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CHAPTER I-PUBLIC HEALTH SERVICE,

DEPARTMENT OF HEALTH, EDUCATION,

AND WELFARE

SUBCHAPTER A-GENERAL PROVISIONS

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Availability of records and information .........
Confidentiality of alcohol and drug abuse patient
records..........

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Narcotic addicts

Medical care for seamen and certain other per-
sons.....

Medical care for certain personnel of the Coast
Guard, National Ocean Survey, Public Health
Service, and former Lighthouse Service

96

......

101

107

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Policies of general applicability

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Grants to States for comprehensive health plan-
ning and public health services ..............

173

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Grants for maternal and child health and crip-
pled children's services........

180

Part

Page

51b

51c

51d

Grants for communicable disease control..............
Grants for community health services.................................
Grants for service projects for genetic and other
diseases..............

207

211

227

51e 52

Grants for home health services...
Grants for research projects..........

234

242

52a

National Heart, Lung, and Blood Institute Grants
for National Research and Demonstration Cen-
ters....

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National Heart, Lung, and Blood Institute grants
for prevention and control projects.

269

53

Grants, loans and loan guarantees for construc-
tion and modernization of hospitals and medical
facilities...............

273

54

54a

Grants for community mental health centers
Grants to States for alcohol abuse and alcoholism
prevention, treatment, and rehabilitation ser-

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54b

55

55a

56

56a

56b

57

Grants to States for drug abuse prevention func-
tions............

Grants for advancement of health in coal mining..
Program grants for coal miners' respiratory clinics
Grants for migrant health services................................
Grants for emergency medical services systems......
Grants for regional medical programs .........
Grants for construction of health research facili-
ties (including mental retardation research fa-
cilities), teaching facilities, student loans, educa-
tional improvement and scholarships.....

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Public Health and National Health Service Corps
Scholarship Program..........

536

63

National Institutes of Health and National Li-
brary of Medicine traineeships............

539

64

65

National Institutes of Health and National Li-
brary of Medicine Training Grants ....
Fees for direct training, Center for Disease Con-
trol..............

541

543

66

National Research Service Awards

544

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SUBCHAPTER G-OCCUPATIONAL SAFETY AND HEALTH RESEARCH AND RELATED ACTIVITIES

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

622

Certification of industrial sound level meter sets...
Certification of gas detector tube units

623

636

Requests for health hazard evaluations

644

85a

Occupational safety and health investigations of
places of employment.................

649

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

653

Grants for research and demonstrations relating
to occupational safety and health ......

661

SUBCHAPTER H-LEAD BASED PAINT POISONING PREVENTION

90

91

Lead-based paint poisoning prevention in Federal
and federally assisted construction ...............
Grants for prevention of lead-based paint poison-
ing .......

668

669

SUBCHAPTER I-MEDICAL CARE QUALITY AND COST CONTAINMENT

100

Cost containment and quality control...............

675

110

SUBCHAPTER J-HEALTH CARE DELIVERY SYSTEMS
Health Maintenance Organizations................
SUBCHAPTER K-HEALTH PLANNING AND RESOURCES

686

DEVELOPMENT

122

Health Systems Agencies...................

724

123

State health planning and development agencies... 753

SUBCHAPTER A-GENERAL PROVISIONS

PART 1-AVAILABILITY OF RECORDS AND INFORMATION

Sec.

1.101 Public inspection of official records. 1.102 Clinical information; disclosure. 1.103 Nonclinical information; disclosure. 1.104 Disclosure upon court or other official order.

1.105 Disclosure to officers and employees of the Service.

1.106 Response to subpoena or other compulsory process.

1.107 Limitations on release of records. 1.108 Relation to other provisions of law.

AUTHORITY: Sec. 215, 58 Stat. 690, as amended; 42 U.S.C. 216, unless otherwise noted.

SOURCE: 21 FR 9805, Dec. 12, 1956, unless otherwise noted.

81.101 Public inspection of official records.

Except as is otherwise provided in this part, the official records of the Public Health Service are available upon request for inspection by persons properly and directly concerned. Requests for permission to inspect official records of the Service are required to be addressed to the Surgeon General of the Public Health Service, Washington 25, D.C. [20852], unless other.. wise directed in published organizational, procedural, or regulatory statements pertaining to specific records or classes of records. Such request shall set forth the interest of the applicant in the subject matter of the records sought to be inspected.

§ 1.102 Clinical information; disclosure.

(a) For the purposes of this section: (1) "Patient" shall mean any person who is receiving or has received medical care or treatment or an examination at facilities of the Public Health Service or at other facilities by, or under the direction of, personnel of the Service or at its expense.

shall

(2) "Clinical information" mean any information received by personnel of the Service from patients or regarding patients and related to their examination, care, or treatment.

(b) Clinical information in the records or in the possession of the Ser

vice is confidential and shall be disclosed only as necessary for the performance of the functions of the Service, or as follows:

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(1) Upon a reasonable showing of the need therefor, the officer charge of a hospital, station or other facility of the Service may authorize disclosure to a patient or a person designated by a patient (or, in the case of a deceased patient, to his next of kin or an authorized representative of his estate) of such clinical information as such officer determines to be medically appropriate for disclosure. The information shall not be disclosed to a person other than the patient except on the condition that it shall not be further disclosed for any purpose other than that for which it was shown to be needed. If the patient's examination, treatment or care was requested or arranged for by a governmental agency, the information shall not in any event be disclosed without the consent of that agency.

(2) Any governmental agency which, in accordance with applicable statutes, has requested or arranged for the examination, treatment, or care of a patient by the Service may upon request be furnished clinical information regarding such examination, treatment,

or care.

(3) At the direction of the Surgeon General or his designee, clinical information may be furnished State or other public health agencies engaged in collecting data regarding disease.

(4) Nothing in this section shall preclude the officer in charge of any facility of the Service from disclosing (i) information as to the presence of a patient in the facility, or as to his general condition and progress, or (ii) such information regarding the commission of crimes or the occurrence of communicable disease as may be required to be disclosed by hospitals generally by the law of the State in which the facility is located.

§1.103 Nonclinical information; disclo

sure.

(a) Information in the records or possession of the Service obtained by

the Service under an assurance of confidentiality which the Surgeon General or his authorized representative determines to be necessary for the purpose of any research, survey, investigation, or collection of statistical data may be disclosed only with the consent of the person, association, or agency to which such assurance was given, or whenever the Surgeon General specifically determines disclosure to be necessary (1) to prevent an epidemic or other grave danger to the public health or (2) to oppose any legal action related to the activities of the Service and brought against the United States or any of its officers or employees.

(b) [Reserved]

(c) The following types of information in the records or possession of the Service are confidential and, subject to the provisions of paragraph (a) of this section, shall be disclosed only as necessary for the performance of the functions of the Service, or as follows:

(1) Information concerning individuals, business enterprises, or public or private agencies obtained by the Service in connection with communicable disease control, water pollution control, licensing of biological products or the manufacture of such products, or with other regulatory functions of the Service may be disclosed to Federal, State or local authorities carrying on related governmental functions to the extent necessary to carry out such related functions.

(2) Information and data obtained and tentative and final conclusions reached in course of or in connection with the conduct of research projects, surveys and investigations may be disclosed at such times and to such extent as the Surgeon General or his designee may determine to be in the public interest.

(3) Information obtained in connection with applications for employment, fellowships, traineeships or commissions or for research or other grants and information obtained for similar purposes may be disclosed upon consent of the person concerned.

[21 FR 9805, Dec. 12, 1956, as amended at 38 FR 34118, Dec. 11, 1973]

§1.104 Disclosure upon court or other official order.

Notwithstanding any other provisions of this part, information in the records or in the possession of the Service, except information described in § 1.103(a) and information the disclosure of which the Surgeon General determines would impair national security, shall be disclosed upon the order of a judge of a court of competent jurisdiction or of a responsible officer of any agency or body having power to compel appearances before it: Provided, however, That (a) clinical information shall be disclosed only in accord with applicable local law regarding the confidentiality of communications to physicians as expressly determined by the court, agency or body, and (b) in the case of an order requiring production of records other than to the court, agency or body involved, the Surgeon General or his designee may determine, in the light of the need to assure the integrity and safety of the records or the efficient administration of the Service, that the records shall be made available for examination of copying at such place as may be designated by him.

[21 FR 9805, Dec. 12, 1956, as amended at 38 FR 34118, Dec. 11, 1973]

§ 1.105 Disclosure to officers and employees of the Service.

No provision of this part shall be deemed to forbid any officer or employee of the Service to disclose any information to any other officer or employee of the Service in the course of official business.

§1.106 Response to subpoena or other compulsory process.

If any officer or employee of the Service is sought to be required, by subpoena or other compulsory process, to produce records of the Service or to disclose any information described in § 1.102 or § 1.103, he shall respond, call attention to the provisions of this part, and respectfully decline to produce records or disclose information inconsistent with such provisions: Provided, That where a patient (or, in the case of a deceased patient, his next of kin or an authorized representative of

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