As a board of director member, staff member, volunteer, service provider, or temporary employee of TASC, Inc., you may have access to confidential information including person served, financial, or business information obtained through your association with TASC. The purpose of this agreement is to help you understand your personal obligation regarding confidential information.
Confidential information is valuable and sensitive and is protected by law and by strict TASC policies. The Health Insurance Portability and Accountability Act of 1995 (HIPPA), requires protection of confidential information contained within our information system. Inappropriate disclosure of person served data may result in the imposition of fines up to $250,000 and ten years imprisonment per incident.
Accordingly, as a condition of and in consideration of my access to confidential information, I promise the following:
1. I will not access confidential information for which I have no legitimate need to know and for which I am not an authorized user.
2. I will not in any way divulge, copy, release, sell, loan, review, alter or destroy any confidential information unless expressly permitted by existing policy except as properly approved in writing by an authorized officer of TASC within the scope of my association with TASC.
3. I will not utilize another user's password in order to access any system. I will not reveal my computer password to anyone else unless a confirmed request for access to my password has been made by the Executive Director and I am able to confirm the legitimacy of the request and the requestors. I accept personal responsibility for all activities occurring under my password.
4. If I observe or have knowledge of unauthorized access of divulgence of confidential information, I will report it immediately to my supervisor and the Executive Director.
5. I will not seek personal benefit or permit others to benefit personally by and confidential information that I may have access to or that I access as an unauthorized user.
6. I will not remove any record, including copies or any other type of confidential information, from the office where it is kept, except in the performance of regular and customary job duties.
7. I will respect the ownership of proprietary software and not operate any licensed software on any computer.
8. I understand that all information, regardless of the media on which it is stored (paper, computer, videos, recorders, etc.), the system which processes it (computers, voicemail, telephone systems, faxes, etc.), or the methods by which it is moved (electronic mail, face to face conversations, facsimilies, etc.) is the property of TASC and shall not be used inappropriately or for personal gain. I also understand that all electronic communication shall be monitored and subject to internal and external audit.
9. I agree to abide by all TASC rules and regulations as specified in TASC's policies unless specifically altered by a separate contractual agreement.
10. I understand that my failure to comply with the Confidentiality Agreement may result in disciplinary action, which might include, but is not limited to, termination of employment and/or loss of my privileges within TASC.
By signing this Agreement, I acknowledge that TASC has an active on-going program to review records and transactions for inappropriate access and I understand that the inappropriate access or disclosure of information can result in penalties up to and including termination of employment and /or legal action.
Signature & Title Date
Executive Director Date
10/12 HIPPA/confidential agreement; 02/14 HIPPA; 02/15 HIPPA; Policies & Procedures/Volume 1/Confidentiality Agreement 2-18; 9-18