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Lutheran Family Services in the Carolinas <br />Refer to HIPAA instructions for when to use Business Associate Addendicrn.. <br />ATTACHMENTI <br />CABARRiIS COUNTY <br />DEPARTMENT OF SOCIAL SERVICES <br />BUSINESS ASSOCIATE ADDENDUM <br />This Agreetent is made effective the _ day of 200_, by and between <br />Cabarrrus County Department of Social Services (name of County Agency) ("Covered <br />Entity") and Lutheran Family Services in the Carolinas (name of contractor) ("Business <br />Associate") (collectively the "Parties"). <br />1. BACKGROUND <br />a. Covered Entity and Business Associate are parties to a contract entitled (identify <br />contract) Lutheran Family Services in the Carolinas (the "Contract"), whereby <br />Business Associate agrees to perform certain services for or on behalf of Covered <br />Entity. <br />b. Covered Entity is an organizational unit of Cabarrus County (the "County") that has <br />been designated in whole or in part by the County as a health care component for <br />purposes of the HIPAA Privacy Rule. <br />c. The relationship between Covered Entity and Business Associate is such that the <br />Parties believe Business Associate is or may be a "business associate" within the <br />meaning of the HIPAA Privacy Rule. <br />d. The Parties enter into this Business Associate Addendum to the Contract with the <br />intention of complying with the HIPAA Privacy Rule provision that a covered entity <br />may disclose protected health information to a business associate, and may allow a <br />business associate to create or receive protected heath information on its behalf, if <br />the covered entity obtains satisfactory assurances that the business associate will <br />appropriately safeguard the information. <br />2. DEFINITIONS <br />Unless some other meaning is clearly indicated by the context, the following terms shall <br />have the following meaning in this Agreement: <br />a. "HIPAA" means the Administrative Simplification Provisions, Sections 261 through <br />264, of the federal Health Insurance Portability and Accountability Act of 1996, <br />Public Law 104-191. <br />b. "Individual" shall have the same meaning as the term "individual" in 45 <br />CFR160.103 and shall include a person who qualifies as a personal representative in <br />accordance with 45 CFR 164.502(g). <br />c. "Privacy Rule" shall mean the Standards for Privacy of Individually Identifiable <br />Health Information at 45 CFR part 160 and part 164, subparts A and E. <br />Contract-I3IPAA (06/04) F- ~ Page 1 of 4 <br />