Tennessee CSMD Data Request (Department of Health)
| Multi Request | Tennessee CSMD Data Request |
| Submitted | Sept. 12, 2019 |
| Due | Oct. 1, 2019 |
| Est. Completion | None |
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Communications
From: HIJ Action Lab
To Whom It May Concern:
Northeastern University's School of Social Justice and Health Equity is interested in the Tennessee Controlled Substance Monitoring Database Program ("CSMD"). Specifically, we want to learn more about law enforcement access to the database, the use of an algorithm that produces a risk score to analyze its contents, and the data access and retention rules governing the system. We understand the algorithm was produced by the corporation Appriss.
In order to permit the public to understand how the Tennessee Board of Pharmacy and Tennessee Department of Health is using the CSMD and how it impacts public health and civil liberties in Tennessee, Northeastern University's Health in Justice Action Lab is making this request under Tenn. Code Ann. 10-7-503 et seq. for the following records:
1. Any and all records reflecting an agreement for purchase, acquisition, or licensing of, or permission to use, test, or evaluate Appriss’s systems or services, including any product or service offered;
2. Any and all memoranda of understanding between the Tennessee Board of Pharmacy or Tennessee Department of Health and any outside entity regarding the CSMD;
3. Any and all records including information about the algorithm that determines risk scores in the CSMD, including but not limited to its source code, developer documentation, and operator manuals (e.g. Narx Score, Overdose Risk Score);
4. Any and all research, technical reports, or internal audits that evaluate the Appriss risk assessment tool’s effectiveness or performance;
5. Any and all records of de-identified red flag algorithm outputs (e.g. provider red flag, pharmacy red flag, 40 MED red flag) and patient behavioral red flags (e.g., anxious patient demeanor, distance between prescriber and dispenser) with prescriber/dispenser training documentation on how to address the red flags;
6. Any record showing the number of patients in the CSMD by quarter and year (2006-present);
7. Any and all records from 2006-present of notification to law enforcement about information in the CSMD Medical Review Group or other channels, including but not limited to how many times law enforcement agencies have been notified about information in the CSMD, and which agencies have been notified;
Because this request involves a matter of public concern and because it is made on behalf of a nonprofit organization, we ask that you waive any fees. If you decide not to waive fees, we request that you permit us to examine, at our election, the responsive documents before deciding which portions to transmit. We prefer the documents in electronic format.
Should you determine that some portion of the documents request are exempt from disclosure, please release any reasonably segregable portions that are not exempt. In addition, please note the applicable statutory exemption and explain why it applies to the redacted portions.
Thank you in advance for your anticipated cooperation in this matter.
I look forward to receiving your response to this request within ten days as requested by the statute.
Sincerely,
Sarah Seymour
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following Tennessee Public Records Act request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following Tennessee Public Records Act request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response.
Thanks for your help, and let me know if further clarification is needed.
From: Department of Health
Thank you for contacting the Tennessee Department of Health. By copy of this email, I am sharing your email with the appropriate team member to address your inquiry.
Best regards.
-
~WRD000
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following Tennessee Public Records Act request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response.
Thanks for your help, and let me know if further clarification is needed.
From: Muckrock Staff
To Whom It May Concern:
I wanted to follow up on the following Tennessee Public Records Act request, copied below, and originally submitted on Sept. 12, 2019. Please let me know when I can expect to receive a response.
Thanks for your help, and let me know if further clarification is needed.
From: Department of Health
Making sure you receive this information, as it looks like you have contacted us via varied email addresses.
Please note when replying to a request we will provide our response to the email address from which we received it.
Please confirm your receipt of this information.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: Department of Health
Making sure you receive this information, as it looks like you have contacted us via varied email addresses. There are additional responses to your questions below.
Please note, when replying to a request we will provide our response to the email address from which we received it.
Please confirm your receipt of this information.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: Department of Health
Please see additional information below in response to your request.
Once again, we ask that you confirm receipt of this information.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: HIJ Action Lab
Hi Shelley,
My apologies. This request got completely lost in the mix as we have requested from all 50 states. I want to confirm this request. Please let me know if there is anything I should do beyond confirming.
Best,
Sarah Seymour
From: Department of Health
Ms. Seymour, we replied to your request on Feb. 13, 2020 with the following:
Sarah, we refer you to our annual reports which include information in graphic form on numbers of patients in the CSMD: https://www.tn.gov/health/health-program-areas/pdo/pdo/facts-figures.html.
In addition, we have quarterly patient number information for specific prescription types: opioids for pain, buprenorphine for medication-assisted treatment and gabapentin. If you would like any of those, please specify which prescription type you would like.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: HIJ Action Lab
Hi Shelley,
Thank you for your assistance and we would like to have all if possible from the past 5 years or the farthest it goes back.
Best,
Sarah Seymour
From: Department of Health
Good afternoon Sarah.
Thanks for the clarification. We will work to gather that information. Please note that due to the extraordinary demands of our work in response to the COVID-19 pandemic, we may require additional time to respond to provide our response to your request.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: HIJ Action Lab
Hi Shelley,
I completely understand. No worries! Hope y'all are staying safe and well.
Best,
Sarah
From: Department of Health
Good morning Sarah.
Please see attached a file containing quarterly data from 2013 – 2019 for patient counts for those prescribed opioids for pain, opioids for treatment and gabapentin. Please note the information in the fourth tab explaining the data source and limitations.
This completes our response to your request.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: HIJ Action Lab
Hi,
Thanks so much for your help with this request! I really appreciate it.
If by chance y'all have anymore detail on the following below please let us know.
1. Records including information about the algorithm that determines risk scores (e.g. NarxScores, Overdose Risk Scores) in the PDMP, including but not limited to its source code, developer documentation, and training manuals
2. Any research, technical reports, or internal audits that evaluate AWARxE’s risk assessment tool’s effectiveness or performance;
Thanks!
Best,
Sarah Seymour
From: Department of Health
Please consider this email our acknowledgement of your additional request.
While we appreciate your submitted search terms, your request is too broad. Please specify the individual(s) from whom you are seeking records for this request. The Public Records Acts states, in pertinent part, “Any request for inspection or copying of a public record shall be sufficiently detailed to enable the governmental entity to identify the specific records for inspection or copying.” TCA. 10-7-503(a)(4). Narrowing the request will enable the department to locate the records you are seeking in an efficient and meaningful manner.
After we receive additional clarification of your request for records, the department will provide an estimated cost to produce these records. The Public Records Act states, “If a person makes a request for copies of a public record and, after copies have been produced, the person fails to pay to the governmental entity the cost for producing such copies, the governmental entity is not required to comply with any public records request from the person until the person pays for such copies; provided, that the person was provided with an estimated cost for producing the copies in accordance with subdivision (a)(7)(C)(ii) prior to producing the copies and the person agreed to pay the estimated cost for such copies.” T.C.A. 10-7-503 (a)(7)(A)(vii)(b). After you receive the cost estimate, please confirm that you agree to pay for the copies so we can proceed with your request.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: HIJ Action Lab
Hi Shelley,
For 1: We are willing to accept training materials only - attached is an example of such from South Carolina (Narx).
For 2: A general summary or audit of PDMP risk scoring and its effectiveness / performance of scoring patients in accuracy related to risk for misuse and overdose
Let me know if anything further clarification is needed.
Best,
Sarah Seymour
From: Department of Health
Good morning Sarah.
Please consider this our acknowledgement of your additional request. Due to the nature of this request and the extraordinary demands of our work in response to the COVID-19 pandemic, we require additional time to provide our response to your request and anticipate that records will be produced in installments.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
From: Department of Health
Our Controlled Substance Monitoring Database does not use NarxCare. Tennessee does not create or disseminate a risk score and does not utilize AWARxE; therefore, we have no records responsive to your request. This completes our response to your request.
[cid:image007.png@01D0AAAF.AF3502B0]
Shelley Walker | Director
Office of Communication & Media Relations
Andrew Johnson Tower, 5th Floor
710 James Robertson Parkway, Nashville, TN 37243
p. 615-253-5184
Shelley.Walker@tn.gov<mailto:Shelley.Walker@tn.gov>
tn.gov/health<https://www.tn.gov/health>
Connect with TDH on Facebook<http://www.facebook.com/TNDeptofHealth> and Twitter<https://twitter.com/TNDeptofHealth> @TNDeptofHealth!
Our Mission – To protect, promote and improve the health and prosperity of people in Tennessee.
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