Slide 1

2010 Virginia Sexual and Domestic Violence Action Alliance

Model Policies on Confidentiality and Record-Keeping

2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

1Thank you for downloading the Model Policies on Confidentiality and Recordkeeping Training Module. Before we get started, wed like to encourage all the participants to take the Pre-Test associated with this module. Please visit http://tiny.cc/MPCR_PRE or use the printed version of the test that was sent with the training module materials. This should only take a few minutes. Thank you!

Click to advance to the next slide2Model Policies are the roots to ensure stability

Course Objectives:Become familiar with Federal, State, and Accreditation requirements on confidentiality and recordkeeping.

Discuss best practices in order to enhance confidentiality and recordkeeping procedures.

Analyze/evaluate effectiveness of current policies and practices.

2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

4Brief History

In the early days of the sexual and domestic violence movements, maintaining confidentiality was relatively simple

no information was disclosed to anyone.

2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

5collaborateViolence Against Women Act

Sharing information -- even identifying information -- with prosecutors, law enforcement, social services and health care providers became the norm Brief History

law enforcementvictim servicesprosecutioncourtsother allied professions

6 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

2/11/2011 3:26 PMsometimes to the detriment of victims.

2/11/2011 3:26 PM7 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

ConfidentialityState and federal laws identify information that must be protected, information that may be shared, when information may be shared and when information must be shared.Persons accessing sexual and domestic violence services expect confidentiality.

8 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

2/11/2011 3:26 PMModel Policieshow to properly handle identifying information, what to do when confidentiality is breached, exceptions to confidentiality and how to respond to requests for confidential information.Staff working in programs must have clear guidelines or model policies -Record-keeping practices are an integral part of confidentiality.

Basic Philosophy of Empowerment asksWhat does a person accessing our services want us to do?

Scenario

11 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

2/11/2011 3:26 PMScenarioDiana has a protective order that prohibits her live-in boyfriend from contacting her. Last night he went to her house and assaulted her. The police arrived after he had left and she went to the shelter with nine year old, Mia.

She did not have a positive experience with the responding officer and has not been successful in finding out if her boyfriend was arrested. She has asked you, the advocate, to assist her in calling the officer to find out if he was arrested. The officer is angry that Diana let the batterer in her residence and suggests that she is mutually responsible for the abuse.Click to advance to the next slide2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

12Should you, the advocate, be aware of any laws prior to taking action on behalf of the client?What agency guidelines or policies should be in place to protect the client?What would an advocate who works in your agency do? Assess the following:

Click to advance to the next slide2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

13Laws and Accreditation StandardsExternal CommunicationWhen requesting technical assistance for a client from the Virginia Sexual and Domestic Violence Action Alliance or any other agency, no personally identifying formation is provided unless the client has signed a time limited consent form.VA Code 63.2-104.1B

The agency does not confirm or deny to any party, including the media, that a person has accessed agency services, unless the client has signed a time limited consent form.VA Code 63.2-104.1BThe agency has a policy addressing Child Protective Services reports.VADVAA Accreditation Manual Section V, Item 7

Click to advance to the next slideScenarioTwo months have gone by and Diana has left the shelter but still attends weekly support groups. She has shared in group that she might do harm to herself or her child. The local police department has received a missing persons report for Diana. The officer who brought Diana to the shelter two months ago, calls to find out if Diana is still at the shelter or if the shelter knows how to contact her to determine if she is missing. The officer becomes frustrated when you explain that you cannot confirm or deny whether she is staying at the shelter. He says that any information you give him will be kept confidential and not shared with the person making the missing persons report.

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2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

15Laws and Accreditation StandardsStaff protects the confidentiality and privacy of clients by not discussing clients with one another if another person can overhear the conversation.VA Code 63.2-104.1

The agency has a policy addressing Adult Protective Services reports. VSDVAA Accreditation Manual Section VThe agency has a policy that includes what to do if a client exhibits or describes a clearly defined threat (a specific plan) of suicide, homicide, or imminent danger of serious bodily harm to her/himself or an identified person.VSDVAA Accreditation Manual Section V, Item 7

The agency has a policy prohibiting staff, who are also employed at an allied agency, from sharing client information with that other agency even if that other agency is also working with the client, unless the client has signed a time limited consent form.VA Code 63.2-104.1

Click to advance to the next slide2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

16Mandated ReportingShould you talk with Diana about her comments about hurting herself and her child?Should staff have a discussion around mandated reporting?Should staff know who is a mandated reporter? What procedures are in place for making reports?Click to advance to the next slide

Mandated ReportingHere are the guidelines on responding to suspected child abuse and neglect:All Sexual and Domestic Violence Agencies should have in place a protocol to guide staff in responding to child abuse and neglect.Protocols should define child abuse and neglect.Protocols should clearly identify staff/positions considered mandatory reporters.Protocols should identify safety planning options for parents and children or youth.

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Telling SecretsThink of a secret in your life.Write down one or more reasons why you might reveal this secret to someone. (You will not have to reveal the secret.)What were the reasons? Write them down.Share with the group or partner.

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Telling SecretsWhat would it feel like if the person you shared a secret with revealed it without your permission?Write down a list of those feelings.What might be the consequences of telling this secret to others without permission?Adapted from PATH. Ensuring Privacy and Confidentiality in Reproductive Health Services: A Training Module and Guide. Washington, D.C.: PATH (2003).

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ConsequencesIsolationDeathTermination of jobExiting from a shelterHomelessLoss of dignityRe-victimizationNegative labelingCriminal consequencesLoss of custody of childrenFear of.

Scenario

22 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

2/11/2011 3:26 PMScenario Informing ClientsI came to the shelter and they gave me 10 pieces of paper to sign and I have no clue what Im suppose to do with them. They say something about confidentiality but what does that mean? What do I do with this stuff? Do I need to take them to a lawyer before I sign them? Does this mean I cant tell my family where I am? Im very confused with confidentially and what it means. This is too overwhelming! Client Karen

Informing Clients How do you explain confidentiality? Do you talk about how people are affected, and the consequences of breaking confidentiality? How is confidentiality shared and appreciated by someone with limited English proficiency?Are there any other considerations that might be important?

Click to advance to the next slideInforming Clients The Agency may only release client information with the informed, written reasonably time limited consent of the person. VA Code 63.2-104VSDVAA Accreditation Manual Section V, Item 5Each person who signs a consent form must receive a copy of the signed consent form.VSDVAA Accreditation Manual Section V, Item 5Agency staff reviews the agency confidentiality policy with each person accessing services.VSDVAA Accreditation Manual Section V, Item 8The agency does not share client lists with identifying information with others outside the agency and does not have these lists visible to those entering a workspace.VA Code 63.2-104-1

Click to advance to the next slideScenario Informing New HiresIve been working at this program for about three months. I was instructed to write down everything the client does. Today when I got to work, I was told that there was a subpoena and that I may have to appear in court. Im scared.

Nobodys told me anything else. I dont want to get any clients in trouble. I keep going over in my head what I might have done wrong. I got a call from the nurse at the local family clinic and gave her some client information. I was invited to participate in a SART meeting last week and I remembered to take the files of a client that I thought might be important to the discussion. No one told me not to. This is overwhelming!New Advocate Lillian

Informing New HiresHow do you train new hires on the complexities of confidentiality? What process is in place for staff who have questions about procedures or are in an emergency situation? Is this process recorded in the policies or is it common knowledge?Are there any other considerations that might be important?

Click to advance to the next slideInforming New HiresThe agency includes confidentiality as part of a all new staff/volunteer/intern orientation.VSDVAA Accreditation Manual Section IIIVSDVAA Accreditation Manual Appendix IIThe agency has a written policy on responding to subpoenas and court orders for client or agency information that includes the reasonable steps the agency will take to protect the privacy of the information. The agency will make reasonable attempts to provide notice to victims affected by the disclosure of information.VSDVAA Accreditation Manual Section V, Item 7VA Code 63.2-104 .1The agency confidentiality policy addresses how the agency will respond to attempts to deliver subpoenas and court orders, warrants or other legal documents to clients.VSDVAA Accreditation Manual Section V, Item 7

Click to advance to the next slideHighly RecommendedThe agency does not disclose personally identifying client information via email or instant messaging between staff and another agency.

The agency works with each client to determine a reasonable length of time for the consent for release of information (consent form) based on her/his circumstances and/or the purpose of the release.

Consent forms are not valid without an expiration date.

The consent forms allow a client to choose to release information by date range and/or by topic for a meeting or specific conversation.

Click to advanceHighly RecommendedThe agency consent form makes it clear that someones medical, HIV/AIDS status, and alcohol/drug information are not part of the release unless the client gives specific written consent to do so.

The agencys CPS and APS policies address when a report is to be made, who made it, exceptions to making a report, if any, and includes steps to inform the parent/victim/client that a report will be made.

In the event of a clients death or incapacitation, the agency does not share information about the client without the prior, informed, written consent of the client.Click to advance Record-Keeping

Keeping Information SecureGenderRacePerson Receiving ServicesType of ViolencePerpetration InformationRelationship to VictimConsent FormMedical Release FormVisitors Confidentiality FormChildren Parental Supervision Form

Laws and Accreditation StandardsAll client files are kept in a secure locked area. VSDVAA Accreditation Manual Section V, Item 2

The agency has a written procedure that describes what it is/is not to be kept in client files.VSDVAA Accreditation Manual Section V, Item 7

The files of clients children are maintained in the same appropriate record-keeping manner as the adult clients files. VSDVAA Accreditation Manual Section V, Item 1

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2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

33Laws and Accreditation StandardsClient files that are stored on computers are password protected.VSDVAA Accreditation Manual Section V, Item 3

The agency does not store personally identifying client information on any portable device, including but not limited to a laptop, Blackberry, external disk drive, flash drive, etc.VSDVAA Accreditation Manual Section V, Item 3

The agency may not enter any personally identifying client information in any third-party databases, including, but not limited to, HMIS.VA Code 63.2-104VSDVAA Accreditation Manual Section V, Item 6VAWA Section 3

Click to advance to the next slide2/11/2011 3:26 PM 2008 Microsoft Corporation. All rights reserved. Microsoft, Windows, Windows Vista and other product names are or may be registered trademarks and/or trademarks in the U.S. and/or other countries.The information herein is for informational purposes only and represents the current view of Microsoft Corporation as of the date of this presentation. Because Microsoft must respond to changing market conditions, it should not be interpreted to be a commitment on the part of Microsoft, and Microsoft cannot guarantee the accuracy of any information provided after the date of this presentation. MICROSOFT MAKES NO WARRANTIES, EXPRESS, IMPLIED OR STATUTORY, AS TO THE INFORMATION IN THIS PRESENTATION.

34Highly RecommendedWritten procedures on how client files are to be treatedClients have the right to review their files.The agency makes a copy of the file for the client.The agency keeps a sample file to show funders.Client files and other written documentation contain limited information.Agency logs do not contain personally identifying information.Agencies must define the purpose of written internal agency communicationWritten record retention procedureThe agency creates participant codes when using VadataConfidential information is not stored on any computer unless safeguarded.

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