HCA Privacy Notice Long Form Template - Workers

PRIVACY NOTICE TEMPLATE – WORKERS
LONG/COMPLETE FORM

Respecting the privacy of our workers is an essential part of the West Virginia Executive Branch Privacy Program. The <DEPARTMENT/AGENCY> is committed to ensuring proper handling of all personal information collected or generated in connection with your employment relationship with us.  This personal information may include, but not be limited to, the following: full name, maiden name (if applicable), address, email address, telephone number, date of birth, social security number, emergency contact information, direct deposit information, spouse name, spouse date of birth, beneficiary designation (including beneficiary name, address, social security number, date of birth, and relationship to employee), and dependent information (including dependent name, address, date of birth, social security number, and relationship to employee).  This notice explains our practices with regard to worker information.

1.         The WV Privacy Policies protect your personal information no matter how it is processed or where it is stored.  

2.         We collect, process and transfer personal information about our workers through automated and paper-based data processing systems.  We have established routine processing functions (such as processing for regular payroll and benefits administration).  We also process worker information on an occasional or ad hoc basis (such as when an employee is being considered for a particular new position). All processing and transfers of personal information are subject to confidentiality and privacy safeguards as set forth in the Privacy Policies and applicable laws; all personal information will be appropriately secured. 

3.         We process worker information for the following purposes: (1) recruitment and staffing; (2) administration of compensation and benefit programs; (3) performance management and training; (4) advancement and succession planning; (5) legal compliance and risk management; (6) workplace management and reporting; (7) to protect WV, its workforce, and the public against injury, theft, legal liability, fraud or abuse; and (8) other legal and customary business-related purposes.

4.         We may process sensitive information if it is needed for business objectives or if it is required to comply with applicable law.  For example, we may process sensitive health information as needed to accommodate a worker’s disability.  Sensitive information will not be collected, processed or transferred, except where adequate privacy protection mechanisms are in place and after having first obtained your informed consent, if required by law.

You may object at any time to sensitive information being processed by contacting your Human Resources Manager.  We will try to find a reasonable accommodation to your objections, although if we cannot process your information you may be denied certain benefits.  

5.         The <DEPARTMENT/AGENCY> respects your concerns regarding disclosure of your social security number and collects it in accordance with Section 7 of the Privacy Act of 1974.  Disclosure of the number is required to facilitate transactions associated with your employment relationship with the <DEPARTMENT/AGENCY>, such as completion of the Employment Eligibility Verification Form I-9.  Failure to provide the number could be grounds for the <DEPARTMENT/AGENCY> to decline or terminate your employment. 

The <DEPARTMENT/AGENCY> is not requesting your social security number for its own uses.  It is requesting your social security number because third parties, such as the Department of Homeland Security, Internal Revenue Service, West Virginia State Tax Department, and West Virginia State Auditor’s Office, among others, have requested your social security number and the <DEPARTMENT/AGENCY> is assisting you in meeting their requirements or obtaining their services.  If you decide to disclose your social security number on their forms, it will be given to them and will be subject to their privacy policies governing use and disclosure of social security numbers.  The <DEPARTMENT/AGENCY> cannot be responsible for their use and disclosure of your social security number.

6.         We will disclose your personal information only to or because of the following:  (a) other West Virginia and Federal agencies, for the purposes listed above; (b) out-of-state agencies as requested by you; (c) to data processors, who use the data only for our purposes, (d) to those companies that provide benefits and services to you, (e) where required by law, or (f) where permitted by law, such as with your consent or in the event of an emergency. 

7.         Your personal information is maintained in your personnel file in the Human Resources Office at the <DEPARTMENT/AGENCY> and may be in paper and electronic form.  Maintenance of such information is in addition to the disclosure of the information to certain agencies or entities as described in Sections 5 and 6 above.  You may reasonably access and update the personal information pertaining to you that is on file with the <DEPARTMENT/AGENCY>.  You can exercise this right by contacting the <DEPARTMENT/AGENCY> Human Resources.  Please note that you have shared responsibility with regard to the accuracy of your personal information.  Please let us know of any changes to your personal information.

8.         If you believe that your personal information is not handled in accordance with the applicable law or the WV Privacy Policies, you may submit a complaint to your Human Resources Manager.  We will investigate the complaint, with the support of the Privacy Officer.

9.         This notice provides basic information about WV’s Privacy Policy, potential uses of personal information, and your privacy rights.  Should you have additional questions, you may contact your Human Resources Manager or Privacy Officer:

                        Human Resources Manager

                        NAME & CONTACT INFORMATION

                        Privacy Officer

                        NAME & CONTACT INFORMATION