectthe SHIE (i.e., Alameda County ISA, SUD ROI). Participant sends a link to the blank form electronically to an Individual’s email or smartphone for electronic signaturesignature via DocuSign. Individual makes selections on data sharing and “signs” electronically at which point the form is available for printingelectronically. North Coast Care Connect The SHIE automatically populates record consistent with Individual data sharing choices and is effective immediately. The completed PDF form is also becomes available in to the Individual's North Coast Care Connect record Community Health Record containing Individual's choices and electronic signature. The Participant will print a copy of the executed form for the Individual. b) Paper versions of the forms may be provided to Individuals to sign and a copy will be provided to the Individualsign. The executed form is uploaded into North Coast Care Connect the SHIE by Participant and selections entered into the systemCHR. North Coast Care Connect The CHR automatically populates record with Individual data sharing choices and is effective immediately. Participant must ensure that the paper is uploaded and legible before destroying or storing according to Participant Policy. North Coast Care Connect The SHIE will maintain a record for each Individual of the authorizations they have he/she has given and will only permit Individuals’ expanded data to be shared throughout North Coast Care Connect the SHIE if the Individual has a current, legally compliant authorization on file.