HIPAA Confidentiality Agreement
I understand that Silver State Baptist Youth Camp and their employees/volunteers have a legal responsibility to protect camper privacy. To do that, it must keep camper information confidential and safeguard the privacy of camper information. In addition, I understand that during the course of my employment or other work with Silver State Baptist Youth Camp, I may see or hear other confidential information including operational and financial information, pertaining to the camp that Silver State Baptist Youth Camp's employee/volunteer must maintain as confidential.
Regardless of the capacity in which I work, I understand that I must sign and comply with this agreement in order to be hired or continue to work for Silver State Baptist Youth Camp.
By signing this agreement, I understand and agree that:
• I will keep all camper information confidential. Regarding other types of important information to the camp, I will keep such information confidential and swill only disclose such information if it is required for the performance of my job and after receiving the permission of my supervisor.
• I will not discuss any information either camper-related or operations-related in public areas (even if specifics such as a campers name are not used), unless that public area is an essential place for the performance of my job.
• I will only access or view camper information for that which is required to do my job. If I have any questions about whether access to certain information is required for me to do my job, I will immediately ask my supervisor or the camp director for assistance.
• I will not disclose, copy, transmit, inquire, modify, or destroy camper information or other camp confidential information without permission from my supervisor.
• Once my job with the camp is terminated, I will immediately return all property (e.g., keys, documents, ID badges, etc.) to the camp. Even after my job is terminated, I agree to meet my obligations under this agreement.
I understand that as an employee/volunteer of a segment of Silver State Baptist Youth Camp that is a health care provider, the use and disclosure of camper information is governed by the rules and regulations established under HIPAA, the Health Insurance Portability and Accountability Act of 1996, and related policies and procedures of Silver State Baptist Youth Camp. Therefore, with regard to camper information, I commit to the following additional obligations:
• I will use and disclose confidential health information solely in accordance with the federal and Camp policies set forth above or elsewhere.
• I will immediately report any unauthorized use or disclosure of confidential health information that I become aware of to the appropriate supervisor.
I also understand and agree that my failure to fulfill any of the obligations set forth in this agreement and/or my violation of any terms of this agreement shall result in my being subject to appropriate disciplinary action, up to and including, termination of service.