Form R DUA for AIM data

Safety Program in Perinatal Care (SPPC)-II Demonstration Project

Attachment R_ Key DUA provisions_revised 062419- clean 7.30.19

DUA for AIM data

OMB: 0935-0246

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DATA USE AGREEMENT

FOR

ALLIANCE FOR INNOVATION ON MATERNAL HEALTH (AIM) PROGRAM DATA



Maintaining the confidentiality of information of de-identified, confidential data submitted by your state to the Alliance for Innovation on Maternal Health (AIM) Program is mandated by law and is the highest priority of AIM Program operations.


Researchers at the Johns Hopkins University request permission to access and use these data for evaluating the Safety Program in Perinatal Care (SPPC)-II Demonstration Project under the following provisions:


  1. Data will only be used to evaluate the SPPC-II Demonstration Project.

  2. Johns Hopkins University researchers will not make the data available nor permit others to make the data available to any person or organization, and controls shall be maintained to prevent unauthorized access.

  3. Johns Hopkins University researchers will not present/publish data in which an institution/hospital can be identified.

  4. Johns Hopkins University researchers will not attempt to learn the identity of any institution/hospital whose data are obtained.

  5. If the identity of any institution/hospital is discovered inadvertently, the following will be done:

      1. Johns Hopkins University researchers will not make use of this knowledge;

      2. Johns Hopkins University researchers will notify the AIM Program of the incident;

      3. Johns Hopkins University researchers will not inform anyone else of the discovered identity.

  6. Johns Hopkins University researchers will comply with the privacy rule of the Health Insurance Portability and Accountable Act of 1996 (HIPAA).

  7. Johns Hopkins University researchers will keep data in a secure environment, with access limited to authorized users involved with the SPPC-II Demonstration Project.

  8. Johns Hopkins University researchers will provide a Certification of Data Destruction to the AIM Program once the source data are destroyed and the project is completed.

  9. Johns Hopkins University researchers will credit the AIM Program as the source of the data.

  10. Johns Hopkins University researchers will send a copy of the finished product (e.g. report, paper) to the AIM Program.



My signature indicates that I agree to comply with the above stated provisions.


____________________________________ ____________________________

Signature Date


____________________________________ ____________________________

Name (printed or typed) Title


____________________________________________________________________________________

Organizational Affiliation


September 2019

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AuthorAndreea Creanga
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File Created2021-06-03

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