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<br />1 <br /> <br /> <br />Addendum 2 <br />Privacy and Security Agreement <br />(Required for all covered entities as defined in HIPAA) <br />(Page 1 of 3) <br /> <br /> <br />These conditions relate to the privacy and security of personal health information (PI) pursuant to the Health <br />Insurance Portability and Accountability Act (HIPAA) and are agreed upon by the employee and his/her <br />supervisor. <br /> <br />1. The employee agrees to provide a work area that will allow for private conversations including those on <br />the telephone and that he/she will store all PHI in a locked file cabinet provided by the County. The <br />employee’s remote work location and designated work area will be: ___________________________ <br />__________________________________________________________________________________ <br />__________________________________________________________________________________ <br />__________________________________________________________________________________ <br /> <br /> <br />2. The following County owned equipment will be used by the employee at a remote location: ________ <br />__________________________________________________________________________________ <br />__________________________________________________________________________________ <br />__________________________________________________________________________________ <br /> <br />3. The employee agrees to the following related to the use of a County owned laptop computer: <br /> <br /> The employee understands that he/she may not use his/her home computer for any work <br />containing PHI. His/her home printer may be used to print files containing PHI from a separate <br />file source as long as the file is not saved to the home computer. <br /> <br /> The employee will bring the laptop into the office once each week to connect it to the network <br />for updates and to back up his/her files to the personal folder on the network Drive. <br /> <br /> The employee understands that all necessary precautions must be taken to protect the laptop from <br />theft or loss including locking it in the trunk of a vehicle or keeping it out of view in a locked <br />vehicle that does not have a trunk. <br /> <br /> The employee understands that confidentiality of any PHI must be protected by password <br />protecting documents stored on the laptop hard drive or any removable media. The password <br />must be shared with the employee’s supervisor. <br /> <br /> The employee understands that is his/her responsibility to notify his/her supervisor promptly of <br />any changes in the remote work location that may affect its suitability as a private and secure <br />remote work site. This includes, but is not limited to, an additional person residing at the location <br />even if the change is expected to be temporary. <br /> <br /> Additional conditions agreed upon by the employee and supervisor are as follows: __________ <br />_____________________________________________________________________________ <br />_____________________________________________________________________________ <br />_____________________________________________________________________________ <br />_____________________________________________________________________________ <br /> <br />