Comments
Needed Now
As reported in a December 20, 2007 PCPA Alert, the Department of
Health (DOH) is moving forward with proposed drug and alcohol (D&A) confidentiality
regulation changes – 4 PA Code 255.5. The proposed regulation changes
were published in the December 15, 2007 Pennsylvania Bulletin (www.pabulletin.com/secure/data/vol37/37-50/37_50_prm.pdf).
There is a 30- day comment period. It is crucial that DOH receive comments on proposed changes. Please carve out some time to send comments directly from your agency. Time is running out.
Reminder
1. The current regulations do not allow the provider to share information outside the realm of the “five elements.” The 255.5(b) regulations make it difficult to get appropriate approvals/authorizations from insurance companies and managed care organizations for higher levels of care, continued care, and appropriate medications even with client support and informed consent. The information most often needed included co-occurring issues, vital signs, and the medications the client was taking. Providers have been put between a rock and a hard place – either share what needs to be shared (with the client’s consent) to get the needed services approved and risk citation by licensing or not share the information and have services denied.
2. The current regulations also make it difficult to work with other important partners in the client’s recovery process such as the child welfare system, the Social Security Administration, and the criminal justice system, particularly probation and parole. The current regulations have made it difficult for providers to work in partnership with other important entities to increase the potential for treatment success. Even sharing positive, supported information has been prohibited.
These primary issues outlined above are addressed by the proposed changes. The proposed changes will expand the amount of drug and alcohol treatment information that may be disclosed to third party payers while still restricting the release of personal information. The changes also open up, with the clients consent, the ability to work with other important partners.
Clarification
The December 20 PCPA Alert: It is important to clarify that if the
client is receiving co-occurring services the provider can and should have
a common treatment plan and one medical record. Access to the records of clients
that are receiving only D&A services must be restricted according to other
state and federal regulations.
