These Policies and procedures cover _________[Insert Name of Covered Entity, such as County”], a ___________[Insert legal description of Covered Entity, such as “Franklin “a political subdivision of the State of Iowa”]. Throughout this document ________[Insert name shall be identified as Entity” of Covered Entity] “Covered In accordance with 45 C.F.R. §164.514(d)(2), the Covered Entity has identified: Those persons or classes of persons, as appropriate, in its workforce who need access to PHI to carry out their duties; and For each such person or class of persons, the category or categories of PHI to which access is needed and any conditions appropriate to such access. The following designations have been made: [Insert applicable information for Covered Entity in the chart below.] PHI Access Category or Categories of Method of access to Position/Job Title Required? PHI to be accessed PHI Community Services Yes All departmental Hard copies, digital Director information and data systems Targeted Case Yes All case management client Hard copies, digital Management information and data systems Supervisor General Assistance Yes Client files related to Hard copies, digital Staff general assistance and data systems Veteran Affairs Staff Yes Client related to Hard copies, digital Veteran Affairs and data systems Case Manager Yes Client specific related Hard copies, digital to case management and data systems Board of Supervisors Yes Claims and Insurance Hard Copies Information, Appeals Auditor Yes Claims information, Hard Copy and insurance information electronic Home Care Aide Yes Medical Charts on Assigned Hard Copy Clients Home Care Director Yes Client Medical Records Hard Copy and electronic Public Health Nurse Yes Client Medical Records Hard Copy and electronic Public Health Secretary Yes Client Medical Records Hard Copy and electronic Public Health Director Yes Client Medical Records Hard Copy and electronic [Insert Workforce Designations for the Group Health Plan in a similar format]
These Policies and procedures cover _________[Insert Name of Covered Entity, such as “Franklin County”], a ___________[Insert legal description of Covered Entity, such as “a political subdivision of the State of Iowa”]. Throughout this document ________[Insert name of Covered Entity] shall be identified as “Covered Entity” In accordance with 45 C.F.R. §164.514(d)(2), the Covered Entity has identified: Those persons or classes of persons, as appropriate, in its workforce who need access to PHI to carry out their duties; and For each such person or class of persons, the category or categories of PHI to which access is needed and any conditions appropriate to such access. The following designations have been made: [Insert applicable information for Covered Entity in the chart below.] Position/Job Title PHI Access Required? Category or Categories of PHI to be accessed Method of access to PHI Community Services Director Yes All departmental information Hard copies, digital and data systems Targeted Case Management Supervisor Yes All case management client information Hard copies, digital and data systems General Assistance Staff Yes Client files related to general assistance Hard copies, digital and data systems Veteran Affairs Staff Yes Client related to Veteran Affairs Hard copies, digital and data systems Case Manager Yes Client specific related to case management Hard copies, digital and data systems Board of Supervisors Yes Claims and Insurance Information, Appeals Hard Copies Auditor Yes Claims information, insurance information Hard Copy and electronic Home Care Aide Yes Medical Charts on Assigned Clients Hard Copy Home Care Director Yes Client Medical Records Hard Copy and electronic Public Health Nurse Yes Client Medical Records Hard Copy and electronic Public Health Secretary Yes Client Medical Records Hard Copy and electronic Public Health Director Yes Client Medical Records Hard Copy and electronic [Insert Workforce Designations for the Group Health Plan in a similar format]
Iowa-Counties-and-Regions-HIPAA-Privacy-and-Security-Policies-Template-For-Counties-not-ISAC-2.docx