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Confidentiality
Overview
Effective Date: 04/12/2001
Revised: 02/01/2005
There is a compelling need to give strong privacy protection to people
who are at risk for, seek, are currently, or have been in treatment for
alcohol and other drug addictions. Without assurances that this information
will remain confidential, many individuals will not seek or stay in lifesaving
treatment and prevention programs out of fear that the highly personal
and stigmatizing information may be disclosed and have damaging consequences
to their personal, family and/or working lives.
Accordingly, confidentiality rules require an individual's specific written
consent to authorize most disclosures of alcohol or drug patient-identifying
information. At the same time, the rules recognize that there are some
clearly definable (though narrowly limited) circumstances and/or exceptions
in which confidential information may be disclosed without an individual
patient's consent.
By the nature of their work, DRI employees will know or have access to
information concerning clients and agency matters which must be held in
the strictest confidence. Because of this, all DRI personnel are responsible
for protecting the confidentiality and privacy of persons in treatment.
Releasing Client Information
Effective Date: 04/12/2001
Revised: 02/01/2005
Except in very special circumstances (outlined below), no client information
can be released without a completed Release of Information Form signed
by the client specifically allowing information to be shared with the inquiring
party or organization. In most cases, this will require multiple forms.
If a program receives a request for a disclosure of an individual's records
that is not permitted under the regulations, it must refuse to make the
disclosure, and must be sure to do so in a way that does not reveal that
the individual in question has ever been diagnosed or treated for an alcohol
or drug problem. An appropriate response to such an inquiry is: "Federal
law prohibits me from disclosing that information." The program can
give inquiring parties copies of the regulations and explain that they
restrict disclosure of alcohol and drug abuse patient records, as long
as the program does not affirmatively identify a particular individual
as a patient whose records are confidential. (NOTE: While Federal law does
permit a program to say that the subject of an inquiry is not and never
has been a patient, DRI still chooses to give the response that "Federal
law prohibits me from disclosing that information." A pattern of responding
to requests for information by saying either "That individual is not
a patient" or "Federal law prohibits an answer" will quickly
make clear to the inquiring person/agency that the latter answer means "yes.")
Exceptions
Although the general rule is that patient-identifying information cannot
be revealed, Federal regulations set out a number of conditions permitting
limited disclosures upon client consent and a very few circumstances in
which disclosures may be made whether or not the client consents. Each
condition permitting disclosure has its own specific requirements and limitations,
all of practical significance. In general, the exceptions to the confidentiality
regulations fall into nine categories:
1) Written Consent: Has the client executed a proper consent form for the
proposed communication?
2) Internal Communications: Is the proposed communication to be made to
other staff of the program, or to an individual or entity with direct administrative
control over the program?
3) No Patient Identifying Information: Can the proposed communication be
made without revealing that the person the disclosure concerns is or was
a client, or an alcohol or drug abuser?
4) Medical Emergency: Is the proposed information needed to respond to
a medical emergency?
5) Court Order: Is the proposed communication authorized by a valid court
order?
6) Crime at Program/Against Program Personnel: Does the proposed communication
concern a crime or a threatened crime on the premises of the program or
against program personnel?
7) Research/Audit and Evaluation: Is the proposed communication for purposes
of research or part of an audit or an evaluation of a program's activities?
8) Child Abuse/Neglect: Does the proposed communication involve the reporting
of child abuse or neglect?
9) QSOA: Will the proposed communication be made pursuant to a Qualified
Service Organization Agreement?
If the answer to all the above questions is "no," then the proposed
communication cannot be made. If, on the other hand, the answer to one
of the questions is "yes," the situation may permit a disclosure
if certain conditions are met and certain procedures followed.
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