42 CFR Part 2

42 CFR 2.14

MINORS

State law not requiring parental consent to treatment.

• Minors are legally allowed to seek treatment without an adult/guardian.
• Consent for disclosure of information may only be given by the minor who received treatment.

State law requiring parental consent to treatment.

• Both adult/guardian have to give consent for treatment.
• The minors decision to not receive treatment can be overruled if they show a lack of rational choice.
• Both the adult/guardian and the minor must consent for disclosure of information about treatment.

Duty to Warn

Limitations in

Sharing Information

42 CFR 2.14 - MINOR PATIENTS. (2005, October 1). Retrieved November 12, 2016, from https://www.gpo.gov/fdsys/granule/CFR-2005-title42-vol1/CFR-2005-title42-vol1-sec2-14/content-detail.html

The Tarasoff Case

• Poddar was stalking Tarasoff and had told his therapist about this plans.
• The therapist warned the police who questioned Poddar but never mentioned anything to Tarasoff.
• Tatiana Tarasoff was murdered by Prosenjit Poddar in 1969.

"About 12.5 percent of all emergency department visits across payers are due to mental health or substance abuse treatment needs."

(The Impact of 42 CFR Part 2 on

Care Coordination... 2016 )

Care Coordination

Many people with substance use disorders (SUD) have medical needs that are directly attributable from their addiction. Liver disease and pancreatitis are two common illness from an SUD. Patients must be cared for while still addressing their addiction. Their PCP needs to know about the SUD so they can monitor medications as well. SUD treatment providers need to know about the treatment that the PCP is giving.

"In ruling on the case of Tarasoff v. Regents of the University of California, the court determined that the need for therapists to protect the public was more important that protecting client-therapist confidentiality." (Vitelli., 2014 )

Vitelli, R. (2014, July 28). Revisiting Tarasoff. Retrieved November 12, 2016, from https://www.psychologytoday.com/blog/media-spotlight/201407/revisiting-tarasoff

The Impact of 42 CFR Part 2 on Care Coordination by Health Plans for Members with Substance Use Disorders. (2016, January). Retrieved November 12, 2016, from http://communityplans.net/Portals/0/Fact Sheets/The Impact of 42 CFR Part 2 on Care Coordination.pdf

42 CFR Part 2

Confidentiality for Substance Abuse Programs

Kimberley Zimmerman

HSE340

Dr. Stacy Haynes

Illegally Releasing

Information

Duty to Warn

"The duty to warn is the legal responsibility of health care providers to forgo their commitment to confidentiality when they determine that a patient is at risk of harming him- or herself or others." (Lasky., 2016)

"Violators of the regulations are subject to a

criminal penalty in the form of a fine of up to $500

for the first offense and up to $5,000 for each

subsequent offense. Violators that are licensed or

State certified (which would include virtually all

programs and their professional employees)

jeopardize their license or certification. The patients

concerned may also sue violators for unauthorized

disclosure."

Assessment Before Warning

The Car Accident

After being in a serious car accident an individual needed to be transported to the hospital. The paramedics that came to her aid were given information that the victim had previously struggled with depression. Based on the information that they were given, not pertaining to the accident, they but the accident victim in four point restraints. Rather than treating the immediate conditions, they acted on past conditions.

Is there a past history of violent behavior with the client?

Are there either relationship or work instability?

Is there a past history of mental illness in the client or family?

Does the client have negative emotions in response to treatment?

How are the clients social networks and living environments?

(Confidentiality of Patient Records for Alcohol and Other ... ,n.d.)

There are some cases where through the assessment it is decided that the risk is so high that the client needs to be admitted into a mental health facility.

Confidentiality of Patient Records for Alcohol and Other ... (n.d.). Retrieved November 12, 2016, from http://adaiclearinghouse.org/downloads/TAP-13-Confidentiality-of-Patient-Records-for-Alcohol-and-Other-Drug-Treatment-103.pdf

Lasky, J. (2016, January). Duty to Warn. Salem Press Encyclopedia of Health. Retrieved November 12, 2016,

Rolf, C. A. (2016). Actuarial risk assessment. Salem Press Encyclopedia Of Science, Retrieved November 12, 2016,