Tennessee CSMD Data Request (Board Of Pharmacy)

Sarah Seymour filed this request with the Board Of Pharmacy of Nashville, TN.
Multi Request Tennessee CSMD Data Request
Status
Completed

Communications

From: Sarah Seymour

To Whom It May Concern:

Northeastern University's School of Social Justice and Health Equity is interested in the Tennessee Controlled Substance Monitoring Database Program ("CSMD"). Specifically, we want to learn more about law enforcement access to the database, the use of an algorithm that produces a risk score to analyze its contents, and the data access and retention rules governing the system. We understand the algorithm was produced by the corporation Appriss.

In order to permit the public to understand how the Tennessee Board of Pharmacy and Tennessee Department of Health is using the CSMD and how it impacts public health and civil liberties in Tennessee, Northeastern University's Health in Justice Action Lab is making this request under Tenn. Code Ann. 10-7-503 et seq. for the following records:

1. Any and all records reflecting an agreement for purchase, acquisition, or licensing of, or permission to use, test, or evaluate Appriss’s systems or services, including any product or service offered;
 
2. Any and all memoranda of understanding between the Tennessee Board of Pharmacy or Tennessee Department of Health and any outside entity regarding the CSMD;

3. Any and all records including information about the algorithm that determines risk scores in the CSMD, including but not limited to its source code, developer documentation, and operator manuals (e.g. Narx Score, Overdose Risk Score);
 
4. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance;

5. Any and all records of de-identified red flag algorithm outputs (e.g. provider red flag, pharmacy red flag, 40 MED red flag) and patient behavioral red flags (e.g., anxious patient demeanor, distance between prescriber and dispenser) with prescriber/dispenser training documentation on how to address the red flags;
 
6. Any record showing the number of patients in the CSMD by quarter and year (2006-present);
 
7. Any and all records from 2006-present of notification to law enforcement about information in the CSMD Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the CSMD, and which agencies have been notified;
 
Because this request involves a matter of public concern and because it is made on behalf of a nonprofit organization, we ask that you waive any fees. If you decide not to waive fees, we request that you permit us to examine, at our election, the responsive documents before deciding which portions to transmit. We prefer the documents in electronic format.

Should you determine that some portion of the documents request are exempt from disclosure, please release any reasonably segregable portions that are not exempt. In addition, please note the applicable statutory exemption and explain why it applies to the redacted portions.

Thank you in advance for your anticipated cooperation in this matter.

I look forward to receiving your response to this request within ten days as requested by the statute.

Sincerely,

Sarah Seymour

From: Board Of Pharmacy

Thank you for contacting the TN Department of Health. At this time we are not adding any suggested solicitation to our website.
-Regards

From: Board Of Pharmacy

Ms. Seymour,

I am in receipt of your September 16, 2019 request for records. Pursuant to T.C.A. § 10-7-503(a)(2)(B), the Department is provided seven (7) business days to respond to your request. The Department calculates, based upon the previously provided advisory opinion from the Tennessee Office of Open Records Counsel, the period to respond concludes on September 25, 2019. During the intervening time, please provide proof of your or Ms. Seymour’s citizenship in the State of Tennessee.

Your request seeks a fee waiver. Such a waiver will not be granted in this instance. Section VI of the October 25, 2018 policy sets forth the fees and charges policies of the Department.

I have also attached my previous response to you the last time that your requested these records. In that instance, you never followed up with my e-mail and no records were produced. I am available to answer any questions you may have.
Best,

[cid:image001.png@01D0AAAF.AF3502B0]
Andrew W. Coffman | Assistant General Counsel
Office of General Counsel
665 Mainstream Drive, 2nd Floor
Nashville, TN 37243

From:

##- Please type your reply above this line -##

You are registered as a CC on this request (111509). Reply to this email to add a comment to the request.

----------------------------------------------

Paige Evans, Sep 23, 11:22 -05

This is a follow-up to your previous request #107728 "RE: [EXTERNAL] Tennessee Pu..."

Shelly (and Bill and Elizabeth),

I somehow missed this email from MuckRock in my inbox last week (sorry). I’m cc’ing Pharmacy.Health to see if they have started looking into this request yet.

Paige Evans | Executive Administrative Assistant I

Office of General Counsel

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-532-6714

paige.evans@tn.gov

tn.gov/health

Connect with TDH on Facebook (http://www.facebook.com/TNDeptofHealth) and Twitter (http://twitter.com/#!/TNDeptofHealth) @TNDeptofHealth!

Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.

CONFIDENTIALITY NOTICE: The information contained in this email, and any attachments, is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held in your systems, and notify the sender immediately. You should not retain, copy or use this email for any purpose, nor disclose all or any part of its content to any other person. We apologize for any inconvenience this may have caused.
--------------------------------
This email is a service from State of Tennessee.

[V0O2YE-PVQ9]

From: Board Of Pharmacy

##- Please type your reply above this line -##

You are registered as a CC on this request (111509). Reply to this email to add a comment to the request.

----------------------------------------------

Shelley Walker, Sep 26, 16:16 -05

I’m still catching up on emails. This doesn’t pass the smell test – if the university wanted info from us, why would the email come from Muckrock?

Where are we on this request? Has it been acknowledged? Do we want to deny this one as the requestor is not a Tennessee resident?

**![cid:image007.png@01D0AAAF.AF3502B0](https://tnhlr.zendesk.com/attachments/token/88jgMLcQyxzyzBi2TjPoa1NLH/?name=image003.png)**

**Shelley Walker**| Director

Office of Communication & Media Relations

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-253-5184

Shelley.Walker@tn.gov

tn.gov/health

Connect with TDH onFacebook and Twitter @TNDeptofHealth!

_Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee._

**From:** Paige Evans
**Sent:** Monday, September 23, 2019 11:22 AM
**To:** Shelley Walker; Bill Christian; Elizabeth Hart
**Cc:** Pharmacy Health; Paige V. Edwards
**Subject:** RE: [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

Shelly (and Bill and Elizabeth),

I somehow missed this email from MuckRock in my inbox last week (sorry). I’m cc’ing Pharmacy.Health to see if they have started looking into this request yet.

**![cid:image001.png@01D0AAAF.AF3502B0](https://tnhlr.zendesk.com/attachments/token/ULIPKsywzwaq79iXh5hVoPqLt/?name=image004.png)**

**Paige Evans**| Executive Administrative Assistant I

Office of General Counsel

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-532-6714

paige.evans@tn.gov

tn.gov/health

Connect with TDH onFacebook and Twitter @TNDeptofHealth!

_Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee._

_CONFIDENTIALITY NOTICE__: The information contained in this email, and any attachments, is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held in your systems, and notify the sender immediately. You should not retain, copy or use this email for any purpose, nor disclose all or any part of its content to any other person. We apologize for any inconvenience this may have caused._

**From:** TN Health
**Sent:** Monday, September 16, 2019 11:47 AM
**To:** requests@muckrock.com
**Cc:** Pharmacy Health; Paige Evans
**Subject:** RE: [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

Thank you for contacting the TN Department of Health. At this time we are not adding any suggested solicitation to our website.

-Regards

**From:** requests@muckrock.com [mailto:requests@muckrock.com]
**Sent:** Monday, September 16, 2019 10:53 AM
**To:** TN Health
**Subject:** [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

***** This is an EXTERNAL email. Please exercise caution. DO NOT open attachments or click links from unknown senders or unexpected email - STS-Security. *****

* * *

Board Of Pharmacy
TPRA Office
710 James Robertson Parkway
Nashville, TN 37243

September 16, 2019

To Whom It May Concern:

Northeastern University's School of Social Justice and Health Equity is interested in the Tennessee Controlled Substance Monitoring Database Program ("CSMD"). Specifically, we want to learn more about law enforcement access to the database, the use of an algorithm that produces a risk score to analyze its contents, and the data access and retention rules governing the system. We understand the algorithm was produced by the corporation Appriss.

In order to permit the public to understand how the Tennessee Board of Pharmacy and Tennessee Department of Health is using the CSMD and how it impacts public health and civil liberties in Tennessee, Northeastern University's Health in Justice Action Lab is making this request under Tenn. Code Ann. 10-7-503 et seq. for the following records:

1. Any and all records reflecting an agreement for purchase, acquisition, or licensing of, or permission to use, test, or evaluate Appriss’s systems or services, including any product or service offered;

2. Any and all memoranda of understanding between the Tennessee Board of Pharmacy or Tennessee Department of Health and any outside entity regarding the CSMD;

3. Any and all records including information about the algorithm that determines risk scores in the CSMD, including but not limited to its source code, developer documentation, and operator manuals (e.g. Narx Score, Overdose Risk Score);

4. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance;

5. Any and all records of de-identified red flag algorithm outputs (e.g. provider red flag, pharmacy red flag, 40 MED red flag) and patient behavioral red flags (e.g., anxious patient demeanor, distance between prescriber and dispenser) with prescriber/dispenser training documentation on how to address the red flags;

6. Any record showing the number of patients in the CSMD by quarter and year (2006-present);

7. Any and all records from 2006-present of notification to law enforcement about information in the CSMD Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the CSMD, and which agencies have been notified;

Because this request involves a matter of public concern and because it is made on behalf of a nonprofit organization, we ask that you waive any fees. If you decide not to waive fees, we request that you permit us to examine, at our election, the responsive documents before deciding which portions to transmit. We prefer the documents in electronic format.

Should you determine that some portion of the documents request are exempt from disclosure, please release any reasonably segregable portions that are not exempt. In addition, please note the applicable statutory exemption and explain why it applies to the redacted portions.

Thank you in advance for your anticipated cooperation in this matter.

I look forward to receiving your response to this request within ten days as requested by the statute.

Sincerely,

Sarah Seymour

Filed via MuckRock.com
E-mail (Preferred): requests@muckrock.com
Upload documents directly: https://accounts.muckrock.com/accounts/login/?url_auth_token=AABj6oTVg5WZ-_4uJCzfpalw8hI%3A1i9tJ2%3A40G8IMxFw9s3iX63jQoS4u5_QKI&next=https%3A%2F%2Fwww.muckrock.com%2Faccounts%2Flogin%2F%3Fnext%3D%252Faccounts%252Fagency_login%252Fboard-of-pharmacy-18537%252Ftennessee-csmd-data-request-board-of-pharmacy-80315%252F%253Femail%253Dtn.health%252540tn.gov
Is this email coming to the wrong contact? Something else wrong? Use the above link to let us know.

For mailed responses, please address (see note):
MuckRock News
DEPT MR 80315
411A Highland Ave
Somerville, MA 02144-2516

PLEASE NOTE: This request is not filed by a MuckRock staff member, but is being sent through MuckRock by the above in order to better track, share, and manage public records requests. Also note that improperly addressed (i.e., with the requester's name rather than "MuckRock News" and the department number) requests might be returned as undeliverable.

![Image removed by sender.](https://tnhlr.zendesk.com/attachments/token/AsS9XiS9OgMVLKFkaNQwdfln6/?name=image005.jpg)

----------------------------------------------

Paige Evans, Sep 23, 11:22 -05

This is a follow-up to your previous request #107728 "RE: [EXTERNAL] Tennessee Pu..."

Shelly (and Bill and Elizabeth),

I somehow missed this email from MuckRock in my inbox last week (sorry). I’m cc’ing Pharmacy.Health to see if they have started looking into this request yet.

Paige Evans | Executive Administrative Assistant I

Office of General Counsel

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-532-6714

paige.evans@tn.gov

tn.gov/health

Connect with TDH on Facebook (http://www.facebook.com/TNDeptofHealth) and Twitter (http://twitter.com/#!/TNDeptofHealth) @TNDeptofHealth!

Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.

CONFIDENTIALITY NOTICE: The information contained in this email, and any attachments, is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held in your systems, and notify the sender immediately. You should not retain, copy or use this email for any purpose, nor disclose all or any part of its content to any other person. We apologize for any inconvenience this may have caused.

Attachment(s):
image001.png - https://tnhlr.zendesk.com/attachments/token/qzRkVP1qT3lsIN9pfQGMZjvJG/?name=image001.png
image002.jpg - https://tnhlr.zendesk.com/attachments/token/rrWtJMBYIu4juKHrgn1U9m0ed/?name=image002.jpg
--------------------------------
This email is a service from State of Tennessee.

[V0O2YE-PVQ9]

From: Board Of Pharmacy

##- Please type your reply above this line -##

You are registered as a CC on this request (111509). Reply to this email to add a comment to the request.

----------------------------------------------

Sheila Bush, Sep 27, 08:43 -05

Good morning,
Andrew Coffman has answer this email when it originally came through on 9/16/19. Thanks

![State of TN Dept. of Health](https://theme.zdassets.com/theme_assets/2416674/17c11305723ae4544f8abdf99e3e8b1600cff0f8.png)
Sheila Bush
Board of Pharmacy
665 Mainstream Drive
Nashville, TN 37243
tn.gov/health
Connect with TDH on Facebook or Twitter @TNDeptofHealth!

Our Mission - To protect, promote and improve the health and prosperity of people in Tennessee.

CONFIDENTIALITY NOTE: The information transmitted, including attachments, is intended only for the person(s) or entity to which it is addressed and may contain confidential and/or privileged material.
Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon this information by persons or entities other than the intended recipient is prohibited.
If you received this in error, please contact the sender and destroy any copies of this information.

----------------------------------------------

Shelley Walker, Sep 26, 16:16 -05

I’m still catching up on emails. This doesn’t pass the smell test – if the university wanted info from us, why would the email come from Muckrock?

Where are we on this request? Has it been acknowledged? Do we want to deny this one as the requestor is not a Tennessee resident?

**![cid:image007.png@01D0AAAF.AF3502B0](https://tnhlr.zendesk.com/attachments/token/88jgMLcQyxzyzBi2TjPoa1NLH/?name=image003.png)**

**Shelley Walker**| Director

Office of Communication & Media Relations

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-253-5184

Shelley.Walker@tn.gov

tn.gov/health

Connect with TDH onFacebook and Twitter @TNDeptofHealth!

_Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee._

**From:** Paige Evans
**Sent:** Monday, September 23, 2019 11:22 AM
**To:** Shelley Walker; Bill Christian; Elizabeth Hart
**Cc:** Pharmacy Health; Paige V. Edwards
**Subject:** RE: [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

Shelly (and Bill and Elizabeth),

I somehow missed this email from MuckRock in my inbox last week (sorry). I’m cc’ing Pharmacy.Health to see if they have started looking into this request yet.

**![cid:image001.png@01D0AAAF.AF3502B0](https://tnhlr.zendesk.com/attachments/token/ULIPKsywzwaq79iXh5hVoPqLt/?name=image004.png)**

**Paige Evans**| Executive Administrative Assistant I

Office of General Counsel

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-532-6714

paige.evans@tn.gov

tn.gov/health

Connect with TDH onFacebook and Twitter @TNDeptofHealth!

_Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee._

_CONFIDENTIALITY NOTICE__: The information contained in this email, and any attachments, is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held in your systems, and notify the sender immediately. You should not retain, copy or use this email for any purpose, nor disclose all or any part of its content to any other person. We apologize for any inconvenience this may have caused._

**From:** TN Health
**Sent:** Monday, September 16, 2019 11:47 AM
**To:** requests@muckrock.com
**Cc:** Pharmacy Health; Paige Evans
**Subject:** RE: [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

Thank you for contacting the TN Department of Health. At this time we are not adding any suggested solicitation to our website.

-Regards

**From:** requests@muckrock.com [mailto:requests@muckrock.com]
**Sent:** Monday, September 16, 2019 10:53 AM
**To:** TN Health
**Subject:** [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

***** This is an EXTERNAL email. Please exercise caution. DO NOT open attachments or click links from unknown senders or unexpected email - STS-Security. *****

* * *

Board Of Pharmacy
TPRA Office
710 James Robertson Parkway
Nashville, TN 37243

September 16, 2019

To Whom It May Concern:

Northeastern University's School of Social Justice and Health Equity is interested in the Tennessee Controlled Substance Monitoring Database Program ("CSMD"). Specifically, we want to learn more about law enforcement access to the database, the use of an algorithm that produces a risk score to analyze its contents, and the data access and retention rules governing the system. We understand the algorithm was produced by the corporation Appriss.

In order to permit the public to understand how the Tennessee Board of Pharmacy and Tennessee Department of Health is using the CSMD and how it impacts public health and civil liberties in Tennessee, Northeastern University's Health in Justice Action Lab is making this request under Tenn. Code Ann. 10-7-503 et seq. for the following records:

1. Any and all records reflecting an agreement for purchase, acquisition, or licensing of, or permission to use, test, or evaluate Appriss’s systems or services, including any product or service offered;

2. Any and all memoranda of understanding between the Tennessee Board of Pharmacy or Tennessee Department of Health and any outside entity regarding the CSMD;

3. Any and all records including information about the algorithm that determines risk scores in the CSMD, including but not limited to its source code, developer documentation, and operator manuals (e.g. Narx Score, Overdose Risk Score);

4. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance;

5. Any and all records of de-identified red flag algorithm outputs (e.g. provider red flag, pharmacy red flag, 40 MED red flag) and patient behavioral red flags (e.g., anxious patient demeanor, distance between prescriber and dispenser) with prescriber/dispenser training documentation on how to address the red flags;

6. Any record showing the number of patients in the CSMD by quarter and year (2006-present);

7. Any and all records from 2006-present of notification to law enforcement about information in the CSMD Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the CSMD, and which agencies have been notified;

Because this request involves a matter of public concern and because it is made on behalf of a nonprofit organization, we ask that you waive any fees. If you decide not to waive fees, we request that you permit us to examine, at our election, the responsive documents before deciding which portions to transmit. We prefer the documents in electronic format.

Should you determine that some portion of the documents request are exempt from disclosure, please release any reasonably segregable portions that are not exempt. In addition, please note the applicable statutory exemption and explain why it applies to the redacted portions.

Thank you in advance for your anticipated cooperation in this matter.

I look forward to receiving your response to this request within ten days as requested by the statute.

Sincerely,

Sarah Seymour

Filed via MuckRock.com
E-mail (Preferred): requests@muckrock.com
Upload documents directly: https://accounts.muckrock.com/accounts/login/?url_auth_token=AABj6oTVg5WZ-_4uJCzfpalw8hI%3A1i9tJ2%3A40G8IMxFw9s3iX63jQoS4u5_QKI&next=https%3A%2F%2Fwww.muckrock.com%2Faccounts%2Flogin%2F%3Fnext%3D%252Faccounts%252Fagency_login%252Fboard-of-pharmacy-18537%252Ftennessee-csmd-data-request-board-of-pharmacy-80315%252F%253Femail%253Dtn.health%252540tn.gov
Is this email coming to the wrong contact? Something else wrong? Use the above link to let us know.

For mailed responses, please address (see note):
MuckRock News
DEPT MR 80315
411A Highland Ave
Somerville, MA 02144-2516

PLEASE NOTE: This request is not filed by a MuckRock staff member, but is being sent through MuckRock by the above in order to better track, share, and manage public records requests. Also note that improperly addressed (i.e., with the requester's name rather than "MuckRock News" and the department number) requests might be returned as undeliverable.

![Image removed by sender.](https://tnhlr.zendesk.com/attachments/token/AsS9XiS9OgMVLKFkaNQwdfln6/?name=image005.jpg)

----------------------------------------------

Paige Evans, Sep 23, 11:22 -05

This is a follow-up to your previous request #107728 "RE: [EXTERNAL] Tennessee Pu..."

Shelly (and Bill and Elizabeth),

I somehow missed this email from MuckRock in my inbox last week (sorry). I’m cc’ing Pharmacy.Health to see if they have started looking into this request yet.

Paige Evans | Executive Administrative Assistant I

Office of General Counsel

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-532-6714

paige.evans@tn.gov

tn.gov/health

Connect with TDH on Facebook (http://www.facebook.com/TNDeptofHealth) and Twitter (http://twitter.com/#!/TNDeptofHealth) @TNDeptofHealth!

Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.

CONFIDENTIALITY NOTICE: The information contained in this email, and any attachments, is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held in your systems, and notify the sender immediately. You should not retain, copy or use this email for any purpose, nor disclose all or any part of its content to any other person. We apologize for any inconvenience this may have caused.

Attachment(s):
image001.png - https://tnhlr.zendesk.com/attachments/token/qzRkVP1qT3lsIN9pfQGMZjvJG/?name=image001.png
image002.jpg - https://tnhlr.zendesk.com/attachments/token/rrWtJMBYIu4juKHrgn1U9m0ed/?name=image002.jpg
--------------------------------
This email is a service from State of Tennessee.

[V0O2YE-PVQ9]

From: Board Of Pharmacy

##- Please type your reply above this line -##

You are registered as a CC on this request (111509). Reply to this email to add a comment to the request.

----------------------------------------------

Shelley Walker, Sep 27, 09:49 -05

Looks like we can mark this one complete.

**![cid:image007.png@01D0AAAF.AF3502B0](https://tnhlr.zendesk.com/attachments/token/0kaenz2H7WmEy4CSJMzry6sE4/?name=image001.png)**

**Shelley Walker**| Director

Office of Communication & Media Relations

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-253-5184

Shelley.Walker@tn.gov

tn.gov/health

Connect with TDH onFacebook and Twitter @TNDeptofHealth!

_Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee._

----------------------------------------------

Sheila Bush, Sep 27, 08:43 -05

Good morning,
Andrew Coffman has answer this email when it originally came through on 9/16/19. Thanks

![State of TN Dept. of Health](https://theme.zdassets.com/theme_assets/2416674/17c11305723ae4544f8abdf99e3e8b1600cff0f8.png)
Sheila Bush
Board of Pharmacy
665 Mainstream Drive
Nashville, TN 37243
tn.gov/health
Connect with TDH on Facebook or Twitter @TNDeptofHealth!

Our Mission - To protect, promote and improve the health and prosperity of people in Tennessee.

CONFIDENTIALITY NOTE: The information transmitted, including attachments, is intended only for the person(s) or entity to which it is addressed and may contain confidential and/or privileged material.
Any review, retransmission, dissemination or other use of, or taking of any action in reliance upon this information by persons or entities other than the intended recipient is prohibited.
If you received this in error, please contact the sender and destroy any copies of this information.

----------------------------------------------

Shelley Walker, Sep 26, 16:16 -05

I’m still catching up on emails. This doesn’t pass the smell test – if the university wanted info from us, why would the email come from Muckrock?

Where are we on this request? Has it been acknowledged? Do we want to deny this one as the requestor is not a Tennessee resident?

**![cid:image007.png@01D0AAAF.AF3502B0](https://tnhlr.zendesk.com/attachments/token/88jgMLcQyxzyzBi2TjPoa1NLH/?name=image003.png)**

**Shelley Walker**| Director

Office of Communication & Media Relations

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-253-5184

Shelley.Walker@tn.gov

tn.gov/health

Connect with TDH onFacebook and Twitter @TNDeptofHealth!

_Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee._

**From:** Paige Evans
**Sent:** Monday, September 23, 2019 11:22 AM
**To:** Shelley Walker; Bill Christian; Elizabeth Hart
**Cc:** Pharmacy Health; Paige V. Edwards
**Subject:** RE: [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

Shelly (and Bill and Elizabeth),

I somehow missed this email from MuckRock in my inbox last week (sorry). I’m cc’ing Pharmacy.Health to see if they have started looking into this request yet.

**![cid:image001.png@01D0AAAF.AF3502B0](https://tnhlr.zendesk.com/attachments/token/ULIPKsywzwaq79iXh5hVoPqLt/?name=image004.png)**

**Paige Evans**| Executive Administrative Assistant I

Office of General Counsel

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-532-6714

paige.evans@tn.gov

tn.gov/health

Connect with TDH onFacebook and Twitter @TNDeptofHealth!

_Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee._

_CONFIDENTIALITY NOTICE__: The information contained in this email, and any attachments, is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held in your systems, and notify the sender immediately. You should not retain, copy or use this email for any purpose, nor disclose all or any part of its content to any other person. We apologize for any inconvenience this may have caused._

**From:** TN Health
**Sent:** Monday, September 16, 2019 11:47 AM
**To:** requests@muckrock.com
**Cc:** Pharmacy Health; Paige Evans
**Subject:** RE: [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

Thank you for contacting the TN Department of Health. At this time we are not adding any suggested solicitation to our website.

-Regards

**From:** requests@muckrock.com [mailto:requests@muckrock.com]
**Sent:** Monday, September 16, 2019 10:53 AM
**To:** TN Health
**Subject:** [EXTERNAL] Tennessee Public Records Act Request: Tennessee CSMD Data Request (Board Of Pharmacy)

***** This is an EXTERNAL email. Please exercise caution. DO NOT open attachments or click links from unknown senders or unexpected email - STS-Security. *****

* * *

Board Of Pharmacy
TPRA Office
710 James Robertson Parkway
Nashville, TN 37243

September 16, 2019

To Whom It May Concern:

Northeastern University's School of Social Justice and Health Equity is interested in the Tennessee Controlled Substance Monitoring Database Program ("CSMD"). Specifically, we want to learn more about law enforcement access to the database, the use of an algorithm that produces a risk score to analyze its contents, and the data access and retention rules governing the system. We understand the algorithm was produced by the corporation Appriss.

In order to permit the public to understand how the Tennessee Board of Pharmacy and Tennessee Department of Health is using the CSMD and how it impacts public health and civil liberties in Tennessee, Northeastern University's Health in Justice Action Lab is making this request under Tenn. Code Ann. 10-7-503 et seq. for the following records:

1. Any and all records reflecting an agreement for purchase, acquisition, or licensing of, or permission to use, test, or evaluate Appriss’s systems or services, including any product or service offered;

2. Any and all memoranda of understanding between the Tennessee Board of Pharmacy or Tennessee Department of Health and any outside entity regarding the CSMD;

3. Any and all records including information about the algorithm that determines risk scores in the CSMD, including but not limited to its source code, developer documentation, and operator manuals (e.g. Narx Score, Overdose Risk Score);

4. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance;

5. Any and all records of de-identified red flag algorithm outputs (e.g. provider red flag, pharmacy red flag, 40 MED red flag) and patient behavioral red flags (e.g., anxious patient demeanor, distance between prescriber and dispenser) with prescriber/dispenser training documentation on how to address the red flags;

6. Any record showing the number of patients in the CSMD by quarter and year (2006-present);

7. Any and all records from 2006-present of notification to law enforcement about information in the CSMD Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the CSMD, and which agencies have been notified;

Because this request involves a matter of public concern and because it is made on behalf of a nonprofit organization, we ask that you waive any fees. If you decide not to waive fees, we request that you permit us to examine, at our election, the responsive documents before deciding which portions to transmit. We prefer the documents in electronic format.

Should you determine that some portion of the documents request are exempt from disclosure, please release any reasonably segregable portions that are not exempt. In addition, please note the applicable statutory exemption and explain why it applies to the redacted portions.

Thank you in advance for your anticipated cooperation in this matter.

I look forward to receiving your response to this request within ten days as requested by the statute.

Sincerely,

Sarah Seymour

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PLEASE NOTE: This request is not filed by a MuckRock staff member, but is being sent through MuckRock by the above in order to better track, share, and manage public records requests. Also note that improperly addressed (i.e., with the requester's name rather than "MuckRock News" and the department number) requests might be returned as undeliverable.

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Paige Evans, Sep 23, 11:22 -05

This is a follow-up to your previous request #107728 "RE: [EXTERNAL] Tennessee Pu..."

Shelly (and Bill and Elizabeth),

I somehow missed this email from MuckRock in my inbox last week (sorry). I’m cc’ing Pharmacy.Health to see if they have started looking into this request yet.

Paige Evans | Executive Administrative Assistant I

Office of General Counsel

Andrew Johnson Tower, 5th Floor

710 James Robertson Parkway, Nashville, TN 37243

p. 615-532-6714

paige.evans@tn.gov

tn.gov/health

Connect with TDH on Facebook (http://www.facebook.com/TNDeptofHealth) and Twitter (http://twitter.com/#!/TNDeptofHealth) @TNDeptofHealth!

Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.

CONFIDENTIALITY NOTICE: The information contained in this email, and any attachments, is confidential and may be privileged. If you are not the intended recipient, please destroy this message, delete any copies held in your systems, and notify the sender immediately. You should not retain, copy or use this email for any purpose, nor disclose all or any part of its content to any other person. We apologize for any inconvenience this may have caused.

Attachment(s):
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This email is a service from State of Tennessee.

[V0O2YE-PVQ9]

From: Board Of Pharmacy

Ms. Seymour,
Per your request included below, please find attached the responsive documents for the currently executed contract. These include:
• Executed base contract, with Attachment 1
• Attachment 2 – Business Associate Agreement
• Attachment 3 – Business Requirements Document
• Attachment 4 – Current Functionality

We are working to gather documents for short-term contracts from fiscal years, 2017, 2018 and 2019. We will provide additional responsive records as soon as we can.

[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.

From: Board Of Pharmacy

Ms. Seymour:

Attached are the FY17, FY18 and FY19 contracts per your request. The FY19 document was a short-term contract that bridged FY18 and the FY19 contract you were previously sent, which currently runs through 2021.

Please confirm your receipt of these records, as well as those provided to you via email on Nov. 5.

[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.

From: Board Of Pharmacy

Making sure you receive this information, as it looks like you have contacted us via varied email addresses. There are additional responses to your questions below.
Please note, when replying to a request we will provide our response to the email address from which we received it.
Please confirm your receipt of this information.

[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.

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