Cancer Statistics - Karmanos Cancer Institute

Appendix B
State of Michigan Letter of Authority
The text of the original letter shown on page 6 has been reproduced here for ease of review.
August 5, 2003
Ann G. Schwartz, PhD, MPH, Director
Metropolitan Detroit Cancer Surveillance System
Wayne State University
110 East Warren Avenue
Detroit, Michigan 48201-1379
Dear Dr. Schwartz:
Michigan law requires the Michigan Department of Community
Health to establish a state-wide cancer registry to “record cases of
cancer and other specified tumorous and precancerous diseases....”
MCLA 333.2619(1). All health care facilities where diagnoses of
cancer occur are required to report such diagnoses. Pursuant to
this statute, a facility may satisfy their reporting requirement by
reporting the diagnoses to an existing cancer registry that “meets
the minimum reporting standards established by the department.”
MCLA 333.2619(2). The Metropolitan Detroit Cancer Surveillance
System (MDCSS) housed at Wayne State University is such a
cancer registry. The Michigan Department of Community Health
ahs granted for many years — and continues to grant — authority
for the collection of individually identifiable cancer diagnoses,
treatment, and survival to the MDCSS. This authority is valid for
the duration of the project unless terminated earlier.
The MDCSS is also a designated medical research project of the
state. This designation is made under the authority of sections
333.2621 through 333.2634 of the Michigan Compiled Laws,
as amended. The designation of the MDCSS cancer registration
effort as a medical research project has the effect of shielding
the data you assemble from use as evidence in a court, as well as
providing protection from liability to those facilities that provide
you with the data. It also obligates you to continue to maintain the
confidentiality of these data in strict conformity to the objectives
of your research effort.
Federal privacy regulations, adopted under the Health Insurance
Portability and Accountability Act (HIPAA), allow “covered entities”
(such as hospitals) to disclose individually-identifiable cancer
data for public health purposes. In this regard, the HIPAA privacy
regulations state that an individual authorization is not required to
disclose protected health information to a “public health authority
that is authorized by law to collect or receive such information
for the purpose of preventing or controlling disease, injury, or
disability, … and the conduct of public health surveillance, public
health investigations, and public health interventions.” 45 CFR
§164.512(b)(1)(i).
The Michigan Department of Community Health is a public health
authority under the HIPAA. It is authorized by the Public Health
Code to collect and utilize health information, provide for research
studies for the purpose of protecting the public health, and make
investigations and inquiries as to the causes of disease and the
causes of morbidity and mortality. MCL 333.2221. Indeed, the
Department must establish a comprehensive health information
system that includes statistics relative to the causes, effects, extent,
and nature of illness and disability of the people of this state. MCL
333.2616-2617. Additionally, as stated above, the Public Health
Code specifically requires that the Department establish a statewide
cancer registry to record information regarding cancer and cancerrelated
diseases. MCL 333.2619.
A “public health authority” includes a person or entity acting under
a grant of authority from the Michigan Department of Community
Health. Based upon both the state statutes and federal regulations,
the Department recognizes the MDCSS as a state-authorized entity
for the collection and reporting of individually-identifiable cancer
information and as a state-authorized medical research project.
This means that the HIPAA Privacy Rule allows covered entities
to report cancer data to MDCSS without individual authorization;
hospitals and other covered entities must simply document that
reporting has occurred. The grant of authority to MDCSS includes
all information reasonably necessary to identify and track patients
and their diagnoses, treatment, subsequent primaries and survival
status. The information being requested represents the minimum
necessary to carry out the public health purposes of the projects
pursuant to 45 CFR §164.514(d) of the Privacy Rule.
The association between the Michigan Department of Community
Health and the Wayne State Unviersity has a long history, dating
back several decades. By assembling cancer data from the many
participating hospitals and laboratories, your efforts contribute
significantly to the efficiency and the quality of the statewide
cancer registry effort. The close consultation and collaboration
with your organization on specific research efforts, cancer control
issues and general data collection and processing concerns have
proven very beneficial to the many cancer related activities
ongoing within the department.
Sincerely,
Janet Olszewski
Director
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