Janus Youth Programs

Human Resource Department

Employee Confidential Statement

Personal Health Information

It is the legal and ethical responsibility and policy of JanusYouth Programs here after as “Janus”that all employees and/or contractors use, protect, and preserve personal and confidential information in accordance with federaland state laws as well asJanus policies and procedures.

Laws controlling the privacy of, access to, and maintenance of confidential information include, but are not limited to, the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA), the Health Information Technology for Economic and Clinical Health Act (HITECH), the HIPAA Final Omnibus Rules, and HIPAA State Laws. These and other laws apply whether the information is held in electronic or any other format, and whether the information is used or disclosed orally, in writing, or electronically.

Janus has in place policies that control the way confidential information may be used, but not limited to,company policy, roles and responsibilities of my position and business associate agreements.

“Confidential Information” includes information that identifies or describes an individual, the unauthorized disclosure of which would constitute an unwarranted invasion of personal privacy.

“Medical Information” includes, but is not limited, to the where, the how and theformat used to maintain medical and psychiatric records.

Unauthorized use, disclosure, viewing of, or access to confidential information in violation of state and/or federal laws may result in personal fines, civil liability, licensure sanctions and/or criminal penalties, in addition to Janusdisciplinary actions.

I understand it is my responsibility to read and abide by any and all policies and procedures regarding the use and distribution of information owned by Januseither currently in effect or which may be implemented or revised from time to time. I understand that information access will be monitored and any violation of Janus policies and procedures will be reported to the appropriate individual(s) and may result in disciplinary action against me including termination of employment or other affiliation(s) with Janus, as well as prosecution to the fullest extent of the federal and state law including civil and criminal penalties.

I understand that upon my separation, termination or non-affiliation with Janus, I must return any and all confidential and/or proprietary information in my possession.

I HAVE READ THE ABOVE CONFIDENTIALITY STATEMENT AND I AGREE TO COMPLY FULLY WITH ITS TERMS.

Employee Name: ______

Employee Signature: ______Date: ______