Policy and Practice August 2016

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August 2016 Policy&Practice 5
In February, the U.S. Department
of Health and Human Services
(HHS) Substance Abuse and Mental
Health Services Administration
(SAMHSA) published the §42 CFR
Part 2 Confidentiality of Substance
Use Disorder Patient Records Notice of
Proposed Rule Making (NPRM), or “Part
2,” in the Federal Register.
The NPRM aims to modernize and
update the regulations at §42 CFR Part
2 to afford patients with substance use
disorders (SUDs) the opportunity to
benefit from emerging multiservice
care models that require enhanced
exchange of health information.
In 1970, Congress passed the
Comprehensive Alcohol Abuse and
Alcoholism Prevention, Treatment, and
Rehabilitation Act, and in 1972, passed
the Drug Abuse Prevention, Treatment,
and Rehabilitation Act; these applied
general rules establishing the con-
fidentiality of alcohol abuse patient
records to drug abuse patient records.
In 1987, the HHS secretary issued regu-
lations, referred to as “Part 2,” that
describe the circumstances in which
information about a substance abuse
patient’s treatment could be disclosed
and used, with or without a person’s
consent. While the two acts and Part
2 regulation limited the availability
of substance abuse records to insure
that patients in a treatment program
are not more vulnerable with regard
to their privacy than those who do
not seek treatment, SAMHSA noted
that the new proposal is necessary
because of the significant changes
that have occurred over the past 25
years. The current regulations are
not aligned to fit the advances in the
U.S. health care delivery system,
legislative update
APHSA Issues Comment on Confidentiality of
Substance Use Disorder Patient Records NPRM
including new models of integrated
care, and could put patients at risk of
adverse consequences surrounding
privacy protections. The proposal was
also prompted to make the regula-
tions more understandable and less
burdensome.
Developed through state and
local members of APHSA’s National
Collaborative for Integration of Health
and Human Services, as well as other
affinity groups of the association,
APHSA submitted formal comments
to the NPRM noting the overall align-
ment of the NPRM with APHSA’s policy
and practice framework, Pathways.1
Pathways outlines the desired future
state of a transformed health and
human service system. In doing so, the
NPRM takes a step forward, toward
enhancing the provision of holistic
services for individuals with SUDS
and balancing important security with
privacy concerns.
Among APHSA’s recommendations
were that SAMHSA:
„ „ Expand the definition of
“Treatment Provider Relationship”
to encompass the full care con-
tinuum, explicitly including those
providing related social services as
part of that relationship. Human
or social service providers, in
addition to substance use, medical,
mental health, and developmental
disability/intellectual disability
providers, may all be involved in
different aspects of an individual’s
care plan, and as such, a part of
promoting recovery, resiliency, and
ensuring the safety of individuals
living and dealing with substance
use. With the appropriate safe-
guards, access to this information
has the potential to enable a better
By Leigh Edwards
See Confidentiality on page 41
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