This page is part of the FHIR Specification ~~(v3.0.2: STU 3).~~ (v3.5.0: R4 Ballot #2). The current version which supercedes this version is 5.0.0 . For a full list of available versions, see the Directory of published versions . Page versions: R5 R4B R4 R3
Contract-example-42cfr-part2.xml

Financial Management Work Group
Maturity Level : N/A
Ballot Status : Informative
Compartments : Not linked to any defined compartments
Raw XML ( canonical form + also see XML Format Specification )
Jump past Narrative
42 CFR Part 2 Consent Directive (id = "C-2121")
<?xml version="1.0" encoding="UTF-8"?>


<Contract xmlns="http://hl7.org/fhir">
  <id value="C-2121"/> 
  <meta> 
    <versionId value="1"/> 
    <lastUpdated value="2016-07-19T18:18:42.108-04:00"/> 
  </meta> 
  : Michigan MDHHS-5515 Consent to Share Behavioral Health Information for Care Coordination
         Purposes (Details : {http://hl7.org/fhir/consentcategorycodes code 'MDHHS-5515' = 'Michigan MDHHS-5515
           Consent to Share Behavioral Health Information for Care Coordination Purposes', given
           as 'Michigan MDHHS-5515 Consent to Share Behavioral Health Information for Care Coordination
           Purposes'}): Restricted (Details: http://hl7.org/fhir/v3/Confidentiality code R = 'restricted', stated
         as 'Restricted'), substance abuse information sensitivity (Details: http://hl7.org/fhir/v3/ActCode
         code ETH = 'substance abuse information sensitivity', stated as 'substance abuse information
         sensitivity'), 42 CFR Part2 (Details: http://hl7.org/fhir/v3/ActCode code 42CFRPart2 =
         '42 CFR Part2', stated as 'null'), treatment (Details: http://hl7.org/fhir/v3/ActReason
         code TREAT = 'treatment', stated as 'treatment'), healthcare payment (Details: http://hl7.org/fhir/v
        3/ActReason code HPAYMT = 'healthcare payment', stated as 'healthcare payment'), healthcare
         operations (Details: http://hl7.org/fhir/v3/ActReason code HOPERAT = 'healthcare operations',
         stated as 'healthcare operations'), persist security label (Details: http://hl7.org/fhir/v3/ActCode
         code PERSISTLABEL = 'persist security label', stated as 'persist security label'), privacy
         mark (Details: http://hl7.org/fhir/v3/ActCode code PRIVMARK = 'privacy mark', stated as
         'privacy mark'), no redisclosure without consent directive (Details: http://hl7.org/fhir/v3/ActCode
         code NORDSCLCD = 'no redisclosure without consent directive', stated as 'no redisclosure
         without consent directive')SELF (Details: http://org.mdhhs.fhir.consent-signer-type code SELF = 'SELF', stated as
             'null')


  <text> <status value="generated"/> <div xmlns="http://www.w3.org/1999/xhtml"><p> <b> Generated Narrative with Details</b> </p> <p> <b> id</b> : C-2121</p> <p> <b> meta</b> : </p> <p> <b> status</b> : executed</p> <p> <b> contentDerivative</b> : Content Registration <span> (Details : {http://terminology.hl7.org/CodeSystem/contract-content-derivative code 'registration'

           = 'Content Registration)</span> </p> <p> <b> issued</b> : 01/11/2013 9:18:27 PM</p> <p> <b> applies</b> : 01/11/2013 9:18:27 PM --&gt; (ongoing)</p> <p> <b> subject</b> : <a> Patient/f201</a> </p> <p> <b> type</b> : Opt-in consent directive <span> (Details : {http://org.mdhhs.fhir.consentdirective-type code 'OPTIN' = 'OPTIN)</span> </p> <p> <b> subType</b> : Health Care Directive <span> (Details : {http://terminology.hl7.org/CodeSystem/consentcategorycodes code 'hcd' = 'Health
           Care Directive)</span> </p> <blockquote> <p> <b> term</b> </p> <h3> Offers</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Decision</b> </td> <td> <b> Text</b> </td> </tr> <tr> <td> *</td> <td> Statutory <span> (Details : {http://terminology.hl7.org/CodeSystem/contracttermtypecodes code 'statutory'
                 = 'Statutory)</span> </td> <td> opt-in <span> (Details : {http://terminology.hl7.org/CodeSystem/v3-ActCode code 'OPTIN' = 'opt-in)</span> </td> <td> Can't refuse</td> </tr> </table> <h3> Assets</h3> <table> <tr> <td> -</td> <td> <b> Period</b> </td> </tr> <tr> <td> *</td> <td> 01/11/2013 9:18:27 PM --&gt; 01/11/2019 9:18:27 PM</td> </tr> </table> <blockquote> <p> <b> action</b> </p> <p> <b> type</b> : Action A <span> (Details : {http://terminology.hl7.org/CodeSystem/contractaction code 'action-a' = 'Action
               A)</span> </p> <blockquote> <p> <b> subject</b> </p> <p> <b> reference</b> : <a> VA Ann Arbor Healthcare System</a> </p> <p> <b> role</b> : Recipient of restricted health information <span> (Details : {http://org.mdhhs.fhir.consent-actor-type code 'IR' = 'IR', given as 'Recipient'})</span> </p> </blockquote> <blockquote> <p> <b> subject</b> </p> <p> <b> reference</b> : <a> Community Mental Health Clinic</a> </p> <p> <b> role</b> : Sender of restricted health information <span> (Details : {http://org.mdhhs.fhir.consent-actor-type code 'IS' = 'IS', given as 'Sender'})</span> </p> </blockquote> <p> <b> intent</b> : health program reporting <span> (Details : {http://terminology.hl7.org/CodeSystem/v3-ActReason code 'HPRGRP' = 'health
               program reporting)</span> </p> <p> <b> status</b> : Sample <span> (Details )</span> </p> </blockquote> </blockquote> <h3> Signers</h3> <table> <tr> <td> -</td> <td> <b> Type</b> </td> <td> <b> Party</b> </td> <td> <b> Signature</b> </td> </tr> <tr> <td> *</td> <td> SELF (Details: http://org.mdhhs.fhir.consent-signer-type code SELF = 'SELF', stated as
             'null')</td> <td> <a> Alice Recruit</a> </td> <td/>  </tr> </table> <h3> Legals</h3> <table> <tr> <td> -</td> <td> <b> Content[x]</b> </td> </tr> <tr> <td> *</td> <td/>  </tr> </table> </div> </text> <status value="executed"/> 

  <contentDerivative> 
    <coding> 
      <system value="http://terminology.hl7.org/CodeSystem/contract-content-derivative"/> 
      <code value="registration"/> 
    </coding> 
  </contentDerivative> 


  <issued value="2013-11-01T21:18:27-04:00"/> 


  <applies> 
    <start value="2013-11-01T21:18:27-04:00"/> 
  </applies> 



  <subject> 
    <reference value="Patient/f201"/> 
  </subject> 


  <type> 
    <coding> 
      <system value="http://org.mdhhs.fhir.consentdirective-type"/> 
      <code value="OPTIN"/> 
    </coding> 
    <text value="Opt-in consent directive"/> 
  </type> 
  <subType> 
    <coding> 
      
      
      Michigan MDHHS-5515 Consent to Share Behavioral Health Information for Care Coordination
       Purposes

      <system value="http://terminology.hl7.org/CodeSystem/consentcategorycodes"/> 
      <code value="hcd"/> 
<!--         <code value="MDHHS-5515"/>
      <display
        value="Michigan MDHHS-5515 Consent to Share Behavioral Health Information for
       Care Coordination Purposes"
      />    -->

    </coding> 
  </subType> 
  
    
    
    
  
  
    
    
    
  
  
    
    
  
  
    
    
    
  
  
    
    
    
  
  
    
    
    
  
  
    
    
    
  
  
    
    
    
  
  
    
    
    
  
  
    
      
      
    
    
      
        
        
        
      
      
    
  
  
    
      
      
    
    
      
        
        
        
      
      
    
  


  <term> 
    <offer> 
      <type> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/contracttermtypecodes"/> 
          <code value="statutory"/> 
        </coding> 
      </type> 
      <decision> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/> 
          <code value="OPTIN"/> 
        </coding> 
      </decision> 
      <text value="Can't refuse"/> 
    </offer> 

    
    <asset> 
      <period> 
        <start value="2013-11-01T21:18:27-04:00"/> 
        <end value="2019-11-01T21:18:27-04:00"/> 
      </period> 
      <!--   

      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-Confidentiality"/>
        <code value="R"/>
        <display value="Restricted"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="ETH"/>
        <display value="substance abuse information sensitivity"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="42CFRPart2"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="TREAT"/>
        <display value="treatment"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="HPAYMT"/>
        <display value="healthcare payment"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/>
        <code value="HOPERAT"/>
        <display value="healthcare operations"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="PERSISTLABEL"/>
        <display value="persist security label"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="PRIVMARK"/>
        <display value="privacy mark"/>
      </securityLabel>
      <securityLabel>
        <system value="http://terminology.hl7.org/CodeSystem/v3-ActCode"/>
        <code value="NORDSCLCD"/>
        <display value="no redisclosure without consent directive"/>
      </securityLabel>
       -->
    </asset> 


    <action> 
      <type> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/contractaction"/> 
          <code value="action-a"/> 
        </coding> 
      </type> 
      <subject> 
        <reference> 
          <reference value="Organization/f001"/> 
          <display value="VA Ann Arbor Healthcare System"/> 
        </reference> 
        <role> 
          <coding> 
            <system value="http://org.mdhhs.fhir.consent-actor-type"/> 
            <code value="IR"/> 
            <display value="Recipient"/> 
          </coding> 
          <text value="Recipient of restricted health information"/> 
        </role> 
      </subject> 
      <subject> 
        <reference> 
          <reference value="Organization/2"/> 
          <display value="Community Mental Health Clinic"/> 
        </reference> 
        <role> 
          <coding> 
            <system value="http://org.mdhhs.fhir.consent-actor-type"/> 
            <code value="IS"/> 
            <display value="Sender"/> 
          </coding> 
          <text value="Sender of restricted health information"/> 
        </role> 
      </subject> 
      <intent> 
        <coding> 
          <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/> 
          <code value="HPRGRP"/> 
        </coding> 
      </intent> 
      <status> 
        <text value="Sample"/> 
      </status> 
    </action> 

    

  </term> 



  <signer> 
    <type> 
      <system value="http://org.mdhhs.fhir.consent-signer-type"/> 
      <code value="SELF"/> 
    </type> 
    <party> 
      <reference value="Patient/f201"/> 
      <display value="Alice Recruit"/> 
    </party> 
    <signature> 
      <type> 
        <system value="urn:iso-astm:E1762-95:2013"/> 
        <code value="1.2.840.10065.1.12.1.1"/> 
      </type> 
      <when value="2017-02-08T10:57:34+01:00"/> 
      
        
      

    <who> 
        <reference value="Patient/f201"/> 
    </who> 
    </signature> 
  </signer> 


  <legal> 
    <contentAttachment> 
      <contentType value="application/pdf"/> 
      <language value="en-US"/> 
      <url value="http://org.mihin.ecms/ConsentDirective-2121"/> 
      <title value="MDHHS-5515 Consent To Share Your Health Information"/> 
    </contentAttachment> 
  </legal> 


</

Contract

>
Usage note: every effort has been made to ensure that the examples are correct and useful, but they are not a normative part of the specification.