**§17.509 Authorized disclosure: Non-Department of Veterans Affairs
requests.**

\(a\) Requests for confidential and privileged quality assurance records
and documents from organizations or individuals outside VA must be made
to the Department and must specify the nature and content of the
information requested, to whom the information should be transmitted or
disclosed, and the purpose listed in paragraphs (b) through (j) of this
section for which the information requested will be used. In addition,
the requestor will specify to the extent possible the beginning and
final dates of the period for which disclosure or access is requested.
The request must be in writing and signed by the requestor. Except as
specified in paragraphs (b) and (c) of this section, these requests
should be forwarded to the Director of the facility in possession of the
records or documents for response. The procedures outlined in 38 CFR
1.500 through 1.584 will be followed where applicable.

\(b\) Disclosure shall be made to Federal agencies upon their written
request to permit VA's participation in healthcare programs including
healthcare delivery, research, planning, and related activities with the
requesting agencies. Any Federal agency may apply to the Under Secretary
for Health for approval. If the VA decides to participate in the
healthcare program with the requestor, the requesting agency will enter
into an agreement with VA to ensure that the agency and its staff will
ensure the confidentiality of any quality assurance records or documents
shared with the agency.

\(c\) Qualified persons or organizations, including academic
institutions, engaged in healthcare program activities shall, upon
request to and approval by the Under Secretary for Health, Regional
Director, medical facility Director, or their designees, have access to
confidential and privileged medical quality assurance records and
documents to permit VA participation in a healthcare activity with the
requestor provided that no records or documents are removed from the VA
facility in possession of the records.

\(d\) When a request under paragraphs (b) or (c) of this section
concerns access for research purposes, the request, together with the
research plan or protocol, shall first be submitted to and approved by
an appropriate VA medical facility Research and Development Committee
and then approved by the Director of the VA medical facility. The VA
medical facility staff together with the qualified person(s) conducting
the research shall be responsible for the preservation of the anonymity
of the patients, clients, and providers and shall not disseminate any
records or documents which identify such individuals directly or
indirectly without the individual's consent. This applies to the
handling of data or information as well as reporting or publication of
findings. These requirements are in addition to other applicable
protections for the research.

\(e\) Individually identified patient medical record information which
is protected by another statute as provided in §17.502 may not be
disclosed to a non-VA person or organization, including disclosures for
research purposes under paragraph (d), except as provided in that
statute.

\(f\) Under paragraph (b), the Under Secretary for Health or designee or
under paragraph (c), the Under Secretary for Health, Regional Director,
medical facility Director, or their designees may approve a written
request if it meets the following criteria:

> \(1\) Participation by VA will benefit VA patient care; or
>
> \(2\) Participation by VA will enhance VA medical research; or
>
> \(3\) Participation by VA will enhance VA health services research; or
>
> \(4\) Participation by VA will enhance VA healthcare planning or
> program development activities; or
>
> \(5\) Participation by VA will enhance related VA healthcare program
> activities; and
>
> \(6\) Access to the record by the requester is required for VA to
> participate in a healthcare program with the requester.

\(g\) Protected quality assurance records or documents, including
records pertaining to a specific individual, will for purposes
authorized under law be disclosed to a civil or criminal law enforcement
governmental agency or instrumentality charged under applicable law with
the protection of public health or safety, including state licensing and
disciplinary agencies, if a written request for such records or
documents is received from an official of such an organization. The
request must state the purpose authorized by law for which the records
will be used. The Under Secretary for Health, Regional Director, medical
facility Director, or their designees will determine the extent to which
the information is disclosable.

\(h\) Federal agencies charged with protecting the public health and
welfare, federal and private agencies which engage in various monitoring
and quality control activities, agencies responsible for licensure of
individual health care facilities or programs, and similar organizations
will be provided confidential and privileged quality assurance records
and documents if a written request for such records or documents is
received from an official of such an organization. The request must
state the purpose for which the records will be used. The Under
Secretary for Health, Regional Director, medical facility Director, or
their designees will determine the extent to which the information is
disclosable.

\(i\) JCAHO (Joint Commission on Accreditation of Healthcare
Organizations) survey teams and similar national accreditation agencies
or boards and other organizations requested by VA to assess the
effectiveness of quality assurance program activities or to consult
regarding these programs are entitled to disclosure of confidential and
privileged quality assurance documents with the following
qualifications:

\(1\) Accreditation agencies which are charged with assessing all
aspects of medical facility patient care, e.g., JCAHO, may have access
to all confidential and privileged quality assurance records and
documents.

\(2\) Accreditation agencies charged with more narrowly focused review
(e.g., College of American Pathologists, American Association of Blood
Banks, Nuclear Regulatory Commission, etc.) may have access only to such
confidential and privileged records and documents as are relevant to
their respective focus.

\(j\) Confidential and privileged quality assurance records and
documents shall be released to the General Accounting Office if such
records or documents pertain to any matter within its jurisdiction.

\(k\) Confidential and privileged quality assurance records and
documents shall be released to both VA and non-VA healthcare personnel
upon request to the extent necessary to meet a medical emergency
affecting the health or safety of any individual.

\(l\) For any disclosure made under paragraphs (a) through (i) of this
section, the name of and other identifying information regarding any
individual VA patient, employee, or other individual associated with VA
shall be deleted from any confidential and privileged quality assurance
record or document before any disclosure under these quality assurance
regulations in §§17.500 through 17.511 is made, if disclosure of such
name and identifying information would constitute a clearly unwarranted
invasion of personal privacy.

\(m\) Disclosure of the confidential and privileged quality assurance
records and documents identified in §17.501 will not be made to any
individual or agency until that individual or agency has been informed
of the penalties for unauthorized disclosure or redisclosure .
(Authority: 38 U.S.C. 5705)