Child Death Case Review Systems Agreement

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CHILD DEATH REVIEW CASE REPORTING SYSTEM DATA USE AGREEMENT BETWEEN THE MICHIGAN PUBLIC HEALTH INSTITUTE AND KITTITAS COUNTY PUBLIC HEALTH DEPARTMENT This data use agreement is entered between the Michigan Public Health Institute (MPHI) (known hereafter as "Receiver") and the Kittitas County Public Health Department (hereinafter referred to as the "Holder") for the period of date of execution through 12/3112020 . The purpose of this agreement is to establish the terms and conditions for the collection, storage and use of data obtained from the case reviews of child deaths submitted by the Child Death Review (CDR) team in Kittitas County Public Health Department and entrusted to the Receiver as the Child Death Review Case Reporting System (CDR-CRS). A. The Receiver 1. The Receiver is a non-profit private agency. It has a Cooperative Agreement, Number U49MC00225, with the Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services , to manage the National Center for the Review and Prevention of Child Deaths (NCRPCD). As part of this agreement, the Receiver is to manage a standardized, web-based reporting system for state and local child death review teams. 2. The Receiver is responsible for the development of the NCRPCD CDR-CRS, training and liaison to state agencies participating in the system, technical assistance in using the system, and analysis and dissemination of national CDR data generated by the system. The Receiver is responsible for the maintenance of the servers, including firewall protection and other securities, and for data storage and data access by users of the CDR- CRS . 3 . The Receiver holds a Federal wide Assurance (FWA) that is a written commitment to protect human research subjects by complying with federal regulations and maintaining adequate programs and procedures for the protection of human subjects . This FWA specifies adherence to the Code of Federal Regulations Title 45 Public Welfare Part 46 Protection of Human Subjects, and the use of the Belmont Report as an ethics guidel ine. The NCRPCD including the CDR-CRS is reviewed annually by the Receiver's Institutional Review Board. Copies of the panel decision letters are available to the Holder. 4 . The Receiver complies with the federal privacy requirements specified in the HIPAA Privacy and Security Rules (45 CFR Parts 160, 162 and 164 , Standards for Privacy of Individually Identifiable Health Information). The Receiver has appointed a Privacy Officer and a Security Officer, developed and adopted HIPAA-compliant privacy and security policies and procedures, and staff receive training in these policies and procedures. The Receiver's Privacy Officer annually reviews the NCRPCD , including the CDR-CRS, for adherence to HIPAA regulations and MPHI policy. Copies of the review decision letters are available to the Holder. RECEIVED MAY 0 22016 1 BY: