Notice2023-09596
Privacy Act of 1974; System of Records
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
May 5, 2023
Issuing agencies
State Department
Abstract
The information of the Bureau of Medical Services (MED) system is used and reviewed by medical and administrative personnel to provide health care to the individuals eligible to participate in the medical program, make clearance decisions for individuals eligible to participate in the health care program and for applicants to the Department of State, and as a reference for local medical capabilities. The system also serves to record and monitor the status of the professional credentials of Department of State Foreign Service, Civil Service and Locally Employed Staff healthcare providers.
Full Text
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<title>Federal Register, Volume 88 Issue 87 (Friday, May 5, 2023)</title>
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[Federal Register Volume 88, Number 87 (Friday, May 5, 2023)]
[Notices]
[Pages 29171-29175]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-09596]
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DEPARTMENT OF STATE
[Public Notice: 12065]
Privacy Act of 1974; System of Records
AGENCY: Department of State.
ACTION: Notice of a modified system of records.
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SUMMARY: The information of the Bureau of Medical Services (MED) system
is used and reviewed by medical and administrative personnel to provide
health care to the individuals eligible to participate in the medical
program, make clearance decisions for individuals eligible to
participate in the health care program and for applicants to the
Department of State, and as a reference for local medical capabilities.
The system also serves to record and monitor the status of the
professional credentials of Department of State Foreign Service, Civil
Service and Locally Employed Staff healthcare providers.
DATES: In accordance with 5 U.S.C. 552a(e)(4) and (11), this modified
system of records will be effective upon publication, except for the
routine uses (u), (v), and (w) that are subject to a 30-day period
during which interested persons may submit comments to the Department.
Please submit any comments by June 5, 2023. Unless comments are
received that would require a revision, this system of records will
become effective on June 5, 2023.
ADDRESSES: Questions can be submitted by mail, email, or by calling
Eric F. Stein, the Senior Agency Official for Privacy, on (202) 485-
2051. If mail, please write to: U.S Department of State; Office of
Global Information Systems, A/GIS; Room 4534, 2201 C St. NW,
Washington, DC 20520. If email, please address the email to the Senior
Agency Official for Privacy, Eric F. Stein, at <a href="/cdn-cgi/l/email-protection#4636342f3027253f06353227322368212930"><span class="__cf_email__" data-cfemail="afdfddc6d9ceccd6efdcdbcedbca81c8c0d9">[email protected]</span></a>.
Please write ``Medical Records, State-24'' on the envelope or the
subject line of your email.
FOR FURTHER INFORMATION CONTACT: Eric F. Stein, Senior Agency Official
for Privacy; U.S. Department of State; Office of Global Information
Services, A/GIS; Room 4534, 2201 C St. NW, Washington, DC 20520 or by
calling (202) 485-2051.
SUPPLEMENTARY INFORMATION: The purpose of this modification is twofold:
(1) to consolidate two existing records systems (State-71--Post
Capabilities Database and State-24--Medical Records) into a single
modified State-24, to accurately reflect the scope of Department
medical records; and (2) to reflect the expansion of Medical Records to
FedRAMP-authorized Cloud environments. The proposed merged System of
Records will include substantive modifications to the following
sections: Routine Uses, Categories of Records, Storage,
[[Page 29172]]
Retrievability, and Record Access Procedures. In addition, the
Department is taking this opportunity to make minor administrative
updates to the notice in the Security Classification and System
Location sections.
SYSTEM NAME AND NUMBER:
Medical Records, State-24.
SECURITY CLASSIFICATION:
Sensitive but unclassified.
SYSTEM LOCATION:
The Enterprise Server Operations Center (ESOC WEST) in Denver,
Colorado. Some records may be stored within a government cloud provided
system (Amazon Web Services and Microsoft Azure Gov) and within a
FedRAMP authorized government cloud system provided, implemented, and
overseen by the Department's Enterprise Server Operations Center
(ESOC), 2201 C Street NW, Washington, DC 20520.
SYSTEM MANAGER(S):
Director for Medical Informatics, Bureau of Medical Services, 2401
E Street NW, Washington, DC 20522, <a href="/cdn-cgi/l/email-protection#58103d2a2a31363f1d1c182b2c392c3d763f372e"><span class="__cf_email__" data-cfemail="1058756262797e7755545063647164753e777f66">[email protected]</span></a>.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
Foreign Service Act of 1980, Sec. 904 (22 U.S.C. 4084); and 5 CFR
part 792 (Federal Employees' Health, Counseling, and Work/Life
Programs).
PURPOSE(S) OF THE SYSTEM:
The records maintained in the systems include Personally
Identifiable Information (PII) and Protected Health Information (PHI)
and are used to enable MED's practitioners to provide the best medical
care possible to a globally dispersed patient population. Records
include patients' medical history/records, which are used to provide
medical care, adjudicate medical clearances, and support medical
evacuations. Additionally, the system describes the medical
capabilities available at each Post to support employees under Chief of
Mission authority. Moreover, the system also serves to provide medical
clearances of applicants to the Department of State. The system also
serves to record and monitor the current status of the professional
credentials of Department of State Foreign Service, Civil Service and
Locally Employed Staff healthcare providers.
CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
Applicants to the Department of State and their family members,
U.S. Government employees and their family members, Locally Employed
Staff, and any other individuals eligible to participate in the medical
program of the U.S. Department of State as authorized by either section
904 of the Foreign Service Act of 1980 (22 U.S.C. 4084) or other
applicable legal authority. The Privacy Act defines an individual at 5
U.S.C. 552a(a)(2) as a United States citizen or lawful permanent
resident.
CATEGORIES OF RECORDS IN THE SYSTEM:
Categories of records include full name; Social Security number
(Department of State Employees and applicants only); date of birth;
address; email address; phone number; State Global Identifier (SGID);
reports of medical examinations and related documents, images, and
other items; reports of treatments and other health services rendered
to individuals; immunization records; narrative summaries of hospital
treatments; personal medical histories; reports of on-the-job injuries
or illnesses; reports on medical evacuation; and/or any other types of
individually identifiable health information generated or used in the
course of conducting health care operations. This system includes
records that contain protected health information and does not include
records maintained by the Department of State and/or other employers in
their capacity as employers.
This system also includes certain records maintained as part of the
Department's Employee Assistance Program pursuant to 5 CFR part 792.
The system also includes a directory of MED staff, and professional
credentials of MED providers. The directory may include addresses,
emails, and phone numbers for direct-hire Foreign Service, Civil
Service, and Locally Employed Staff medical personnel. The credentials
that are maintained include copies of licenses and certifications
(Professional, Clinical, Drug Enforcement Administration (DEA),
clinical privileges information, and National Provider Identifier
(NPI)). For use by MED clinical staff, the system maintains directories
and high-level assessments of the location and quality of medical
resources offered in the areas surrounding most Post locations. This
system also includes the medical clearance records of applicants to the
Department of State who are in the final stages of their application
process and may further include the medical clearance records of their
family members.
RECORD SOURCE CATEGORIES:
Information contained in these records comes from applicants,
patients, hospitals, clinics, laboratories, private medical providers,
employers, and medical professionals employed by the Department of
State.
ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES
OF USERS AND PURPOSES OF SUCH USES:
Medical Records may be disclosed:
A. To another health care provider, a group health plan, a health
insurance issuer, or a health maintenance organization for purposes of
carrying out treatment, payment, or health care operations;
B. To a parent, guardian or other person acting in loco parentis
with respect to the subject of the information;
C. To a health oversight agency or public health authority
authorized by law to investigate or otherwise oversee the relevant
conduct or conditions of the Department of State's medical program, or
for such oversight activities as audits; civil, administrative, or
criminal proceedings or actions; inspections; and licensure or
disciplinary action;
D. To a public health authority (domestic or foreign) that is
authorized by law to collect or receive protected health information
for the purpose of preventing or controlling disease, injury, or
disability, including, but not limited to, the reporting of disease,
injury, vital events such as birth or death, and the conduct of public
health surveillance, public health investigations, and public health
interventions;
E. To the U.S. Department of Health and Human Services (HHS), when
required by the Secretary of HHS;
F. To a public health authority or other appropriate government
authority (domestic or foreign) authorized by law to receive reports of
child abuse or neglect;
G. To a person subject to the jurisdiction of the Food and Drug
Administration (FDA) with respect to an FDA-regulated product or
activity for which that person has responsibility, for the purpose of
activities related to the quality, safety, or effectiveness of such
FDA-regulated product or activity;
H. To a person who may have been exposed to a communicable disease
or may otherwise be at risk of contracting or spreading a disease or
condition, to the extent MED is authorized by law to notify such person
and as necessary in the conduct of a public health intervention or
investigation;
I. To a government authority (domestic or foreign), including a
social service or protective services agency, authorized by law to
receive reports of abuse, neglect or domestic violence (1)
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to the extent such a disclosure is required by law; (2) where in the
exercise of professional judgment, the disclosure is necessary to
prevent serious harm to the individual or other potential victims; or
(3) where, if the subject of the information is incapacitated, a law
enforcement, or other public official authorized to receive the report,
represents that the information sought is not intended to be used
against the individual and that an immediate enforcement activity that
depends upon the disclosure would be adversely affected by waiting
until the individual is able to agree to the disclosure;
J. To the Department of Justice, as required by law, for the
purpose of submitting information to the National Instant Criminal
Background Check System;
K. In the course of any judicial or administrative proceeding in
response to an order of a court or administrative tribunal;
L. To a law enforcement official (1) as required by law or in
compliance with a court order or court-ordered warrant, a subpoena or
summons issued by a judicial officer, a grand jury subpoena, or an
administrative request, including an administrative subpoena or
summons; (2) in response to a request for the purposes of identifying
or locating a suspect, fugitive, material witness, or missing person;
in response to a request for such information about an individual who
is or is suspected to be a victim of a crime; (3) to provide notice of
the death of an individual if there is a belief that the death may have
resulted from criminal conduct; (4) where it is believed in good faith
that such information constitutes evidence of criminal conduct; or (5)
in response to an emergency, where it is believed such disclosure is
necessary to alert law enforcement to the commission and nature of a
crime, the location of such crime or of the victim(s) of such crime,
and the identity, description, and location of the perpetrator of such
crime;
M. As necessary in order to prevent or lessen a serious and
imminent threat to the health or safety of a person or the public or to
a person or persons reasonably able to prevent or lessen the threat,
including the target of the threat;
N. To authorized federal officials for the conduct of lawful
intelligence, counter-intelligence, and other national security
activities authorized by the National Security Act (50 U.S.C. 401, et
seq.) and other applicable authorities (e.g., Executive Order 12333);
O. To authorized federal officials for the provision of protective
services to the President or other persons authorized by 18 U.S.C. 3056
or to foreign heads of state or other persons authorized by 22 U.S.C.
2709(a)(3), or for the conduct of investigations authorized by 18
U.S.C. 871 and 879;
P. To Department of State officials for the purposes of clearance
and suitability determinations, including (1) for a national security
clearance conducted pursuant to Executive Orders 10450 and 12698; (2)
for medical clearance determinations, consistent with the Foreign
Service Act, including sections 101(a)(4), 101(b)(5), 504, and 904;
Q. To a medical transcription or translation service for MED's
purposes of carrying out treatment or health care operations;
R. To a correctional institution or a law enforcement official
having lawful custody of an individual, if the correctional institution
or law enforcement official represents that such information is
necessary for the provision of health care to such individual, the
health and safety of other individuals (including others at the
correctional institution), or the administration and maintenance of the
safety, security, and good order of the correctional institution;
S. To a coroner or medical examiner for the purpose of identifying
a deceased person, determining a cause of death, or other duties as
authorized by law;
T. To appropriate domestic or foreign government officials
(including but not limited to the U.S. Department of Labor), as
authorized by and to the extent necessary to comply with laws relating
to workers' compensation or other similar programs, established by law,
that provide benefits for work-related injuries or illnesses without
regard to fault.
U. To appropriate agencies, entities, and persons when (1) the
Department of State suspects or has confirmed that there has been a
breach of the system of records; (2) the Department of State has
determined that as a result of the suspected or confirmed breach there
is a risk of harm to individuals, the Department of State (including
its information systems, programs, and operations), the Federal
Government, or national security; and (3) the disclosure made to such
agencies, entities, and persons is reasonably necessary to assist in
connection with the Department of State efforts to respond to the
suspected or confirmed breach or to prevent, minimize, or remedy such
harm.
V. To another Federal agency or Federal entity, when the Department
of State determines that information from this system of records is
reasonably necessary to assist the recipient agency or entity in (1)
responding to a suspected or confirmed breach or (2) preventing,
minimizing, or remedying the risk of harm to individuals, the recipient
agency or entity (including its information systems, programs, and
operations), the Federal Government, or national security, resulting
from a suspected or confirmed breach.
W. To private sector entities when required as part of U.S. Embassy
services or the operations of the State Department Medical Program.
The Department of State periodically publishes in the Federal
Register its standard routine uses that apply to all of its Privacy Act
systems of records. These notices appear in the form of a Prefatory
Statement (published in Volume 73, Number 136, Public Notice 6290, on
July 15, 2008). All these standard routine uses apply to Medical
Records, State-24.
POLICIES AND PRACTICES FOR STORAGE OF RECORDS:
Records are stored electronically. A description of standard
Department of State policies concerning storage of electronic records
is found at <a href="https://fam.state.gov/FAM/05FAM/05FAM0440.html">https://fam.state.gov/FAM/05FAM/05FAM0440.html</a>.
POLICIES AND PRACTICES FOR RETRIEVAL OF RECORDS:
Patient records are retrievable by individual name and/or date of
birth, or patient identification number. MED practitioner records are
retrieval by name or Post. Post capability records are retrievable by
Post name.
POLICIES AND PRACTICES FOR RETENTION AND DISPOSAL OF RECORDS:
Records are retired and destroyed in accordance with published
Department of State Records Disposition Schedules as approved by the
National Archives and Records Administration (NARA) and outlined at
<a href="https://foia.state.gov/Learn/RecordsDisposition.aspx">https://foia.state.gov/Learn/RecordsDisposition.aspx</a>. Additionally,
patient information will be retained in the system for no less than the
period of time specified in Disposition Authorities and will be
archived rather than destroyed when the retention period has passed.
Medical Program Files (permanent) will be transferred to the National
Archives 25 years after the end of the calendar year in which the file
was last updated. Non-Occupational Individual Medical Case Files
(temporary) will be archived by MED no earlier than 10 years after the
most recent encounter. Occupational Individual Medical Case Files (long
term--temporary) will be archived by MED no earlier than 30 years after
employee separation or when the
[[Page 29174]]
Official Personnel Folder is destroyed, whichever is longer. More
specific information may be obtained by writing to the following
address: U.S. Department of State; Director, Office of Information
Programs and Services; A/GIS/IPS; 2201 C Street NW, Room B-266;
Washington, DC 20520.
ADMINISTRATIVE, TECHNICAL, AND PHYSICAL SAFEGUARDS:
All Department of State network users are given cyber security
awareness training which covers the procedures for handling Sensitive
but Unclassified (SBU) information, including personally identifiable
information (PII). Annual refresher training is mandatory. In addition,
all Department OpenNet users are required to take the Foreign Service
Institute distance learning course instructing employees on privacy and
security requirements, including the rules of behavior for handling PII
and the potential consequences if it is handled improperly. Before
being granted access to Medical Records, a user must first be granted
access to the Department of State computer systems.
Department of State employees and contractors may remotely access
this system of records using non-Department owned information
technology. Such access is subject to approval by the Department's
mobile and remote access program and is limited to information
maintained in unclassified information systems. Remote access to the
Department's information systems is configured in compliance with OMB
Circular A-130 multifactor authentication requirements and includes a
time-out function. All Department of State employees and contractors
with authorized access to records maintained in this system of records
have undergone a thorough background security investigation. Access to
the Department of State, its annexes, and Posts abroad is controlled by
security guards and admission is limited to those individuals
possessing a valid identification card or individuals under proper
escort. Access to computerized files is password-protected and under
the direct supervision of the system manager. The system manager has
the capability of printing audit trails of access from the computer
media, thereby permitting regular and ad hoc monitoring of computer
usage. When it is determined that a user no longer needs access, the
user account is disabled.
The safeguards in the following paragraphs apply only to records
that are maintained in government-certified cloud systems. All cloud
systems that provide IT services and process Department of State
information must be specifically authorized by the Department of State
Authorizing Official and Senior Agency Official for Privacy.
Information that conforms with Department-specific definitions for
Federal Information Security Modernization Act (FISMA) low, moderate,
or high categorization are permissible for cloud usage and must
specifically be authorized by the Department's Cloud Program Management
Office and the Department of State Authorizing Official. Specific
security measures and safeguards will depend on the FISMA
categorization of the information in a given cloud system. In
accordance with Department policy, systems that process more sensitive
information will require more stringent controls and review by
Department cybersecurity experts prior to approval. Prior to operation,
all Cloud systems must comply with applicable security measures that
are outlined in FISMA, FedRAMP, OMB regulations, National Institute of
Standards and Technology's (NIST) Special Publications (SP) and Federal
Information Processing Standards (FIPS) and Department of State
policies and standards.
All data stored in cloud environments categorized above a low FISMA
impact risk level must be encrypted at rest and in-transit using a
federally-approved encryption mechanism. The encryption keys shall be
generated, maintained, and controlled in a Department data center by
the Department key management authority. Deviations from these
encryption requirements must be approved in writing by the Department
of State Authorizing Official. High FISMA impact risk level systems
will additionally be subject to continual auditing and monitoring,
multifactor authentication mechanism utilizing Public Key
Infrastructure (PKI) and NIST 800 53 controls concerning
virtualization, servers, storage, and networking, as well as stringent
measures to sanitize data from the cloud service once the contract is
terminated.
RECORD ACCESS PROCEDURES:
Individuals who wish to gain access to or amend records pertaining
to themselves should write to U.S. Department of State; Director,
Office of Information Programs and Services; A/GIS/IPS; 2201 C Street
NW, Room B-266; Washington, DC 20520. The individual must specify that
he or she wishes the Medical Records to be checked. At a minimum, the
individual must include: full name (including maiden name, if
appropriate) and any other names used; current mailing address and zip
code; date and place of birth; notarized signature or statement under
penalty of perjury; a brief description of the circumstances that
caused the creation of the record (including the city and/or country
and the approximate dates) which gives the individual cause to believe
that Medical Records include records pertaining to the individual.
Detailed instructions on Department of State procedures for accessing
and amending records can be found on the Department's FOIA website at
<a href="https://foia.state.gov/Request/Guide.aspx">https://foia.state.gov/Request/Guide.aspx</a>.
Further, patients can access their medical records through the
patient portal, My Global Health (MGH). Patients can seek a printed
copy of their medical records by submitting a request to Medical
Records, Bureau of Medical Services (address above). Parents may also
request medical records of dependent children. At a minimum, the
individual requesting a copy of his or her medical records must include
the following: name, date and place of birth, current mailing address
and zip code, signature, a brief description of the circumstances that
may have caused the creation of the records that are the subject of the
request, and the approximate date(s) of those records.
CONTESTING RECORD PROCEDURES:
Individuals who wish to contest record procedures should write to
U.S. Department of State; Director, Office of Information Programs and
Services; A/GIS/IPS; 2201 C Street NW, Room B-266; Washington, DC
20520.
NOTIFICATION PROCEDURES:
Individuals who have cause to believe that the Bureau of Medical
Services might have medical records pertaining to them and want to
request a copy of those medical records should write to write to U.S.
Department of State; Director, Office of Information Programs and
Services; A/GIS/IPS; 2201 C Street NW, Room B-266; Washington, DC
20520. The individual must specify that he/she wishes the Medical
Records to be checked. At a minimum, the individual must include: full
name (including maiden name, if appropriate) and any other names used;
current mailing address and zip code; date and place of birth;
notarized signature or statement under penalty of perjury; a brief
description of the circumstances that caused the creation of the record
(including the city and/or country and the approximate dates) which
gives the individual cause to believe that Medical Records include
records pertaining to the individual.
[[Page 29175]]
EXEMPTIONS PROMULGATED FOR THE SYSTEM:
None.
HISTORY:
Post Capability Database (State-71)--previously published at 74 FR
65586; Medical Records (State-24)--previously published at 74 FR 24891.
Eric F. Stein,
Deputy Assistant Secretary, Global Information Services (A/GIS),
Department of State.
[FR Doc. 2023-09596 Filed 5-4-23; 8:45 am]
BILLING CODE 4710-36-P
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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.