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Tennessee Secretary of State Tre Hargett
Records Management Division
RDA
RDA Management System
RDA Details
RDA
RDA: 11178
Database ID: 2148
Record Series Title: Tennessee Rehabilitation Center (TRC) at Smyrna and Community Tennessee Rehabilitation Centers (TRC) Student Health Information and Medical Records.
Record Series Abstract: This record series consist of a HIPAA Authorization Form, TRC Student Health Questionnaire, TRC Student Health Medication Sheet, TRC Admissions Medication Sheet, Student Health Medication and Treatment Consent Form, TRC Student Health Referrals, TRC Initial Safety Contact & Plan, Intake Checklist, Student Health Medical Dormitory Inventory of Student's Personal Effects, Med Dorm Student Info Sheet, Student Health Medical File Charts, Student Intake-History and Physical, Physical Exam, TRC Physical Function Assessment, Student Health Doctor's Orders/Progress Notes and Nurse's Notes, Medical Consultant Sheet, TRC Student Health TB Skin Test Record, Self Harm or Threatening Behavior Student Check List, and other related information. The facilities provide Vocational Evaluations, Vocational training, Physical Rehabilitation Services, Traumatic Brain Injury (TBI) Program, Vision Impairment Services (VIS), Work adjustment training, a School to Work Program, Job Placement/Coaching Services, Transitional Living Skills and at our residential facility, TRC Smyrna, an onsite student health dorm.
Record Series Active: Yes
Cut Off at End of: Other
If Other, Explain: Cut off happens when student participation in a TRC program or service has ended.
Total Retention: 6 Years 0 Months
Retention End Action: Destroy
Disposition Notes: Upon student admission into a Tennessee Rehabilitation Center (TRC) program a complete medical health history is gathered, in order to best serve and evaluate the students physical limitations and any health risks or hazards. The maintenance and monitoring of TRC student health and medical issues is crucial in providing an optimal learning, living and training environment. The accumulated health history and medical information is a critical tool for staff in developing an individualized learning and training plan, focused on ability rather than disability. The mission of Tennessee Rehabilitation Centers is “To provide all program participants individualized, quality, timely services that will lead to gainful employment and an improved quality of life”.
View Signed Form: Form Not Received
Worksheet
Worksheet ID: 2149
Record Location: Tennessee Rehabilitation Center (TRC) at Smyrna & 17 Community Tennessee Rehabilitation Centers (TRC) located across the state.
File Arrangement: alpha/numeric
Media Format Generated: Paper
Media Format Stored: Paper: Sheet
Date Range: 2008-present
Annual Accumulation: 4 cubic feet
Current Volume: 128 cubic feet
Record Value: Administrative, Legal
Audit Requirements: Both
Reference Frequency:
Current Year per Month: 999
Past Year: 500
2 - 5 Years: 100
Over 5 Years: 25
Data Update Frequency: Weekly
Information Shared Outside of State: Yes
If Shared, List Agencies: Commission on Accreditation of Rehabilitation Facilities (CARF), U.S. Department of Education
Essential Record: No
Essential Record Stored:
Essential Record Media Type: Paper
Confidential: Yes
Confidential Legal Citation: 45 CFR 164.530 / 34 CFR 361.38 / TCA 46-11-604 / TCA 49-11-613
Media Recommendation: Current Format
Media Recommendation Other:
Agency Retention: 6 years 0 months
Agency Retention - Years Active:
Agency Retention - Years Inactive:
Records Center Retention Period:
Final Disposition after Retention Expires:
Legal Citation: 45 CFR 164.530 / 34 CFR 361.38 / TCA 46-11-604 / TCA 49-11-613
Record Sample: No Sample
Legal Documentation: No Legal Documentation
Electronic Records Plan Inventory
System Name:
IT-ABC Number:
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Software Description:
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Backup Procedures:
Disaster Recovery:
Data Migration Description:
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Contact Information
Contact Name: Karen Maclin-Barber
Job Title: TDHS Records Liaison
Address 1: Citizens Plaza Building, 3rd Floor
Address 2: 400 Deaderick Street
City: Nashville
Zip: 37243
Phone: 615-253-1195
Email: karen.maclin-barber@tn.gov
Agency: Dept. of Human Services
Agency Head: Commissioner Raquel Hatter
Director: RMU Director Pennye Neal
Allotment Code: 345.00
Status
Action Requested: New RDA
Comments
  Date Comments
Records Management Division (RMD): 06-30-2016 No recommended changes
Tennessee State Libary and Archives: 06-30-2016 No recommended changes.
Comptroller Audit Review: 2016-07-01 We have reviewed RDA 11178 from an audit standpoint. We concur with the recommended retention and disposition specifications.
Agency: 07-08-2016 No recommended changes
RMD Director Recomendations: 09-30-2016 RDA 11178 is a request for a new RDA. The retention period will be six years and destroy. The format will be paper. Recommend approval of request to create RDA 11178.
Signed Form Received: 2016-09-30
PRC Meeting Date: 11-03-2016
PRC Comments: PRC approves RDA 11178.
PRC Action: Approved
RDA History
ID RDA PRC Reviewed PRC Action
2148 11178 2016-11-03 Approved