Confidentiality:

In your work with Community Connections, you will likely be exposed to information regarding students participating in the program and their families that is considered confidential in nature.

In recognition of the Family Educational Rights and Privacy Act (FERPA), the Community Connections program expects all employees and contracted service providers to protect all personally identifying information and/or information considered confidential that pertains to individuals participating in the program.

- FERPA defines confidential information as information containing:

§ The student’s name;

§ The name of the student’s parent or other family member;

§ The address of the student or student’s family;

§ A personal identifier, such as the student’s social security number or student number,

§ A list of personal characteristics that would make the student’s identity easily traceable; or

§ Other information that would make the student’s identity easily traceable.

If you are privy to any information as described above, you are bound by this agreement to not share that information with anyone outside the program. In addition, you are agreeing not to discuss this information with program staff in a frivolous way.

Violating the confidentiality rights of a student is a civil crime placing liability on the institution and the person sharing the information.

Mandated Reporting:

Everyone working for Community Connections is a mandated reporter. All cases of suspected abuse or neglect of children must be reported. This includes physical abuse, sexual abuse, emotional abuse, or neglect (lack of food, hygiene, or other basic care.) Discuss making a report with your supervisor or with the Community Connections Director. To make a report call the Barre District Office at 479-4260 or 1-800-649-5285.

I have received information about confidentiality and about mandatory reporting and I understand my responsibilities concerning these issues.

____________________________ _________________________

Community Connections Staff or Contracted Service Provider Representative (signature) (signature)

Date: ______________________ ____________________________

(print name)