Ethics,%20Confidentiality,%20and%20HIPAA! - PowerPoint PPT Presentation

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Ethics,%20Confidentiality,%20and%20HIPAA!

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Several rules apply to participants in Drug treatment courts. ... Is your Drug Court a HIPAA Covered Entity? ... Joe and Mary are in your drug court. ... – PowerPoint PPT presentation

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Title: Ethics,%20Confidentiality,%20and%20HIPAA!


1
Ethics, Confidentiality, and HIPAA!
  • 2006 ASAC
  • Drug Court Confidentiality
  • FMJ Multi- County
  • November 8, 2006

2
Confidentiality/Privacy
  • Several rules apply to participants in Drug
    treatment courts.
  • 42 CFR Part 2 The alcohol and substance abuse
    treatment confidentiality rule.
  • HIPAA New federal rules covering all health
    related information.

3
42 U.S. Code 290dd42 CFR Part 2
  • First issued 1975, revised 1987
  • Designed to help deal with the stigma of
    addiction.
  • Requires notification of confidentiality, consent
    forms, prohibition of redisclosure
  • Im sorry I cannot acknowledge whether someone
    is or isnt in our treatment program.

4
What 42 CFR Covers
  • Any program or activity relating to substance
    abuse education, prevention, training, treatment,
    rehabilitation or research which is directly or
    indirectly assisted by any department or agency
    of the United States.

5
HIPAA
  • Health Insurance Portability and Accountability
    Act of 1996
  • Designed to ensure maintenance of health
    insurance coverage when you change jobs.
  • Administrative simplification Healthcare
    processes becoming very complex look to
    standardize information make it easier.
  • Protect confidentiality and security of patient
    information

6
Is your Drug Court a HIPAA Covered Entity?
  • http//www.cms.hhs.gov/hipaa/hipaa2/support/tools/
    decisionsupport/default.asp

7
HIPAA vs. 42 CFR Part 2
  • The laws cover a lot of the same material.
  • Some points of difference more specific or more
    recent rule usually applies.
  • For the CD Treatment providers, in most cases the
    rules of 42 CFR Part 2 are more stringent
  • In several cases HIPAA wins.

8
Do These Laws Apply to Drug Court
Practitioners?How Do We Know They Apply?
9
Is the Drug Court Program a Treatment Program for
the Purposes of the Confidentiality Regulations
and Why?
10
General Rule of Disclosure
  • Treatment Programs may only release information
    or records that will directly or indirectly
    identify a drug court participant as a substance
    abuser or treatment patient
  • With a knowing and written consent from the
    participant, AND
  • Nine limited exceptions

11
How do You Obtain Written Consent from Your
Participants?
12
Elements of a Consent
  • Name of person or organization that may make the
    disclosure
  • Name or title of person (or organization) to whom
    disclosure may be made
  • Participants name
  • Purpose of the disclosure
  • How much and what kind of information may be
    disclosed
  • Participants signature
  • Date on which the consent was signed
  • Date, event, or condition upon which the consent
    will expire
  • (Consent cannot be revoked unless in the adult
    terminates Drug Court)

13
Consents
  • A proper consent can authorize all parties
    involved in the drug court to share information
    necessary to monitor treatment progress and
    compliance.
  • To be effective the consent form should be signed
    at the earliest possible time.
  • Judge, coordinator, probation, etc., should get
    consent and fax it to treatment before 1st
    appointment.

14
Requiring Consents
  • HIPAA prohibits a program from conditioning
    treatment on a patient signing a consent, but
  • The judge, probation/parole, child welfare can
    condition participation in the drug court program
    on the defendant signing the consent form.

15
Satisfying 42 CFR and HIPAA
  • HIPAA requires all consents to be revocable, but
  • HIPAA also allows for the use of an
    administrative order for information disclosure.
    Therefore,
  • Drug courts can pair their 42 CFR consent with a
    HIPAA administrative order and/or build HIPAA
    language into their consent

16
In Drug Court, is the consent really valid?
Arent defendants being coerced into giving their
consents?
17
Even without written consent, under what other
circumstances may you release information?
18
Permitted disclosures -no consent
  • Medical emergency
  • Crimes on the premises
  • Crimes against staff
  • Administration / qualified service programs
    working with drug court
  • Outside auditors, central registries and
    researchers
  • No re-disclosures unless permitted

19
Mandatory disclosure -no consent
  • State child abuse laws
  • A valid court order
  • State laws relating to cause of death
  • Duty to protect others, to warn of imminent,
    serious harm

20
What if your court clerk answers the telephone,
Good morning. Drug Court.Is this a violation
of the confidentiality laws?
21
Hypothetical
  • Joe and Mary are in your drug court. They have
    different primary counselors at different
    agencies. At a pre-staffing meeting of treatment
    providers, the counselors share the following
    information Marys counselor reports that Mary
    is thrilled because she and Joe are going to try
    to have a baby. Joes counselor reports that Joe
    is excited that he and Mary are trying to have a
    baby, but that although theyve begun having
    unprotected sex, hes unwilling to share with
    Mary that hes HIV positive.

22
Hypothetical
  • What ethical issues are presented?
  • What confidentiality issues are presented?
  • What difference, if any, would it make if the
    whole team had been given this information?
  • What difference, if any, would it make if Mary or
    Joe were underage?

23
HIPAA
  • HIPPA Study Guide and Test
  • Course Protecting Information Privacy
  • Employee ID Your Name
  • Course Code 12345
  • Web Site http//209.224.50.33
  • Please submit results to Coordinator to keep on
    file
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