Transcript confidentiality

CONFIDENTIALITY
DEFINING CONFIDENTIALITY
• THE OBLIGATION OF PROFESSIONALS TO
RESPECT THE PRIVACY OF CLIENTS AND
THE INFORMATION THEY
PROVIDE.(HANDELSMAN)
• HAS ETHICAL AND LEGAL
RAMIFICATIONS.
• ONE LEGAL APPLICATION OF
CONFIDENTIALITY IS PRIVILEGED
COMMUNICATION.
• NEBRASKA STATUTES
PRIVILEGED COMMUNICATION
• THE LEGAL RIGHT WHICH EXISTS BY
STATUTE AND WHICH PROTECTS THE
CLIENT FROM HAVING HIS/HER
CONFIDENCES REVEALED PUBLICLY
FROM THE WITNESS STAND DURING
LEGAL PROCEEDINGS WITHOUT
HIS/HER PERMISSION. (SHAH)
• DOES NOT APPLY TO GROUP OR
FAMILY COUNSELING
LIMITS TO CONFIDENTIALITY
• DANGER TO SELF AND OTHERS
• CHILD ABUSE/VULNERABLE ADULT
ABUSE
• POSSIBLE NEED FOR
HOSPITALIZATION
• WHEN INFORMATION IS MADE AN
ISSUE IN A COURT ACTION
• WHEN CLIENT REQUESTS
INFORMATION TO BE RELEASED TO
THEMSELVES OR 3RD PARTY
LIMITS TO CONFIDENTIALITY
• DANGER TO SELF AND OTHERS
• CHILD ABUSE/VULNERABLE ADULT
ABUSE
• POSSIBLE NEED FOR
HOSPITALIZATION
• WHEN INFORMATION IS MADE AN
ISSUE IN A COURT ACTION
• WHEN CLIENT REQUESTS
INFORMATION TO BE RELEASED TO
THEMSELVES OR 3RD PARTY
OTHER ISSUES REGARDING
CONFIDENTIALITY
• DUTY TO WARN (TARASOFF)
• THE IMPORTANCE OF
DOCUMENTATION
• WORKING WITH HIV/AIDS CLIENTS
• WORKING WITH MINORS
• 42-CFR-PART 2
• HIPAA
STEPS TO PROTECT OTHERS
• AS IN ALL OTHER SITUATIONS, DISCUSS
THE ISSUE FULLY AND OPENLY WITH
CLIENTS.
• INFORM CLIENTS OF THE COUNSELOR’S
LEGAL RESPONSIBILITY TO WARN
OTHERS.
• INFORM YOUR SUPERVISOR OF THE
POTENTIALLY DANGEROUS SITUATION.
IF THERE IS NO SUPERVISOR, CONSULT
WITH ANOTHER PROFESSIONAL.
• NOTIFY THE PERSON WHO MIGHT BE
RESPONSIBLE FOR THE CLIENT OR
CONTACT THE POLICE.
STEPS TO PROTECT OTHERS
• NOTIFY THE INTENDED VICTIM.
• EXPLORE OTHER OPTIONS, WHICH
MAY INCLUDE COMMITMENT TO AN
APPROPRIATE PSYCHIATRIC FACILITY.
• FROM THE ACA LEGAL SERIES:
CONFIDENTIALITY AND PRIVILEGED
COMMUNICATION BY G.L. ARTHUR
AND C.D. SWANSON.
POINTS TO REMEMBER RE: 42-CFRPART TWO
• APPLIES TO FEDERALLY FUNDED
SUBSTANCE ABUSE TREATMENT
FACILITIES.
• INACTED TO PROTECT POTENTIAL,
CURRENT, AND PAST CLIENTS.
• RESTRICTS DISCLOSURE OF PATIENT
IDENTIFYING INFORMATION.
• VIOLATIONS INCLUDE FINES AND
POSSIBLE LOSS OF CERTIFICATION
AND/OR LICENSE.
EXCEPTIONS TO RESTRICTIONS:
• INTRA-AGENCY COMMUNICATION
• WRITTEN CONSENT OF CLIENT
• ANONYMOUS OR NON-PATIENT-IDENTIFYING
INFORMATION
• CRIMES ON PROGRAM PREMISES
• MEDICAL EMERGENCIES
• CHILD ABUSE/NEGLECT
• AUDIT
• COURT ORDERS (PUBLIC SAFETY
OUTWEIGHS PROTECTING PRIVACY)
HEALTH INSURANCE PORTABILITY AND
ACCOUNTABILITY ACT (HIPAA)
• FEDERAL LAW (1996) ENACTED TO
STRIKE A BALANCE TO PROTECT THE
PRIVACY OF PEOPLE WHO SEEK OUT
HEALTH CARE BUT STILL PERMITS
IMPORTANT USES OF INFORMATION.
• SPECIFIC TO ELECTRONIC
TRANSMISSION OF INFORMATION
HIPAA
• MUST OBTAIN UNCOERCED CONSENT TO
RELEASE OF INFORMATION FOR TREATMENT,
PAYMENT, AND HEALTH CARE OPERATIONS.
• RELEASE FORMS MUST BE SPECIFIC AS TO THE
NATURE OF INFORMATION BEING SENT AND FOR
WHAT PURPOSE.
• WHEN RECORDS ARE TRANSFERRED, MUST
TAKE STEPS TO ENSURE THAT THE RECIPIENT
ALSO PROTECTS THE PRIVACY OF THE CLIENT.
DEALING WITH SUBPOENAS
• DON’T IMMEDIATELY RESPOND
• CHECK WITH SUPERVISOR, LAWYER,
AND AGENCY POLICIES AND
PROCEDURES
• CONSULT WITH CLIENT AND CLIENT’S
LAWYER (WRITTEN CONSENT)
• INFORM COURT ABOUT THE NEED FOR
CONFIDENTIALITY
DEALING WITH SUBPOENAS
• IF YOU DECIDE NOT TO ANSWER
SUBPOENA OR TESTIFY YOU MUST
CONTACT JUDGE WHO WILL REVIEW
YOUR CONCERNS AND MAKE A
DECISION.
• NEVER IGNORE A SUBPOENA W/O
LEGAL COUNSEL.
• DOCUMENT YOUR PROCEDURE IN
DEALING WITH THE SUBPOENA.
(COTTONE;TARVYDAS)