Business Associate Addendum 04/13/2003
Cleltl aiDe
Circul coun
Danny L. Kolhage
Phone: 305-292-3550 Fax: 305-295-3663
Memnrandum
To:
James Roberts,
County Administrator
From:
Maria Z. Fernandez, Administrator
Group Insurance
Isabel C. De&J.ntis. )
Deputy Clerk
Attn:
Date:
Tuesday, May 06, 2003
At the Board meeting on April 16, 2003, the Board approved the fOllowing was
approved:
Business Associate Addendum between Monroe County and Mental Health Care
Center of the Lower Keys, Inc., d/bla Care Center for Mental Health. Agreement covers
security of Protected Health Information (PHI) as required by the Health Insurance
Portability and Accountability Act of 1996 (HIPAA) Privacy Rule effective April 13,
2003.
Enclosed please find a duplicate original of the subject document for your
handling.
Copies: Finance
County Attorney
File ,,/
I\t I\@~t ~\~J .~VJ 1\
DATE:
TO: Isabelle DeSantis, Office of Clerk of courts
FROM:
RE:
Business Associate Agreement
e..J. I
~ \ \ v
At the Monroe County BOCC meeting of March~ 2003 the enclosed
Business Associate Agreement for our EAP program was approved.
Enclosed are four originals for each agreement. Please handle as necessary
to have the documents executed and return to my attention for
forwarding. Your assistance in this matter will be greatly appreciated.
If you have any Questions, please call me at Ext. 4448.
BUSINESS ASSOCIATE ADDENDUM
THIS AGREEMENT, made and entered into this 16th day of April, 2003, by and
between Monroe County Board of County Commissioners (hereinafter called "Covered Entity")
and MENTAL HEALTH CARE CENTER OF THE LOWER KEYS, INe. DIB/ A Care Center
for Mental Health (hereinafter called "Business Associate"), is hereinafter set forth:
1. Definitions
Terms used, but not otherwise defined, in this Agreement shall have the same meaning as
those terms in 45 CFR ~~ 160.103 and 164.501, as the same may be amended from time to time.
(a) Business Associate. "Business Associate" shall mean Mental Health Care Center of the
Lower Keys, Inc. D/B/A Care Center for Mental Health.
(b) Covered Entity. "Covered Entity" shall mean Monroe County Board of County
Commissioners.
(c) Individual. "Individual" shall have the same meaning as the term "individual" in 45
CFR ~164.501 and shall include a person who qualifies as a personal representative in
accordance with 45 CFR~ 164.502(g).
(d) Privacy Rules. "Privacy Rules" shall mean the Standards for Privacy of Individually
Identifiable Health Information at 45 CFR Part 160 and Part 164, Subparts A and E.
( e) Protected Health Information. "Protected Health Information" shall have the same
meaning as the term "protected health information" in 45 CFR ~164.501, limited to the
information created or received by Business Associate from or on behalf of Covered Entity.
(f) Required By Law. "Required By Law" shall have the same meaning as the term
"required by law" in 45 CFR ~ 164.50 I.
(g) Secretary. "Secretary" shall mean the Secretary of the Department of Health and Human
Services or his or her designee.
(h) Designated Record Set. "Designated Record Set" shall have the same meaning as the
term "designated record set" in 45 CFR 164.501.
II. Obligations and Activities of Business Associate
(a) Business Associate agrees to not use or further disclose Protected Health Information
other than as permitted or required by the Agreement or as Required By Law.
(b) Business Associate agrees to use appropriate safeguards to prevent use or disclosure of
the Protected Health Information other than as provided for by this Agreement.
(c) Business Associate agrees to report to Covered Entity any use or disclosure of the
Protected Health Information not provided for by this Agreement.
(d) Business Associate agrees to ensure that any agent, including a subcontractor, to whom it
provides Protected Health Information received from, or created or received by Business
Associate on behalf of Covered Entity agrees to the same restrictions and conditions that apply
through this Agreement to Business Associate with respect to such information.
( e) Business Associate agrees to provide access, at the request of Covered Entity, and in the
time and manner designated by Covered Entity, to Protected Health Information in a Designated
Record Set, to Covered Entity or, as directed by Covered Entity, to an Individual in order to meet
the requirements under 45 CFR ~164.524.
(f) Business Associate agrees to make any amendment( s) to Protected Health Information in
a Designated Record Set that the Covered Entity directs or agrees to pursuant to 45 CFR
~ 164.52 at the request of Covered Entity or an Individual, and in the time and manner
designated by Covered Entity.
(g) Business Associate agrees to make internal practices, books, and records relating to the
use and disclosure of Protected Health Information received from, or created or received by
Business Associate on behalf of, Covered Entity available to the Covered Entity, or at the request
of the Covered Entity to the Secretary, in a time and manner designated by the Covered Entity or
the Secretary, for purposes of the Secretary determining Covered Entity's compliance with the
Privacy Rule.
(h) Business Associate agrees to document such disclosures of Protected Health Information
and information related to such disclosures as would be required for Covered Entity to respond
to request by an Individual for an accounting of disclosures of Protected Health Information in
accordance with 45 CFR ~164.528.
(i) Business Associate agrees to provide to Covered Entity or an Individual, in time and
manner designated by Covered Entity, information collected in accordance with this Agreement,
to permit Covered Entity to respond to a request by an Individual for an accounting of
disclosures of Protected Health Information in accordance with 45 CFR ~ 164.528.
III. Permitted Uses and Disclosures by Business Associate
2
(a) Except as otherwise limited in this Agreement, Business Associate may use or disclose
Protected Health Information to perform functions, activities, or services for, or on behalf of,
Covered Entity as specified in the Employee Assistance Program Agreement by and between
Monroe County Board of County Commissioners and Business Associate, provided that such use
of disclosure would not violate the Privacy Rules if done by Covered Entity.
(b) Covered Entity shall notify Business Associate in writing of any restriction to the use of
disclosure of Protected Health Information that Covered Entity has agreed to in accordance with
45 CFR S 164.522.
(c) Disclose PHI in its possession to third parties for the purpose of its proper management
and administration or to fulfill any of its present or future legal responsibilities provided that (i)
the disclosures are required by law, as provided for in 45 C.F.R. 164.501, or (ii) Business
Associate has received from the third party written assurances that the PHI will be held
confidentially, that the PHI will only be used or further disclosed as required by law or for the
purpose for which it was disclosed to the third party, and that the third party will notify the
Business Associate of any instances of which it is aware in which the confidentiality of the
information has been breached, as required under 45 C.F.R. 164.504 (e)(4).
IV. Obligation of Covered Entity
No later than the effective date of this Agreement, Covered Entity will provide Business
Associate with a copy of the Plan Sponsor's certification that the health plan meets and will
abide by all HIP AA requirements. With respect to the use and/or disclosure of PHI by Business
Associate, the Covered Entity hereby agrees:
(a) to use appropriate safeguards to maintain and ensure the confidentiality, privacy, and
security of PHI transmitted to Business Associate pursuant to the Agreement, in accordance with
the standards and requirements of HIP AA and the HIP AA Regulations, until such PHI is
received by Business Associate.
(b) to inform Business Associate of any changes in, or withdrawal of, the consent or
authorization provided to the Covered Entity by individuals pursuant to 45 C.F.R. 164.506 or
164.508.
(c) to notify Business Associate, in writing and in a timely manner, or any arrangements
permitted or required of the Covered Entity under 45 C.F.R. Parts 160 and 164 that may impact
in any manner the use and/or disclosure of PHI by the Business Associate under the agreement,
including, but not limited to, restrictions on the use and/or disclosure of PHI as provided for in
45 C.F.R. 164.522 agreed to by the Covered Entity.
(d) that Business Associate may make any use and/or disclosure of PHI permitted under 45
C.F.R. 164.512.
3
V. Term and Termination
(a) Term. The Term of this Agreement shall be effective as of April 16, 2003, and shall
terminate when all of the Protected Health Information provided by Covered Entity to Business
Associate, or created or received by Business Associate on behalf of Covered Entity, is destroyed
or returned to Covered Entity, or, if it is infeasible to return or destroy Protected Health
Information, protections are extended to such information, in accordance with the termination
provisions in this Section.
(b) Termination for Cause. Upon Covered Entity's knowledge of a material breach by
Business Associate, Covered Entity shall provide a reasonable opportunity for Business
Associate to cure the breach or end the violation. If such breach is not cured to the satisfaction
of the Covered Entity and in a manner consistent with the requirements of HIP AA, this
Agreement shall be terminated.
(c) Effect of Termination.
(1) Except as provided in paragraph (2) of this section, upon termination of this
Agreement, for any reason, Business Associate shall return or destroy all Protected Health
Information received from Covered Entity, or created or received by Business Associate on
behalf of Covered Entity. This provision shall apply to Protected Health Information that is in
the possession of subcontractors or agents of Business Associate. Business Associate shall retain
no copies of the Protected Health Information.
(2) In the event that Business Associate determines that returning or destroying the
Protected Health Information is infeasible, Business Associate shall provide to Covered Entity
notification of the conditions that make return or destruction infeasible. Upon mutual agreement
of the Parties that return or destruction Protected Health Information is infeasible, Business
Associate shall extend the protections of this Agreement to such Protected Health Information
and limit further uses and disclosures of such Protected Health Information to those purposes that
make the return or destruction infeasible, for so long as Business Associate maintains such
Protected Health Information.
VI. Miscellaneous
(a) Regulatory References. A reference in this Agreement to a section in the Privacy
Rule means the section as in effect or as amended, and for which compliance is required.
(b) Amendment. The Parties agree to take such action as is necessary to amend this
Agreement from time to time as is necessary for Covered Entity to comply with the requirements
of the Privacy Rule and the Health Insurance Portability and Accountability Act, Public Law
104-191.
(c) Survival. The respective rights and obligations of Business Associate under
Section V. (Q of this Agreement shall survive the termination of this Agreement.
4
(d) Interpretation. Any ambiguity in this Agreement shall be resolved in favor of a
meaning that permits Covered Entity to comply with the Privacy Rule.
IN WITNESS WHEREOF, this contract has been executive by the respective parties on
the date and year first written above.
BUSINESS ASSOCIATE:
Mental Health Care Center of the Lower
Keys, Inc.
By: ~~"'/f
PrintName:~~f,,// ~#04
Print Title:/J.#rfJe..T ~ CFO'
COVERED ENTITY
By Plan Administrator
By: ,t)J# >n ~l-J
Print Name: /)/x /t- /11. fpe,.,ha. f"
,
Print Title:
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