Home > 1997 Privacy Act Documents > Privacy Act: [F044 AFSG C]...Privacy Act: [F044 AFSG C]...
Brooks Air Force Base, TX 78235.
Notification procedure:
Individuals seeking to determine whether information about
themselves is contained in this system should address written
inquiries to or visit the Air Force Medical Service Center, Aerospace
Medical Consultants Division, Directorate of Professional Services
(HQ AFMSC/SGPA), Brooks Air Force Base, TX 78235.
Record access procedures:
Individuals seeking access to information about themselves
contained in this system should address written inquiries to or visit
the Air Force Medical Service Center, Aerospace Medical Consultants
Division, Directorate of Professional Services (HQ AFMSC/SGPA),
Brooks Air Force Base, TX 78235.
Contesting record procedures:
The Air Force rules for accessing records, and for contesting
contents and appealing initial agency determinations are published in
Air Force Instruction 37-132; 32 CFR part 806b; or may be obtained
from the system manager.
Record source categories:
Information obtained from medical institutions.
Exemptions claimed for the system:
None.
#..F044 AF SG B
#....System name:
Drug Abuse Rehabilitation Report System.
System location:
Headquarters United States Air Force and major command
headquarters. Official mailing addresses are published as an appendix
to the Air Force's compilation of systems of records notices.
Categories of individuals covered by the system:
Any active duty military personnel who are confirmed as drug
abusers as a result of drug abuse urinalysis testing. These
individuals are not patients as defined in 42 U.S.C. 300s-3(6).
Categories of records in the system:
File contains Drug Abuse Rehabilitation Reports in Electrical
Message Form in which demographic data, urine testing results and
abuser disposition are detailed.
Authority for maintenance of the system:
Pub. L. 91-513 as applied to Federal agencies by Section 2b of
E.O. 11599, June 17, 1971, Comprehensive Drug Abuse Prevention and
Control Act of 1970.
Purpose(s):
At HQ USAF to provide statistical data for required reports to
Department of Defense (DOD) and to the Special Action Office on Drug
Abuse Prevention, White House; to perform epidemiologic and
statistical studies for use in evaluating the effectiveness of Air
Force urinalysis testing programs; to provide information for
answering congressional inquiries.
Routine uses of records maintained in the system, including
categories of users and the purposes of such uses:
In addition to those disclosures generally permitted under 5
U.S.C. 552a(b) of the Privacy Act, these records or information
contained therein may specifically be disclosed outside the DoD as a
routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:
The `Blanket Routine Uses' published at the beginning of the Air
Force's compilation of systems of records notices apply to this
system.
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage:
Maintained in file folders and card files.
Retrievability:
Retrieved by Social Security Number.
Safeguards:
Records are accessed by custodian of the record system and are
controlled by personnel screening.
Retention and disposal:
Retained in office files for fifteen years after annual cut-off,
then destroyed by tearing into pieces, shredding, pulping, macerating
or burning.
System manager(s) and address:
The Surgeon General, Headquarters United States Air Force,
Washington DC 20330.
Notification procedure:
Individuals seeking to determine whether information about
themselves is contained in this system should address written
inquiries to or visit the Surgeon General, Headquarters United States
Air Force, Washington DC 20330.
Record access procedures:
Individuals seeking access to information about themselves
contained in this system should address written inquiries to or visit
the Surgeon General, Headquarters United States Air Force, Washington
DC 20330.
Contesting record procedures:
The Air Force rules for accessing records, and for contesting
contents and appealing initial agency determinations are published in
Air Force Instruction 37-132; 32 CFR part 806b; or may be obtained
from the system manager.
Record source categories:
Information obtained from medical institutions.
Exemptions claimed for the system:
None.
#..F044 AF SG C
#....System name:
Dental Health Records.
System location:
Air Force hospitals, medical centers and clinics; other
authorized medical units serving military personnel and/or
dependents. Official mailing addresses are published as an appendix
to the Air Force's compilation of record systems notices. Air Force
Military Personnel Center, Randolph Air Force Base, TX 78148;
National Personnel Records Center, Military Personnel Records, 9700
Page Boulevard, St. Louis, MO 63132, National Personnel Records
Center, Civilian Personnel Records, 111 Winnebago Street, St. Louis,
MO 63118.
Categories of individuals covered by the system:
Active duty and retired Air Force military personnel; Air Force
Academy nominees/applicants; family members of military and retired
personnel; foreign Nationals residing in the United States; American
Red Cross personnel; other DOD civilian employees, Peace Corps and
State Department personnel; Exchange Officers.
Categories of records in the system:
Chronological record of all care received in military dental
facilities. This is primarily a record of all treatment received on
an outpatient basis with supporting documentation such as
consultations, dental history, laboratory, and x-ray reports; the
record also includes temporary copies of appointment slips and
attendance records until entered in the record.
Authority for maintenance of the system:
10 U.S.C. 55, Medical and Dental Care.
Purpose(s):
Chronological record of patient's dental health while authorized
care in a military dental facility. Used by patient for further
dental care, other uses such as insurance requests or compensation
claims as specifically authorized by the patient. Used by dentist for
further dental care of the patient, research, teaching. Used by other
patient care providers within the hospital for further medical/dental
care of the patient, research, teaching. Used by hospital and dental
staff for evaluation of dental staff performance in the dental care
rendered; dental research; teaching; hospital accreditation;
preparation of statistical reports. Used by Army, Navy, Department of
Veterans Affairs, Public Health Service, and other hospitals/clinics,
for further dental care of the patient if currently undergoing
treatment there. Record is released only upon receipt of the
patient's signed authorization or a court order. Insurance companies
require the patients' written consent for release. Used for
establishing insurance benefits or payment of benefits. Used by other
Air Force Agencies such as Central Tumor Registry which maintains
files on all patients in whom a malignancy has been diagnosed.
Routine uses of records maintained in the system, including
categories of users and the purpose of such uses:
In addition to those disclosures generally permitted under 5
U.S.C. 552a(b) of the Privacy Act, these records or information
contained therein may specifically be disclosed outside the DoD as a
routine use pursuant to 5 U.S.C. 552a(b)(3) as follows:
The `Blanket Routine Uses' published at the beginning of the Air
Force's compilation of record system notices apply to this system,
except as stipulated in `Note' below.
Information from the inpatient or outpatient dental records of
retirees and dependents may be disclosed to third party payers in
accordance with 10 U.S.C. 1095 as amended by Public Law 99-272, for
the purpose of collecting reasonable inpatient/outpatient hospital
care costs incurred on behalf of retirees or dependents.
Records are used and reviewed by health care providers in the
performance of their duties. Health care providers include military
and civilian providers assigned to the medical facility where care is
being provided.
Students participating in a training affiliation program with a
USAF medical facility may also use and review records as part of
their training program.
In addition, records may be disclosed to: (1) Officials and
employees of the Department of Veterans Affairs in the performance of
their official duties relating to the adjudication of veterans claims
and in providing medical care to members of the Air Force. (2)
Officials and employees of other departments and agencies of the
Executive Branch of government upon request in the performance of
their official duties relating to review of the official
qualifications and medical history of applicants and employees who
are covered by this record system and for the conduct of research
studies. (3) Private organizations (including educational
institutions) and individuals for authorized health research in the
interest of the Federal government and the public. When not
considered mandatory, patient identification data shall be eliminated
from records used for research studies. (4) Officials and employees
of the National Research Council in cooperative studies of the
National History of Disease; of prognosis and of epidemiology. Each
study in which the records of members and former members of the Air
Force are used must be approved by the Surgeon General of the Air
Force. (5) Officials and employees of local and state governments and
agencies in the performance of their official duties pursuant to the
laws and regulations governing local control of communicable
diseases, preventive medicine and safety programs, child abuse and
other public health and welfare programs. (6) Authorized surveying
bodies for professional certification and accreditations. (7) The
individual's organization or government agency as necessary when
required by Federal statute, E.O., or by treaty.
NOTE: Records of identity, diagnosis, prognosis or treatment of
any client/patient, irrespective of whether or when he/she ceases to
be a client/patient, maintained in connection with the performance of
any alcohol/drug abuse treatment function conducted, requested, or
directly or indirectly assisted by any department or agency of the
United States, shall, except as provided herein, be confidential and
be disclosed only for the purposes and under the circumstances
expressly authorized in 42 U.S.C. 290dd-2. These statutes take
precedence over the Privacy Act of 1974 in regard to accessibility of
such records except to the individual to whom the record pertains.
The `Blanket Routine Uses' do not apply to these types of records.
Policies and practices for storing, retrieving, accessing,
retaining, and disposing of records in the system:
Storage:
Maintained in file folders, notebooks/binders, visible file
binders/cabinets, card files, on x-ray film, and as photographs.
Retrievability:
Retrieved by name, Social Security Number, or Military Service
Number.
Safeguards:
Records are accessed by commanders of medical centers and
hospitals, custodian of the record system and by person(s)
responsible for servicing the record system in performance of their
official duties who are properly screened and cleared for need-to-
know. Records are stored in locked cabinets or rooms, protected by
guards, and controlled by personnel screening.
Retention and disposal:
Records for military personnel are retained for fifty years after
date of last document; for all others, twenty-five years. While on
active duty, the Health Record of a US military member is maintained
at the dental unit at which the person receives treatment. On
separation/retirement the records are forwarded to National Personnel
Records Center (NPRC/MPR) or other designated depository; such as Air
Reserve Personnel Center, if reservist; to appropriate state National
Guard unit, if National Guard member, to appropriate Department of
Veterans Affairs Regional Office, if VA claim has been filed. Records
of other personnel may be handcarried or mailed to the next military
medical facility at which treatment will be received, or the records
are retained at the treating facility for a minimum of 1 year after
date of last treatment then retired to NPRC or other designated
depository, such as but not limited to, Commandant (G-PO) US Coast
Guard, Washington DC 20593 for Coast Guard active duty members;
Medical Director, American Red Cross, Washington DC 20006 for Red
Cross Personnel.
System manager(s) and address:
The Surgeon General, Headquarters United States Air Force.
Assistant Surgeon General for Dental Services USAF; commanders of
medical centers, hospitals, clinics, and medical aid stations.
Official mailing addresses are published as an appendix to the Air
Force's compilation of record systems notices.
Notification procedure:
Individuals seeking to determine whether this system of records
contains information on them should address inquiries to or visit the
system manager giving complete name, social security number of
individual through whom eligibility for care is established, year in
which treatment was received, location treatment was received,
whether treatment was on an inpatient or outpatient basis.
Record access procedures:
Individuals seeking to access records about themselves contained
in this system should address requests to the system manager. An
appropriately signed authorization for the release of information is
required with complete name and Social Security Number of individual
through whom eligibility for care was established.
Contesting record procedures:
The Air Force rules for accessing records, and for contesting
contents and appealing initial agency determinations are published in
Air Force Instruction 37-132; 32 CFR part 806b; or may be obtained
from the system manager.
Record source categories:
Information obtained from patient and other medical institutions.
Exemptions claimed for the system:
None.
#..F044 AF SG D
#....System name:
Automated Medical/Dental Record System.
System location:
At Air Force medical centers, hospitals and clinics, major
command headquarters and separate operating agency headquarters; Air
Force Data Service Center, Air Force Medical Service Center, USAF
School of Aerospace Medicine, and USAF School of Health Care
Sciences. Official mailing addresses are published as an appendix to
the Air Force's compilation of systems of records notices.
Categories of individuals covered by the system:
Any individual who is hospitalized in, is dead on arrival at, or
has received medical or dental care at an Air Force medical treatment
facility.
Individuals who have received medical care at other DOD or
civilian medical facilities but whose records are maintained at or
processed by Air Force medical facilities.
Any military active duty member who is on an excused-from-duty
status, on quarters, or subsistence elsewhere, on convalescent leave,
meets Medical Evaluation Board (MEB), or a Physical Evaluation Board
(PEB), on an outpatient basis or who is hospitalized in a non-federal
hospital and for whom an Air Force medical facility has assumed
administrative responsibility.
Any individual who has undergone medical or dental examinations
at any Air Force medical facility (or whose records are maintained or
processed by the Air Force), e.g., pre-employment examinations and
food handlers examinations, or who has otherwise had medical or
dental tests performed at any Air Force medical facility.
Categories of records in the system:
Files consist of automated records of treatment received and
medical/dental test performed on an inpatient/outpatient basis in
military medical treatment facilities and of military members treated
in civilian facilities. These records may include radiographic images
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