	Client Rights

Introduction

Administration and Management

Service Delivery Administration Standards

Service Standards

PA-CR 2: Confidentiality and Privacy Protections*

The agency protects the confidentiality of information about clients and assumes a protective role regarding the disclosure of confidential information.

Interpretation: The agency must carefully reconcile its policies, procedures, and practices with all applicable confidentiality laws and regulations including, but not limited to, laws and regulations governing information about youth involved with the juvenile justice system, mental health consumers, victims of domestic violence, drug and alcohol treatment, and HIV/AIDS.

The agency’s procedures must reconcile legal restrictions on the release of identifying information about clients with mandatory reporting and duty to warn requirements. Written procedures should include guidance to personnel in determining the degree of danger a person may pose to him or herself or to the community.

Adult Guardianship (PA-AG) programs must have procedures in place to ensure the decision to release confidential information is made in an ethical manner. See PA-AG 8.02 for more information on ethical decision-making. The level of client involvement in the decision to release confidential information will vary based on the court order and state law.

PA-CR 2.01

The agency informs the client, prior to his or her disclosure of confidential or private information, about circumstances when the agency may be legally or ethically permitted or required to release such information without the client's consent.

PA-CR 2.02

When the agency receives a request for confidential information about a client, or when the release of confidential information is necessary for the provision of services, prior to releasing such information, the agency:

determines if the reason to release information is valid;
obtains the client's informed, written authorization to release the information; and
obtains informed, written authorization from a parent or legal guardian, as appropriate.

Interpretation: In the context of this standard, “valid” means justifiable, legitimate, convincing, legally permissible, and in the best interest of the client.

The agency obtains legal counsel regarding the confidentiality of records and the conditions under which they may be subpoenaed. Unless otherwise required by law, authorization to release confidential information is not necessary where the request for information is pursuant to a subpoena. The agency seeks additional legal counsel, as necessary, when others seek person-identifying information about an individual or family, or when the release of confidential information is necessary for the provision of services.

When the client is a minor or an adult under the care of a guardian, the agency should follow any laws or regulations allowing or requiring the agency to obtain the authorization of clients' parents or legal guardians.

When permitted or required by law, regulation, or court order, confidential information may be released without the authorization of the client and legal guardian. However, the client and legal guardian should still be informed that the information will be released.

PA-CR 2.03

Informed, written consent is obtained from the client, or a legal guardian, prior to recording, photographing, or filming.

Interpretation: When required by law, consent may not be necessary. However, it is still expected that theagency inform clients prior to recording, photographing, or filming.

PA-CR 2.04

The release form for disclosure of confidential information includes the following elements:

the name of the person whose information will be released;
the signature of the person whose information will be released, or the parent or legal guardian of a person who is unable to provide authorization;
the specific information to be released;
the purpose for which the information is to be used;
the date the release takes effect;
the date the release expires, not to exceed 90 days from when authorization is given for a one time release of information, and not to exceed one year, or as the law or court order requires, when a contracted or cooperating service provider requires the release of information for ongoing service provision;
the name of the person or position to whom the information is to be released;
the name of the person or position within the agency who is providing the confidential information; and
a statement that the person or family may withdraw their authorization at any time.

Update: Added Third Interpretation - 06/01/10

Added Third Interpretation

Interpretation: When permitted or required by law, regulation, or court order, confidential information may be released without authorization of the person or legal guardian. In this case elements (b) and (i) will not apply. However, the agency should still inform the person and/or legal guardian that the information will be shared, as referenced in CR 2.01 and CR 2.02.

Interpretation: Blanket release forms signed by clients when service is initiated do not meet the requirements of this standard, except as put forth by federal regulation, for example, when making application to FEMA/DHS in a declared disaster.

Interpretation: Credit counseling agencies may provide a release at the initiation of service to allow for information sharing for the duration of the DMP, or as required by law.

Research Note: Research suggests that agencies with clear confidentiality policies and consent form requirements have increased collaboration among providers, consumers, and families. This increased collaboration can have a positive impact on the relationship between providers and family members and further open lines of communication for the future.

PA-CR 2.05

The agency offers a copy of the signed release form to the person or family authorizing the disclosure of confidential information and places a copy in the case record.

Interpretation: A copy of the completed release form should be offered to the person, and placed in the case record, even when it is permissible by law to release confidential information without the person's authorization and signature.

Interpretation: When there are concerns about the individual’s capacity to understand the confidential nature of the document, such as when the individual has been deemed incapacitated by the court, it may be inappropriate to provide the individual with a copy of the release form. Instead, the worker should include a copy of the release form in the case record and document reasons why the form was not provided.

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	PURPOSE: The rights and dignity of clients are respected throughout the agency.

RELATED FILES


	CONFIDENTIALITY An ethical and practice principle that requires the protection of information shared within a professional-client relationship. An organization that upholds confidentiality prohibits personnel from disclosing information about persons served without their written consent.


	PRACTICE Established actions or ways of proceeding in the regular performance of organizational duties. Policies and procedures often guide practice.


	CONSUMER The individual, family, group, or community that seeks or receives services.


	MANDATORY REPORTING The legal obligation to report specific forms of child abuse to a government authority when a person suspects that abuse has occurred. State laws outline specific reporting requirements for professionals if they have information related to public or private safety issues. For example, certain professionals are required to report to state authorities if they see evidence of child abuse or neglect, or have knowledge that someone is likely to be dangerous to themselves or others.


	PERSONNEL The body of employees and/or volunteers that carries out the organization's tasks under the organization's administration and/or supervision. This definition does not include foster parents who are specifically referenced in relevant standards


	COMMUNITY A specific group of people living in the same locality and who may share a common culture, values, and norms. Communities can also be defined by race, religion, ethnicity, age, occupation, political status, tribal affiliation, interest in particular problems or outcomes, or other common bonds. The term "community" encompasses worksites, schools, tribes, residential neighborhoods, business districts, recreational areas, and health and human service sites.


	PROGRAM A system of services offered by an organization. For example, an organization providing a mental health service may offer several mental health programs to different populations, e.g., a mental health program for adolescent teens. The word "program" can be used interchangeably with the word "service" or to describe specific programs.


	SERVICE One or more organization-operated programs or activities that have a common general objective and deploy the organization's material and human resources in a planned and systematic manner. An organization that publicly promotes or identifies itself in writing as offering a service, is licensed to deliver a service, assigns personnel and/or space to a service, or allocates financial resources to a service is considered to offer that service.


	LEGAL GUARDIAN A person who has legal responsibility for the care and management of a person incapable of administering his/her own affairs. In the case of a minor child, the guardian is charged with the legal responsibility for the care and management of the child and of the minor child's estate.


	FAMILY Two or more people who consider themselves family and who assume obligations, functions, and responsibilities generally essential to healthy family life. Child care and child socialization, income support, long-term care, and other caregiving are among the functions of family life. The definition of "family" will rest with an individual's indication of who plays a family member role, including current or former foster family, adoptive family, extended family members, fictive kin, or significant others. Organizations that believe family is the central constellation in a child's life, and that family attachments are of primary importance for human development, will strive to work with professional staff to develop a common understanding of "family."


	CLIENT See service recipient.


	RESEARCH For purposes of COA accreditation, all forms of internal or external research involving persons served except internal program evaluation and outcomes research, or educational projects performed by students and interns that are part of their professional training.


	CASE RECORD A written compilation that describes the client and the services delivered. Records can be in hard copy and/or electronic format. The case record can be used as a source of information for quality improvement or other evaluation activities, for research purposes, or to demonstrate accountability to funding bodies.


	PARENTS Parents can include: birth, foster, kinship, and adoptive parents. Please see service standards for more specific information about use of this term.


	CASE A general term used to designate clients (including individuals, families, and groups) served by an organization for purposes of monitoring the provision of services. A foster care case is generally based on the placement of an individual child, although casework for the child may include services to the child's family. A child protective services case is based on an entire family household if a family assessment model is used; otherwise a case is defined as a child.