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EXHIBIT I <br />1. PURPOSE AND JUSTIFICATION FOR SHARING THE DATA <br />Provide a detailed description of the purpose and justification for sharing the data, including <br />specifics on how the data will be used. <br />Data will be used to inform community health assessment reports, which occur on a 3 to five year <br />cycle. No confidential information will be shared; the only data that will be utilized is general <br />population measures, sorted by demographic category, as well as mortality rates and fertility <br />data. There may also be intermittent access to general hospitalization rate data, BRFSS data and <br />vital records data to inform annual updates to community health data and grant applications. <br />Is the purpose of this agreement for human subjects research? <br />D Yes 0 No <br />If yes: Does the research require WA State Institutional Review Board (WSIRB) approval? <br />D Yes 0 No <br />If yes: The WSIRB has their own set of forms that must be used and this DSA may not be <br />needed. If this DSA is still needed, please provide a copy of the approval. <br />If no: Does the research require an exempt determination from the IRB? <br />D Yes (?J No <br />If yes: Please provide a copy of the Exempt Determination Request from the WSIRB . <br />If no: Do the following criteria meet the purpose of this agreement? <br />1. Agreement is for a de-identified limited data set: <br />2. Data will not be used to re-identify or contact individuals. <br />3. Data will not be linked with any other information. <br />~Yes <br />[QI' Yes <br />Gr'Yes <br />0 No <br />0 No <br />D No <br />If any of the criteria above are marked "No", attach an Exempt Determination Request to <br />this DSA. <br />Page 13 of 26 <br />09/2017