Attachment J - BAA.pdf

PDF 3 MB Posted

Attached to
IMMUNIZATION INFORMATION SYSTEM (IIS)
Solicitation number
CRFP 0506 MIS2700000001 2
Issued by
Kanawha County, West Virginia

About this file

Attachment J is a Business Associate Agreement (BAA) document related to West Virginia's Immunization Information System (IIS) contract opportunity. The attachment outlines the categories of protected health information and personally identifiable information that may be accessed or processed under the contract. The BAA specifies data elements including biometric identifiers, demographic information (date of birth, gender, address, place of birth), contact information (email, phone numbers), identification numbers (Social Security Number, taxpayer identification, medical record number), and health-related data subject to both HIPAA and non-HIPAA regulations. Additionally, the document details vaccination-specific information such as vaccination dates, vaccination status, vaccine type, manufacturer, lot numbers, administration site, dose information, and clinical notes including contraindications, recalls, and adverse reactions.

This BAA establishes the framework for a business associate to handle sensitive personal health information in connection with West Virginia's immunization registry operations. The comprehensive data categories listed indicate that the contractor will have access to complete patient records necessary for immunization tracking, clinical decision-making, and public health surveillance. The inclusion of both HIPAA-covered and non-HIPAA health information suggests the system must comply with multiple regulatory standards for data protection and privacy. The specification of detailed vaccination data elements reflects the technical scope required to maintain a functional immunization information system capable of supporting clinical care coordination and public health initiatives.

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Text version

Attachment J

Biometric Identifier Date of Birth Emergency Contact First and Last Name Gender Health Information (HIPAA Covered) Health Information (Non-HIPAA Covered) Home Street Address Individual Taxpayer Identification Number Maiden Name (Individual) Maiden Name (Mother's) Other ID Number Other Names Person Email Address Personal Internet Protocol (IP) Address Phone - Home Phone - Mobile (Personal only) Place of Birth Social Security Number (Full) Social Security Number (Last 4 digits) Vaccination Dates Forecasting Dates

MRN

Vaccination Status Vaccine Type / Manufacturer / Lot Numbers / Site / Dose Clinical Notes / Contradictions / Recalls / Adverse Reactions / Results

File details come from the government source that posted it. Updated .