Data Request Checklist (AB 2876) – California Licensed Hospitals

Before You Start
1. Confirm your eligibility Before you start the application process, please confirm your eligibility.  OSHPD is authorized to disclose HIPAA-limited versions of its patient-level data files to California-licensed hospitals.
2. Review data sets Next, review the variables in the data sets to see if the data meets your analytical need.
 AB 2876 Request Process – Hospitals
3. Complete and submit an UNSIGNED preliminary request package for review
  • Download the AB 2876 REQUEST FOR NONPUBLIC PATIENT LEVEL DATA for Licensed California Hospitals Form. Follow the detailed instructions below to complete the form. Do not sign this version of the request.
  • If the hospital is a nonprofit, please provide a copy of the IRS 501(c)(3) certificate with the request package to receive complimentary copies of the most current three years of AB 2876 PDD/ED/AS data available.
  • If your hospital is using outside contractor(s), provide a signed, current Business Associate Agreement between the hospital and each contractor.
  • Submit your preliminary request package to OSHPD using the contact information on the request form.  OSHPD will review it and an analyst will contact you if there are any questions about your request.
4. OSHPD will return the preliminary request package to you for signature when deemed complete Once the request appears complete, you will be sent:
  • A copy of the complete request with a Request Number, date received, and date revised
  • A Data Use Agreement (DUA) for the CEO/Administrator
The CEO, or equivalent, needs to sign the data request and DUA form. The Delegation Order OSH-HIRC-520 may be signed by the CEO or equivalent, to allow the designated delegate to sign the form on behalf of the hospital.
5. Submit SIGNED request package The signed forms should then be scanned as PDF and e-mailed to OSHPD.
6. Request package reviewed by OSHPD Your request will be reviewed by OSHPD management. When OSHPD has approved it, you will be sent:
  • An approval letter,
  • A copy of the signed DUA(s), and
  • A list of the Model Data Set(s) you are approved to receive
Generally, from the time the request is received until the data is shipped or transmitted, an AB 2876 request takes about one month. It may be longer or shorter depending on the complexity of the request.
7. Payment and shipping options At the time of data release, OSHPD will contact you to arrange payment and shipping options:
  • Encrypted CD to be picked up by you;
  • Shipped Overnight Delivery, with encrypted CD(s); or
  • Encrypted files sent via Accellion (Secure FTP)
NOTE: Data is not released until all required approvals have occurred and payment has been received.

This page was last updated on Friday, September 30, 2016.

Data Years Available
PUF 2010-2014 2010-2014
AB 2876 1983-2015 2005-2015
IPA 1983-2015 2005-2015
Custom 1983-2015 2005-2015
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