Policy Manual sample

MDT Home Health Care Agency, Inc. PLEDGE PROCEDURE: All employees of MDT Home Health Care Agency, Inc. as a condition of employment, shall sign a Confidentiality Pledge. The administration of this pledge shall be handled by MDT Home Health Care Agency, Inc. employee’s supervisor and the original forwarded to the employee’s file. All MDT Home Health Care Agency, Inc. students, registered in educational programs, as a condition of utilizing MDT Home Health Care Agency, Inc.’s resources to learn, shall sign a Confidentiality Pledge. The administration of this pledge shall be handled by designated staff and the original shall be retained within MDT Home Health Care Agency, Inc. at a place designated by MDT Home Health Care Agency, Inc. Compliance Officer. All volunteers shall sign a Confidentiality Pledge. The administration of this pledge shall be handled by the Volunteer Services Department of MDT Home Health Care Agency, Inc. and the original retained in Volunteer Services of MDT Home Health Care Agency, Inc. All persons contracted under a Purchase Service Agreement, as a condition of acceptance of the contract, shall sign a Purchase Service Agreement that provides, for protection of confidential information including personal health information. The administration of this agreement shall be handled by the department responsible for the agreement and shall retain the original. All contractors engaged in providing a service for MDT Home Health Care Agency, Inc., where the service provided would expose them to confidential information shall sign a Confidentiality Pledge. The administration of this pledge shall be handled by the contracting department and the original retained in that department. All MDT Home Health Care Agency, Inc. Board Members shall sign a Confidentiality Pledge. The administration of this pledge shall be handled by the Administrator who shall retain the original. All agents of MDT Home Health Care Agency, Inc., who are regularly associated with MDT Home Health Care Agency, Inc., shall sign a Confidentiality Pledge. The administration of this pledge shall be handled by the personnel department and the original retained in personnel. All employees of other agencies, who regularly associate withMDTHome Health Care Agency, Inc., shall sign a Confidentiality Pledge. The administration of this pledge shall be handled by the Department with whom the agency has an association and the original retained in that Department. All information managers shall sign an agreement that provides, for protection of personal health information. The administration of this agreement shall be handled by the department responsible for retaining the information manager. The department shall retain the original. PROCEDURE IF A BREACH IS ALLEGED: An allegation of a breach of confidentiality of personal health information may be made to any staff member or volunteer of MDT Home Health Care Agency, Inc. Any individual receiving an allegation of a breach of confidentiality, or having knowledge or a reasonable belief that a breach of confidentiality of personal health information may have occurred, shall immediately notify his/her supervisor or where this is not possible, shall notify MDT Home Health Care Agency, Inc. Compliance Officer, or designate. The person so notified shall in turn, notify the supervisor of the Home Health Agency Policies A-85