20 Cfr 10.801 Feca

20 CFR 10.801 FECA regs.pdf(2006 clearance).pdf

Pharmacy Billing Requirements

20 CFR 10.801 FECA

OMB: 1240-0050

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Federal Register / Vol. 67, No. 67 / Monday, April 8, 2002 / Notices

Compensation Programs of the Department of
Labor. The Office asserts control of these
records under the provisions of 5 U.S.C. 8149
and Department regulations at 20 CFR 10.10.
This notice applies to copies of claim forms
and other documents relating to a
compensation claim maintained by the
employing agency. This notice, however,
does not apply to other medical or related
files not created pursuant to the Federal
Employees’ Compensation Act which may be
in the possession of an agency. This system
is entitled DOL/GOVT–1, Office of Workers’
Compensation Programs, Federal Employees’
Compensation File.
Initial determinations on requests for
access, amendment or correction of records
maintained in this system of records shall be
made by the OWCP district office having
jurisdiction over the particular claim. In
addition, requests for access to copies of
records maintained by the employing agency
may be directed to that agency.
Administrative appeals from initial
determinations denying access, amendment
or correction, shall be addressed to the
Solicitor of Labor, U.S. Department of Labor,
200 Constitution Avenue, NW, Washington,
DC 20210, as required by 20 CFR 10.12.
2. Job Corps Student Records: All records
which contain information about students
during their stay in Job Corps, from entrance
to placement and/or termination, are records
which must be maintained by the Job Corps
center. The Employment and Training
Administration asserts control of these
records under 29 U.S.C. 2881 et seq. This
system is entitled DOL/GOVT–2, Job Corps
Student Records.
Initial determinations concerning access,
amendment or correction of this governmentwide system of records shall be made by
screening contractors, Job Corps Center
Directors, Job Corps National or Regional
Offices. Administrative appeals shall be
referred to the Solicitor of Labor, U.S.
Department of Labor, 200 Constitution
Avenue, NW, Washington, DC 20210.
Special California Earthquake Co-operative
Agreement
The San Francisco, California Regional
Office of the Department of Labor’s Office of
Assistant Secretary for Administration and
Management (OASAM), Region IX of
OASAM, has entered into a reciprocal
agreement with the U.S. Internal Revenue
Service’s Office of the Regional Counsel
located in San Francisco. The purpose of this
reciprocal agreement is to provide each with
an alternative off-site location to store
computer data. This back-up storage capacity
will mitigate damage if an earthquake ever
occurs in the San Francisco area. This
agreement is based upon the fact that the
respective offices of the participants are
located at opposite ends of the downtown
San Francisco district and the ground
structure of the two areas is substantially
different.
Addresses to Which Requests May Be
Directed
The addresses of the various component
units of the Department as well as its regional
offices are contained in the Appendix
annexed to this document.

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In addition, the following government
agencies also have Government-wide
Systems of Records:
Government-Wide Systems
EEOC/GOVT–/–1—Equal Employment
Opportunity Complaint Records and
Appeal Records
FEMA/GOVT–1—National Defense Executive
Reserve System
GSA/GOVT–2—Employment Under
Commercial Activities Contracts
GSA/GOVT–3—Travel Charge Card Program
GSA/GOVT–4—Contracted Travel Services
Programs
MSPB/GOVT–1—Appeal and Case Records
OGE/GOVT–1—Executive Branch Public
Financial Disclosure Reports and Other
Ethics Program Records
OGE/GOVT–2—Confidential Statements of
Employment and Financial Interests
OPM/GOVT–1—General Personnel Records
OPM/GOVT–2—Employee Performance File
System Records
OPM/GOVT–3—Adverse Actions and
Actions Based on Unacceptable
Performance
OPM/GOVT–4—[Reserved]
OPM/GOVT–5—Recruiting, Examining and
Placement Records
OPM/GOVT–6—Personnel Research and Test
Validation Records
OPM/GOVT–7—Applicant—Race, Sex,
National Origin and Disability Status
Records
OPM/GOVT–8—[Reserved]
OPM/GOVT–9—Position Classification
Appeals, Job Grading Appeals, and
Retained Grade or Pay
OPM/GOVT–10—Employee Medical File
System Records
DOL/GOVT–1
SYSTEM NAME:

Office of Workers’ Compensation
Programs, Federal Employees’
Compensation Act File.
SECURITY CLASSIFICATION:

Most files and data are unclassified.
Files and data in certain cases have Top
Secret classification, but the rules
concerning their maintenance and
disclosure are determined by the
agency, which has given the information
the security classification of Top Secret.
SYSTEM LOCATION:

The central database for DOL/GOVT–
1 is located at SUNGUARD, 600 Laurel
Oak Road, Voorhees, New Jersey, 08043.
Paper claim files and local databases are
located at the various OWCP district
offices, and in Kansas City (for imaged
cases only); claim files of employees of
the Central Intelligence Agency are
located at that agency. Records from this
system of records may be temporarily
located in the office of health care
providers and other individuals or
entities with whom the Department
contracts for such services as
examination or evaluation of claimants.

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Copies of claim forms and other
documents arising out of a job-related
injury that resulted in the filing of a
claim under the Federal Employees’
Compensation Act (FECA), may also be
maintained by the employing agency
(and where the forms were transmitted
to the Office of Workers’ Compensation
Programs (OWCP) electronically, the
original forms are maintained by the
employing agency). In addition, records
relating to third-party claims of FECA
beneficiaries are maintained in the
Division of Employee Benefits, Office of
the Solicitor, United States Department
of Labor, 200 Constitution Avenue, NW,
Washington, DC 20210–0002, in the
offices of the Regional and Associate
Regional Solicitors, and in various
offices of the United States Postal
Service, which undertakes various
duties relating to third party claims
pursuant to an agreement with OWCP.
Pursuant to the Department of Labor’s
Flexiplace Programs, copies of records
may be temporarily located at
alternative worksites, including
employees’ homes or at geographically
convenient satellite offices for part of
the workweek. All appropriate
safeguards will be taken at these sites.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:

Individuals and/or their survivors
who file claims seeking benefits under
the FECA by reason of injuries sustained
while in the performance of duty. The
FECA applies to all civilian federal
employees, including various classes of
persons who provide or have provided
personal service to the government of
the United States, and to other persons
as defined by law such as state or local
law enforcement officers, and their
survivors, who were injured or killed
while assisting in the enforcement of
federal law. In addition, the FECA
covers employees of the Civil Air Patrol,
Peace Corps Volunteers, Job Corps
students, Volunteers in Service to
America, members of the National
Teacher Corps, certain student
employees, members of the Reserve
Officers Training Corps, certain former
prisoners of war, and employees of
particular commissions and other
agencies.
CATEGORIES OF RECORDS IN THE SYSTEM:

This system may contain the
following kinds of records: reports of
injury by the employee and/or
employing agency; claim forms filed by
or on behalf of injured federal
employees or their survivors seeking
benefits under the FECA; forms
authorizing medical care and treatment;
other medical records and reports; bills

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and other payment records;
compensation payment records; formal
orders for or against the payment of
benefits; transcripts of hearings
conducted; and any other medical,
employment, or personal information
submitted or gathered in connection
with the claim. The system may also
contain information relating to dates of
birth, marriage, divorce, and death;
notes of telephone conversations
conducted in connection with the claim;
information relating to vocational and/
or medical rehabilitation plans and
progress reports; records relating to
court proceedings, insurance, banking
and employment; articles from
newspapers and other publications;
information relating to other benefits
(financial and otherwise) the claimant
may be entitled to; and information
received from various investigative
agencies concerning possible violations
of Federal civil or criminal law.
The system may also contain
consumer credit reports on individuals
indebted to the United States,
information relating to the debtor’s
assets, liabilities, income and expenses,
personal financial statements,
correspondence to and from the debtor,
information relating to the location of
the debtor, and other records and
reports relating to the implementation of
the Federal Claims Collection Act (as
amended), including investigative
reports or administrative review
matters. Individual records listed here
are included in a claim file only insofar
as they may be pertinent or applicable
to the employee or beneficiary.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

5 U.S.C. 8101 et seq., 20 CFR 1.1 et
seq.
PURPOSE(S):

The FECA establishes the system for
processing and adjudicating claims that
federal employees and other covered
individuals file with the Department of
Labor’s OWCP, seeking monetary,
medical and similar benefits for injuries
or deaths sustained while in the
performance of duty. The records
maintained in this system are created as
a result of and are necessary to this
process. The records provide
information and verification about the
individual’s employment-related injury
and the resulting disabilities and/or
impairments, if any, on which decisions
awarding or denying benefits provided
under the FECA must be based.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF SUCH USES:

In addition to those Department-wide
routine uses set forth above in the

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General Prefatory Statement to this
document, disclosure of information
from this system of records may be
made to the following individuals and
entities for the purposes noted when the
purpose of the disclosure is both
relevant and necessary and is
compatible with the purpose for which
the information was collected:
a. To any attorney or other
representative of a FECA beneficiary for
the purpose of assisting in a claim or
litigation against a third party or parties
potentially liable to pay damages as a
result of the FECA beneficiary’s FECAcovered injury and for the purpose of
administering the provisions of sections
8131–8132 of the FECA. Any such third
party, or a representative acting on that
third party’s behalf, may be provided
information or documents concerning
the existence of a record and the amount
and nature of compensation paid to or
on behalf of the FECA beneficiary for
the purpose of assisting in the
resolution of the claim or litigation
against that party or administering the
provisions of sections 8131–8132 of the
FECA.
b. To federal agencies that employed
the claimant at the time of the
occurrence or recurrence of the injury or
occupational illness in order to verify
billing, to assist in administering the
FECA, to answer questions about the
status of the claim, to consider rehire,
retention or other actions the agency
may be required to take with regard to
the claim or to permit the agency to
evaluate its safety and health program.
Disclosure to federal agencies, including
the Department of Justice, may be made
where OWCP determines that such
disclosure is relevant and necessary for
the purpose of providing assistance in
regard to asserting a defense based upon
the FECA’s exclusive remedy provision
to an administrative claim or to
litigation filed under the Federal Tort
Claims Act.
c. To other federal agencies, other
government or private entities and to
private-sector employers as part of
rehabilitation and other return-to-work
programs and services available through
OWCP, where the entity is considering
hiring the claimant or where otherwise
necessary as part of that return-to-work
effort.
d. To federal, state or private
rehabilitation agencies and individuals
to whom the claimant has been referred
for evaluation of rehabilitation and
possible reemployment.
e. To physicians, pharmacies, and
other health care providers for their use
in treating the claimant, in conducting
an examination or preparing an
evaluation on behalf of OWCP and for

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other purposes relating to the medical
management of the claim, including
evaluation of and payment for charges
for medical and related services and
supplies.
f. To medical insurance or health and
welfare plans (or their designees) that
cover the claimant in instances where
OWCP had paid for treatment of a
medical condition that is not
compensable under the FECA, or where
a medical insurance plan or health and
welfare plan has paid for treatment of a
medical condition that may be
compensable under the FECA, for the
purpose of resolving the appropriate
source of payment in such
circumstances.
g. To labor unions and other
voluntary employee associations from
whom the claimant has requested
assistance for the purpose of providing
such assistance to the claimant.
h. To a federal, state or local agency
for the purpose of obtaining information
relevant to a determination concerning
initial or continuing eligibility for FECA
benefits, and for a determination
concerning whether benefits have been
or are being properly paid, including
whether dual benefits that are
prohibited under any applicable federal
or state statute are being paid; and for
the purpose of utilizing salary offset and
debt collection procedures, including
those actions required by the Debt
Collection Act of 1982, to collect debts
arising as a result of overpayments of
FECA compensation and debts
otherwise related to the payment of
FECA benefits.
i. To the Internal Revenue Service
(IRS) for the purpose of obtaining
taxpayer mailing addresses for the
purposes of locating a taxpayer to
collect, compromise, or write-off a
federal claim against such taxpayer; and
informing the IRS of the discharge of a
debt owed by an individual. Records
from this system of records may be
disclosed to the IRS for the purpose of
offsetting a federal claim from any
income tax refund that may be due to
the debtor.
j. To the Occupational Safety and
Health Administration (OSHA) for the
purpose of using injury reports filed by
Federal agencies pursuant to the FECA
to fulfill agency injury reporting
requirements. Information in this
system of records may be disclosed to
OSHA by employing agencies as part of
any MIS system established under
OSHA regulations to monitor health and
safety.
k. To contractors providing services to
DOL or any other federal agency or any
other individual or entity specified in
any of these routine uses or in the

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Department’s General Prefatory
Statement who require the data to
perform the services that they have
contracted to perform, provided that
those services are consistent with the
routine use for which the information
was disclosed to the contracting entity.
Should such a disclosure be made to the
contractor, the individual or entity
making such disclosure shall insure that
the contractor complies fully with all
Privacy Act provisions, including those
prohibiting unlawful disclosure of such
information.
l. To the Defense Manpower Data
Center—Department of Defense and the
United States Postal Service to conduct
computer matching programs for the
purpose of identifying and locating
individuals who are receiving Federal
salaries or benefit payments and are
delinquent in their repayment of debts
owed to the United States under
programs administered by the DOL in
order to collect the debts under the
provisions of the Debt Collection Act of
1982 (Pub. L. 97–365) by voluntary
repayment, or by salary or
administrative offset procedures.
m. To a credit bureau for the purpose
of obtaining consumer credit reports
identifying the assets, liabilities,
expenses, and income of a debtor in
order to ascertain the debtor’s ability to
repay a debt incurred under the FECA,
to collect the debt, or to establish a
payment schedule.
n. To consumer reporting agencies as
defined by section 603(f) of the Fair
Credit Reporting Act (15 U.S.C.
1681a(f)) or in accordance with section
3(d)(4)(A)(ii) of the Federal Claims
Collection Act of 1966 as amended (31
U.S.C. 3711(f)) for the purpose of
encouraging the repayment of an
overdue debt, the amount, status and
history of overdue debts, the name and
address, taxpayer identification (SSN),
and other information necessary to
establish the identity of a debtor, the
agency and program under which the
claim arose, may be disclosed pursuant
to 5 U.S.C. 552a(b)(12)
o. To a Member of Congress or to a
Congressional staff member in response
to an inquiry made by an individual
seeking assistance who is the subject of
the record being disclosed for the
purpose of providing such assistance.
p. To individuals, and their attorneys
and other representatives, and
government agencies, seeking to enforce
a legal obligation on behalf of such
individual or agency, to pay alimony
and/or child support for the purpose of
enforcing such an obligation, pursuant
to an order of a state or local court of
competent jurisdiction, including
Indian tribal courts, within any State,

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territory or possession of the United
States, or the District of Columbia or to
an order of a State agency authorized to
issue income withholding notices
pursuant to State or local law or
pursuant to the requirements of section
666(b) of title 42, United States Code, or
for the purpose of denying the existence
of funds subject to such legal obligation.
Note: Disclosure of information contained
in this system of records to the subject of the
record, a person who is duly authorized to
act on his or her behalf, or to others to whom
disclosure is authorized by these routine
uses, may be made over the telephone or by
electronic means. Disclosure over the
telephone or by electronic means will only be
done where the requestor provides
appropriate identifying information.
Telephonic or electronic disclosure of
information is essential to permit efficient
administration and adjudication of claims
under the FECA. Pursuant to 5 U.S.C.
552a(b)(1), information from this system of
records may be disclosed to members and
staff of the Employees’ Compensation
Appeals Board, the Office of Administrative
Law Judges, the Office of the Solicitor and
other components of the Department who
have a need for the record in the performance
of their duties.
DISCLOSURE TO CONSUMER REPORTING
AGENCIES:

The amount, status and history of
overdue debts, the name and address,
taxpayer identification (SSAN), and
other information necessary to establish
the identity of a debtor, the agency and
program under which the claim arose,
may be disclosed pursuant to 5 U.S.C.
552a(b)(12) to consumer reporting
agencies as defined by section 603(f) of
the Fair Credit Reporting Act (15 U.S.C.
1681a(f)) or in accordance with section
3(d)(4)(A)(ii) of the Federal Claims
Collection Act of 1966 as amended (31
U.S.C. 3711(f)) for the purpose of
encouraging the repayment of an
overdue debt.
POLICIES AND PRACTICES FOR STORING,
RETRIEVING, ACCESSING, RETAINING AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:

Paper case files are maintained in
manual files, while security case files
are in locked cabinets. Automated data,
including case files that have been
transformed into electronic form, are
stored in computer discs or magnetic
tapes, which are stored in cabinets.
Microfiche is stored in cabinets.
RETRIEVABILITY:

Files and automated data are retrieved
after identification by coded file number
and/or Social Security Number which is
cross-referenced to employee by name,
employing establishment, and date and
nature of injury. Since the electronic

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case management files were created in
1975, these electronic files are located
in District Offices which have
jurisdiction over the claim, and (as
noted above under ‘‘system location’’), a
complete central data base is
maintained at the location of the
contractor. Prior to 1975, a paper index
file was maintained; these records were
transferred to microfiche and are located
in the national office.
SAFEGUARDS:

Files and automated data are
maintained under supervision of OWCP
personnel during normal working
hours—only authorized personnel, with
the appropriate password, may handle,
retrieve, or disclose any information
contained therein. Only personnel
having an appropriate security clearance
may handle or process security files.
After normal working hours, security
files are kept in locked cabinets. Access
to electronic records is controlled by
password or other user identification
code.
RETENTION AND DISPOSAL:

All case files and automated data
pertaining to a claim are destroyed 15
years after the case file has become
inactive. Case files that have been
scanned to create electronic copies are
destroyed after the copies are verified.
Automated data is retained in its most
current form only, however, and as
information is updated, outdated
information is deleted. Some related
financial records are retained only in
electronic form, and destroyed 6 years
and 3 months after creation or receipt.
SYSTEM MANAGER(S) AND ADDRESS:

Director for Federal Employees’
Compensation, Office of Workers’
Compensation Programs, 200
Constitution Avenue, NW, Room S–
3229, Washington, DC 20210–0002.
NOTIFICATION PROCEDURE:

An individual wishing to inquire
whether this system of records contains
information about him/her may write or
telephone the OWCP district office that
services the state in which the
individual resided or worked at the time
he or she believes a claim was filed. In
order for the record to be located, the
individual must provide his or her full
name, OWCP claim number (if known),
date of injury (if known), and date of
birth.
RECORD ACCESS PROCEDURES:

Any individual seeking access to nonexempt information about a case in
which he/she is a party in interest may
write or telephone the OWCP district
office where the case is located, or the

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Federal Register / Vol. 67, No. 67 / Monday, April 8, 2002 / Notices
systems manager, and arrangements will
be made to provide review of the file.
Access to copies of documents
maintained by the employing agency
may be secured by contacting that
agency’s designated disclosure officials.

DOL/GOVT–2

CONTESTING RECORD PROCEDURES:

SYSTEM LOCATION:

Specific materials in this system have
been exempted from certain Privacy Act
provisions regarding the amendment of
records. The section of this notice
entitled ‘‘Systems Exempted From
Certain Provisions of the Act,’’ indicates
the kind of materials exempted, and the
reasons for exempting them. Any
individual requesting amendment of
non-exempt records should contact the
appropriate OWCP district office, or the
system manager. Individuals requesting
amendment of records must comply
with the Department’s Privacy Act
regulations at 29 CFR 71.1 and 71.9, and
with the regulations found at 20 CFR
10.12 (1999).
RECORD SOURCE CATEGORIES:

Injured employees; beneficiaries;
employing Federal agencies; other
Federal agencies; physicians; hospitals;
clinics; suppliers of health care
products and services and their agents
and representatives; educational
institutions; attorneys; Members of
Congress; OWCP field investigations;
State governments; consumer credit
reports; agency investigative reports;
correspondence with the debtor
including personal financial statements;
records relating to hearings on the debt;
and other DOL systems of records.
SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS
OF THE ACT:

In accordance with 5 U.S.C.
552a(k)(2), investigative material in this
system of records compiled for law
enforcement purposes is exempt from
subsections (c)(3), (d), (e)(1), (e)(4)(G),
(H) and (I), and (f) of 5 U.S.C. 552a,
provided, however, that if any
individual is denied any right, privilege,
or benefit that he or she would
otherwise be entitled to by Federal law,
or for which he or she would otherwise
be eligible, as a result of the
maintenance of these records, such
material shall be provided to the
individual, except to the extent that the
disclosure of the material would reveal
the identity of a source who furnished
information to the Government under an
express promise that the identity of the
source would be held in confidence, or
prior to January 1, 1975, under an
implied promise that the identity of the
source would be held in confidence.

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SYSTEM NAME:

Job Corps Student Records.
SECURITY CLASSIFICATION:

None.
Screening contractors; Job Corps
centers and operators (which includes
contract and agency centers); Job Corps
National Office; Job Corps Regional
Offices; Federal Records Centers.
CATEGORIES OF INDIVIDUALS COVERED BY THE
SYSTEM:

Job Corps applicants, students, and
terminees.
CATEGORIES OF RECORDS IN THE SYSTEM:

Records contain information kept on
the students, such as separate running
accounts of the students’ general
biographical data; educational training,
vocational training; counseling;
recreational activities; dormitory logs;
health (dental, medical, mental health,
and drug testing records); administrative
records covering data pertaining to
enrollment allowances and allotments;
leave records; Student Profile (ETA–
640); and Center Standards Officer’s
disciplinary records.
AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

Subtitle C of Title I of the Workforce
Investment Act of 1998, 29 U.S.C. 2881
et seq.
PURPOSE(S):

These records are maintained to
ensure that all appropriate documents of
the student’s stay in Job Corps (covering
application to placement and/or
termination) are retained and are
available to those officials who have a
legitimate need for the information in
performing their duties and to serve the
interests and needs of the students in
accordance with 29 U.S.C. 2881 et seq.
ROUTINE USES OF RECORDS MAINTAINED IN THE
SYSTEM, INCLUDING CATEGORIES OF USERS AND
THE PURPOSES OF THE SUCH USES:

These records and information in
these records may be used when
relevant, necessary, and appropriate:
(1) To disclose photographs and
student identities, with appropriate
consent, to the news media, for the
purpose of promoting the merits of the
program.
(2) To disclose information, giving the
summary of a student’s academic and
vocational achievement and general
biographical information, to placement
and welfare agencies, prospective
employers, school or training
institutions to assist in the employment
of a student.

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(3) To disclose information to State
and Federal law enforcement agencies
or other government investigators to
assist them in locating a student and/or
his or her family.
(4) To disclose information to
appropriate Federal, State, and local
agencies which have law enforcement
jurisdiction over students (which
includes probation or parole officers);
and/or the property on which the center
is located.
(5) To disclose all or any information
to parents/guardians regarding students
under the age of 18 for performance of
parental rights and responsibilities.
(6) To disclose information to Job
Corps health consultants; Job Corps
Center Review Board members (in
appropriate disciplinary cases); State,
county, and local health services
personnel; family planning agencies;
and physicians (public or private) to
whom a student is referred for diagnosis
or to receive treatment to assure
continuance of proper health care, or
notification and contact tracking for
communicable disease control.
(7) To disclose to State and local
health departments all cases of infection
or disease that are required to be
reported to them in accordance with
state and local laws. This disclosure
shall be made by the Center Director.
Note: Center physicians shall deal with all
cases of communicable diseases in
accordance with Job Corps directives based
on current recommendations of the Center for
Disease Control of the Department of Health
and Human Services.

(8) To disclose information to State
and local health departments regarding
infected persons who are unwilling to
notify their contacts at the center for the
purpose of enabling the counseling of
contacts.
(9) To disclose information to medical
laboratories necessary in identifying
specimens for the purpose of testing.
(10) To disclose information to social
service agencies in cases of a student’s
termination in order to provide services
such as Medicaid, housing, finance, and
placement.
(11) To disclose information to the
Army Finance Center, Fort Benjamin
Harrison, Indiana, to pay student
allowances and maintain and dispose of
their pay records.
(12) To disclose information to
Federal, State, and local agencies and to
community-based organizations for the
operation of experimental, research,
demonstration, and pilot projects
authorized under sections 156, 171, or
172 of the Workforce Investment Act of
1998, 29 U.S.C. 2856, 2916, or 2917,
except that in the case of a research
project, the researcher shall guarantee to

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File Typeapplication/pdf
File TitleDocument
SubjectExtracted Pages
AuthorU.S. Government Printing Office
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