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4884-1724-9679, v. 1 <br />Appendix II <br /> <br />ORANGE COUNTY HEALTH DEPARTMENT <br /> <br />Employee <br />Conditions of Employment Statement <br /> <br /> <br />Confidentiality <br /> <br />I acknowledge that, in my role as a school nurse employed by the Orange County Board of Education I may <br />have access to information that is confidential as mandated by state and federal law, including but not <br />limited to the Federal Educational Rights and Privacy Act (FERPA), the Health Insurance Portability and <br />Accountability Act (HIPAA), and Orange County Schools and/or Orange County Health Department policies. I <br />recognize my legal obligation to maintain the confidentiality of information that is protected under those laws <br />or policies. <br /> <br />I agree to preserve the security of computer access by unauthorized persons by not storing information <br />about my computer access code in any place that might be accessible to such persons. <br /> <br />I understand that release of information determined to be confidential by law to unauthorized persons may <br />result in civil or criminal liability. I further understand that the failure to maintain legally required <br />confidentiality of information may lead to disciplinary action by Orange County Schools and/or restrictions <br />on or removal of my affiliation with the Orange County Health Department for purposes of receiving medical <br />oversight and direction from the Orange County Health Department Medical Director . <br /> <br />If a question arises regarding whether a release of information may be public record vs. confidential <br />information, I will seek assistance from my supervisor. <br /> <br />Title X Information Requirement <br /> <br /> To the extent applicable, I agree to comply with all requirements of Title X of the public Health Service Act, <br />42 U.S.C. 300 to 300a-6. <br /> <br />Public Health Activities Outside of Normal Working Hours <br /> <br />In order to fulfill the responsibilities of the department in emergency situations or in training, I understand <br />that I may be asked to work outside the regular work schedule at emergency shelters or other locations <br />designated by the health director or emergency operations and agree to do so if approved by the Orange <br />County Schools’ Superintendent or designee. <br /> <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 position with my supervisor or designated agency representative. <br /> <br /> <br /> <br />School Employee Signature: ______________________________ Date: __________________ <br /> <br />Agency Representative: ____________________________ Date: __________________ <br />DocuSign Envelope ID: CEF0A315-C0D6-4618-8F2A-729FFE153BB6