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<br /> <br /> <br /> <br /> Every age. Every vaccination. <br /> <br />DOH 348-576 November 2017 <br /> <br />N22402 - <br /> <br />Washington State Immunization Information System <br /> <br />Information Sharing Agreement for <br /> <br />EXCHANGE OF IMMUNIZATION DATA <br /> <br />This agreement (“Agreement”) is between the Washington State Department of Health (“DOH”) and <br />__________________________________________ (“Provider/Plan”) for the exchange of immunization records. <br /> <br />BACKGROUND <br /> <br /> DOH is the public health agency that maintains the Washington State Immunization Information System <br />(“IIS”). IIS serves as a communications link, repository, and retrieval tool for data on the immunization <br />status of individuals (“immunization data”). IIS allows health care providers and health plans to exchange <br />immunization data with other health care providers and health plans as authorized under Chapter 70.02 <br />RCW . <br /> <br /> Provider/Plan is: (check one): <br /> <br />[ ] A public agency, corporation, or other entity with individual shareholders, members, officers, <br />employees, contractors, or other personnel who are authorized under Washington law to provide health <br />care or public health services to individuals. <br /> <br />[ ] A healthcare service contractor authorized by the Washington Insurance Commissioner to sell health <br />insurance to, and/or administer health insurance plans in Washington State. <br /> <br />[ ] A school, school district, Head Start organization, and/or ECEAP grantee authorized to provide or <br />coordinate healthcare services for students through personnel who are authorized under Washington law <br />to provide such services. <br /> <br />[ ] An individual authorized under Washington law to provide health care services to individuals. <br /> <br /> Health Insurance Portability and Accountability Act of 1996 (HIPAA) and Chapter 70.02 RCW, the uniform <br />health care information act require healthcare providers to keep personal health care information <br />confidential. Immunization records are personal health care data. Healthcare providers may disclose <br />immunization records to DOH under 45 Code of Federal Regulations (CFR) § 164.512(b)(1)(i) and RCW <br />70.02.050(2) because DOH is a public health agency authorized to collect immunization data. <br /> <br /> Chapter 42.48 RCW governs the release for research of confidential personal records obtained or <br />maintained by a Washington state agency. Individually identifiable immunization records obtained by IIS <br />are as such personal records. Therefore, release of IIS individually identifiable immunization data for <br />research is subject to the requirements of Chapter 42.48 RCW. <br /> <br /> Subject to the terms and conditions of this agreement, Provider/Plan and DOH may exchange <br />immunization records for patients cared for by Provider/Plan. The purpose of the data exchange is to <br />improve patient care and public health.