Embrace Nondisclosure and Confidentiality Policy

Confidentiality pertains to the treatment of information that an individual has disclosed in a trusted relationship with the expectation that it will not be divulged to others in ways that are inconsistent with the understanding of the original disclosure unless permission is granted. Confidentiality is a core value shaping Embrace’s work as domestic violence and sexual assault service provider. It is considered a fundamental element underlying safety and therefore guides the development and delivery of all Embrace services. Additionally, it is important to discuss the differences in confidentiality protections among community services with survivors so they can make informed decisions.

Many victims of domestic violence and sexual assault fear retribution from their abuser for seeking assistance and therefore do not want anyone outside of the Embrace Program knowing that they sought services or advice. Some victims may still be living with their abuser while others may be fleeing a situation and looking for confidential locations where they can stay. In both instances, breaches of confidentiality can be lethal.

Policy

In response to protecting a program participant’s safety and privacy, it is the policy of Embrace to uphold the confidentiality and privacy of any person receiving services by keeping confidential all communications, observations and information made by, between, or about program participants confidential. This includes all program participant contact and administrative records, including any and all records resulting from telephone contacts and any other work product of personnel related to recipients of service. Communications are confidential whether made by adults or children, and whether to or between staff, volunteers, student interns or board members of this organization. There are a limited number of exceptions to breaching the confidentiality of program participants. These exceptions are as follows:

  • Duty to report child abuse and neglect in accordance with Embrace Child Abuse and Neglect Reporting Policies.
  • Duty to warn of an imminent threat of harm to self or others in accordance with Embrace Protocols for Maintaining Confidentiality.
  • Following a court order in accordance with Embrace Protocols for Maintaining Confidentiality.
  • When given express permission by the program participant to release information.

All Embrace Personnel and recipients of Embrace’s services are accountable for adherence to the Embrace Nondisclosure and Confidentiality Policy, Embrace Protocols for Maintaining Confidentiality and Embrace Child Abuse and Neglect Reporting Policies. Violation of this Policy or Protocols will be considered grounds for disciplinary action up to and including the Personnel Member’s dismissal. Program participants must sign a Program Participant Notice of Rights and Confidentiality Agreement to assist in maintaining the confidentiality of other program participants and their violation of the Policy will be considered grounds for terminating a client’s services and the relationship with Embrace as well as possible legal action.

Nondisclosure

Embrace shall not disclose any personally identifying information or individual information collected in connection with services requested (including services utilized or denied). All service recipients, whether they are receiving services in person or on the telephone, will be informed of this confidential nature of services.

A communication or information is “confidential” if not intended to be disclosed to 3rd persons other than persons present to further the interest of the person receiving counseling, assistance, or support services, persons reasonably necessary for the transmission of the communication or information, and persons who are participating in providing counseling, assistance, or support services under the direction of an advocate, including family members of the person receiving counseling, assistance, or support services and members of any group of individuals with whom the person receives counseling, assistance, or support services.

Release of Information and Waiver of Nondisclosure

Embrace shall not reveal personally identifying information without the informed, written, reasonably time-limited consent by the person about whom the information is sought, whether for Embrace or any other Federal or State grant program, which consent shall be given by the person, except in the case of an unemancipated minor, where the minor and the parent or guardian must need give consent; and in the case of an individual with a guardian, the individual’s guardian must need give consent. Consent may not be given by the abuser or suspected abuser of the minor or individual with a guardian, or the abuser or suspected abuser of the other parent of the minor. Consent must be given in writing using the Release of Information and Waiver of Nondisclosure as instructed by the Executive Director.

If release of information and/or disclosure of services received is compelled by statutory or court mandate, Embrace shall make reasonable attempts to provide notice to victims affected by the disclosure of information; and Embrace shall take steps necessary to protect the privacy and safety of the persons affected by the release of the information by following the Embrace Protocols for

Maintaining Confidentiality.

In no circumstances may an adult, youth, or child victim of domestic violence, dating violence, sexual assault, or stalking be required to provide a consent to release his or her personally identifying information as a condition of eligibility for the services provided by Embrace; any personally identifying information be shared in order to comply with Federal, tribal, or State reporting, evaluation, or data collection requirements, whether for this program or any other Federal, tribal, or State grant program.

Non-Personally Identifying Information Sharing

Embrace may share non-personally identifying data in the aggregate regarding services to their clients and non-personally identifying demographic information in order to comply with Federal, State, tribal, or territorial reporting, evaluation, or data collection requirements; court-generated information and law enforcement-generated information contained in secure, governmental registries for protection order enforcement purposes; and law enforcement-generated and prosecution-generated information necessary for law enforcement and prosecution purposes.

 

 


 

Program Participant Notice of Rights and Confidentiality Agreement

Confidentiality means not sharing private information that someone trusted you with. At Embrace, anyone’s information can only be shared if that person writes on paper that it’s okay. Confidentiality is a core value to Embrace’s work. Confidentiality keeps people safe and creates better services for everyone who comes to Embrace. Breaking confidentiality can be deadly for some people that Embrace serves. It is important to know how confidentiality protects you so that you can make the best decisions for yourself.

I understand:

  • Embrace will keep my information confidential to help keep me safe and protect my privacy.
  • Anything I say to Embrace Staff or Volunteers is kept private within Embrace, even if I share that information in front of another person who is helping me. Embrace Staff can’t even tell their friends or families anything.
  • If someone contacts Embrace about me, Embrace Staff will pretend they don’t know who I am unless I give my permission for Embrace to talk to them. If I want information shared with another person, I need to sign the Release of Information and Waiver of Nondisclosure Form. If I decide later that I want to change my mind about signing the form, I can take it back.
  • The are only two times when it is okay for Embrace to tell someone else my information without my permission.
    1. One is if staff thinks I might hurt myself or someone else. If my conversation goes in this direction, Embrace Staff will stop me before I say anything and tell me the different things they have to report.
    2. The second is if the Court Orders that Embrace shares information. If this happens, I will be notified immediately, and if I choose, Embrace will do everything they can to not give up any information.
  • Other people who work at Embrace might be told my information in order for them to provide the best services they can.
  • In order to keep everyone who comes here safe, I have to keep confidential anything I see, hear or find out about other people accessing Embrace’s services or participating in support groups. It is against the law to say anything to anyone about other people who come here.
  • If I break confidentiality by telling anyone else’s secrets including that I overheard them or saw them at Embrace, it is grounds for terminating services and Embrace can take legal action.

 

____________________________           _____________________________        _________________

Printed Name                                                    Signature                                                             Date

 

 


 

Embrace Personnel Confidentiality Agreement

Confidentiality pertains to the treatment of information that an individual has disclosed in a trusted relationship with the expectation that it will not be divulged to others in ways that are inconsistent with the understanding of the original disclosure unless permission is granted. Confidentiality is a core value shaping Embrace’s work as domestic violence and sexual assault service provider. It is considered a fundamental element underlying safety and therefore guides the development and delivery of all Embrace services. Additionally, it is important to discuss the differences in confidentiality protections among community services with survivors so they can make informed decisions.

Many victims of domestic violence and sexual assault fear retribution from their abuser for seeking assistance and therefore do not want anyone outside of the Embrace Program knowing that they sought services or advice. Some victims may still be living with their abuser while others may be fleeing a situation and looking for confidential locations where they can stay. In both instances, breaches of confidentiality can be lethal.

In response to protecting a program participant’s safety and privacy, it is the policy of Embrace to uphold the confidentiality and privacy of any person receiving services by keeping confidential all communications, observations and information made by, between, or about program participants confidential. This includes all program participant contact and administrative records, including any and all records resulting from telephone contacts and any other work product of personnel related to recipients of service. Communications are confidential whether made by adults or children, and whether to or between staff, volunteers, student interns or board members of this organization. There are a limited number of exceptions to breaching the confidentiality of program participants. These exceptions are as follows:

  • Duty to report child abuse and neglect in accordance with Embrace Child Abuse and Neglect Reporting Policies.
  • Duty to warn of an imminent threat of harm to self or others in accordance with Embrace Protocols for Maintaining Confidentiality.
  • Following a court order in accordance with Embrace Protocols for Maintaining Confidentiality.
  • When given express permission by the program participant to release information.

All program participants, denied or assisted, whether they are receiving services in person or on the telephone, will be informed of the confidential nature of our services.

All Embrace Personnel and recipients of Embrace’s services are accountable for adherence to the Embrace Nondisclosure and Confidentiality Policy, Embrace Protocols for Maintaining Confidentiality and Embrace Child Abuse and Neglect Reporting Policies. Violation of these Policy or Protocols will be considered grounds for disciplinary action up to and including the Personnel Member’s dismissal.

 

 

____________________________           _____________________________        _________________

Printed Name                                                    Signature                                                             Date

 

 

 


 

Embrace’s Confidentiality Guidelines for Children and Teens

Your confidentiality is VERY important to us! Anything that you and your advocate talk about is kept completely secret. What is said here, stays here. If you don’t want us to, we won’t tell your parents or anyone anything without your written permission.  We can’t even tell them you talked with us. There are a few different exceptions when we can tell someone about our conversations. These exceptions are:

  • Reporting child abuse and neglect following the guidelines in the Embrace Child Abuse and Neglect Reporting Policies. We will tell you when we have to report something, work with you to complete the report, and do everything we can in your best interests.
  • Warn appropriate people of an imminent threat of harm to yourself or others following the guidelines in Embrace Protocols for Maintaining Confidentiality. This could include things like a suicide attempt or plan, fighting or other physical violence—something that puts your health or safety, or someone else’s health and safety, at extreme risk.
  • When Embrace has to follow a court order according to the guidelines in Embrace Protocols for Maintaining Confidentiality. We cannot guarantee that your information will be kept confidential because the court could demand that we cooperate with them. But, we will always do EVERYTHING we can to not share any information with any outside people (we will try to quash subpoenas or say as little as possible in a legal situation).
  • When we are given written permission by you to give information to specific people who you want to know something in order to help you.

If there is ever a need to reveal information, we will let you know in advance, and work with you to handle the situation in a way that respects you, your feelings, and your needs.

I have read and I understand Embrace’s Confidentiality Guidelines for Children and Teens.

 

_________________________        ________________________________                 __________________

Your (minor’s) printed name                       Signature                                                                   Date

 

_________________________        ________________________________                 __________________ Parent/Guardian printed name and signature, if applicable                                                  Date