Page images
PDF
EPUB
[blocks in formation]

51a

51b

51c

Project grants for maternal and child health ...
Project grants for preventive health services
Grants for community health services

172

174

181

51d-51g [Reserved]

52

Grants for research projects ....

197

52a

52b

52c

52d

....

National Institutes of Health center grants
National Cancer Institute construction grants
Minority Biomedical Research Support Program
National Cancer Institute Clinical Cancer Edu-
cation Program

201

204

208

211

52e

52h

National Heart, Lung, and Blood Institute grants
for prevention and control projects............
Scientific peer review of research grant applica-
tions and research and development contract
projects

214

217

53

Grants, loans and loan guarantees for construction
and modernization of hospitals and medical fa-
cilities ......

222

54a

Grants for alcohol abuse and alcoholism preven-
tion, treatment, and rehabilitation services and
National Alcohol Research Centers

[blocks in formation]

Grants for construction of teaching facilities, edu-
cational improvements, scholarships and student
loans

254

58

59

60

888 8

Grants for training of public health and allied
health personnel

398

59a

Grants for family planning services
National Library of Medicine grants
Health Education Assistance Loan Program

422

434

438

SUBCHAPTER E-FELLOWSHIPS, INTERNSHIPS, TRAINING

[subsumed][subsumed][subsumed][subsumed][subsumed][ocr errors][merged small][merged small]

National Health Service Corps Scholarship and
Loan Repayment Programs ...

475

Traineeships

[ocr errors]

494

64a

National Library of Medicine training grants
Obligated service for mental health traineeships
National Institute of Environmental Health
Sciences hazardous waste worker training

496

499

502

H

[blocks in formation]

72 75

Interstate shipment of etiologic agents

538

Standards for the accreditation of educational pro-
grams for and the credentialing of radiologic per-
sonnel

542

80

84

85

85a

SUBCHAPTER G- OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES

Administrative functions, practices, and proce

dures ......

Approval of Respiratory Protective Devices
Requests for health hazard evaluations .......
Occupational safety and health investigations of
places of employment ......

555

556

621

626

86

Grants for education programs in occupational
safety and health......

631

87

National Institute for Occupational Safety and
Health Research and demonstration grants

639

90

SUBCHAPTER H-HEALTH ASSESSMENTS AND HEALTH EFFECTS STUDIES OF HAZARDOUS SUBSTANCES RELEASES AND FACILITIES

Administrative functions, practices, and proce-
dures.....

[blocks in formation]

Medical facility construction and modernization ... 651 125-399 [Reserved]

[graphic][subsumed]
[blocks in formation]

Subpart E-Court Orders Authorizing
Disclosures and Use

2.61 Legal effect of order.

2.62 Order not applicable to records dis-
closed without consent to researchers,
auditors and evaluators.

2.63 Confidential communications.

2.64 Procedures and criteria for orders an-

thorizing disclosures for noncriminal

purposes.

2.65 Procedures and criteria for orders au-

thorizing disclosure and use of records to

criminally investigate or prosecute pa-

tients.

2.66 Procedures and criteria for orders au-

thorizing disclosure and use of records to

investigate or prosecute a program or

the person holding the records.

2.67 Orders authorizing the use of under-

cover agents and informants to crimi-

nally investigate employees or agents of

a program.

AUTHORITY: Sec. 408 of Pub. L. 92-255, 86

Stat. 79, as amended by sec. 303 (a), (b) of

Pub L. 93-282, 83 Stat. 137, 138; sec. 4(c)(5)(A)

of Pub. L. 94-237, 90 Stat. 244; sec. 111(c)(3) of

Pub. L. 94-581, 90 Stat. 2852; sec. 509 of Pub.
L. 96-88, 93 Stat. 695; sec. 973(d) of Pub. L. 97-

35, 95 Stat. 598; and transferred to sec. 527 of

the Public Health Service Act by sec.

2(b)(16)(B) of Pub. L. 98-24, 97 Stat. 182 and as

amended by sec. 106 of Pub. L. 99-401, 100

Stat. 907 (42 U.S.C. 290ee-3) and sec. 333 of

Pub. L. 91-616, 84 Stat. 1853, as amended by

sec. 122(a) of Pub. L. 93-282, 88 Stat. 131; and

sec. 111(c)(4) of Pub. L. 94-581, 90 Stat. 2852

and transferred to sec. 523 of the Public

Health Service Act by sec. 2(b)(13) of Pub. L.

98-24, 97 Stat. 181 and as amended by sec. 106

of Pub. L. 99-401, 100 Stat. 907 (42 U.S.C.

290dd-3), as amended by sec. 131 of Pub. L.

102-321, 106 Stat. 368, (42 U.S.C. 290dd-2).

SOURCE: 52 FR 21809, June 9, 1987, unless
otherwise noted.

י

[ocr errors]

at 42 U.S.C. 290ee-3. The amended statutory authority is set forth below:

$290ee-3.

CONFIDENTIALITY OF PATIENT
RECORDS.

(a) Disclosure authorization

Records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any drug abuse prevention function conducted, regulated, or directly or indirectly assisted by any department or agency of the United States shall, except as provided in subsection (e) of this section, be confidential and be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b) of this section. (b) Purposes and circumstances of disclosure affecting consenting patient and patient regardless of consent

(1) The content of any record referred to in subsection (a) of this section may be disclosed in accordance with the prior written consent of the patient with respect to whom such record is maintained, but only to such extent, under such circumstances, and for such purposes as may be allowed under reguLlations prescribed pursuant to subsection (g) of this section.

D

[ocr errors][ocr errors][ocr errors][merged small][merged small]

6

(2) Whether or not the patient, with respect to whom any given record referred to in subsection (a) of this section is maintained, gives his written consent, the content of such record may be disclosed as follows:

(A) To medical personnel to the extent necessary to meet a bona fide medical emergency.

(B) To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any individual patient in any report of such research, audit, or evaluation, or otherwise disclose patient identities in any manner.

(C) If authorized by an appropriate order of a court of competent jurisdiction granted after application showing good cause therefor. In assessing good cause the court shall weigh the public interest and the need for disclosure against the injury to the patient, to the physician-patient relationship, and to the treatment services. Upon the granting of such order, the court, in determining the extent to which any disclosure of all or any part of any record is necessary, shall impose appropriate safeguards against unauthorized disclosure.

(c) Prohibition against use of record in making criminal charges or investigation of patient Except as authorized by a court order granted under subsection (b)(2)(C) of this section, no record referred to in subsection (a) of this section may be used to initiate or substantiate any criminal charges against a

patient or to conduct any investigation of a patient.

(d) Continuing prohibition against disclosure irrespective of status as patient

The prohibitions of this section continue to apply to records concerning any individual who has been a patient, irrespective of whether or when he ceases to be a patient.

(e) Armed Forces and Veterans' Administration; interchange of records; report of suspected child abuse and neglect to State or local authorities

The prohibitions of this section do not apply to any interchange of records

(1) within the Armed Forces or witrhin those components of the Veterans' Administration furnishing health care to veterans, or (2) between such components and the Armed Forces.

The prohibitions of this section do not apply to the reporting under State law of incidents of suspected child abuse and neglect to the appropriate State or local authorities. (f) Penalty for first and subsequent offenses

Any person who violates any provision of this section or any regulation issued pursuant to this section shall be fined not more than $500 in the case of a first offense, and not nore than $5,000 in the case of each subsequent offense.

(g) Regulations; interagency consultations; definitions, safeguards, and procedures, including procedures and criteria for issuance and Scope of orders

Except as provided in subsection (h) of this section, the Secretary, after consultation with the Administrator of Veterans' Affairs and the heads of other Federal departments and agencies substantially affected thereby, shall prescribe regulations to carry out the purposes of this section. These regulations may contain such definitions, and may provide for such safeguards and procedures, including procedures and criteria for the issuance and scope of orders under subsection (b)(2)(C) of this section, as in the judgment of the Secretary are necessary or proper to effectuate the purposes of this section, to prevent circumvention or evasion thereof, or to facilitate compliance therewith.

(Subsection (h) was superseded by section 111(c)(3) of Pub. L. 94-581. The responsibility of the Administrator of Veterans' Affairs to write regulations to provide for confidentiality of drug abuse patient records under Title 38 was moved from 21 U.S.C. 1175 to 38 U.S.C. 4134.)

§2.2 Statutory authority for confidentiality of alcohol abuse patient records.

The restrictions of these regulations upon the disclosure and use of alcohol abuse patient records were initially authorized by section 333 of the Comprehensive Alcohol Abuse and Alcohol

[graphic]

ism Prevention, Treatment, and Rehabilitation Act of 1970 (42 U.S.C. 4582). The section as amended was transferred by Pub. L. 98-24 to section 523 of the Public Health Service Act which is codified at 42 U.S.C. 290dd-3. The amended statutory authority is set forth below:

§290dd-3. CONFIDENTIALITY OF PATIENT
RECORDS

(a) Disclosure authorization

Records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to alcoholism or alcohol abuse education, training, treatment, rehabilitation, or research, which is conducted, regulated, or directly or indirectly assisted by any department or agency of the United States shall, except as provided in subsection (e) of this section, be confidential and be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b) of this section.

(b) Purposes and circumstances of disclosure affecting consenting patient and patient regardless of consent

(1) The content of any record referred to in subsection (a) of this section may be disclosed in accordance with the prior written consent of the patient with respect to whom such record is maintained, but only to such extent, under such circumstances, and for such purposes as may be allowed under regulations prescribed pursuant to subsection (g) of this section.

(2) Whether or not the patient, with respect to whom any given record referred to in subsection (a) of this section is maintained, gives his written consent, the content of such record may be disclosed as follows:

(A) To medical personnel to the extent necessary to meet a bona fide medical emergency.

(B) To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any individual patient in any report of such research, audit, or evaluation, or otherwise disclose patient identities in any manner.

(C) If authorized by an appropriate order of a court of competent jurisdiction granted after application showing good cause therefor. In assessing good cause the court shall weigh the public interest and the need for disclosure against the injury to the patient, to the physician-patient relationship, and to the treatment services. Upon the granting of such order, the court, in determining the extent to which any disclosure of all or any part of any record is necessary, shall impose

appropriate safeguards against unauthorized disclosure.

(c) Prohibition against use of record in making criminal charges or investigation of patient Except as authorized by a court order granted under subsection (b)(2)(C) of this section, no record referred to in subsection (a) of this section may be used to initiate or substantiate any criminal charges against a patient or to conduct any investigation of a patient.

(d) Continuing prohibition against disclosure irrespective of status as patient

The prohibitions of this section continue to apply to records concerning any individual who has been a patient, irrespective of whether or when he ceases to be a patient.

(e) Armed Forces and Veterans' Administration; interchange of record of suspected child abuse and neglect to State or local authorities

The prohibitions of this section do not apply to any interchange of records

(1) within the Armed Forces or within those components of the Veterans' Administration furnishing health care to veterans, or (2) between such components and the Armed Forces.

The prohibitions of this section do not apply to the reporting under State law of incidents of suspected child abuse and neglect to the appropriate State or local authorities.

(f) Penalty for first and subsequent offenses Any person who violates any provision of this section or any regulation issued pursuant to this section shall be fined not more than $500 in the case of a first offense, and not more than $5,000 in the case of each subsequent offense.

(g) Regulations of Secretary; definitions, safeguards, and procedures, including procedures and criteria for issuance and scope of orders

Except as provided in subsection (h) of this section, the Secretary shall prescribe regulations to carry out the purposes of this section. These regulations may contain such definitions, and may provide for such safeguards and procedures, including procedures and criteria for the issuance and scope of orders under subsection(b)(2)(C) of this section, as in the judgment of the Secretary are necessary or proper to effectuate the purposes of this section, to prevent circumvention or evasion thereof, or to facilitate compliance therewith.

(Subsection (h) was superseded by section 111(c)(4) of Pub. L. 94-581. The responsibility of the Administrator of Veterans' Affairs to write regulations to provide for confidentiality of alcohol abuse patient records under Title 38 was moved from 42 U.S.C. 4582 to 38 U.S.C. 4134.)

§2.3 Purpose and effect.

(a) Purpose. Under the statutory provisions quoted in §§2.1 and 2.2, these regulations impose restrictions upon

« PreviousContinue »