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DocuSign Envelope ID:5B6FF7D8-5B74-4BD3-BC2C-DDBAEB3C9E82 <br /> ORANGE COUNTY HEALTH DEPARTMENT <br /> Conti acted Interpreters <br /> Conditions of Contract Statement <br /> Confidentiality <br /> As a Contract Interpreter for Orange County Health Department (OCHD), I acknowledge that I may have <br /> access to information that is confidential as mandated by state and federal law, HIPAA regulation and/or <br /> Orange County policy. I recognize my legal obligation as a Contractor to maintain the confidentiality of <br /> information about former and current recipients of OCHD services. <br /> I understand that release of information determined to be confidential by law to unauthorized persons may <br /> result in criminal prosecution. I further understand that the failure to maintain legally required confidentiality <br /> of information constitutes "misconduct"within the meaning of the Orange County Personnel Ordinance and <br /> may lead to disciplinary action, including termination of contract. <br /> If'a question arises regarding whether a release of information may be public record vs. confidential client <br /> information, I will seek assistance from an OCHD Clinic Manager <br /> Title X Infoxmation Requirement <br /> OCHD provides services solely on a voluntary basis. A client's acceptance of'service is not a prerequisite to <br /> eligibility or receipt of a non-Title X service (family Planning). <br /> As an OCHD Contract Interpreter, you may be subject to prosecution under f ederal law if you coerce or <br /> endeavor to coerce any person to undergo an abortion or a sterilization procedure. <br /> As an Interpreter, your responsibility is to convey the message from.the provider to the client to the best of <br /> your ability, without prejudice or personal bias. If'you are present when an OCHD employee attempts to <br /> coerce a person to undergo an abortion oar a sterilization procedure, discontinue interpreting, and report this to <br /> the Clinic Manager <br /> Public Health Activities in Emergency Situations <br /> In order to fulfill the responsibilities of the department in emergency situations or in training, and due to our <br /> limited number of bilingual staff, you maybe asked to work at emergency shelters or other locations <br /> designated by the Health Director or emergency operations„ You may also be asked to participate in <br /> emergency drills and exercises As a Contractor, you do have the right to decline any of these special <br /> requests,. <br /> I certify that I have read and understand the conditions stated above. I have had an opportunity to discuss the <br /> conditions and requirements of my contract with a designated agency representative. <br /> Contractor Name: zahra Brooks Date: 8/20/2015 <br /> DocuSigned by! <br /> brbks 8/20/2015 <br /> Contractor Signature: Date: <br /> DacuSigned by! <br /> OCHD Representative: IL, Date: 8/23/2015 <br /> 2FE2C29B947F40W... <br />