<?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"/> <security> <system value="http://terminology.hl7.org/CodeSystem/v3-ActReason"/> <code value="HTEST"/> <display value="test health data"/> </security> </meta> <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://mdhhs.org/fhir/consentdirective-type"/> <code value="OPTIN"/> </coding> <text value="Opt-in consent directive"/> </type> <subType> <coding> <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://mdhhs.org/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://mdhhs.org/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://mdhhs.org/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>