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SORN_A0400-5a DASG DoD.pdf

Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas

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Department of the Army
A0040-5a DASG DoD

SYSTEM NAME:
Defense Medical Surveillance System.  (August 19, 2009,  74 FR 41877)

SYSTEM LOCATION:
Armed Forces Health Surveillance Center, Building T-20, Room 213, 6900 Georgia Avenue, NW,
Washington, DC 20307-5001; and Armed Forces Health Surveillance Center, 503 Robert Grant Avenue,
Silver Spring, MD 20910-7500.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:
Department of Defense military personnel (active and reserve) and their family members; separated
service members and retirees; DoD civilian personnel; contract personnel deploying with the Armed
Forces; applicants for military service; and individuals who participate in DoD health surveys.

CATEGORIES OF RECORDS IN THE SYSTEM:
Information in this system of records originates from personnel systems, medical records, health surveys
(e.g., Pentagon Post Disaster Health Assessment, periodic, pre and post deployment health assessments)
and/or health assessments made from specimen collections (remaining serum from blood samples) from
which serologic tests can be performed (serum number, specimen locator information, collection date,
place of collection). Records being maintained include but are not limited to individual's name, Social
Security Number, date of birth, sex, branch of service, home address, age, occupation, job series, rank,
grade, education level, Armed Forces Qualification Test data, marital status, number of dependents,
medical encounters, medical treatment facility, condition of medical and physical health and
capabilities, responses to survey questions, register number assigned, and similar records, information
and reports, relevant to the various registries; and specimen collections (remaining serum from blood
samples) from which serologic tests can be performed (serum number, specimen locator information,
collection date, place of collection).

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:
5 U.S.C. 301, Departmental Regulations; 10 U.S.C. 136, Under Secretary of Defense for Personnel and
Readiness; 10 U.S.C. 3013, Secretary of the Army, 10 U.S.C. 8013, Secretary of the Air Force, 10 U.S.C.
5013, Secretary of the Navy; DoD Instruction 1100.13, Surveys of DoD Personnel; DoD Directive 6490.2,
Comprehensive Health Surveillance; DoD Directive 6490.3, Deployment Health; DoD Instruction 6485.01,
Human immunodeficiency Virus; DoD Directive 1404.10, Civilian Expeditionary Workforce; and E.O. 9397
(SSN), as amended.

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PURPOSE(S):
The Defense Medical Surveillance System (DMSS) supports a systematic collection, analysis,
interpretation, and reporting of standardized, population based data for the purposes of characterizing
and countering medical threats to a population's health, well being and performance. The Armed Forces
Health Surveillance Center, which operates the DMSS, routinely publishes summaries of notifiable
diseases, trends of illnesses of special surveillance interest and field reports describing outbreaks and
case occurrences in the Medical Surveillance Monthly Report, the principal vehicle for disseminating
medical surveillance information of broad interest. Through DMSS, the Armed Forces Health Surveillance
Center provides the sole link between the DoD Serum Repository and other databases. This repository
contains over 46 million frozen serum specimens and is the largest of its kind in the world.

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 of 1974,
these records 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 DoD 'Blanket Routine Uses' set forth at the beginning of the Army's compilation of systems of records
notices also apply to this system, except that these routine uses do not apply to the Serum Repository.
NOTE: This system of records contains individually identifiable health information. The DoD Health
Information Privacy Regulation (DoD 6025.18-R) issued pursuant to the Health Insurance Portability and
Accountability Act of 1996, applies to most such health information. DoD 6025.18-R may place additional
procedural requirements on the uses and disclosures of such information beyond those found in the
Privacy Act of 1974 or mentioned in this system of records notice.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, AND
DISPOSING OF RECORDS IN THE SYSTEM:
STORAGE:
Paper records in file folders and electronic storage media.

RETRIEVABILITY:
Information is retrieved by individual's name, Social Security Number (SSN), registry number and
specimen number.

SAFEGUARDS:
Records are maintained within secured buildings in areas accessible only to persons having official need,

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and who therefore are properly trained and screened. Automated segments are protected by controlled
system passwords governing access to data.

RETENTION AND DISPOSAL:
Records are destroyed when no longer needed for reference and for conducting business.

SYSTEM MANAGER(S) AND ADDRESS:
Director of the Armed Forces Health Surveillance Center, The Army Surgeon General, Headquarters,
Department of the Army, 5109 Leesburg Pike, Falls Church, VA 22041-3258.

NOTIFICATION PROCEDURE:
Individuals seeking to determine whether information about themselves is contained in this system should
address written inquiries to the Director, Armed Forces Health Surveillance Center, 503 Robert Grant
Avenue, Silver Spring, MD 20910-7500.
For verification purposes, individual should provide their full name, Social Security Number (SSN), any
details which may assist in locating record, and their signature.
In addition, the requester must provide a notarized statement or an unsworn declaration made in
accordance with 28 U.S.C. 1746, in the following format:
If executed outside the United States: `I declare (or certify, verify, or state) under penalty of perjury
under the laws of the United States of America that the foregoing is true and correct. Executed on
(date). (Signature)'.
If executed within the United States, its territories, possessions, or commonwealths: `I declare (or
certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on
(date). (Signature)'.

RECORD ACCESS PROCEDURES:
Individuals seeking access to information about themselves contained in this system should address
written inquiries to the Director of the Armed Forces Health Surveillance Center, 503 Robert Grant
Avenue, Silver Spring, MD 20910-7500.
For verification purposes, individual should provide their full name, Social Security Number, any details
which may assist in locating record, and their signature.
In addition, the requester must provide a notarized statement or an unsworn declaration made in
accordance with 28 U.S.C. 1746, in the following format:
If executed outside the United States: `I declare (or certify, verify, or state) under penalty of perjury
under the laws of the United States of America that the foregoing is true and correct. Executed on
(date). (Signature)'.
If executed within the United States, its territories, possessions, or commonwealths: `I declare (or
certify, verify, or state) under penalty of perjury that the foregoing is true and correct. Executed on
(date). (Signature)'.

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CONTESTING RECORD PROCEDURES:
The Army's rules for accessing records, and for contesting contents and appealing initial agency
determinations are contained in Army Regulation 340-21; 32 CFR part 505; or may be obtained from the
system manager.

RECORD SOURCE CATEGORIES:
From the individual, personnel and medical records, and mortality and casualty reports.

EXEMPTIONS CLAIMED FOR THE SYSTEM:
None.

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