Data Request Checklist (AB 2876) – Local Public Health Department

Before You Start
1. Confirm your eligibility Before you start the application process, please confirm your eligibility. OSHPD is authorized to disclose HIPAA-limited versions of its patient-level data files to local health officers and local health departments in California
2. Review data sets Next, review the variables in the data sets to see if the data meets your analytical need.
AB 2876 Request Process – Public Health
3. Complete and submit an UNSIGNED preliminary request package for review
  • Download the AB 2876 REQUEST FOR NONPUBLIC PATIENT LEVEL DATA For Local Public Health Departments and Officials Form. Complete, but do not sign, this version of the request.
  • If your department is using outside contractor(s), provide a signed, current Business Associate Agreement or contract between your department and each outside contractor.
  • Submit your preliminary request package to OSHPD using the contact information on the request form.  OSHPD will review it and an analyst will contact you if there are any questions about your request.
4. OSHPD will return the preliminary request package to you for signature when deemed complete Once the request appears complete, you will be sent:
  • A copy of the complete request with a Request Number, date received, and date revised
  • A Data Use Agreement (DUA) for each person that will have access to the data
The local health officer needs to sign the data request form and applicable DUA. Each person accessing the data needs to sign their associated DUA. The Delegation Order OSH-HIRC-520 may be signed by the local health officer to allow the designated delegate to sign the form on behalf of the local health officer.
5. Submit SIGNED request package The signed forms should then be scanned as PDF and e-mailed to OSHPD.
6. Request package reviewed by OSHPD Your request will be reviewed by OSHPD management. When OSHPD has approved it, you will be sent:
  • An approval letter,
  • A copy of the signed DUA(s), and
  • A list of the Model Data Set(s) you are approved to receive
Generally, from the time the request is received until the data is shipped or transmitted, an AB 2876 request takes about one month. It may be longer or shorter depending on the complexity of the request
7. Payment and shipping options At the time of data release, OSHPD will contact you to arrange payment and shipping options:
  • Encrypted CD to be picked up by you;
  • Shipped Overnight Delivery, with encrypted CD(s); or
  • Encrypted files sent via Accellion (Secure FTP)
NOTE: Data is not released until all required approvals have occurred and payment has been received.

This page was last updated on Friday, September 30, 2016.

Data Years Available
PUF 2010-2014 2010-2014
AB 2876 1983-2016 2005-2016
IPA 1983-2016 2005-2016
Custom 1983-2016 2005-2016

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