Series Title (Agency Series #): Description, Retention (Legal Citation)
Client Contact Log (DOH22-001): Log documents clients seen through the STD and Hepatitis C clinics. Log shows client name, date and time seen, provider visited, and comments.
Retention: Retain 5 years. (MOAR 166-150-0065(6))
Correspondence: Records that: 1. document communications created or received by an agency AND 2. directly relate to an agency program or agency administration AND 3. are not otherwise specified in the Multnomah County Retention Schedules. Records may include but are not limited to letters, memoranda, notes and electronic messages that communicate formal approvals, directions for action, and information about contracts, purchases, grants, personnel and particular projects or programs.
Retention: File with the associated program or administrative records. Communications not meeting the above criteria do not need to be filed and may be retained as needed. (OAR 166-150-0005(10)) Updated 01/08/2018
Epidemiological Reports (DOH22-003): Documents investigations into client STD's. Includes confidential sexually transmitted disease case reports and field reports. Information may include client identification; exposure, examination, diagnosis, referral and treatment information; interview notes; provider information, and supporting documentation. If a health service record has been created for a client, these reports will be included there.
Retention: If a health service record does not exist: retain 6 years. (45 CFR 164.530(j))
Health Service Records: Sexually Transmitted Diseases (STDs) (DOH22-004): Records documenting clinic care services for STDs. These services may include physicals, management of acute illness and injury, immunizations, family planning and reproductive health care, health education and promotion activities, and mental health services. Records may include correspondence; reports; professional notations; laboratory reports; treatment and x-ray authorizations; release of information; clinical or medical records including client identification, progress notes, and records of visits; a history of previous service; referrals; testing and evaluation reports; treatment plans; progress notes; enrollment, fee, and billing records; legal records; permission to treat; medical assessment including laboratory and other tests, emergency room services, and medication and prescription records; reports; and other related data. Access to these records may be exempt from disclosure by ORS 179.505; ORS 192.502(2).
Retention: For paper charts: Retain 10 years after last entry. For EHR: Retain 10 years after last service. (MOAR 166-150-0065(20); OAR 410-141-3520(10)) Retention updated 12/10/2018
Health Service Records: Sexually Transmitted Diseases (STDs) - Outside Provider Records (DOH22-007): Records documenting clinic care services for STDs (see DOH22-004) provided by outside providers. Records are requested in order to provide more information for a client's case.
Retention: Retain one year after entry into Orpheus (see DOH22-004). Updated 3/14/2019.
Immunization Records - VARS (DOH22-005): Series documents immunizations received by clinic patients. Record is usually the county Vaccine Administration Record (VAR), but may include any records which document the consent to and administration of immunizations. Does not include ITARS reports. Information includes date, patient name and personal information, identification number, income and insurance information, signature and date of consent, description and date of immunization(s), and signature and date of immunization administrator. Access to these records may be exempt from disclosure by ORS 179.505; ORS 192.502(2).
Retention: Retain 10 years. (MOAR 166-150-0065(9,10)) Updated 12/10/2018
Reportable Disease Database (DOH22-006): Documents clients with diseases which are reportable to the State Health Division. Database contains client information, diagnosis, partner name(s), treatment information, and referrals. Currently an Access database maintained at the desktop level.
Retention: Retain 5 years. (MOAR 166-150-0065(6))