Waukesha County

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HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA)
2017 HIPAA Annual Assessment for Volunteers

Click the link below to see the 2017 HIPAA Training Document for this Assessment.
2017 HIPAA Training Document for Volunteers

Record your answers on this form by selecting the correct letter.

1. Our volunteers may work with or have access to the following type of information, which is considered PHI and something we need to protect for our clients:
2. Why do we need to protect our client’s information?
3. Who should volunteers report an accidental HIPAA violation to?
4. You are a volunteer driver who needs to go to a client’s home to provide them with services. Which of the following information do you NOT need to know to do your job? (think “Need to Know” policy)
5. You see a client you work with at a grocery store. What should you do:
6. You have a concern about a client you are working with and want to email your supervisor about it. What is the best way to email your supervisor information?

WAUKESHA COUNTY DEPARTMENT OF HEALTH AND HUMAN SERVICES
CONFIDENTIALITY/NON-DISCLOSURE AGREEMENT

I understand that Waukesha County Department of Health and Human Services (WCDHHS) has the legal and ethical responsibility to safeguard the privacy of all its clients and to protect the confidentiality of all the information we maintain in their written and/or electronic client file. I am aware that access to these records is governed by a variety of State and Federal Statutes and State Administrative Codes.

PRIVACY:

In the performance of my normal job duties, WCDHHS may give me access to information that is confidential in nature. This information may include, but is not limited to: billing information, records containing psychiatric, medical, Health and Human Services information, personnel records and/or payroll data of other employees and electronic computerized data.

My use and/or access to this type of information may be required because of the nature of my job duties and assignments. I am required to protect this data and maintain the highest degree of confidentiality regarding its use, both within WCDHHS and outside of WCDHHS to the extent that I use or access this information as a result of my job duties and assignments.

My use and/or access to confidential material as a result of my job duties and assignments is to be limited to only the information required by those job duties and assignments (“Need to Know”). If I use my job position or responsibilities to access information not required for my job, it will constitute misuse. Deliberate efforts to use the privileges accompanying my official duties to gain access to data I am not authorized for, by breaching installed security provisions or getting around them, will constitute abuse of my job responsibilities.

I am aware that further disclosure of this information without legal authorization, as outlined in State and Federal Statutes and State Administrative Codes, is prohibited. I understand that failure to follow this will expose me to the legal consequences identified in those specific statutes and codes. Even though my personal medical records or those of my family members may be maintained by WCDHHS, I must follow the same rules as any patient would when accessing those records.

SECURITY:

I understand systems utilized by WCDHHS are equipped with security measures such as unique logins, passwords etc that prevent unauthorized access. My access is determined by my role within the organization. I am responsible for all entries, activities and access to accounts (systems with my user ID). I shall not share my password(s) with anyone or manipulate software or hardware configurations. I shall have no expectation of privacy in anything I create, store, send or receive on the computer system. I understand that monitoring my usage, access and activity can and will occur, without notification or request for authorization from me. Any misuse of privileges or violation of information systems will be investigated and appropriate corrective action taken.

GENERAL OBLIGATIONS:

Any abuse, misuse, or dissemination of any confidential information (whether listed above or not) will result in disciplinary action, which can include termination of employment. All employees, volunteers, students and contracted staff are required to uphold the confidentiality requirements beyond tenure with the County and will report any misuse of information to the HHS Privacy and Security Coordinator.

CONFIDENTIALITY AGREEMENT:

My signature below indicates that I have read this confidentiality statement and understand my responsibilities. I further acknowledge that I have been trained in and reviewed the Waukesha County Policies and Procedures governing the creation, handling, and disposal of this confidential client information and will abide by established policies and procedures.