**DA 04-1716**

**Released: June 16, 2004**

**CLARIFICATION OF THE USE OF TELECOMMUNICATIONS RELAY SERVICES (TRS)
AND THE HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)**

The Federal Communications Commission (FCC) has been working with the
Department of Health and Human Services (HHS) to clarify that the use of
Telecommunications Relay Services (TRS) to facilitate telephone calls
between health care professionals and patients, when one of the parties
to the call has a hearing or speech disability, does not violate the
Privacy Rule of the Health Insurance Portability and Accountability Act
(HIPAA). The Commission has received inquiries on this issue from TRS
users and providers. We take this opportunity to clarify that,
consistent with HIPAA, a covered entity, such as a doctor or other
health care professional, *can* contact a patient using TRS without
requiring the TRS facility or individual communications assistants (CAs)
to sign a disclosure agreement (what HIPAA generally refers to a
"business associate contract").

As background, TRS, as mandated by Title IV of the Americans with
Disabilities Act of 1990, makes the telephone system accessible to
individuals with hearing or speech disabilities.[^1] This is
accomplished through TRS facilities that are staffed by specially
trained CAs using special technology. The CA relays conversations
between persons using various types of assistive communication devices
and persons who do not require such assistive devices.

HHS enacted HIPAA in 1996, which included provisions mandating the
adoption of federal privacy protections for individual's health
information.[^2] In response to the HIPAA mandate, HHS published the
Privacy Rule, stating that as of April 14, 2003 (April 14, 2004, for
small health plans), covered entities must implement standards to
protect and guard against the misuse of individually identifiable health
information.[^3]

Some health professionals have been concerned that contacting patients
and discussing health related information via TRS poses a possible
violation of the Privacy Rule because a "third party," the TRS CA, hears
the information being discussed as the call is relayed. Some state TRS
facilities have informed the FCC that health professionals are requiring
all of the facility's CAs to sign disclosure forms before they will use
TRS to contact patients with hearing or speech disabilities.

We therefore emphasize that all forms of TRS, including "traditional"
TTY based relay, Internet Protocol (IP) Relay, Video Relay Service
(VRS), and Speech-to-Speech (STS), can be used to facilitate calls
between health care professionals and patients without violating HIPPA's
Privacy Rule. For further information on this issue see HHS's FAQ sheet
which is available at
[www.hhs.gov/ocr/hipaa](http://www.hhs.gov/ocr/hipaa) or on the FCC's
Disability Rights Office's website at
<http://www.fcc.gov/cgb/dro/trs.html>.

The full texts of these documents are available for public inspection
and copying during regular business hours at the FCC Reference
Information Center, Portals II, 445 12^th^ Street, SW, Room CY-A257,
Washington, DC, 20554. These documents may be purchased from the
Commission\'s duplicating contractor, Best Copy and Printing, Inc.,
Portals II, 445 12^th^ Street, SW, Room CY-B402, Washington, DC 20554.
Customers may contact BCPI at their web site:
[www.bcpiweb.com](http://WWW.BCPIWEB.COM/) or call 1-800-378-3160.

To request this document in accessible formats for people with
disabilities (braille, large print, electronic files, audio format),
send an e-mail to <fcc504@fcc.gov> or call the Consumer & Governmental
Affairs Bureau at 202-418-0530 (voice), 202-418-0432 (TTY). This *Public
Notice* can also be downloaded in Word and Portable Format at
<http://www.fcc.gov/cgb.dro>.

Consumer & Governmental Affairs Bureau Contact: Traci Randolph, (202)
418-0569 (voice), (202) 418-0537 (TTY); e-mail
<traci.randolph@fcc.gov>[.]{.underline}

**-FCC-**

[^1]: *See* 47 U.S.C. § 225.

[^2]: *See* Pub. L. No. 104-191 (1996).

[^3]: *See* 45 C.F.R. Parts 160 and 164.