WHEREAS, pursuant to an agreement dated ____________________ ("Services Agreement") entered into by and between Covered Entity and Business Associate, Business Associate creates, receives, maintains or transmits Protected Health Information ("PHI") on behalf of Covered Entity when providing certain functions, activities, and services (collectively "Services") to Covered Entity;

WHEREAS, Covered Entity and Business Associate intend to protect the privacy and provide for the security of PHI disclosed pursuant to this BAA in compliance with the Health Insurance Portability and Accountability Act of 1996, Public Law 104-191 ("HIPAA"), as amended by the Privacy and Security provisions set forth in Subtitle D of the Health Information Technology for Economic and Clinical Health Act of 2009, Public Law 111-5 ("HITECH"), and the regulations promulgated thereunder, codified at 45 CFR Parts 160 and 164 (commonly known as the Privacy and Security Rules) (collectively, "HIPAA"), as well as the Federal Confidentiality of Alcohol and Drug Abuse Patient Records law and regulations, 42 USC §290dd-2 and 42 CFR Part 2 (collectively, "Part 2") and other applicable federal and state laws;

WHEREAS, Covered Entity operates a federally assisted part 2 program that must comply with the Federal Confidentiality of Alcohol and Drug Abuse Patient Records law and regulations, 42 USC §290dd-2 and 42 CFR Part 2 (collectively, "Part 2");

WHEREAS, the purpose of this BAA is to satisfy the obligations of Business Associate under HIPAA and Part 2 and to ensure the privacy and security of PHI before Business Associate is permitted to create, receive, maintain or transmit PHI on behalf of Covered Entity.

NOW, THEREFORE, in consideration of the foregoing, and for other good and valuable consideration, the receipt and adequacy of which is hereby acknowledged, the parties agree as follows: