<?xml version=“1.0” encoding=“UTF-8”?><Contract xmlns=“hl7.org/fhir”>
<id value="C-2121"/> <meta> <versionId value="1"/> <lastUpdated value="2016-07-19T18:18:42.108-04:00"/> </meta> <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>issued</b>: Nov 1, 2031 9:18:27 PM</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>: Michigan MDHHS-5515 Consent to Share Behavioral Health Information for Care Coordination Purposes <span>(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'})</span></p><p><b>securityLabel</b>: 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/v3/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')</p><blockquote><p><b>agent</b></p><p><b>actor</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>agent</b></p><p><b>actor</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><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><issued value="2031-11-01T21:18:27-04:00"/> <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> <system value="http://hl7.org/fhir/consentcategorycodes"/> <code value="MDHHS-5515"/> <display value="Michigan MDHHS-5515 Consent to Share Behavioral Health Information for Care Coordination Purposes"/> </coding> </subType> <securityLabel> <system value="http://hl7.org/fhir/v3/Confidentiality"/> <code value="R"/> <display value="Restricted"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="ETH"/> <display value="substance abuse information sensitivity"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="42CFRPart2"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActReason"/> <code value="TREAT"/> <display value="treatment"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActReason"/> <code value="HPAYMT"/> <display value="healthcare payment"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActReason"/> <code value="HOPERAT"/> <display value="healthcare operations"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="PERSISTLABEL"/> <display value="persist security label"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="PRIVMARK"/> <display value="privacy mark"/> </securityLabel> <securityLabel> <system value="http://hl7.org/fhir/v3/ActCode"/> <code value="NORDSCLCD"/> <display value="no redisclosure without consent directive"/> </securityLabel> <agent> <actor> <reference value="Organization/f001"/> <display value="VA Ann Arbor Healthcare System"/> </actor> <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> </agent> <agent> <actor> <reference value="Organization/2"/> <display value="Community Mental Health Clinic"/> </actor> <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> </agent> <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"/> <whoReference> <reference value="Patient/f201"/> </whoReference> </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>