Okaloosa County BOCC — January 19, 2016 — REVISED Acknowledgement of Notice of Statutory Requirement to Comply with the Confidentiality.... — reading text

U.S. Department of Justice Office on Violence Against Women Acknowledgement of Notice of Statutory Requirement to Comply with the Confidentiality and Privacy Provisions of the Violence Against Women Act, as Amended Under section 40002(b)(2) of the Violence Against Women Act, as amended (42 U.S.C. 13925(b)(2)), grantees and subgrantees with funding from the Office on Violence Against Women (OVW) are required to meet the following terms with regard to nondisclosure of confidential or private information and to document their compliance. By signature on this form, applicants for grants from OVW are acknowledging that that they have notice that, if awarded funds, they will be required to comply with this provision, and will mandate that subgrantees, if any, comply with this provision, and will create and maintain documentation of compliance, such as policies and procedures for release of victim information, and will mandate that subgrantees, if any, will do so as well. (A) In general In order to ensure the safety of adult, youth, and child victims of domestic violence, dating violence, sexual assault, or stalking, and their families, grantees and subgrantees under this subchapter shall protect the confidentiality and privacy of persons receiving services. (B) Nondisclosure Subject to subparagraphs (C) and (D), grantees and subgrantees shall not— (i) disclose, reveal, or release any personally identifying information or individual information collected in connection with services requested, utilized, or denied through grantees’ and subgrantees’ programs, regardless of whether the information has been encoded, encrypted, hashed, or otherwise protected; or (ii) disclose, reveal, or release individual client information without the informed, written, reasonably time-limited consent of the person (or in the case of an unemancipated minor, the minor and the parent or guardian or in the case of legal incapacity, a court-appointed guardian) about whom information is sought, whether for this program or any other Federal, State, tribal, or territorial grant program, except that consent for release may not be given by the abuser of the minor, incapacitated person, or the abuser of the other parent of the minor. If a minor or a person with a legally appointed guardian is permitted by law to receive services without the parent’s or guardian’s consent, the minor or person with a guardian may release information without additional consent. (C) Release If release of information described in subparagraph (B) is compelled by statutory or court mandate— (i) grantees and subgrantees shall make reasonable attempts to provide notice to victims affected by the disclosure of information; and (ii) grantees and subgrantees shall take steps necessary to protect the privacy and safety of the persons affected by the release of the information. (D) Information sharing (i) Grantees and subgrantees may share— (I) nonpersonally identifying data in the aggregate regarding services to their clients and nonpersonally identifying demographic information in order to comply with Federal, State, tribal, or territorial reporting, evaluation, or data collection requirements; (II) court-generated information and law enforcement-generated information contained in secure, governmental registries for protection order enforcement purposes; and (III) law enforcement-generated and prosecution-generated information necessary for law enforcement and prosecution purposes. (ii) In no circumstances may— (I) 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 the grantee or subgrantee; (II) 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. (E) Statutorily mandated reports of abuse or neglect Nothing in this section prohibits a grantee or subgrantee from reporting suspected abuse or neglect, as those terms are defined and specifically mandated by the State or tribe involved. (F) Oversight Nothing in this paragraph shall prevent the Attorney General from disclosing grant activities authorized in this Act to the chairman and ranking members of the Committee on the Judiciary of the House of Representatives and the Committee on the Judiciary of the Senate exercising Congressional oversight authority. All disclosures shall protect confidentiality and omit personally identifying information, including location information about individuals. (G) Confidentiality assessment and assurances Grantees and subgrantees must document their compliance with the confidentiality and privacy provisions required under this section. 1 ________________________________________________________________________ As the duly authorized representative of the applicant, I hereby acknowledge that the applicant has received notice that if awarded funding they will comply with the above statutory requirements. This acknowledgement shall be treated as a material representation of fact upon which the Department of Justice will rely if it determines to award the covered transaction, grant, or cooperative agreement. Charles K. Windes, Jr. Chairman ________________________________________________________________________ Typed Name of Authorized Representative Title Telephone (850) 689-5050 Number_____________________________________ ________________________________________________________________________ Signature of Authorized Representative Date Signed Okaloosa County Board of County Commissioners ________________________________________________________________________ Agency Name 2