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Tennessee Secretary of State Tre Hargett
Records Management Division
RDA
RDA Management System
RDA Details
RDA
RDA: 3033
Database ID: 1226
Record Series Title: Sick Leave Bank Records
Record Series Abstract: Records contain: Medical records, PR-0270 (Sick Leave Bank Enrollment), PR-0272 (Sick Leave Bank Medical Certification), PR-0339 (Sick Leave Donation Agreement), PR-0401 (Sick Leave Bank Determination), PR-0433 (Sick Leave Bank Application Checklist), and related correspondence. These records are protected under HIPPA Minimum Necessary rule 45 CFR 164.502(b), 164.514(d)
Record Series Active: Yes
Cut Off at End of: Other
If Other, Explain: Files are to be cut-off upon employee leaving state service.
Total Retention: 50 Years 0 Months
Retention End Action: Destroy
Disposition Notes: After cutoff, maintain in agency fifty (50) years; then destroy by state-approved method.
View Signed Form: Form Not Received
Worksheet
Worksheet ID: 1226
Record Location: First Floor James K. Polk Building 505 DEADRICK ST NASHVILLE TN 37243; and on agency servers
File Arrangement: alpha, numeric, and date
Media Format Generated: Both
Media Format Stored: Paper/Electronic
Date Range: 1988 (the year Sick Leave Bank program was enacted) to present
Annual Accumulation: Paper: 5 cubic feet Electronic: .2 GB
Current Volume: Paper: 173 cubic feet Electronic: 1.9 GB
Record Value: Administrative, Legal
Audit Requirements: State
Reference Frequency:
Current Year per Month: 50
Past Year: 40
2 - 5 Years: 20
Over 5 Years: 15
Data Update Frequency: Daily
Information Shared Outside of State: No
If Shared, List Agencies:
Essential Record: Yes - Original
Essential Record Stored: First Floor James K. Polk Building 505 DEADRICK ST NASHVILLE TN 37243; and on agency servers
Essential Record Media Type:
Confidential: Yes
Confidential Legal Citation: Although this record series is not confidential as a whole, it does contain medical records which are subject to the Health Insurance Portability and Accountability Act (HIPAA). Public Law 104-191
Media Recommendation: Current Format
Media Recommendation Other:
Agency Retention: 50 years
Agency Retention - Years Active: 50 years
Agency Retention - Years Inactive:
Records Center Retention Period: 0
Final Disposition after Retention Expires: Destroy
Legal Citation: P.L. 104-191
Record Sample: No Sample
Legal Documentation: No Legal Documentation
Electronic Records Plan Inventory
System Name: Sick Leave Bank G, H & K drive.
IT-ABC Number: NA
Hardware Description: Internal DOHR server located on the 1st floor of the James K. Polk Bldg. at 505 Deaderick Street Nashville, TN 37243.
Software Description: Microsoft Office Suite installed on work stations of DOHR employees.
System Location: DOHR internal server I located on the 1st floor of the James K. Polk Bldg. at 505 Deaderick Street Nashville, TN 37243.
Backup Procedures: Backup procedures-Symantec Net backup every night at 6:00 pm and incremental backups 7 days a week. This process in managed by the Department of Finance and Administration within their Office of Information Resources (OIR) division.
Disaster Recovery: Disaster Recovery procedures established by the Department of Finance and Administration (F&A) under the Information Systems Council (ISC) Policy 9.00
Data Migration Description: NA
Metadata Description: NA
Contact Information
Contact Name: Jessica Montgomery
Job Title: SLB-Admin
Address 1: James K. Polk Bldg
Address 2: 1st Floor
City: Nashville
Zip: 37243
Phone: 615-741-4787
Email: jessica.montgomery@tn.gov
Agency: Dept. of Human Resources
Agency Head: Rebecca Hunter
Director: Steve Brown
Allotment Code: 319.01
Status
Action Requested: New RDA
Comments
  Date Comments
Records Management Division (RMD): 09-17-2015 Agency will provide Migration and Metadata description when available. Records Management will update RDA when information is received.
Tennessee State Libary and Archives: 09-17-2015 TSLA concurs in RMD comments.
Comptroller Audit Review: 2015-09-17 Audit concurs with RMD comments.
Agency: 08-20-2015 This RDA should not involve deceased employees. We have requested a new RDA specific to this.
RMD Director Recomendations: 09-19-2015 RDA 3033 is a request to revise an RDA. The cut off is changing from when an employee is deceased to upon separation. The retention period will be increased from one year to fifty years. The format will become paper/electronic. Recommend approval of request to revise RDA 3033.
Signed Form Received: 2015-09-18
PRC Meeting Date: 10-13-2015
PRC Comments: PRC approves RDA 3033.
PRC Action: Approved
RDA History
ID RDA PRC Reviewed PRC Action
1226 3033 2015-10-13 Approved
2358 3033 2018-10-30 Approved