*Pages 1--2 from  Microsoft Word - 39249*
 PUBLIC  NOTICE  Federal  Communications  Commission  445  12  th  St.,  S.  W.  Washington,  D.  C.  20554  News  Media  Information  202  /  418-  0500  Internet:  http://  www.  fcc.  gov  TTY:  1-  888-  835-  5322 
 DA  04-  1716 
 Released:  June  16,  2004 


 CLARIFICATION  OF  THE  USE  OF  TELECOMMUNICATIONS  RELAY  SERVICES  (TRS)  AND  THE  HEALTH  INSURANCE  PORTABILITY  AND  ACCOUNTABILITY  ACT  (HIPAA) 


 The  Federal  Communications  Commission  (FCC)  has  been  working  with  the  Department  of  Health  and  Human  Services  (HHS)  to  clarify  that  the  use  of  Telecommunications  Relay  Services  (TRS)  to  facilitate 
 telephone  calls  between  health  care  professionals  and  patients,  when  one  of  the  parties  to  the  call  has  a  hearing  or  speech  disability,  does  not  violate  the  Privacy  Rule  of  the  Health  Insurance  Portability  and 
 Accountability  Act  (HIPAA).  The  Commission  has  received  inquiries  on  this  issue  from  TRS  users  and  providers.  We  take  this  opportunity  to  clarify  that,  consistent  with  HIPAA,  a  covered  entity,  such  as  a 
 doctor  or  other  health  care  professional,  can  contact  a  patient  using  TRS  without  requiring  the  TRS  facility  or  individual  communications  assistants  (CAs)  to  sign  a  disclosure  agreement  (what  HIPAA 
 generally  refers  to  a  “business  associate  contract”). 


 As  background,  TRS,  as  mandated  by  Title  IV  of  the  Americans  with  Disabilities  Act  of  1990,  makes  the  telephone  system  accessible  to  individuals  with  hearing  or  speech  disabilities.  1  This  is  accomplished 
 through  TRS  facilities  that  are  staffed  by  specially  trained  CAs  using  special  technology.  The  CA  relays  conversations  between  persons  using  various  types  of  assistive  communication  devices  and  persons  who 
 do  not  require  such  assistive  devices. 


 HHS  enacted  HIPAA  in  1996,  which  included  provisions  mandating  the  adoption  of  federal  privacy  protections  for  individual’s  health  information.  2  In  response  to  the  HIPAA  mandate,  HHS  published  the 
 Privacy  Rule,  stating  that  as  of  April  14,  2003  (April  14,  2004,  for  small  health  plans),  covered  entities  must  implement  standards  to  protect  and  guard  against  the  misuse  of  individually  identifiable  health 
 information.  3 


 Some  health  professionals  have  been  concerned  that  contacting  patients  and  discussing  health  related  information  via  TRS  poses  a  possible  violation  of  the  Privacy  Rule  because  a  “third  party,”  the  TRS  CA, 
 hears  the  information  being  discussed  as  the  call  is  relayed.  Some  state  TRS  facilities  have  informed  the  FCC  that  health  professionals  are  requiring  all  of  the  facility’s  CAs  to  sign  disclosure  forms  before  they 
 will  use  TRS  to  contact  patients  with  hearing  or  speech  disabilities. 
 1  See  47  U.  S.  C.  §  225. 


 2  See  Pub.  L.  No.  104-  191  (1996). 
 3  See  45  C.  F.  R.  Parts  160  and  164. 
1
 2 
 We  therefore  emphasize  that  all  forms  of  TRS,  including  “traditional”  TTY  based  relay,  Internet  Protocol  (IP)  Relay,  Video  Relay  Service  (VRS),  and  Speech-  to-  Speech  (STS),  can  be  used  to  facilitate  calls 
 between  health  care  professionals  and  patients  without  violating  HIPPA’s  Privacy  Rule.  For  further  information  on  this  issue  see  HHS’s  FAQ  sheet  which  is  available  at  www.  hhs.  gov/  ocr/  hipaa  or  on  the 
 FCC’s  Disability  Rights  Office’s  website  at  http://  www.  fcc.  gov/  cgb/  dro/  trs.  html. 


 The  full  texts  of  these  documents  are  available  for  public  inspection  and  copying  during  regular  business  hours  at  the  FCC  Reference  Information  Center,  Portals  II,  445  12  th  Street,  SW,  Room  CY-  A257, 
 Washington,  DC,  20554.  These  documents  may  be  purchased  from  the  Commission's  duplicating  contractor,  Best  Copy  and  Printing,  Inc.,  Portals  II,  445  12  th  Street,  SW,  Room  CY-  B402,  Washington, 
 DC  20554.  Customers  may  contact  BCPI  at  their  web  site:  www.  bcpiweb.  com  or  call  1-  800-  378-  3160. 


 To  request  this  document  in  accessible  formats  for  people  with  disabilities  (braille,  large  print,  electronic  files,  audio  format),  send  an  e-  mail  to  fcc504@  fcc.  gov  or  call  the  Consumer  &  Governmental  Affairs 
 Bureau  at  202-  418-  0530  (voice),  202-  418-  0432  (TTY).  This  Public  Notice  can  also  be  downloaded  in  Word  and  Portable  Format  at  http://  www.  fcc.  gov/  cgb.  dro. 


 Consumer  &  Governmental  Affairs  Bureau  Contact:  Traci  Randolph,  (202)  418-  0569  (voice),  (202)  418-  0537  (TTY);  e-  mail  traci.  randolph@  fcc.  gov. 


 -FCC- 
2