This curriculum meets or exceeds the criteria in compliance with Section 2.013, Texas Family Code. Specifically, the curriculum offered will be a minimum of eight hours and include instruction in:
(1) Conflict management;
(2) Communication skills; and
(3) The key components of a successful marriage

In addition, the curriculum offered meets or exceeds the requirements as stipulated
by statute provides the skills-based and research-based curricula of:
(1) The United States Department of Health and Human Services healthy marriage initiative;
(2) The National Healthy Marriage Resource Center;
(3) Criteria developed by the Health and Human Services Commission; or
(4) Other similar resources.


The services offered will be conducted by instructors trained in this skills-based and research-based marriage preparation curriculum.
HHSC determines if the curriculum proposed by the provider meets the statutory requirements. HHSC has no authority over the marriage license discount. Similarly, HHSC has no authority to take adverse action against any provider who refuses to educate individuals based on the provider's religious belief.
______________________________________________________________________________

Health and Human Services

SECURITY AND PRIVACY AGREEMENT (SPA)

The purpose of this agreement is to help you understand your duties regarding confidential information.

You will be required to reaffirm your understanding of these duties on a periodic basis. As a volunteer using HHS Systems with access to what this agreement refers to as "confidential information", it is important that you understand the requirements for protecting this information. Confidential information is valuable, sensitive and is protected by law as well as HHS policies. Confidential information includes the following:

• Any information by which the identity of a client can be determined, either directly or indirectly
• Employees, contractors, volunteers, personal information such as home addresses, home phone numbers, social security numbers, etc.
• Patient/client such as records, conversations, admittance information, diagnosis, prognosis, treatment plan, financial information, etc.
• HHS information such as financial information, internal reports, memos, contracts, peer review information, communications, proprietary computer software, etc.
• Third party information such as vendor information, etc.
• Any information (patient or otherwise) that is classified confidential by federal or state law and Health and Human Service (HHS) standards.
• You acknowledge you are not a Business Associate of HHSC for HIPAA related issues and acknowledge that you acting on behalf your clients and not on behalf of HHSC.

The intent of these laws and policies is to assure that confidential information will remain protected and used only as necessary to accomplish your organization's mission. As a user of HHS systems you may have access to some or all of this confidential information through a computer system or through your associated activities with HHS Systems. You are required to conduct yourself in conformance to applicable laws and HHS policies governing confidential information. Your principle obligations in this area are outlined below. The violation of any of these duties will subject you to actions which might include, but is not limited to, termination of access privileges, and/or legal liability.

Accordingly, as a condition of and in consideration of your access to confidential information, you agree that:

1. You will use confidential information only as needed to perform legitimate duties. This means, among other things, that:

• You will only access confidential information for which you have a need to know; and
• You will not in any way divulge, copy, release, sell, loan, review, alter, or destroy any confidential information except as properly authorized within the scope of your activities; and
• You will not misuse confidential information or carelessly handle confidential information.

2. You will safeguard and will not disclose your password or any other authorization you have that allows you to access confidential information, except as permitted by law.

3. You acknowledge that you will receive and will be required to use a personal security identification code (User ID and Password) to gain access to and to use HHS Systems. Further you agree that the security identification code provided will only be used by you, and that you accept responsibility for all activities undertaken making use of your User ID/password and other authorization. If you suspect your personal security code has been compromised, you shall:

• Change your personal security identification code immediately
• Notify your supervisor
• Notify HHS' Chief Information Security Office through the HHS Privacy Office

4. You will report activities by any other individual or entity that you suspect may compromise the confidentiality, integrity or availability of confidential information. Reports are made in good faith about suspect activities and will be held in confidence to the extent permitted by law, including the name of the individual reporting the activities.

5. You understand that your obligations regarding HHS information under this Agreement will continue after termination of your association with HHS or HHS applications.

6. You understand that your privileges hereunder are subject to periodic review, revision, and if appropriate, renewal.

7. You understand that you have no right or ownership interest in any confidential information referred to in this Agreement. HHS may revoke your access code or other authorized access to confidential information.

8. You will, at all times, safeguard and retain the confidentiality, integrity and availability of confidential information.

9. You understand that your failure to comply with this Agreement may also result in the loss of access privileges to HHS applications.

By completing this form and signing below, you are providing the requested information to HHS in order to gain access to secured systems. This information will not be shared in any manner or for any reason not permitted by the laws of the State of Texas. You may, in writing, request copies of this information at any time and may request that any information in error be corrected.
______________________________________________________________________________

I hereby certify that all of the above information is true and correct, including the description of the Twogether in Texas Healthy Marriage services that will be offered by as a Twogether in Texas Healthy Marriage Provider. I understand that my participation in the Twogether in Texas Healthy Marriage program may be terminated in the event that HHSC determines any of the information I have provided is false or incorrect.

Name :  
Title :  
Telephone number :  
e-mail :  

I accept the certification
I do not accept the certification