Candice Robinson

8/7/2017 https://hshr.mednet.ucla.edu/s/trainings/policiesprocedures/printcert.asp Certificate of Completion This is to certify that I, Robinson, Candice D have read, understand or know where to ask questions about and agree to abide by the Policies and Procedures associated with the UCLA OCR Resolution Agreement and I have completed the required online HIPAA Privacy and Information Security training for New Workforce Members on Monday, August 07, 2017 at UCLA Health System Reference No: 287431 https://hshr.mednet.ucla.edu/s/trainings/policiesprocedures/printcert.asp 1/2 8/7/2017 https://hshr.mednet.ucla.edu/s/trainings/policiesprocedures/printcert.asp Applies to all UCLA Health System "workforce members" including: employees, medical staff and other health care professionals; volunteers; agency, temporary and registry personnel; and trainees, house staff, students, and interns (regardless of whether they are UCLA trainees or rotating through UCLA Health System facilities from another institution). It is the responsibility of all UCLA Health Sy stem workf orce members, as def ined abov e, including employ ees, medical staf f , house staf f , students and v olunteers, to preserv e and protect conf idential patient, employ ee and business inf ormation. The f ederal Health Insurance Portability Accountability Act (the "Priv acy Rule"), the Conf identiality of Medical Inf ormation Act (Calif ornia Civ il Code 56 et seq.) and the Lanterman-Petris-Short Act (Calif ornia Welf are & Institutions Code 5000 et seq.) gov ern the release of patient identif iable inf ormation by hospitals and other health care prov iders. The State Inf ormation Practices Act (Calif ornia Civ il Code sections 1798 et seq.) gov erns the acquisition and use of data that pertains to indiv iduals. All of these laws establish protections to preserv e the conf identiality of v arious medical and personal inf ormation and specif y that such inf ormation may not be disclosed except as authorized by law or the patient or indiv idual. Confidential Patient Care Information includes: Any indiv idually identif iable inf ormation in possession or deriv ed f rom a prov ider of health care regarding a patient's medical history , mental, or phy sical condition or treatment, as well as the patients and/or their f amily members records, test results, conv ersations, research records and f inancial inf ormation. (Note: this inf ormation is def ined in the Priv acy Rule as "protected health inf ormation.") Examples include, but are not limited to: - Phy sical medical and psy chiatric records including paper, photo, v ideo, diagnostic and therapeutic reports, laboratory and pathology samples; - Patient insurance and billing records; - Mainf rame and department based computerized patient data and alphanumeric radio pager messages; - Visual observ ation of patients receiv ing medical care or accessing serv ices; and - Verbal inf ormation prov ided by or about a patient. Confidential Employee and Business Information includes, but is not limited to, the following: - Employ ee home telephone number and address; - Spouse or other relativ e names; - Social Security number or income tax withholding records; - Inf ormation related to ev aluation of perf ormance; - Other such inf ormation obtained f rom the Univ ersity 's records which if disclosed, would constitute an unwarranted inv asion of priv acy ; or - Disclosure of Conf idential business inf ormation that would cause harm to UCLA Health Sy stem. Peer rev iew and risk management activ ities and inf ormation are protected under Calif ornia Ev idence Code section 1157 and the attorney -client priv ilege. I understand and acknowledge that: 1. I shall respect and maintain the conf identiality of all discussions, deliberations, patient care records and any other inf ormation generated in connection with indiv idual patient care, risk management and/or peer rev iew activ ities. 2. It is my legal and ethical responsibility to protect the priv acy , conf identiality and security of all medical records, proprietary inf ormation and other conf idential inf ormation relating to UCLA Health Sy stem and its af f iliates, including business, employ ment and medical inf ormation relating to our patients, members, employ ees and health care prov iders. 3. I shall only access or disseminate patient care inf ormation in the perf ormance of my assigned duties and where required by or permitted by law, and in a manner which is consistent with of f icially adopted policies of UCLA Health Sy stem, or where no of f icially adopted policy exists, only with the express approv al of my superv isor or designee. I shall make no v oluntary disclosure of any discussion, deliberations, patient care records or any other patient care, peer rev iew or risk management inf ormation, except to persons authorized to receiv e it in the conduct of UCLA Health Sy stem af f airs. 4. UCLA Health Sy stem Administration perf orms audits and rev iews patient records in order to identif y inappropriate access. 5. My user ID is recorded when I access electronic records and that I am the only one authorized to use my user ID. Use of my user ID is my responsibility whether by me or any one else. I will only access the minimum necessary inf ormation to satisf y my job role or the need of the request. 6. I agree to discuss conf idential inf ormation only in the work place and only f or job related purposes and to not discuss such inf ormation outside of the work place or within hearing of other people who do not hav e a need to know about the inf ormation. 7. I understand that any and all ref erences to HIV testing, such as any clinical test or laboratory test used to identif y HIV, a component of HIV, or antibodies or antigens to HIV, are specif ically protected under law and unauthorized release of conf idential inf ormation may make me subject to legal and/or disciplinary action. 8. I understand that the law specially protects psy chiatric and drug abuse records, and that unauthorized release of such inf ormation may make me subject to legal and/or disciplinary action. 9. My obligation to saf eguard patient conf identiality continues af ter my termination of employ ment with the Univ ersity of Calif ornia. I, Robinson, Candice D, certify that on 8/7/2017 I have read and understand the Confidentiality Agreement and agree to abide by it. In the event of a breach or threatened breach of the Confidentiality Agreement, I acknowledge that the University of California may, as applicable and as it deems appropriate, pursue disciplinary action up to and including my termination from the University of California. Name: Robinson, Candice D Employee ID: 287431 Date: 8/7/2017 Print Name: S ignature: https://hshr.mednet.ucla.edu/s/trainings/policiesprocedures/printcert.asp 2/2