Any information pertaining to the client or client’s record (including the fact of treatment involvement or non-involvement) is released only by specific written consent of the client and in accordance with guidelines contained in Federal Register, Volume 40, Number 127, Part IV (“Confidentiality of Alcohol and Drug Abuse Patient Records”) and Chapter 125 of the Iowa Code. This means that absolutely no information is released to anyone, who is not a member of the Area Substance Abuse Council staff, without the client’s specific written permission; this applies whether or not the person is, or has been, an active client. There are some extraordinary circumstances under which the confidentiality relationship may be breached with the express permission of the Deputy Director (ie: medical emergencies, clear and imminent danger to the life of the client or others, child abuse).

Specific Written Consent

A client’s written consent for the release of information shall be considered valid only when the following conditions of “informed consent” have been met:

1.  The client is informed in a manner that assures his/her understanding, of the specific type of information that has been requested, as well as the benefits and disadvantages of releasing information (if known);
2.  The client is informed of the purpose or need for the information;
3.  Treatment services are not contingent upon the client’s decision concerning authorization for the release of information; and,
4.  The client gives his/her consent freely and voluntarily.


Consent Procedure to Release/Obtain Voluntary Client Information to/from Others

1.  The consent shall be given on the “Consent to Release/Obtain Information”.
2.  The clinical staff member obtaining the consent from the client shall be certain the conditions of the informed consent have been met.
3.  The “Consent to Release/Obtain Information” shall be completed thoroughly, including:

The staff member shall:

a) Print the name of the client/patient;
b) Fill in the name or title of person or organization to whom information is to be released;
c) Identify the specific information to be released;
d) Delineate the purpose or need for disclosure of the specified information;
e) Clarify the voluntary nature of the release;
f) Set a reasonable date, event, or condition upon which the consent is void if not revoked by the client earlier;
g) Witness the client’s signing signature on release;
h) Sign signature as witness of client’s signing release.

4.  It is important the client understand the significance and nature of the release. Clinical staff should remember that a number of our clients are functionally illiterate and may need the consent form read to them.
5.  The original copy of the “Consent to Release/Obtain Information” shall be placed in the client’s record.
6.  By signing a “Consent to Obtain”: the client implies consent to release the fact they are seeking treatment; if no other information than the fact of treatment involvement is to be released (with a “Consent to Obtain”) a “Consent to Release” is not necessary.

Consent Procedure for Release of Criminal Justice System Client Information

1.  Criminal Justice System Clients are those whose participation in treatment is made a condition of:
a) Their release from confinement;
b) The disposition or status of any criminal proceedings against them;
c) Execution or suspension of any sentence imposed upon them.

2.  Clients who are involved with the Criminal Justice System, but whose participation in treatment is not a condition of their Criminal Justice Status, are voluntary clients and this section does not apply to them.
3.  When participation in treatment is a condition of Criminal Justice Status benefit (probation, parole, release from confinement), the court, correctional services, parole board, parole or probation officers require “unrestricted communication” (regarding client treatment participation and progress) between our agency and them. The client’s “Consent to Release” is “voluntary” at the time of criminal justice system action (e.g.: sentencing, etc.) and the criminal justice system action is contingent upon such a consent to release.
4.  Such contingent Consents to Release shall expire at the point the final disposition of all criminal justice proceedings of which substance abuse services were conditioned.
5. Such a Consent to Release may not be revoked by the client.
6.  When parole, probation, or release from confinement (including court ordered treatment) is contingent upon participation in treatment, the client shall sign
a) “Consent to Release Information (Criminal Justice Client)”. A Criminal Justice Release includes the Iowa Dept. of Corrections, Iowa Parole Board, Community Correctional Services Agencies, and the Iowa District Court. Such consents shall be obtained upon first contact with the client and shall include “informed consent.”
b)“Informed Consent” shall include the client understanding all that is outlined on the consent form.
7. “Unrestricted Communication” regarding client treatment participation and progress shall be limited to that which the recipient needs to know in order to perform their official duties.
8. The original of the Consent to Release shall be retained in the client’s record.

Procedure for Correspondence/Reports/etc. Containing Released Client Information

1.  All envelopes mailed out containing correspondence and/or reports containing any client information shall be clearly stamped “Confidential”.
2.  Each page of all correspondence and/or reports containing any client information shall be clearly stamped:

This information has been disclosed to you from records whose confidentiality is protected by Federal law. Federal regulations (42CFR Part 2) prohibit you from making further disclosure of it without the specific written consent of the person to whom it pertains or as otherwise permitted by such regulations. A general authorization for the release of medical or other information is not sufficient for this purpose.

conrecin DS 2/03

on October 23 • by