Confidentiality and the HIPAA

1
Confidentiality and the HIPAA Related Issues
for Mental Health in the Job Corps Setting

• Valerie Cherry, Ph.D., Principal Mental Health
  ConsultantDon Kraybill, Ph.D., Region
  2/Philadelphia Mental Health Consultant
• National Health and Wellness Conference
• May 7, 2003

2
Introduction to Session

• This interactive question and answer format will
  assist participants in the process of HIPAA
  compliance
• Emphasis will be given to gaining knowledge of
  the law as a guide for clinical decision making
• The session will address a wide variety of issues
  related to record keeping, informed consent,
  scope of practice, as well as security and
  transaction rules

3
Section I HIPAA and State Law

1. What are the relationships between HIPAA and
   state laws?

4
Section I HIPAA and State Law

1. Under what conditions does HIPAA preempt state
   laws?

5
Section I HIPAA and State Law

1. What happens when state law conflicts with HIPAA?

6
Section I HIPAA and State Law

1. What happens when state law and HIPAA are not
   comparable?

7
Section I HIPAA and State Law

1. What is the HIPAA state-by-state preemption
   analysis?

8
Section I HIPAA and State Law

1. What are the relationships between HIPAA and the
   Code of Ethics?

9
Section I HIPAA and State Law

1. State law and HIPAA.

10
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. What is the HIPAA Privacy Rule?

11
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. How is CMHC/patient privacy protected?

12
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. Can two sets of records be maintained?

13
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. What is the general idea of psychotherapy notes?

14
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. What is included in the psychotherapy notes?

15
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. What is excluded from the psychotherapy notes?

16
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. Can I see an example of the two types of
   notations?

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Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. Do individuals have a right to review their
   psychotherapy notes?

18
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. Can psychotherapy notes be shared with other
   treating clinicians?

19
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. Can a Job Corps student authorize disclosure of
   the psychotherapy notes?

20
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. Can psychotherapy notes be disclosed without
   student authorization?

21
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. What is the 1996 Supreme Court decision (Jaffee
   v. Redmond) all about?

22
Section II The Privacy Rule, Records,
Psychotherapy Notes, and Students Access to
Records

1. What about re-disclosure of psychotherapy notes?

23
Section III Consents, Authorizations,
Disclosures, and Releases

1. What do I need to know about consents and
   authorizations?

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Section III Consents, Authorizations,
Disclosures, and Releases

1. What are the issues around authorizations?

25
Section III Consents, Authorizations,
Disclosures, and Releases

1. What is the difference between a consent and an
   authorization?

26
Section III Consents, Authorizations,
Disclosures, and Releases

1. When is neither consent nor authorization
   required?

27
Section III Consents, Authorizations,
Disclosures, and Releases

1. What about HIPAA Notice of Privacy Practices?

28
Section III Consents, Authorizations,
Disclosures, and Releases

1. What about students rights to request privacy?

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Section III Consents, Authorizations,
Disclosures, and Releases

1. If I already have an informed consent, do I need
   an additional HIPAA consent form?

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Section III Consents, Authorizations,
Disclosures, and Releases

1. What is the difference between use and
   disclosure?

31
Section III Consents, Authorizations,
Disclosures, and Releases

1. What about disclosure where there is a threat or
   danger?

32
Section III Consents, Authorizations,
Disclosures, and Releases

1. What rights do Job Corps students have to access
   their records?

33
Section III Consents, Authorizations,
Disclosures, and Releases

1. When do Job Corps students not have the right to
   access their records?

34
Section III Consents, Authorizations,
Disclosures, and Releases

1. Under what circumstances may Job Corps students
   be denied access to their records?

35
Section III Consents, Authorizations,
Disclosures, and Releases

1. What about minors records?

36
Section III Consents, Authorizations,
Disclosures, and Releases

1. What about consultation?

37
Section III Consents, Authorizations,
Disclosures, and Releases

1. Can a CMHC disclose records created by other
   providers?

38
Section III Consents, Authorizations,
Disclosures, and Releases

1. What are the considerations surrounding substance
   abuse disclosures?

39
Section III Consents, Authorizations,
Disclosures, and Releases

1. What is the need-to-know requirement?

40
Section III Consents, Authorizations,
Disclosures, and Releases

1. What is the minimum necessary requirement?

41
Section III Consents, Authorizations,
Disclosures, and Releases

1. What is HIPAAs Security Rule?

42
Section III Consents, Authorizations,
Disclosures, and Releases

1. What are the administrative procedures of the
   Security Rule?

43
Section III Consents, Authorizations,
Disclosures, and Releases

1. What are the differences between privacy and
   Security Rules?

44
Section IV Security and Transaction Rules
Office, Computers, Internet, etc.

1. How shall I physically arrange my office so it is
   HIPAA compliant?

45
Section IV Security and Transaction Rules
Office, Computers, Internet, etc.

1. What about general computer protection?

46
Section IV Security and Transaction Rules
Office, Computers, Internet, etc.

1. What about e-mail security?

47
Section IV Security and Transaction Rules
Office, Computers, Internet, etc.

1. What about faxes?