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DATA USE ADDENDUM TO MASTER AGREEMENT BETWEEN THE MICHIGAN PUBLIC HEALTH INSTITUTE AND THE Kittitas County Public Health This Data Use Addendum ("Addendum") is made and entered into as of this 1st day of May 2017 by and between the Michigan Public Health Institute (known as "Receiver") and the Kittitas County Public Health (known as "Holder") both to be referred to herein as "parties ". WHEREAS, the Receiver and the Holder entered into a Master Agreement dated AprilS, 2016 for establishing 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 and entrusted to the Receiver as the Child Death Review Case Reporting System. WHEREAS, the Receiver seeks to amend Appendix B to clarify the HIP AA Required Elements to De-Identify Case Data by specifically listing all elements or categories of elements that HIPAA law considers to be identifiers (45 CFR 164.514) and to clarify the Holder's responsibility to remove identifying information in preparation for de-identified downloads; NOW, THEREFORE, in consideration of the above account the parties agree as follows: Appendix B HIPAA Required Elements to De-Identify Case Data· The CDR-CRS supports two types of data downloads: identified and de-identified. NCFRP staff and researchers who have been approved by the NCFRP will receive only de-identified data. The CDR-CRS variables that will be removed in de-identified downloads are listed below. The CDR-CRS contains many free text fields (most often in the 'specify' or 'describe' text fields). The CDR-CRS also provides users the opportunity to provide more detail surrounding the circumstances of the death in Section N: Narrative text field. When the Narrative, 'specify,' and/or 'describe' text fields are included in a de-identified download, the Narrative, 'describe,' and 'specify' text fields SHOULD NOT contain any HIPAA Identifiers. HIP AA Identifiers include names; all geographical subdivisions smaller than a state; all elements of dates (except ye ar) for dates directly related to an individual; phone numbers; fax numbers; electronic mail addresses; social security numbers; medical record numbers; health plan beneficiary numbers; account numbers; certificate/license numbers; vehicle identifiers and serial numbers; device identifiers and serial numbers; web universal resource locators; internet protocol address numbers; biometric identifiers; full face photographic images; and any other unique identifying number, characteristic or code. * Source: Code of Federal Regulations Section 164 .514(b)(2)(i). 1