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| ### Office of the Director             |   |   |                       |
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| 150 North 18^th^ Avenue, Suite 500     |   | J |                       |
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| Phoenix, Arizona 85007-3247            |   | S |                       |
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+----------------------------------------+---+---+-----------------------+
| \(602\) 542-1025                       |   |   |                       |
+----------------------------------------+---+---+-----------------------+
| \(602\) 542-1062 FAX                   |   |   |                       |
+----------------------------------------+---+---+-----------------------+

![](media/image1.wmf){width="2.2006944444444443in" height="1.5in"}

May 24, 2005

To Whom It May Concern:

Dear Health Care Provider:

The Arizona Department of Health Services certifies that it is a public
health authority and health oversight agency as mandated by the State of
Arizona. As such**, FEDERAL LAW, INCLUDING THE HEALTH INSURANCE
PORTABILITY AND ACCOUNTABILITY ACT (HIPAA), DOES NOT RELIEVE ANY
INDIVIDUAL OR ENTITY FROM A [CONTINUING DUTY TO REPORT OR
DISCLOSE]{.underline} PUBLIC HEALTH INFORMATION AS REQUIRED BY ARIZONA
LAW**.

For its public health and health oversight activities, the Arizona
Department of Health Services collects and receives protected health
information and related records as required or permitted by law. [^1]
The protected health information and related records collected and
received by the Arizona Department of Health Services include, but are
not limited to:

1\. Reports of disease, injury, and vital events, such as birth or
death;

2\. Information and records related to, public health surveillance,
disease prevention and control, public health investigations, or public
health interventions; and

3\. Information and records related to public health oversight, such as:

> a\. Audits;
>
> b\. Civil, administrative, or criminal investigations;
>
> c\. Inspections;
>
> d\. Licensure or disciplinary actions;
>
> e\. Civil, administrative, or criminal proceedings or actions; or
>
> f\. Other activities necessary for oversight of the state's health
> care system.

The Health Insurance Portability and Accountability Act (HIPAA) permits
disclosure of protected health information and related records to a
public health authority for public health and health oversight
activities (45 CFR 164.512(b)(1)(i); 45 CFR 164.512(d)). In

Health Care Providers

May 24, 2005

Page 2

addition, HIPAA permits disclosure of protected health information as
required by law (45 CFR 164.512(a)). These disclosures are permitted
without authorization by the individual who is the subject of the
protected health information (45 CFR 164.512). [^2]The information being
requested represents that amount of information minimally necessary to
carry out the public health purposes, which are the basis for the
request (45 CFR 164.514 (d)).

This certification incorporates by reference the enclosure(s)
identifying the Arizona Department of Health Services/Public Health
Services Division programs that collect and receive protected health
information and related records. The Arizona Department of Health
Services certifies that the Public Health Services Division programs
identified in the enclosure(s) collect, receive, use and disclose
protected health information and related records solely for the purposes
allowed under HIPAA.

Any questions pertaining to this Certification or accompanying
enclosures may be directed to:

# Mary Beth Joublanc, JD

# HIPAA Project Manager/Privacy Officer

Arizona Department of Health Services

1740 West Adams Street, Room 101

Phoenix, Arizona 85007-2670

\(602\) 364-1560

Thank you for your cooperation and assistance.

Sincerely,

Susan Gerard

Director

SG:sa

Enclosures(s)

[^1]: ^\*^ Arizona Revised Statutes §§ 36-104, 36-132, 36-136, and other
    related statutes

[^2]: Catherine R. Eden, Arizona Department of Health Service's
    Director, originally signed this letter on April 17, 2003, however
    due to a change in the Directorship this letter is dated May 24,
    2005, and signed by Susan Gerard, the current Department of Health
    Service's Director. The content of this letter has not changed.