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ORANGE COUNTY HEALTH DEPARTMENT <br />FY 2024-25 <br />Contracted Interpreters: Conditions of Contract Statement <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <br /> <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 contract with a designated agency representative. <br /> <br />Contractor Name: _______________________________________ Date: ____________________ <br /> <br />Contractor Signature: ____________________________________ Date: ____________________ <br /> <br />OCHD Representative: __________________________________ Date: _____________________ <br /> <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 /> <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 /> <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 the Compliance Manager/Language Services Supervisor who also <br />serves as the OCHD HIPAA Privacy and Security Officer. <br /> <br />Title X Information 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 /> <br />As an OCHD Contract Interpreter, I understand that I may be subject to prosecution under Federal law if I <br />coerce or endeavor to coerce any person to undergo an abortion or a sterilization procedure. I must also <br />follow mandatory reporting requirements of child abuse, child molestation, rape, incest and human <br />trafficking, and will seek assistance from the Clinic Manager and Compliance Manager/Language Services <br />Supervisor if I have questions or concerns. <br /> <br />As an Interpreter, my responsibility is to convey the message from the provider to the client to the best of my <br />ability, without prejudice or personal bias. If I am present when an OCHD employee attempts to coerce a <br />person to undergo an abortion or a sterilization procedure, I should discontinue interpreting, and report this to <br />the Clinic Manager and Compliance Manager/Language Services Supervisor. <br /> <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 may be asked to work at emergency shelters or other locations <br />designated by the Health Director or emergency operations. I understand that I may be asked to participate in <br />emergency drills and exercises. As a Contractor, I do have the right to decline any of these special requests. <br /> <br /> <br />Docusign Envelope ID: 89E3DD83-36C1-471E-B20E-2066F92010F1 <br />11/11/2024 <br />11/11/2024Laura Price <br />11/11/2024