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Live Webinar on

3-Hour Virtual Seminar on HIPAA vs. SAMHSA 42 CFR Part 2:

Managing Disclosures when Substance Use Disorders are
Involved

Date: Monday September 16, 2019   Time: 09:00 AM PDT | 12:00 PM EDT Register Now

Duration: 3 Hours Location: Online Instructor: Jim Sheldon Dean

Overview:
This session focuses on the issues of managing health information when it may involve substance use
disorder treatment information. HIPAA allows a number of disclosures without consent that SAMHSA
prohibits without consent.

First we will explain how HIPAA relates to information management and release and explain the
processes required for various releases of information under the HIPAA rules, including release according
to individual access requests, and under HIPAA authorizations. 

When substance use disorder treatment information is involved, first you need to understand how to
identify it. We will discuss how to make it distinguishable from "regular" health information, so that the
appropriate extra protections can be provided. You may be able to use functions in your EHR to flag the
information, or you may create a manual process for tracking the information, if it is rarely handled in your
organization. And the substance use disorder treatment information you collect may or may not be under
SAMHSA depending on whether or not you have a department or even a response team that specializes
in SAMHSA-related situations. You need to understand your status under the rules before you release
information inappropriately. We will discuss what qualifies treatment that falls under SAMHSA. 

If your organization provides services that create information that is under the SAMHSA regulations, you
will need to establish the consent and release of information processes that are required to be followed for
information releases under 42 CFR Part 2. This involves getting the proper consents upon establishment
of the relationship, as well as managing consents for releases that may be necessary after the initial
establishment of the relationship. The session will include an explanation of the consent and release
requirements that must be followed. 

When you release information under HIPAA, there are no special notices required to be placed on the
records. But when you release information under SAMHSA, each document must have a notice that
explains that re-disclosure is not permitted without a new consent. Complicating matters are updated rules
going into effect that will allow a consent that permits a re-release to a defined team of providers caring
for the individual, but then require meticulous documentation of to whom the information has been
released under such a consent.The session will go over the rules on consents and re-release of
information. 

With the current epidemic of opioid abuse, there has been a great deal of publicity around the release of
information and the necessity to share information with family and friends to facilitate recovery, but the
rules remain in place as is. HIPAA allows such releases under some circumstances, while a consent is
required under 42 CFR Part 2.HHS has issued guidance on how to deal with the regulations in the face of
the crisis, but the inconsistencies and difficulties remain. In this session we will review the guidance and
learn how it helps explain some of the rules. 

In addition, the session will review the processes used for and some of the enforcememt settlements
reached in the reporting of breaches under HIPAA, as well as proposals to further harmonize HIPAA
and 42 CFR Part 2, including the levying of HIPAA-level penalties for violations of the Part 2 rules. The
latest proposals to modify the Part 2 rules and their potential impacts will be discussed. 

Overall, substance use disorder treatment information can complicate your records management and
release processes, but by recognizing and planning for the issues, you can minimize the impacts. 

Why should you Attend:Today we are in the midst of an epidemic of substance use disorders, and particularly
opioid abuse, and more and more providers are involved in providing treatment to people with substance use
disorders. When substance use disorders are involved, the rules of SAMHSA under 42 CFR Part 2 come into play.
But who is covered under the rules, what’s involved in meeting them, and how do they interact with HIPAA? HIPAA
allows a number of disclosures, for treatment, payment, and healthcare operations purposes, without consent from
the individual being treated. 

SAMHSA rules, on the other hand, require consent for every disclosure or re-disclosure, and if the proper consents
aren’t obtained, the provider can be in violation of the rules and subject to penalties. 
Not every provider that treats a person with substance abuse issues automatically falls under the SAMHSA rules,
and not all mental health information is necessarily substance abuse information. How do you know whether or not
your services put you under the SAMHSA regulations? If you are under 42 CFR Part 2, how do you identify and keep
separate the substance abuse information? 

When a provider receives health information about an individual, under HIPAA the provider may re-disclose the
information as needed for treatment, payment, and healthcare operations purposes. Information may be received,
however, that has a special notice on it about re-disclosure, requiring consent from the individual before re-
disclosure. Even though you may not operate under SAMHSA rules, you have obligations to respect the SAMHSA
consent requirements. How can you make sure information is only shared appropriately and is not released contrary
to the rules? 

Areas covered in the session:

l What HIPAA allows, what SAMHSA requires, and the differences will be explained
l We will examine how to deternmine if the services you provide place you under 42 CFR Part 2
l We will explore the means for making sure substance use disorder treatment information receives the
appropriate protections
l The consent and release requirements under 42 CFR Part 2 will be explained
l Re-release of information released under 42 CFR Part 2 will be discussed
l Sharing of information with family and friends in an overdose incident will be explored
l The latest guidance from the US Department of Health and Human Services on harmonization of SAMHSA
and HIPAA will be explained
l Enforcement of the rules and the handling of breaches of information will be explained

Who Will Benefit: About Speaker

Jim Sheldon-Dean
l Compliance Director is the founder and director of compliance services at Lewis
l CEO Creek Systems, LLC, a Vermont-based consulting firm
l CFO founded in 1982, providing information privacy and security
regulatory compliance services to a wide variety of health
l Privacy Officer
care entities. Sheldon-Dean serves on the HIMSS
l Security Officer Information Systems Security Workgroup, has co-chaired
l Information Systems Manager the Workgroup for Electronic Data Interchange Privacy and
l HIPAA Officer Security Workgroup, and is a recipient of the WEDI 2011
Award of Merit. He is a frequent speaker regarding HIPAA
l Chief Information Officer and information privacy and security compliance issues at
l Health Information Manager seminars and conferences, including speaking
l Healthcare Counsel/Lawyer engagements at numerous regional and national
healthcare association conferences and conventions and
l Office Manager
the annual NIST/OCR HIPAA Security Conference in
Washington, D.C. ... more

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