North Caroline PDMP Request
| Tracking # |
2019091202 |
| Submitted | Sept. 12, 2019 |
| Est. Completion | None |
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Communications
From: HIJ Action Lab
To Whom it May Concern,
Northeastern University’s School of Social Justice and Health Equity is interested in the state’s prescription monitoring program, the NC Controlled Substance Reporting System. Specifically, we want to learn more about law enforcement access to the database, the use of an algorithm that produces a risk assessment 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 Health.
In order to permit the public to understand how the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services is using the NC Controlled Substance Reporting System and how it impacts public health and civil liberties in North Carolina, Northeastern University’s Health in Justice Action Lab is making this request under the North Carolina Public Records Law, G.S. § 132-1, 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 Division of Mental Health, Developmental Disabilities, and Substance Abuse Services and any outside entity regarding the NC Controlled Substance Reporting System.
3. Any and all records including information about the algorithm that determines risk scores in the NC Controlled Substance Reporting System, including but not limited to its source code, developer documentation, and operator manuals (e.g. NarxScore, Overdose Risk Score);
4. Any and all research, technical reports, or internal audits that define and/or evaluate the NC Controlled Substance Reporting System effectiveness or performance;
5. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance
6. Any document containing a full list of the data fields in the NC Controlled Substance Reporting System;
7. 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;
8. Any record showing the number of patients in the NC Controlled Substance Reporting System by quarter and year (2006-present);
9. Any record showing the number of prescribers and pharmacists in the NC Controlled Substance Reporting System by quarter and year (2006-present);
10. Any and all records containing Division of Mental Health, Developmental Disabilities, and Substance Abuse Services analysis of whether and/or how the NC Controlled Substance Reporting System has impacted public health in North Carolina (e.g. decrease or increase in overdose rates, “doctor shopping,” prescribing volume, etc.) over time;
11. Any and all records 2006-present of notification to law enforcement about information in the NC Controlled Substance Reporting System Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the NC Controlled Substance Reporting System, and which agencies have been notified;
12. Any and all internal policy, memoranda, and/or training documentation describing how entities outside of Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, including law enforcement, may obtain access to information in the NC Controlled Substance Reporting System, including but not limited to the rules, regulations, and procedures of the Medical Review Group;
13. The legal authorization for sharing NC Controlled Substance Reporting System information with the law enforcement entities; and
14. Any and all records showing how often law enforcement entities or individuals have requested information or records from the NC Controlled Substance Reporting System, or made electronic queries of the system, including but not limited to what types of information or records have been requested, which agencies have made the requests, the percent of requests that were accepted versus denied, temporal trends, the form of the request (e.g. subpoena, warrant, etc.), and whether the requests were granted or denied.
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 requested 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. As you know, a custodian of public records shall comply with a request within 10 days after receipt.
Thank you for your assistance. We look forward to your response.
Sincerely,
Sarah Seymour
From: North Carolina Department of Health and Human Services
Good afternoon,
Thank you for your public records request. This email is to acknowledge the North Carolina Department of Health and Human Services has received your request:
…under the North Carolina Public Records Law, G.S. § 132-1, 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 Division of Mental Health, Developmental Disabilities, and Substance Abuse Services and any outside entity regarding the NC Controlled Substance Reporting System.
3. Any and all records including information about the algorithm that determines risk scores in the NC Controlled Substance Reporting System, including but not limited to its source code, developer documentation, and operator manuals (e.g. NarxScore, Overdose Risk Score);
4. Any and all research, technical reports, or internal audits that define and/or evaluate the NC Controlled Substance Reporting System effectiveness or performance;
5. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance
6. Any document containing a full list of the data fields in the NC Controlled Substance Reporting System;
7. 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;
8. Any record showing the number of patients in the NC Controlled Substance Reporting System by quarter and year (2006-present);
9. Any record showing the number of prescribers and pharmacists in the NC Controlled Substance Reporting System by quarter and year (2006-present);
10. Any and all records containing Division of Mental Health, Developmental Disabilities, and Substance Abuse Services analysis of whether and/or how the NC Controlled Substance Reporting System has impacted public health in North Carolina (e.g. decrease or increase in overdose rates, “doctor shopping,” prescribing volume, etc.) over time;
11. Any and all records 2006-present of notification to law enforcement about information in the NC Controlled Substance Reporting System Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the NC Controlled Substance Reporting System, and which agencies have been notified;
12. Any and all internal policy, memoranda, and/or training documentation describing how entities outside of Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, including law enforcement, may obtain access to information in the NC Controlled Substance Reporting System, including but not limited to the rules, regulations, and procedures of the Medical Review Group;
13. The legal authorization for sharing NC Controlled Substance Reporting System information with the law enforcement entities; and
14. Any and all records showing how often law enforcement entities or individuals have requested information or records from the NC Controlled Substance Reporting System, or made electronic queries of the system, including but not limited to what types of information or records have been requested, which agencies have made the requests, the percent of requests that were accepted versus denied, temporal trends, the form of the request (e.g. subpoena, warrant, etc.), and whether the requests were granted or denied.
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 requested 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. As you know, a custodian of public records shall comply with a request within 10 days after receipt.
We are in the process of identifying what public records are responsive to your request, the location of those records, and assessing the resources necessary to complete your request.
The North Carolina Department of Health and Human Services is pleased to provide requestors an opportunity to inspect and make their own copies of public records free-of-charge. In the unlikely event staff estimate there could be a cost to you associated with providing records as you have requested them, we will contact you to discuss other options before assessing any charge. For your added convenience and to avoid the costs associated with producing physical duplicates, we are happy to provide you electronic copies of records when practical.
Your request identification number is 2019091202. In order to serve you more quickly, please refer to this number when inquiring about the status of your request.
I am copying my colleague Emily Kirby as well as our public records service account (public.records@dhhs.nc.gov) on this email in the event you need immediate help and I am unavailable. Otherwise, please consider me your primary contact for this request. My direct contact information is below.
The North Carolina Department of Health and Human Services is committed to responding to your request as promptly as possible. In the meantime, I encourage you to contact me if you have any questions, concerns, wish to amend your request, or I can otherwise be of service.
Thank you again for your public records request to the North Carolina Department of Health and Human Services.
Best regards,
Paul Hogle
Associate General Counsel
Office of General Counsel
NC Department of Health and Human Services<http://www.ncdhhs.gov/>
Office: 919-855-4838
Fax: 919-733-3854
paul.hogle@dhhs.nc.gov<mailto:paul.hogle@dhhs.nc.gov>
101 Blair Drive, Adams Building
2001 Mail Service Center
Raleigh, NC 27699-2001
Twitter<https://twitter.com/ncdhhs> | Facebook<https://www.facebook.com/ncdhhs/> | YouTube<https://www.youtube.com/user/ncdhhs/> | LinkedIn<https://www.linkedin.com/company/nc-state-government/>
From: HIJ Action Lab
Hi Paul,
Thank you and looking forward to hearing from your department on this record request.
Best,
Sarah Seymour
From: North Carolina Department of Health and Human Services
Thank you for your email. I am currently out of the office. I am regularly available M/T/W during normal business hours.
If your message is not time sensitive and concerns a public records request, please forward your email to our service account (public.records@dhhs.nc.gov) and available staff will respond as promptly as possible.
If you require more immediate assistance, please call 919-855-4840.
Otherwise, I look forward to returning your email.
________________________________
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State official. Unauthorized disclosure of juvenile, health, legally privileged, or otherwise confidential information, including confidential information relating to an ongoing State procurement effort, is prohibited by law. If you have received this email in error, please notify the sender immediately and delete all records of this email.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: North Carolina Department of Health and Human Services
Thank you for your email. I am currently out of the office. I am regularly available M/T/W during normal business hours.
If your message is not time sensitive and concerns a public records request, please forward your email to our service account (public.records@dhhs.nc.gov) and available staff will respond as promptly as possible.
If you require more immediate assistance, please call 919-855-4840.
Otherwise, I look forward to returning your email.
________________________________
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State official. Unauthorized disclosure of juvenile, health, legally privileged, or otherwise confidential information, including confidential information relating to an ongoing State procurement effort, is prohibited by law. If you have received this email in error, please notify the sender immediately and delete all records of this email.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: North Carolina Department of Health and Human Services
Thank you for your email. I am currently out of the office. I am regularly available M/T/W during normal business hours.
If your message is not time sensitive and concerns a public records request, please forward your email to our service account (public.records@dhhs.nc.gov) and available staff will respond as promptly as possible.
If you require more immediate assistance, please call 919-855-4840.
Otherwise, I look forward to returning your email.
________________________________
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State official. Unauthorized disclosure of juvenile, health, legally privileged, or otherwise confidential information, including confidential information relating to an ongoing State procurement effort, is prohibited by law. If you have received this email in error, please notify the sender immediately and delete all records of this email.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: North Carolina Department of Health and Human Services
Thank you for your email. I will be out of the office until Monday, January 6 and will respond to your message as promptly as possible when I return. If you require more immediate assistance with a public records request, please contact Charles Epstein at 919-855-4841 or Charles.Epstein@dhhs.nc.gov.
________________________________
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State official. Unauthorized disclosure of juvenile, health, legally privileged, or otherwise confidential information, including confidential information relating to an ongoing State procurement effort, is prohibited by law. If you have received this email in error, please notify the sender immediately and delete all records of this email.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: North Carolina Department of Health and Human Services
Hello,
I am currently out of the office. I am regularly available M/T/W during normal business hours.
If your message is not time sensitive and concerns a public records request, please forward your email to our service account (public.records@dhhs.nc.gov) and available staff will respond as promptly as possible.
If you require more immediate assistance with a public records request, please contact Charles Epstein at 919-855-4841 or Charles.Epstein@dhhs.nc.gov.
Otherwise, I look forward to returning your email.
________________________________
Email correspondence to and from this address is subject to the North Carolina Public Records Law and may be disclosed to third parties by an authorized State official. Unauthorized disclosure of juvenile, health, legally privileged, or otherwise confidential information, including confidential information relating to an ongoing State procurement effort, is prohibited by law. If you have received this email in error, please notify the sender immediately and delete all records of this email.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: HIJ Action Lab
Hi Paul,
I just wanted to follow-up on this FOIA request. I am aware we are distressful times and your department is likely functioning at lower capacity but if you can provide any information it would be much appreciated. Thank you!
Best,
Sarah Seymour
From: North Carolina Department of Health and Human Services
Good afternoon, Ms. Seymour,
Thank you for checking in on the status of your public records request #2019091202 to the North Carolina Department of Health and Human Services. Paul Hogle has transitioned to another role at NCDHHS and is no longer handling public records requests. I have copied my colleague, Charles Epstein, on this email. Please feel free to contact either of us regarding your request going forward.
Below in red and attached, please find the responses staff provided to items 3-10 of your request. Please note that your request is still in process, and any additional responsive public records that staff identify will be provided as promptly as possible.
Thank you again for your public records request to NCDHHS, and thank you for your patience.
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 Division of Mental Health, Developmental Disabilities, and Substance Abuse Services and any outside entity regarding the NC Controlled Substance Reporting System.
3. Any and all records including information about the algorithm that determines risk scores in the NC Controlled Substance Reporting System, including but not limited to its source code, developer documentation, and operator manuals (e.g. NarxScore, Overdose Risk Score);
NC has purchased an off the shelf product from APPRISS to supply overdose risk scores to registered users of the CSRS. That product is NarxCare and all documentation including source code, developer documentation and operator manuals belong to APPRISS. Some information can be accessed on the APPRISS website: https://apprisshealth.com/solutions/narxcare/
4. Any and all research, technical reports, or internal audits that define and/or evaluate the NC Controlled Substance Reporting System effectiveness or performance;
Staff were unable to identify or locate records responsive to this portion of your request.
5. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance
Staff were unable to identify or locate records responsive to this portion of your request.
6. Any document containing a full list of the data fields in the NC Controlled Substance Reporting System;
See attached Data Guide, which contains the elements that are publicly available and would not disclose security features of electronic data processing systems (See NCGS 132-6.1).
7. 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;
See 21 NCAC 36 .0815 REPORTING CRITERIA (Board of Nursing); 21 NCAC 32Y .0101REPORTING CRITERIA NC Medical Board; 21 NCAC 46 .3501 REPORTS FROM THE CONTROLLED SUBSTANCES REPORTING SYSTEM NC Board of Pharmacy; 21 NCAC 16U .0103REPORTS FROM THE CONTROLLED SUBSTANCES REPORTING SYSTEM North Carolina State Board of Dental Examiners; NC 90-113.74 Confidentiality Controlled Substances Reporting System (b1). https://files.nc.gov/ncdhhs/NC%20Opioid%20Action%20Plan%208-22-2017.pdf
8. Any record showing the number of patients in the NC Controlled Substance Reporting System by quarter and year (2006-present);
NC Controlled Substances Reporting System Annual Report 2017, https://files.nc.gov/ncdhhs/documents/files/GS-90-113.75B---SL-2017-74-Section-12-Controlled-Substance-Reporting--Final-.pdf
9. Any record showing the number of prescribers and pharmacists in the NC Controlled Substance Reporting System by quarter and year (2006-present);
NC Controlled Substances Reporting System Annual Report 2017, https://files.nc.gov/ncdhhs/documents/files/GS-90-113.75B---SL-2017-74-Section-12-Controlled-Substance-Reporting--Final-.pdf
10. Any and all records containing Division of Mental Health, Developmental Disabilities, and Substance Abuse Services analysis of whether and/or how the NC Controlled Substance Reporting System has impacted public health in North Carolina (e.g. decrease or increase in overdose rates, “doctor shopping,” prescribing volume, etc.) over time;
https://files.nc.gov/ncdhhs/NC%20Opioid%20Action%20Plan%208-22-2017.pdf
11. Any and all records 2006-present of notification to law enforcement about information in the NC Controlled Substance Reporting System Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the NC Controlled Substance Reporting System, and which agencies have been notified;
12. Any and all internal policy, memoranda, and/or training documentation describing how entities outside of Division of Mental Health, Developmental Disabilities, and Substance Abuse Services, including law enforcement, may obtain access to information in the NC Controlled Substance Reporting System, including but not limited to the rules, regulations, and procedures of the Medical Review Group;
13. The legal authorization for sharing NC Controlled Substance Reporting System information with the law enforcement entities; and
14. Any and all records showing how often law enforcement entities or individuals have requested information or records from the NC Controlled Substance Reporting System, or made electronic queries of the system, including but not limited to what types of information or records have been requested, which agencies have made the requests, the percent of requests that were accepted versus denied, temporal trends, the form of the request (e.g. subpoena, warrant, etc.), and whether the requests were granted or denied.
Regards,
Emily Kirby, JD
Legal Communications Liaison
Office of Communications
NC Department of Health and Human Services<http://www.ncdhhs.gov/>
Office: 919-855-4956
Fax: 919-733-7447
emily.kirby@dhhs.nc.gov<mailto:emily.kirby@dhhs.nc.gov>
101 Blair Drive, Adams Building
2001 Mail Service Center
Raleigh, NC 27699-2001
Twitter<https://twitter.com/ncdhhs> | Facebook<https://www.facebook.com/ncdhhs/> | YouTube<https://www.youtube.com/user/ncdhhs/> | LinkedIn<https://www.linkedin.com/company/ncdhhs/>
-
~WRD000
From: HIJ Action Lab
Hi Emily and Charles,
Thank you! We greatly appreciate the assistance. Hope y'all are staying safe and well. Look forward to hearing from y'all soon.
Best,
Sarah
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following North Carolina Public Records Law request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response. You had assigned it reference number #2019091202.
Thanks for your help, and let me know if further clarification is needed.
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