HomeMy WebLinkAboutAgreement A-15-052 with UCSF.pdf AGREEMENT NO. 15-052
UCSF MD Link Electronic Health Record Access Participation Agreement
This Electronic Health Record Access Participation Agreement("Agreement") is made by and between
Loun4oS FreSr,D("Participant"),and the University of California San Francisco on behalf of 3�5
UCSF Medical Center and UCSF Benioff Children's Hospital ("UCSF"),effective as of A— JD_ 2619-
("Effective Date").
I. Software("Service")
WHEREAS,UCSF has compiled a secure electronic database consisting of clinical information
(including progress notes,specialty consults,laboratory and imaging results),member demographics,
insurance carrier information,other information regarding patients of UCSF and Proprietary Information
of UCSF("Data");and
WHEREAS,UCSF has an interest in improving the delivery and coordination of care to patients in the
community by providing secure electronic access to select portions of their patients'medical records as
contained in the Data;and
WHEREAS, UCSF has the ability to offer care providers secure electronic access to Data concerning
their patients via a connection to the internet and Participant desires to obtain access to Data concerning
patients by utilizing the MD Link Service;
NOW THEREFORE, in consideration of the promises and covenants contained in this Agreement and for
good and valuable consideration, UCSF and Participant agree as follows:
Upon execution of this Agreement and any other required documents,and approval of all access, UCSF
will provide the Participant with Logon IDs, passwords and information to allow Participant to access the
Data relating to Participant's patients. UCSF will provide limited training which may be done in-person,
via eLearning,or by remote web meeting on the use of the MD Link Service,
I. Definitions:
a. Confidential Patient Information: Individually identifiable health information regarding patients
stored in the Data and accessed through the MD Link Service, including clinical information such
as progress notes, specialty consults, laboratory and imaging results, and patient
demographic and insurance information.This information is protected by various state and
federal privacy laws and regulations,including but not limited to the Health Insurance
Portability and Accountability Act(HIPAA).
b. Covering User:An individual employed by the Participant who is temporarily covering the duties
of another User who is sick,on vacation,or on extended leave.
c. Data:Confidential Patient Information and Proprietary Information contained in a secure
electronic database owned by UCSF.
d. Participant:The physician practice/practice group,organized as a legal entity,consisting of
either one or several physicians providing care to patients who have also been treated by UCSF
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providers.The legal entity is considered the Participant and an authorized representative of the
Participant practice must sign the UCSF MD Link EHR Access Participant Agreement on behalf
of the entity.
e. Participant Privacy Standards: Prior to being granted access to Data, the Participant must
complete and agree to the terms of use as laid out in this Agreement.
f. Personally Identifiable Information(11111"): is information that can be used on its own or with
other information to identify, contact, or locate a single person, or to identify an individual in
context. Pll is defined as any information about an individual maintained by an agency, including
any information that can be used to distinguish or trace an individual's identity, such as name,
social security number, date and place of birth, mother's maiden name, or biometric records; and
any other information that is linked or linkable to an individual, such as medical, educational,
financial, and employment information.
g. Proprietary Information: Information relating to internal business affairs, including information
regarding products, pricing,personnel data, vendor information, financial data, and other
competitively sensitive information that UCSF maintains as confidential. If such information is
already made available in the public domain,then such information is not Proprietary
information. All Proprietary Information is confidential and may not be used for any purpose
other than treatment without the advanced written consent of UCSF.
h. Protected Health Information("PHI"): Any information, including electronic PHI,whether oral
or recorded in any form or medium: (i)that relates to the past, present,or future physical or
mental condition of an individual; the provision of health care to an individual; or the past,
present, or future payment for the provision of health care to an individual, and(ii)that identifies
the individual with respect to which there is a reasonable basis to believe the information can be
used to identify the individual, and shall have the meaning given to such term under HIPAA and
HIPAA Regulations, not limited to 45 CFR § 160.103. For the purposes of this Agreement, PHI
includes all medical information and health insurance information as defined in California Civil
Code §§ 56.05 and 1798.82.
i. Service: The UCSF MD Link software that provides a secure method of communication,which
enables users to view Confidential Patient Information concerning Participant's patients as
contained in the Data.
j. UCSF Liaison: The individual employed by UCSF who acts as a link to facilitate communication
and cooperation between Participant and UCSF.
k. User: This individual may be the practice owner, physician, registered nurse, care giver, or staff
member of the practice entity, or otherwise be approved and designated by the leadership of the
practice as someone who requires access to MD Link Service.
2. Access
a. Proprietary Information: Data contains Confidential Patient Information,PHI,and Proprietary
Information, which is the sole property of UCSF. The parties agree and understand that the Data
will remain the property of UCSF and that there is no intent to transfer any rights or legal interest
in the Data to the Participant. Participant agrees that it will not copy or utilize Data for any
purpose except treatment of Participant's patients, unless Participant obtains written consent from
the patient and/or UCSF, or such use or disclosure is required by law. If Participant receives a
request or demand for disclosure of the Data, it will immediately provide written notice and a
COPY of such request or demand to the UCSF Liaison.
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b. Term and Termination: This Agreement is effective on the date first listed above and will
continue until either party notifies the other in writing of its intent to terminate. Either Party may
terminate this Agreement by sending advanced written notice of the intent to terminate. UCSF
retains the right to unilaterally terminate access, at its sole discretion, and without advance notice
to the Participant. UCSF will consider any unauthorized access, use, or disclosure of Data as a
breach of this Agreement and grounds for immediate termination of this Agreement. Upon
termination of this Agreement, Participant agrees to discontinue accessing the Data immediately.
c. Permitted Use of Data: Participant understands that the Data contains confidential patient
information, PHI, and Proprietary Information that is protected from unlawful disclosure by state
and federal laws and regulations.
i. Participant is permitted to access, use, and disclose Data only for purposes related to
treatment of Participant's patients. Participant agrees that they will comply with all
applicable laws and regulations, and the terms of this Agreement, in its access, use, and
disclosure of the Data.
ii. Participant will not access their personal medical records or the medical records of their
family members and friends if they are not the treating provider, should such records
exist in UCSF's Data.
iii. Participant understands that all activities and access to Data is monitored and audited.
d. Prohibited Use of Data: Participant agrees it will not access, use, or disclose the Data for any
purpose other than those set forth above and that if UCSF determines that Participant has
accessed, used, or disclosed Data in a prohibited or unlawful manner, UCSF may unilaterally
terminate all access and seek any such other relief as appropriate. Specifically, Participant may
not:
i. Sell,disclose to any third party, transfer to any third party, or otherwise permit or
facilitate third-party access to the Data
ii. Transmit in any way, Data obtained through the Service for any purpose other than those
listed above
iii. Use or disclose any Data with the intent to negatively impact the competitive advantage
of UCSF in the marketplace
iv. Use or disclose the Data other than as permitted by this Agreement
e. Confidentiality of Data: Participant understands that Data includes confidential patient
information, including protected health information("PHI")as defined by the Health Insurance
Portability and Accountability Act, 45 C.F.R. §164.501, as amended, ("HIPAA"). Participant
agrees to comply with HIPAA in its use of Data and take all reasonable and necessary measures
and precautions as required by HIPAA to ensure security and privacy of the electronic Data it
accesses.
i. Specifically, Participant agrees to:
a) Report to the UCSF Liaison any known or suspected unauthorized access, use, or
disclosure of any portion of Data of which Participant becomes aware
b) Advise patients requesting copies of or amendments to their medical records that
the Participant does not have the authority or the ability to alter their PHI and that
any amendments or corrections to it must be accomplished by contacting UCSF
directly
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c) Take appropriate action to ensure that patients, visitors, or unauthorized
personnel will not be able to see the computer screen during access to UCSF
patient Data
d) Make its internal practices, books, and records relating to the access, use, and
disclosure of UCSF Data available to UCSF and,after notice,to the Secretary of
Health and Human Services, for the purpose of determining Participant's
compliance with privacy regulations
e) Document Participant's disclosures of UCSF Data from a court or governmental
agency
f) If it receives a request for disclosure of UCSF Data from a court or governmental
agency, Participant will immediately notify their UCSF Liaison prior to any
disclosure in order to allow UCSF the opportunity to seek the appropriate
protective order to protect UCSF Data
f. Obligations of Participant:
i. Equipment and Supplies: Participant is solely responsible for the cost of the equipment,
maintenance and supplies required for access to and use of UCSF Data through the
Service. Such costs include, but are not limited to,cost of acquisition, installation,
operation and maintenance of personal computers and printers; cost related to wiring,
hardware, software, phone charges, and internet access services; and cost of ongoing
equipment and supply upgrades.
ii. Participant Access: Each Participant must sign the UCSF MD Link EHR Access
Participant Agreement, and each User must sign the UCSF MD Link EHR Access
Confidentiality Agreement. Signed Agreements must be returned to UCSF before access
will be granted to Users.
iii. Appropriate Use of Service: Participant agrees to access the UCSF Data in accordance
with the terms of this Agreement. In the event the Participant suspects any problems
related to unauthorized data alteration or destruction, Participant will immediately
discontinue access to the Service and report problems to UCSF technical support("IT
Service Desk")at 415-514-APeX(2739).
g. Communication: Participant understands that by agreeing to the use of UCSF MD Link they are
agreeing to and acknowledge that the UCSF MD Link portal will become the primary means of
communication between UCSF and Users. Communications such as patient summaries and
consult letters will no longer be faxed or mailed, but will instead be sent to the User via UCSF
MD Links internal communication tool (InBasket). Users will receive an external email message
notifying them that there is a new communication in UCSF MD Link ready to be viewed.
Participant agrees to retrieve these communications on a regular basis.
h. Relationship of the Parties: It is expressly understood and agreed upon that this Agreement is not
intended to, and does not, create a joint venture, partnership, association, or other affiliation or
business relationship between UCSF and Participant.
i. Copied and Downloaded Information: Each Party acknowledges and agrees that it would be
separately and solely responsible for securing and protecting any PHI upon it being printed,
copied, or downloaded by Participant.
3. Privacy
a. Material Privacy Breach: If there is any known or suspected inappropriate access, use,or
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disclosure by an authorized or un-authorized Participant user,the parties agree to actively and
promptly cooperate through the appropriate sharing of audit logs and other information necessary
to allow for a quick determination of the details of such an incident.The Parties agree to meet and
confer in good faith, using their best efforts to resolve any differences around the dispute over a
privacy breach as the Parties also agree that a satisfactory resolution of any dispute over a privacy
breach is the preferred outcome for the Parties rather than immediate termination of this
Agreement.
b. Patient Information: Participant shall not disclose any patient or medical record information
regarding Hospital or Hospital's patients,and shall comply with all federal and state laws and
regulations, and all rules, regulations, and policies of Hospital and its Medical Staff, regarding
the confidentiality of such information, including, but not limited to,the Health Insurance
Portability and Accountability Act(HIPAA)(45 C.F.R. Part 160, et seq.) the Confidentiality
of Alcohol and Drug Abuse Patient Records Act(42 C.F.R. Part 2), as amended from time to
time, and California's Confidentiality of Medical Information Act set forth at California
Health& Safety Code § 56 et seq.
c. Notification of Disclosures: Participant will notify UCSF's Privacy Office of the unauthorized
access, use, or disclosure of any personally identifiable information, or protected health
information known or suspected by such Party within two business days of learning of the
same in order to ensure that the reporting of such unauthorized access, use or disclosure of this
information is reported within five days of detection to the California Department of Public
Health(CDPH)and as appropriate,to the Office of Civil Rights (OCR)and/or Department of
Health and Human Services (HHS). Participant will oversee the required notification to
CDPH.
d. Costs Associated with Disclosure: Participant agrees that if they fail to adhere to any of the
privacy, confidentiality, and/or data security provisions set forth herein and, as a result,
Personally Identifiable Information or Protected Health Information is unlawfully accessed,
used or disclosed,that they agree to pay,upon written demand of the other Party, any and all
costs associated with any notification to affected individuals required by law or deemed
appropriate, and that they also agree to pay for any and all fines and/or administrative
penalties imposed for such unauthorized, access, use or disclosure of Personally Identifiable
Information or Protected Health Information or for delayed reporting.
4. Indemnification
a. Each Party shall defend, indemnify and hold the other Parties, their officers, employees and
agents harmless from and against any and all liability, loss, or expense(including reasonable
attorneys' fees) arising from claims for damages arising out of the performance of this Agreement
but only in proportion to and to the extent such liability, loss, expense, attorneys' fees, or claims
are caused by or result from the negligent or intentional acts or omissions of the indemnifying
Party, its officers, agents, or employees.
5. Insurance
a. Each party agrees to effect and maintain adequate comprehensive general liability and property
damage insurance or equivalent programs of self-insurance for the tenor of the Agreement with
combined single limits as follows: (1) Each Occurrence: $1,000,000; (2)Products/Completed
Operations Aggregate: $2,000,000; Personal and Advertising Injury: $1,000,000; and General
Aggregate: $2,000,000.
b. It is expressly understood, however,that the coverages set forth herein shall not in any way limit
the liability of any party. Such provision, however, shall only apply in proportion to and to the
extent of the negligent acts or omissions of the parties, its officers, agents, and employees. Each
party further agrees to maintain such other insurance in such amounts, which from time to time
may reasonably be required by mutual consent of the other party against other insurable hazards
relating to performance.
c. Prior to the commencement of this contract, each party agrees to issue a Certificate of Insurance
indicating compliance with the aforementioned insurance coverage requirements. Each party
agrees to provide the other party with certificates showing such insurance to be in force, and
naming the other party as an additional insured. Each party agrees that it will give the other party
thirty(30)days advance written notice of any modification,change, or cancellation of any of the
insurance coverage.
This Agreement constitutes the entire Agreement between the Parties and supersedes all other written or
oral agreements with respect to the subject matter hereof. This Agreement may not be altered, amended
or modified except as agreed in writing by the Parties. No consent or waiver,express or implied, by
either Party in the performance of the other Party of its obligations under this Agreement shall be deemed
or construed to be a consent to or waiver of any other breach or default by the other Party.
UCSF Medical Center and UCSF Benioff
Children's Hospital
Participant Practtiice%Tractice Group Name
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UCSF Liaison Signature Authorized Representative Si atu`re
Brian Cosrove ��C�orQY� P . �c�C�CI�IC IClYI
UCSF Liaison Name Authorized Representative Name
APeX Director; Community Connect L)L.IXA &� SLpeX V ISb('&
UCSF Liaison Title Authorized Representative Tide
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Date Date
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Phone Number Phone Number
Email Address Email Address
ATTEST:
BERNICE E.SEIDEL,Clerk
Board of Supenfisors
By ` Lfl
Deputy
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UCSF MD Link EHR Access Confidentiality Agreement
I understand that 1 am being granted access to UCSF's APeX Electronic Health Record("EHR")thru the UCSF
MD Link web portal.The EHR is used to store clinical information, including progress notes,results, and other
Protected Health Information("PHI") and as such must be treated in a manner consistent with industry
standards, and all applicable state and federal privacy and security laws and regulations.
I understand and agree to the following:
1. 1 will protect the privacy,confidentiality and security of the PHI used and accessed from the UCSF MD
Link portal in accordance with all applicable state and federal privacy and security laws and regulations.
2. 1 will comply with the privacy,confidentiality,and security policies of UCSF as identified within the
general Terms and Conditions, UCSF Group Participant Agreement and of my employer.
3. 1 will only access and use UCSF PHI that is reasonably necessary for me to perform the duties required.
4. 1 will not in any way divulge, copy, release, sell, loan,alter or destroy any PHI except as properly
authorized by the policies of the contributing entity.
5. 1 will not electronically transmit PHI in a manner that is not secure.
6. 1 will not misuse or neglectfully care for PHI. I will safeguard all PHI and will not attempt to gain
access to information for which I am not authorized. Where my authorized use or communication of
PHI results in incidental disclosures, I will use appropriate safeguards to minimize the degree of these
incidental disclosures.
7. If my employment is terminated during the course of my access to UCSF MD Link, I will hand over any
PHI in my possession to my employer prior to departure.
8. I will safeguard and will not disclose my access codes, passwords or any other authorizations I may
have that allow me to access PHI. I will accept responsibility for all activities performed under my
access codes, passwords or other authorizations.
9. I will not use the access codes or passwords of another individual to access PHI.
10. 1 will be responsible for any misuse,wrongful disclosure or failure to safeguard PHI as a result of my
actions or behavior.
11. 1 will not access my own medical record. I will not access the medical records of my family members
or friends, if I am not involved in their care or treatment.
12. 1 understand that my activities and access to the EMR may be monitored and audited.
13. 1 acknowledge that my failure to comply with this Confidentiality Agreement may result in termination
of access to the EHR as well as disciplinary action imposed by my employer which may include
termination of employment.
14, I also acknowledge that I and or my employer may be subject to civil or criminal penalties as described
by federal/state law. I understand and acknowledge that my employer may hold me accountable for
any inappropriate access and handling of PHI and may seek cost reimbursement for fees and penalties
associated with handling of breaches.
15. 1 understand my responsibility to report to my employer and UCSF any known or suspected
inappropriate access, use,or disclosure of PHI that I observe or of which I am aware.
Signature of Person receiving Access:
Printed Name of Person Receiving Access:
Job Title:
Employer/Physician Group:
Date:
7
COUNTY OF FRESNO: ti
By_
Chairman, Board of Supervisors
Date: a�'I�IrS
BERNICE E. SEIDEL, Clerk
Board of Supervisors //f�
By L�(�15AJw S )� sQ
Date:_ Fe!hro.x q I a , aD I S
APPROVED AS TO LEGAL FORM:
DANIEL CEDERBORG, COUNTY COUNSEL
By_ kz6UX
//li'
6�11
APPROVED AS TO ACCOUNTING FORM:
VICKI CROW, C.P.A., AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
By
REVIEWED AND RECOMMENDED FOR APPROVAL:
By_ zj(/pm��x
David Pomaville
Director
Department of Public Health
Fund/Subclass: 0001/10000
Organization: 56201600
Account#: 7295
[SG]
13
TERMS AND CONDITIONS
Notice of Health Information Privacy Practices
By agreeing to these terms and conditions, I acknowledge that I am requesting access to
portions of health records and the ability to communicate with UCSFMC via the Internet
using an electronic application called UCSF MD Link. If I subscribe, I will have the ability to
view UCSFMC's patient information and communicate with health care team members.
Important Reminder
UCSF MD Link displays certain health information from medical records, but does not
display all information from medical records.
Use of UCSF MD Link for Health Care Services
I understand that UCSFMC's health care team may send me messages via UCSF MD Link.
These messages may contain information that is important to the health and medical care of
my patients or UCSFMC's patients. It is my responsibility to monitor these messages. By
entering my valid and functional e-mail address, I have enabled UCSF MD Link to notify me
of messages sent to my UCSF MD Link Inbox. I will update my e-mail address on UCSF
MD Link as needed. I agree not to hold UCSF MD Link or UCSFMC, hereafter known as the
"Service Provider," liable for any loss, injury or claims of any kind resulting from UCSF MD
Link messages that I fail to read in a timely manner.
If I elect to subscribe to UCSF MD Link Messaging, I agree to use this service appropriately
and judiciously. I agree that all communication through UCSF MD Link will only be in regard
to my patients. I understand that contents of any message may be stored in my patients'
permanent health records.
I understand that UCSF MD Link service is available only to providers under an active
affiliated agreement and will be deactivated once I am no longer an affiliate. I agree to
contact UCSF MD Link via e-mail or voicemail within a timely manner once my affiliated
agreement has terminated.
UCSF MD Link ID and Password
I understand that UCSF will create a unique identification (ID) code and a password will be
chosen by me to be used to access health information via UCSF MD Link. I understand that
this ID and password are unique codes that identify me in the UCSF MD Link computer
system. Inquiries and entries that I make via UCSF MD Link will be logged with my identity.
I understand that it is extremely important that I keep the ID and password that I use to
access UCSF MD Link completely confidential. If at any time I feel that the confidentiality of
my password has been compromised, I will change it by going to the Password link on the
UCSF MD Link website. I understand that the Service Provider takes no responsibility for
and disclaims any and all liability or consequential damages arising from a breach of health
1
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record confidentiality resulting from my sharing or losing my password. If the Service
Provider discovers that I have inappropriately shared my password with another person, or
that I have misused or abused my UCSF MD Link access privileges in any way, my
participation in UCSF MD Link may be discontinued by the Service Provider without prior
notice.
Verification of Identity
I understand that my enrollment is contingent on verification of my identity either in person
by an employee or physician of UCSFMC or based on comparison of my signature provided
on the Request for Enrollment, with the signature on my registration sheet in my affiliated
agreement with UCSFMC.
Security and Confidentiality
We afford the same degree of confidentiality to medical information stored on UCSF MD
Link as is given to health information stored by UCSFMC in any other medium. UCSFMC
is committed to protecting the confidentiality of everyone's health information. We limit
UCSFMC employees' access and ability to enter or view health information based upon
their role in patient care. We have taken steps to make all health information received
from our online visitors as secure as possible against unauthorized access, use, or
disclosure.
It is important to check for the extra layer of security and protection that is used to protect
patient health information each time UCSF MD Link is used. This extra protection can be
seen when you are working with the secure site by looking for the lock and https:// at the
front of the web address area on your screen. This should be checked before putting in
credentials of any kind.
All providers, such as physicians, hospitals and health plans, are required by law to keep
health information private and confidential.
Disclaimer
I understand that UCSF MD Link may not be available to me all the time due to system
failures, back-up procedures, maintenance, or other causes beyond the control of the
Service Provider. Access is provided on an "as-is, as-available" basis and the Service
Provider does not guarantee that I will be able to access UCSF MD Link at any particular
time.
I understand that the Service Provider takes no responsibility for and disclaims any and all
liability arising from any inaccuracies or defects in software, communication lines, virtual
private network, the Internet or my Internet Service Provider (ISP), access system,
computer hardware or software, or any other service or device that I use to access UCSF
MD Link. During times when UCSF MD Link is unavailable, other communication methods
(e.g., telephone) should be used to access UCSF MD Link.
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UCSF MD Link and its content and all site-related services are provided "as is," with all
faults, with no representations or warranties of any kind, either expressed or implied,
including, but not limited to, the implied warranties of merchantability, fitness for a
particular purpose or non-infringement. You assume total responsibility and risk for your
use of this site, all site-related services, and third party web sites. No oral or written
information given by UCSFMC or its authorized representatives shall create a warranty of
any kind. Any references to specific products or services on UCSF MD Link do not
constitute or imply a recommendation or endorsement by UCSFMC unless specifically
stated otherwise.
Surveys
I understand that from time to time I may be asked to complete satisfaction surveys via
UCSF MD Link or mailing. UCSF MD Link and UCSFMC may analyze information
submitted via UCSF MD Link as part of descriptive (demographic) studies and reports. In
such cases personal identifying information will be removed.
Copyrights
Except as otherwise indicated, all content on UCSF MD Link, including text, graphics,
logos, button icons, photos, images, forms, audio, video, questionnaires, and software, is
the property of UCSFMC or its licensors and is protected by United States and
international copyright laws. UCSFMC allows you to view or download a single copy of
the material on UCSF MD Link solely for the purpose of treatment of your patients.
The compilation of all content on UCSF MD Link is the exclusive property of UCSFMC
and is protected by United States and international copyright laws. Unless specifically
authorized in writing by UCSFMC, any use of these materials, or of any materials
contributed to UCSF MD Link by entities other than UCSFMC, on any other Web site or
networked computer environment for any purpose is prohibited.
Any rights not expressly granted by these Terms and Conditions or any applicable end-
user license agreements are reserved by UCSFMC. Content and features are subject to
change or termination without notice in the editorial discretion of UCSFMC.
The Digital Millennium Copyright Act of 1998 (the "DMCA") provides recourse for
copyright owners who believe that material appearing on the Internet infringes their rights
under U.S. copyright law. If you believe in good faith that materials appearing on UCSF
MD Link infringe your copyright, you (or your agent) may send us a notice requesting that
the material be removed, or access to it blocked.
In addition, if you believe in good faith that a notice of copyright infringement has been
wrongly filed against you, the DMCA permits you to send us a counter-notice. Notices
and counter-notices must meet statutory requirements imposed by the DMCA. One place
to find more information is the U.S. Copyright Office Web site, currently located at
http://www.loc.gov/copyright. In accordance with the DMCA, UCSFMC has designated an
agent to receive notification of alleged copyright infringement in accordance with the
3
DMCA. Any written Notification of Claimed Infringement should comply with Title 17,
United States Code, Section 512(c)(3)(A) and should be provided in writing to our
designated agent as follows:
Agent: UCSF Office of Legal Affairs
Address: 745 Parnassus Ave, San Francisco 94143
Please note: If you materially misrepresent that online material, product, or activity is
infringing your copyrights, you may be liable for damages (including court costs and
attorneys' fees) and could be subject to criminal prosecution for perjury. We suggest that
you consult your legal advisor before filing a notice or counter-notice.
Trademarks and Service Marks
"UCSFMC" and the UCSFMC logo are registered service marks of UCSF or its affiliates.
Other proprietary marks of UCSFMC or third parties may be designated as such from
time to time on UCSF MD Link through use of the TM, SM, or 0 symbols. Users of UCSF
MD Link are not authorized to make any use of the UCSFMC marks or the proprietary
marks of third parties, including but not limited to, as metatags or in any other fashion that
may create a false or misleading impression of affiliation or sponsorship with or by
UCSFMC or the applicable third party.
Agreement
BY USING UCSF MD LINK OR BY CLICKING "I ACCEPT" BELOW, YOU SIGNIFY
YOUR AGREEMENT TO THESE TERMS AND CONDITIONS. IF YOU DO NOT AGREE
TO THESE TERMS AND CONDITIONS, you are not able to use UCSF MD Link.
Customer Service Information
If you need information or technical assistance regarding the UCSF MD Link website,
please call 415-514-4100.
To deactivate your UCSF MD Link account, please call 415-514-4100.
4
ry
COUNTY OF FRESNO:
By 19
Chairman,, /Board of Supervisors
Date: oV ill15
BERNICE E. SEIDEL, Clerk
Board of Supervisors
F,
By (1L15�.y� IJ.ISXIt
Date: re h('t.8xj
APPROVED AS TO LEGAL FORM:
DANIEL CEDERBORG, COUNTY COUNSEL
By -/�&�
APPROVED AS TO ACCOUNTING FORM:
VICKI CROW, C.P.A., AUDITOR-CONTROLLER/
TREASURER-TAX COLLECTOR
By
REVIEWED AND RECOMMENDED FOR APPROVAL:
By !/
David Pomaville
Director
Department of Public Health
Fund/Subclass: 0001/10000
Organization: 56201600
Account#: 7295
[SG]
13
Exhibit A
University California, San Francisco
List of County of Fresno Employees
Authorized to access information from UCSF electronic medical records
Name Title
Melissa Aguirre Public Health Physician
Noel Almaguer Public Health Nurse
Keisha Ammonds Admitting Interviewer
Faisal Aranki Epidemiologist
Maria Baldovinos Communicable Disease Specialist
Lillarose Bangs Public Health Nurse
Marla Bomgardner Public Health Nurse
Joseph Burgess Staff Nurse
Denise Butler Occupational Therapist
Monica Carrasco Public Health Nurse
Mercedes Chapa Public Health Physician
Pon Chin Public Health Nurse
Joy Conde Physical Therapist
Rogenia Cox Communicable Disease Specialist
Michael Dang Public Health Nurse
Harsharn Dhillon Occupational Therapist
Jovanna Dominguez Office Assistant
Maria Escobedo Admitting Interviewer
Penny Fleming Physical Therapist
Arturo Flores Admitting Interviewer
Hope Garcia Public Health Nurse
Lee Garcia Admitting Interviewer
Stephanie Garcia Supervising Communicable Disease Specialist
Claudia Gasca Public Health Nurse
Stephanie German Staff Analyst
Jeri Guerrero Public Health Nurse
Rachel Guzman Office Assistant
Theresa Hartsock Public Health Nurse
Danielle Holmes Physical Therapist
Stella Jauregui Public Health Nurse
Maribeth Jensen Staff Nurse
Peter Jew Systems and Procedure Analyst
Alvishia Johnson Admitting Interviewer
Sherilee Lawson Head Nurse
Rebecca Lopez Admitting Interviewer
Sally Lopez Public Health Nurse
Evelyn Lotter Public Health Nurse
Elizabeth Manfredi Public Health Nurse
Martha Marron Communicable Disease Specialist
Darawadee Martin Staff Nurse
Rene Martz Public Health Nurse
Julie McCaslin Staff Nurse
Marites Mendoza Staff Nurse
Paula Mendoza Communicable Disease Specialist
Sonya Mendoza Senior Admitting Interviewer
Page 1
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Exhibit A
Alicia Molina Admitting Interviewer
Edward Morales Communicable Disease Specialist II
Mary Morrisson Supervising Public Health Nurse
Melissa Olson Physical Therapist
Ginger Parker Physical Therapist
Angela Perez Communicable Disease Specialist
Janelle Petersen Public Health Nurse
Eleana Phillips Physical Therapist
Marjelyn Ramiro Staff Nurse
Jennifer Rhea Public Health Nurse
Gabriela Rodriguez-Reyna Admitting Interviewer
Maria Rojas-Singh Admitting Interviewer
Jared Rutledge Epidemiologist
Jeanette Salas Therapy Aide
Norma Sanchez Communicable Disease Specialist
Julie Slaughter Supervising Public Health Nurse
Susana Sotelo Therapy Aide
Amy Sticklin Physical Therapist
Nancy Sullivan Supervising Public Health Nurse
Vivien Tagoe Staff Nurse
Bobbi Taylor Admitting Interviewer
Kim Thomas Communicable Disease Specialist
Joanne Thorne Staff Nurse
Khamsay Vanhelsdingen Supervising Admitting Interviewer
Valerie Wells Supervising Office Assistant
Mariah Wilson Physical Therapist
Heather Woo Public Health Nurse
Jing Yang Staff Nurse
Norma Zieska Supervising Account Clerk
Kristen Zuspann Admitting Interviewer
Page 2
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