Privacy Act of 1974, Amendment of Routine Use

DEPARTMENT OF VETERANS AFFAIRS

Privacy Act of 1974, Amendment of Routine Use

AGENCY: Department of Veterans Affairs.

ACTION: Notice of amendment of routine use.

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SUMMARY: As required by the Privacy Act of 1974 notice is hereby given

that the Department of Veterans Affairs (VA) is amending a routine use

statement that appears in the system of records, 77VA11, Health Care

Provider Credentialing and Privileging Records-VA.

DATES: Interested persons are invited to submit written comments,

suggestions, or objections regarding the proposed amendment to the

routine uses. All relevant materials received before May 9, 1997, will

be considered. All written comments received will be available for

public inspection at the Office of Regulations Management, Room 1158,

at the address given below, between the hours of 8 a.m. and 4:30 p.m.

Monday through Friday (except holidays). If no public comment is

received during the 30-day review period allowed for public comment or

unless otherwise published in the Federal Register by VA, the routine

use amendment is effective May 9, 1997.

ADDRESSES: Written comments concerning the routine use amendment may be

mailed to the Director, Office of Regulations Management (02D),

Department of Veterans Affairs, 810 Vermont Avenue, NW, Washington, DC

20420.

FOR FURTHER INFORMATION CONTACT:

Ruth-Ann Phelps, Ph.D., Health Systems Specialist, Office of the Under

Secretary For Health, Patient Care Services, (202) 273-8473.

SUPPLEMENTARY INFORMATION:

Background

On July 27, 1990, the Department published original notice of the

system of records (77VA11) at 55 FR 30790. This system of records was

re-published in its entirety on June 13, 1991 at 56 FR 27292. Routine

use number 19, and the retention and disposal statement were amended on

July 30, 1993 at 58 FR 40852. This proposal intends to amend routine

use number 6 in order to adhere to a change in VA policy as set forth

below. The proposed amendment is not within the purview of subsection

(r) of the Privacy Act (5 U.S.C. 552a), as amended, which would require

the submission of a new or altered system report.

Policy

The Department of Veterans Affairs (VA) is amending its policy

regarding initiating reporting to State Licensing Boards to include

current VA employees who are licensed health care professionals.

Therefore, VA proposes to add the words ``currently employed'' by

amendment to routine use number 6 of the System of Records, 77VA11,

Health Care Provider Credentialing and Privileging Records, where the

existing release authority is contained. VA has long had a policy of

initiating communications with other Federal Agencies, appropriate

State Licensing Boards, and appropriate non-governmental entities about

the professional performance history of former licensed health care

professionals. This includes those who have been terminated for any

reason, or who have resigned or retired and whose behavior or clinical

practice so substantially failed to meet generally accepted standards

of clinical practice as to raise reasonable concern for the safety of

patients. This policy is contained in 58 FR 48455, September 16, 1993,

further explained at 38 CFR part 47, and is recognized by Congress in

Section 204 of Pub. L. 99-166.

While VA has responded to inquiries from appropriate State

Licensing Boards about the professional practice of its current

employees, it has generally restricted its initiation of communications

to State Licensing Boards regarding professional practice standards to

former licensed health care employees. Generally, concerns about

clinical practice standards or behavior of current VA licensed health

care professionals are addressed under traditional management methods

such as mentorships, proctorships, co-reviews and other controls

designed to insure patient safety. The scope of these procedures,

however, is limited to VA supervised or controlled provision of health

care services and does not consider, those licensed health care

professionals who, in addition to their VA employment, either full-time

or part-time, may be providing health care services outside of VA in a

jurisdiction where they are licensed. This is the basis for making

current VA licensed health care professionals subject to the same VA

initiated reporting requirements that have long existed for former VA

licensed health care employees. Further, extending this reporting

practice is consistent with VA's commitment to promote patient safety

in the health care community at large and is consistent with reporting

practices in private sector health care facilities.

Authority

VA has broad authority to report both employed or separated health

care professionals. VA has long-standing statutory authority, contained

in 38

[[Page 17286]]

U.S.C. 501 and 7401-7405, which authorizes VA to set the terms and

conditions of initial appointment and continued employment of health

care personnel as may be necessary to operate VA health care

facilities. This authority includes requiring health care professionals

to obtain and maintain a current license, registration, or

certification in their health care field. Additionally, the Health Care

Amendments Act of 1985, Pub. L. 99-166, and Part B of Title IV of Pub.

L. 99-660, the Health Care Quality Improvement Act of 1986 are both

Acts which authorize and require VA to strengthen quality assurance and

reporting systems to promote better health care.

Additionally, there are minor changes in the wording for

consistency sake such as changing ``professional medical practice'' to

read ``clinical practice'' to more accurately reflect the coverage of

all licensed clinicians who may not be medical doctors. Likewise, minor

amendments are being made to the System Location, the Safeguards, and

the System Manager and Address categories. These changes reflect

internal reorganization changes.

Approved: April 1, 1997.

Jesse Brown,

Secretary of Veterans Affairs.

77 VA 11

System name:

Health Care Provider Credentialing and Privileging Records--VA

System location:

Records are maintained at each VA health care facility. Address

locations for VA facilities are listed in VA Appendix 1 at the end of

this document. In addition, information from these records or copies of

records may be maintained at the Department of Veterans Affairs Central

Office, 810 Vermont Avenue, NW, Washington, DC 20420 and/or Veterans

Integrated Service Network (VISN) Offices, as well as at consolidated

Health Care Systems Offices.

* * * * *

Routine uses of records maintained in the system, including categories

of users and the purposes of such uses:

* * * * *

6. Records from this system of records may be disclosed to a

Federal agency or to a State or local government licensing board and/or

to the Federation of State Medical Boards or a similar non-government

entity which maintains records concerning individuals' employment

histories or concerning the issuance, retention or revocation of

licenses, certifications, or registration necessary to practice an

occupation, profession or specialty, in order for the Department to

obtain information relevant to a Department decision concerning the

hiring, retention or termination of an employee or to inform a Federal

agency or licensing boards or the appropriate non-government entities

about the health care practices of a currently employed, terminated,

resigned, or retired health care employee whose professional health

care activity so significantly failed to meet generally accepted

standards of clinical practice as to raise reasonable concern for the

safety of patients. These records may also be disclosed as part of an

ongoing computer matching program to accomplish these purposes.

* * * * *

System manager(s) and address:

Official responsible for policies and procedures: Credentialing and

Privileging Manager (11B), Veterans Health Administration, Department

of Veterans Affairs, 810 Vermont Avenue, NW, Washington DC 20420.

Officials maintaining the system: the Chief of Staff at the VA health

care facility where the provider made application for employment, or

was or is employed; and the credentialing coordinator for individuals

who made application for employment to, or are or were employed at VA

Central Office or at a VISN location.

* * * * *

[FR Doc. 97-9023 Filed 4-8-97; 8:45 am]

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