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San Francisco Department of Public Health Privacy Practices


Privacy Policies


 
TITLE POLICY NUMBER REVISION DATE
**NEW** COVID-19 Privacy Information
06/04/2020
06/04/2020
GENERAL
A.1.0
09/23/2013
HIPAA Compliance – Admin Policies
A.2.0
11/01/2012
HIPAA Compliance – Patient/Client Resident Rights regarding Protected Health Information (PHI)
A.3.0
04/2013
BREACHES
B.1.0
12/15/2017
Reporting of Unlawful or Unauthorized Access of PHI
B.1.1
09/10/2018
Major Privacy Breach Emergency Quick Reference Response Guide
B.2.0
SHARING POLICIES
C.1.0
09/23/2013
FORM: Authorization to Disclose Health Information
C.1.1
12/15/2017
*NEW* Release of Protected Health Information in a Major Emergency or Multi-Casualty Incident
C.2.0
06/01/2019
DPH Privacy Policy Matrix - Sharing Protected Health Information for Treatment
C.3.0
12/19/2013
Use of PHI in Disciplinary Hearings and Proceedings Investigations
C.4.0
01/12/2009
Special Situations Governing the Release of Information - Duty to Warn and Protect Third Parties in Response to a Client Threat
C.5.0
09/13/2013
Special Situations Governing the Release of information - Child Abuse and Neglect Reporting Act
C.6.0
10/29/2013
Special Situations Governing the Release of Information - Elder and Dependent Adult Release
C.7.0
10/29/2013
Reporting Individuals with Lapse of Consciousness to DMV
C.8.0
01/12/2009
Consent for Minors: Urgent, Primary Care & Behavioral Health Services; Confidentiality; Obligations
C.9.0
12/01/2005
Victims of Dependent Adult/Elder Abuse, Child Abuse, Assaultive & Abuse Conduct and Rape Sexual Assault
C.10.0
05/01/2013
Response to a Request from Law Enforcement
C.11.0
04/01/2015
HIPAA Compliance: Social Media Policy
C.12.0
07/06/2015
Patients, Visitors and Staff Photo/Audio/Video Recording (Clinical and Operations Purposes)
C.13.1
03/01/2016
FORM: Consent to Record/Authorization for Publication
C.14.1
09/30/2015
FORM: Request to Amend Protected Health Information (PHI)
C.15.0
07/01/2013
SFDPH Business Associates Agreement (BAA) Contract Exhibit E
C.16.0
04/12/2018
SFDPH Privacy and Security Agreement (PSA) Contract Exhibit E
C.17.0
06/21/2017
SFDPH Attach 1 Attestation PRIVACY, version 6/7/2017
C.18.1
06/07/2017
SFDPH Attach 2 Attestation DATA SECURITY, version 6/7/2017
C.18.2
06/07/2017
SFDPH Attach 3 Attestation COMPLIANCE, version 6/7/2017
C.18.3
06/07/2017
FORM: Data Sharing Request Form
C.18.4
1/23/2019
STORING AND DELIVERING PHI
D.1.0
05/13/2010
FORM: Secure Delivery of PHI - Cover sheet for fax or mailing
D.1.1
05/13/2010
Sending Electronic Messages to Adult Patients            
D.1.2
06/01/2017
RESEARCH/EVALUATION
E.1.0
05/11/2011
FORM: DPH Research Proposal Approval
E.3.0
05/11/2011
Research Misconduct: Definitions and Procedures
E.4.0
02/10/2014
FORM: DPH Health Information Data Use Agreement Form
E.5.1
04/21/2011
AGREEMENTS
F.1.0
03/19/2015
*NEW* FORM: SFDPH User Agreement for Confidentiality, Data Security and Electronic Signature
F.2.0
05/14/2018
RETENTION & STORAGE OF PHI
G.1.0
10/01/2008
Security & Retention of Medical Records
G.2.0
02/29/2016
Electronic Recordkeeping
G.3.0
12/02/2010
FORMS - HIPAA PRIVACY RIGHTS
Summary Notice of HIPAA Privacy Practices Poster Kit
English
H.1.1
05/19/2015
Spanish
H.1.2
05/19/2015
Chinese
H.1.3
05/19/2015
Russian
H.1.4
05/19/2015
Tagalog
H.1.5
05/19/2015
Vietnamese
H.1.6
05/19/2015
Summary Notice of HIPAA Privacy Practices and Acknowledgement of Receipt Forms
English
H.2.1
05/19/2015
Spanish
H.2.2
05/19/2015
Chinese
H.2.3
05/19/2015
Russian
H.2.4
05/19/2015
Tagalog
H.2.5
05/19/2015
Vietnamese
H.2.6
05/19/2015
Full Notice of HIPAA Privacy Rights
English
H.3.1
05/19/2015
Spanish
H.3.2
05/19/2015
Chinese
H.3.3
05/19/2015
Russian
H.3.4
05/19/2015
Tagalog
H.3.5
05/19/2015
Vietnamese
H.3.6
05/19/2015
Authorization for Release or Disclosure of PHI
CBHS English
H.4.1
01/27/2005
CBHS Chinese
H.4.2
01/27/2005
CBHS Russian
H.4.3
01/27/2005
CBHS Spanish
H.4.4
01/27/2005
CBHS Vietnamese
H.4.5
01/27/2005
DPH Authorization Form
H.4.5
03/01/2005
ALL STAFF MEMOS REGARDING PRIVACY
New DPH Hotline Posters please place in prominent area at your site
I.1.0
02/19/2016
**New** Authorized Use of Third-Party Dialers
I.2.0
12/16/2020
Privacy Pulse eNewsletters
Topics:  Release of Patient Information –Verification and Confirmation        
J 1.0       
3/1/18
Topics: Special Edition- Unauthorized Access to PHI (Snooping)                    
J 2.0       
6/1/18
Topics:  Business Associate Agreement   
J 3.0       
7/1/18
Topics:  Top 5 Common HIPAA Violations   
J 4.0       
10/1/18
Topics:  Annual Compliance & Privacy Training, Data Sharing    
J 5.0       
4/1/2019
Topics: HIPAA Penalties and Fines    
J 6.0       
7/1/2019
Topics: Break the Glass    
J 7.0       
9/1/2019
Topics: Special Edition - Handling PHI Documents    
J 8.0       
11/1/2019
Winter Topics: Audits, Passwords    
J 9.0       
2/1/2020