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DocuSign Envelope ID: 885498D2-1CBA-4928-AE9B-EDEEE17D7376 <br />c. The Action Officer shall oversee notification of individuals affected by the <br />breach or unauthorized use/disclosure of Medi-Cal PII when notification is <br />required. <br />d. The Action Officer shall engage Human Resource Services, County Counsel, <br />Risk Management, and/or the County Executive Office as needed to determine if <br />internal processes, such as disciplinary action, are necessary. <br />e. At the conclusion of the investigation and completion of all required <br />notifications and consultations regarding necessary internal processes, the Action <br />Officer will send the completed PIR that includes all required documentation <br />from the investigation to QST/COR at the <br />SSACustodianofrecordsinbox@SSA.ocgov.com with the subject line "Final PIR <br />[secure]." <br />7. The County Privacy Officer will submit the final PIR to DHCS as required. <br />8. QST/COR will retain the final PIR for all incident types. <br />V. REFERENCES <br />Compliance of this policy shall be in accordance with the: <br />For Loss of Medi-Cal PII: <br />State of California Department of Health Care Services Privacy and Security Agreement <br />https•//www dhcs ca gov/services/medi-cal/eli ig bility/letters/Documents/cl9-16.pdf <br />For Loss of all other program PII: <br />State of California Department of Social Services Privacy and Security Agreement <br />httl2s:Hcdss ca gov/Portals/9/ACL/2019/19-56E.pdf?ver=2019-07-02-071938-893 <br />For Loss of Federal Tax Information (FTI): State of California Health and Human Services <br />Agency Department of Social Services (CDSS) All County Letters No. 15-56 <br />California SB 1386 Personal Information: Privacy <br />California Civil Code 1798.29 <br />Children and Family Services Division (CFS Policy F-0105), Confidentiality-CFS Client <br />Records <br />WDM0522 Page 5 of 6 March 1, 2022 <br />