Confidentiality Agreement

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I understand that I require information to perform my duties for Behavior Intervention Services. This information may include, but is not limited to, information on clients, their families, employees, students, other workforce members, donors, and financial and business operations. Some of this information is made confidential by law (such as “protected health information” or “PHI” under the federal Health Insurance Portability and Accountability Act) or by Behavior Intervention Services policies. Confidential information may be in any form, e.g., written, electronic, oral, overheard or observed. Access to all confidential information is granted on a need-to-know basis. A “need-to- know” is defined as information access that is required in order to perform my work. If my duties change, my need-to-know also may change. I pledge to review the Behavior Intervention Services policies on confidentiality and privacy. I will access, use and disclose confidential information in keeping with these policies and only on a need-to-know basis. Before I make any other use or disclosure of confidential information, I will contact my supervisor or manager (if applicable) in order to obtain proper permission. If I have no manager or I am the manager, I will assure that the use or disclosure is within the law and Behavior Intervention Services policies. I will not disclose confidential information to patients, friends, relatives, co-workers or anyone else except as permitted by Behavior Intervention Services policies and applicable law and as necessary to perform my work requirements. I will protect the confidentiality of all confidential information, including PHI, while with Behavior Intervention Services and after I leave Behavior Intervention Services. All confidential information remains the property of Behavior Intervention Services and may not be removed or kept by me when I leave Behavior Intervention Services except as permitted by Behavior Intervention Services policies or specific agreements or arrangements applicable to my situation. It is important that the entire Behavior Intervention Services team share a culture of respect for confidential information. To that end, if I observe access to or sharing of confidential information that is or appears to be unauthorized or inappropriate, I will try to make sure that this use or disclosure does not continue. This might include advising the person involved that they may want to check the appropriateness of the use or disclosure with the head of the agency. It may also involve letting my manager (if applicable) or others in authority at Behavior Intervention Services know about the issue or possible issue. Behavior Intervention Services may have additional policies regarding procedures for reporting possible inappropriate use or disclosure, and I understand that I must follow these policies, if applicable. I understand that signing this pledge and complying with its terms is a requirement for me to work with Behavior Intervention Services. If I violate this agreement, I will be subject to disciplinary action up to and including termination. In addition, under applicable law, I may be subject to criminal or civil penalties. I have read the above and agree to be bound by it.*