Service Providers

Security & Security Breach Instructions

SECURITY & SECURITY BREACH INSTRUCTIONS

If you are a vendor of San Andreas Regional Center and sensitive/confidential information was breached,  the following forms need to be completed and submitted to San Andreas Regional Center and Email to Phien Phan at pphan@sarc.org ASAP:

1.  TEMPLATE-DS-5340B
2.   Police Report # that was filed.

3. Breach Notification Rule

In addition to this report, you must submit a special incident report for each affected consumer.  We’ll need to know what the corrective actions for the Vendor are? (e.g. is there a policy in place about leaving PHI in an unattended vehicle?).  We will also required a “redacted” copy of (1x) of the letters that have gone out  to each person who may have been affected by the breach.   Here are some sample letters for you to consider.

ISO-Sample-Notification-Letter

 

Best Practices for Protecting Confidential, Sensitive and Personal Information

All service providers should review the Technical Bulletin from the Department of Developmental Services (DDS) regarding best practices for protecting confidential, sensitive, and personal information, regardless of format (i.e. electronic or paper).

 

 

Agency Information for Security Incident Report Instructions and Forms

Please read the Agency Information on Security Incident Report Instructions and complete the Incident Report posted below in the event of a security breach. We are also posting information from The Office of Information Security (OIS) for the State of California, “Privacy Protection Recommendations: What to do if your personal information is compromised.”

Questions? Please call (818) 756-6116.

>> View the Privacy Protection Recommendations (English)

>> View the Privacy Protection Recommendations (Spanish)

>> View the Agency Information Security Incident Report Instructions & Incident Report

Security Breach Sample Breach Notices

>> View the Social Security (Number only) sample breach notice

>> View the driver’s license or California ID card number sample breach notice

>> View the credit card number or financial account (number only) sample breach notice

>> View the medical information only sample breach notice

>> View the health insurance information only sample breach notice

>> View the hybrid (SSN and health information) sample breach notice

English