REQUIRED 2013 Updated Survey Packet Training

Transcription

1 REQUIRED 2013 Updated Survey Packet Training PRIVACY A ND SECURITY TRAINING WEBINAR SEPTEMBER 1 9TH, 2013 M E L A N I E M I T R O S, P H D D I R E C T O R, A Z L W I V I R G I N I A R O D R I G U E Z T - T R A I N E R, Y C C H S

2 Overview The Administration for Community Living (ACL) underwent extensive Office of Management and Budget (OMB) and Institutional Review Board (IRB) review processes to ensure that the proposed CDSME Program data collection forms and procedures met the necessary standards. Use of forms is now a requirement for ACL-Administration on Aging (AoA) funded states. AZ is a funded state. Start transitioning now; required to be fully transitioned by January 1, 2014 Must train personnel and start using updated forms by 1/1/14 ** This 30 minute webinar will provide the required training with the test module ed following the webinar.** 2

3 Tips for Evaluation Paperwork 3

4 Updated Evaluation Tools 4 About This Survey Packet Data Collection Cheat sheet Workshop Information Form Facilitator Non- Disclosure Agreement Welcome Letter Consent Letter Attendance Log Participant Survey Pre and post Workshop Tracking Form Submitted with final paperwork Workshop Cover Sheet Submitted with other workshop materials

5 Workshop Information Form Without this form we will not know a workshop is going to happen or is in progress Please complete online under forms tab What do I need to know to fill it out? Location Times/Dates Session 0 Licensing information Registration contacts 5

6 About this Survey Packet 6 Overview of all the forms included in the Survey Packet For each Form Description Purpose How to use

7 Welcome and Consent Letters Welcome Letter REQUIRED to read aloud If necessary due to challenges, may be handed to participants Explains how participant privacy is protected and why data is being collected (the evaluation process) For information purposes only Consent Letter Without this letter signed, no data will be submitted! Even data that is submitted is shredded without a consent! New letters include a space for printed name REQUIRE witness signature (faciliator not reading welcome letter or another workshop participant) 7

8 Facilitator Non-Disclosure Agreement New Form Must be filled out prior to workshop start One agreement per facilitator Substitutes must also sign Similar language to what is included in Leader/Trainer & Confidentiality Agreements 8 Replaces the Confidentiality Agreement

9 Attendance Log Names on attendance log must correspond with names on surveys and consent forms Can use a nickname Filled out by facilitators Must be legible 9 X for Present A for Absent

10 Pre and Post Surveys 10 Four pages Post survey includes feedback questions May be copied double- sided Filling in the Shaded box Check to make sure survey is completed Currently using the same PRE and POST survey for all English curriculums (CDSMP, Arthritis, Diabetes)

11 6. Has a health care provider ever told you that you have any of the following chronic conditions? Alzheimer s or Related Dementia Chronic Pain Multiple Sclerosis 7. During the past year did you provide regular care or assistance to a friend or family member who has a long-term health problem or disability? Yes No 8. Are you limited in any way in any activities because of physical, mental, or emotional problems? Yes No 10. What is the highest grade or year of school you completed? Some elementary, middle, or high school High school graduate or GED Some college or technical school College 4 years or more Changes to Pre Surveys 11

12 Workshop Cover Sheet Submitted with the Attendance Log and PRE & POST surveys at the end of a workshop Within 2 weeks List substitute facilitators Indicate type of workshop Explain missing or excluded paperwork Use the checklist on page 2 12

13 Workshop Tracking Form Useful for keeping track of participant s paperwork Optional Does not need to be submitted to Institute 13

14 Incident Report Form Only needed if an incident occurs during a workshop 14 Please follow your organizations protocol and submit a copy to Institute AZLWI has an example policy Workshop Site Form would help if an incident occurred. Provided in front, sheet protector of LL/MT Manual

15 Privacy and Security Basics for Survey Collection 15 T R A I N I N G M O D U L E T O B E C O M P L I A N T W I T H A D M I N I S T R A T I O N F O R C O M M U N I T Y L I V I N G R E Q U I R E M E N T S F O R F E D E R A L L Y F U N D E D S T A T E S

16 Training for Survey Collection Overview Purpose of the Privacy Act Primary Features of the Act Who Needs Privacy Training? Master Trainers and Lay Leaders Program Coordinators and Data Collection/Data Entry Personnel Types of Information Protected by the Act Disclosure Safeguarding, Transporting and Disposing of PII Roles and Responsibilities Test Questions Certificate 16

17 Privacy Act of 1974 Public Law (5 U.S.C.A. 552a) 17 Purpose: to protect records that can be retrieved by personal identifiers such as a name, social security number, or other identifying number or symbol. The act was created in response to concerns about how the use of computerized databases might impact individuals' privacy rights. requires government agencies to show individuals any records kept on them requires agencies to follow "fair information practices," when gathering and handling personal data. places restrictions on how agencies can share an individual's data with other people and agencies. lets individuals sue the government for violating of these provisions /

18 Who Needs to be Trained? If your work involves the management of sensitive information, PII (Personally Identifiable Information), or protected health information, you need to ensure you are taking precautions to protect it from unauthorized access/disclosure, theft, loss and improper disposal. Anyone who is involved in the collection, handling, and/or data entry of PII on individuals participating in workshops. Including: Employees, Managers, Supervisors, Coordinators, Master trainers (MTs), and Lay leaders (LLs) And Volunteers 18

19 Types of Information Covered by the Privacy Act 19 Sensitive: if the loss of confidentiality, integrity, or availability could be expected to have a serious, severe or catastrophic adverse effect on organizational operations, organizational assets or individuals. Protected Health Information: Individually identifiable health information that relates to a person s past/present/future physical/mental health, health care received, or payment.

20 Information Protected by the Privacy Act 20 PERSONALLY IDENTIFIABLE INFORMATION (PII) Home address Home telephone number Complete date of birth Personal medical information Social Security Number (including last four digits of SSN) Personal/private information (if the information can uniquely identify the individual) Photographs Education records Financial transactions Employment history

21 Information Protected by the Privacy Act PERSONALLY IDENTIFIABLE INFORMATION (PII) 21 "the term Personally Identifiable Information means any information about an individual maintained by an agency, including, but not limited to, education, financial transactions, medical history, and criminal or employment history and information which can be used to distinguish or trace an individual s identity, such as their name, social security number, date and place of birth, mother s maiden name, biometric records, etc., including any other personal information which is linked or linkable to an individual.

22 Safeguarding PII PII must always be treated as FOR OFFICIAL USE ONLY and must be marked accordingly. This applies not only to paper records but also includes , faxes, etc., which must contain the cautionary marking FOR OFFICIAL USE ONLY ). 22 All records containing PII should be stored in locked filing cabinets or other secure containers to prevent unauthorized access. Electronic records must be password protected and be transferred via encrypted .

23 Transporting PII 23 Hand Carrying Use a Cover sheet to shield contents Using Mail: PLEASE USE! Use manila or white envelopes Mark the envelope to the attention of the authorized recipient Never indicate on the outer envelope that it contains PII Using WE WILL NOT ACCEPT!! Password protect personal data placed on shared drives, the Internet or the Intranet Use encrypted Do not send PII to a personal, home or unencrypted address Announce in the opening line of the text (NOT the subject line) that FOUO information is contained

24 Disposing of PII A disposal method is considered adequate if it renders the information unrecognizable or beyond reconstruction. Disposal methods may include: Burning Melting Chemically decomposing Pulping Pulverizing Shredding Mutilating Degaussing (erasing from magnetic field or disc) Deleting/Emptying Recycle Bin 24

25 Your Role and Responsibility 25 Take privacy protection seriously Respect the privacy of others Ensure messages, faxes and s that contain personal information are properly marked and is encrypted Make sure you have consent forms in place for PII Don t share PII with individuals who are not authorized Have appropriate transfer, storage and disposal protocols in place for PII Do not PII to personal, home or unencrypted accounts

26 Your Role and Responsibility Advise all Program Participants of their right to consent or refuse use of data about them Provide each person with a blank copy of the consent form If a participant initially consents, but changes their mind during the workshop, destroy the original form and replace with a new form indicating refusal to consent Collect Participant Consent Forms and maintain in a secure, locked container until transfer to data entry location Maintain hard copies of Participant Consent Forms in a secure, locked storage area for 3 years after grant end Electronically scanned copies must be stored in a secure, password-protected database for 3 years after grant end 26

27 Your Role and Responsibility 27 All individuals involved in providing workshops must sign Non-Disclosure Agreements All individuals involved in data collection, data transfer and/or data entry must sign Non-Disclosure Agreements The Non-Disclosure Agreement has replaced our Confidentiality Agreement. Non-Disclosure Agreements should be maintained for 3-years after the end of the grant and stored by the state leader or the state s designee for data collection/data entry (AZLWI)

28 Master Trainers and Lay Leader Role 28 Use the CDSME Program Group Leader Script at a Class Zero pre-session or at the start of Session 1 and with any new participants who start at Session 2 The script explains why participant data is being collected and how it will be kept secure Emphasize that completing the survey is voluntary Individuals may skip any questions they do not want to answer Individuals may choose to not complete the Survey, but they can still participate in the program Collect consent forms and surveys from individuals who sign consent forms Make sure the consent form has a WITNESS Signature Store forms in securely, sealed envelope and mail to AZLWI upon workshop completion

29 Program Coordinator/Data Entry Roles 29 Store completed forms in a secure, locked cabinet when not in use AZLWI will enter data into secure, password protected database, including the CDSME National database Destroy participant data forms after data entry Hard copies of participant consent forms MUST be stored in a secure, locked cabinet for a minimum of 3 years after grant end Electronically scanned copies MUST be stored on a secure, password protected site for a minimum of 3 years after grant end

30 Test Questions 30 P L E A S E G O T O T H E W U F O O S U R V E Y T O C O M P L E T E T H E T E S T A N D R E C E I V E Y O U R C E R T I F I C A T E O F C O M P L E T I O N. H T T P S : / / G V A H E C. W U F O O. C O M / F O R M S / Z 7 R 5 Q 9 /

31 Test Question #1 1.Information about an individual that is unique, or identifies or describes him or her (such as Social Security Number, medical history, date of birth, home address) is called: 31 a. Interesting b. Record c. Data d. Personally Identifiable Information

32 Test Question # 2 2. Disposal methods may include all except: 32 a. Burning b. Shredding c. Tearing in half and putting in the garbage can d. Melting

33 Test Question #3 3. The Welcome Letter/Group Leader Script: 33 a. Describes what participants will learn in the workshop b. Requests participants to share their birth date, address and sex c. Explains how participant privacy is protected and why data is being collected d. Emphasizes that participants are required to complete all survey forms

34 Test Question #4 4. Signed Participant Consent Forms must be maintained for 34 a. 36 months b. 60 months c. 3 years after the grant period ends d. The same length of time as tax return records are kept

35 NOW Complete Survey 35 P L E A S E G O T O T H E W U F O O S U R V E Y T O C O M P L E T E T H E T E S T A N D R E C E I V E Y O U R C E R T I F I C A T E O F C O M P L E T I O N. H T T P S : / / G V A H E C. W U F O O. C O M / F O R M S / Z 7 R 5 Q 9 / Y O U W I L L A L S O R E C E I V E T H I S L I N K I N T H E F O L L O W - U P E M A I L 1 H O U R A F T E R T O D A Y S W E B I N A R.

36 Questions? 36

37 Thank You! 37 Melanie Mitros, PhD Director, AZLWI Direct: , x 117 mmitros@azlwi.org Virginia Rodriguez T-Trainer, Program Coordinator Yavapai County Community Health Services virginia.rodriguez@yavapai.us (928)