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Acknowledgement of Notice of Statutory Requirement to Comply with the Confidentiality <br /> and Privacy Provisions of the Violence Against Women Act, as Amended <br /> (Victim Services Providers Only) <br /> Under section 40002(b)(2) of the Violence Against Women Act, as amended (42 U.S.C. 13925(b)(2)), <br /> grantees and subgrantees with funding from the Office on Violence Against Women are required to <br /> meet the following terms with regard to nondisclosure of confidential or private information and to <br /> document their compliance. By signature on this form, applicant for the STOP Grant acknowledges that <br /> they have notice that, if awarded funds,they will be required to comply with this provision, and will <br /> mandate that subgrantees, if any, comply with this provision, and will create and maintain <br /> documentation of compliance, such as policies and procedures for release of victim information, and <br /> will mandate that subgrantees, if any, will do so as well. <br /> (A) In general <br /> In order to ensure the safety of adult, youth, and child victims of domestic violence, dating violence, <br /> sexual assault, or stalking, and their families, grantees and subgrantees under this subchapter shall <br /> protect the confidentiality and privacy of persons receiving services. <br /> (B) Nondisclosure <br /> Subject to subparagraphs (C) and (D), grantees and subgrantees shall not-- <br /> (i) disclose, reveal, or release any personally identifying information or individual information collected <br /> in connection with services requested, utilized, or denied through grantees' and subgrantees' <br /> programs, regardless of whether the information has been encoded, encrypted, hashed, or otherwise <br /> protected; or <br /> (ii) disclose, reveal, or release individual client information without the informed,written, reasonably <br /> time-limited consent of the person (or in the case of an unemancipated minor,the minor and the <br /> parent or guardian or in the case of legal incapacity, a court-appointed guardian) about whom <br /> information is sought,whether for this program or any other Federal,State, or Tribal grant program, <br /> except that consent for release may not be given by the abuser of the minor, incapacitated person, or <br /> the abuser of the other parent of the minor.. <br /> If a minor or a person with a legally appointed guardian is permitted by law to receive services without <br /> the parent's or guardian's consent,the minor or person with a guardian may release information <br /> without additional consent. <br /> (C) Release <br /> If release of information described in subparagraph (B) is compelled by statutory or court mandate -- <br /> (i) grantees and subgrantees shall make reasonable attempts to provide notice to victims affected by <br /> the disclosure of information; and <br /> (ii) grantees and subgrantees shall take steps necessary to protect the privacy and safety of the <br /> persons affected by the release of the information. <br /> Washington State STOP Formula Grant Program Renewal Application for FFY 2019 22 <br /> 81 <br />