ATR Recovery Coach Learning Community Facilitated by: Haner Hernandez, Ph.D., CADCII, LADCI Beth Fraster, LICSW, December 19, 2013

Recovery Coach Learning Community Welcome and Introductions December 19, 2013 Beth Fraster, LICSW Haner Hernandez, Ph.D., CADCII, LADCI

Recovery Coach Learning Community Introductions: Name Organization Coaching Now?

Learning Community The Massachusetts ATR Recovery Coach Learning Community is a group of people who share common emotions, values or beliefs, and are actively engaged in learning together and from each other. Adapted from Wikipedia

GOAL To Create a Supportive Network of Competent Recovery Coaches

Objectives: To learn from Recovery Coaches implementing Coaching in a different settings; To share strategies and resources to best meet the needs of Recoverees; To ensure that Recovery Coaching services are Culturally Competent; and To provide and receive support and guidance.

CODE OF FEDERAL REGULATIONS 42 Part 2 A.K.A. 42CFR Part 2 TODAY’S AGENDA

So what about Confidentiality? In the early 1970’s, Congress recognized that the stigma associated with substance abuse and fear of prosecution deterred people from entering treatment and enacted legislation that gave patients a right to confidentiality. For the almost three decades since the Federal confidentiality regulations (42 CFR Part 2 or Part 2) were issued, confidentiality has been a cornerstone practice for substance abuse treatment programs across the country.

Additional Policies and Regulations In December, 2000, the Department of Health and Human Services (HHS) issued the “Standards for Privacy of Individually Identifiable Health Information” final rule (Privacy Rule), pursuant to the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). Substance abuse treatment programs that are subject to HIPAA must comply with the Privacy Rule.

Allowable Communication and Sharing of Confidential Information

With Informed Consent Consent Form Must Include the Following Elements : Name or general designation of the program or person permitted to make the disclosure; Name or title of the individual or name of the organization to which disclosure is to be made; Name of the patient; Purpose of the disclosure; How much and what kind of information is to be disclosed ;

With Informed Consent Consent Form Must Include the Following Elements (continued) : Signature of patient (and, in some States, a parent or guardian); Date on which consent is signed; Statement that the consent is subject to revocation at any time except to the extent that the program has already acted on it; and Date, event, or condition upon which consent will expire if not previously revoked.

Internal Program Communications Need to Know Basis... be limited to those persons who have a need for the information in connection with their duties that arise out of the provision of diagnosis, treatment or referral for treatment of alcohol or drug abuse.

Crimes on Program Premises or Against Program Personnel Part 2 permits programs to disclose limited information to law enforcement. Such disclosures must: be directly related to crimes and threats to commit crimes on program premises or against program personnel and be limited to the circumstances of the incident and be limited to the patient’s status, name, address and last known whereabouts.

Child Abuse Reporting Part 2 permits programs to comply with State laws that require the reporting of child abuse and neglect.

Medical Emergencies Part 2 allows patient-identifying information to be disclosed to medical personnel who have a need for the information about a patient for the purpose of treating a condition which poses an immediate threat to the health of any individual and which requires immediate medical intervention. A program can disclose information only to medical personnel and must limit the amount of information to that which is necessary to treat the emergency medical condition.

Subpoenas & Court- Ordered Disclosures Part 2 permits programs to release information in response to a subpoena if the patient signs a consent permitting release of the information requested in the subpoena. When the patient does not consent, Part 2 prohibits programs from releasing information in response to a subpoena, unless a court has issued an order that complies with the rule.

What does Confidentiality Look Like in Small Communities and for Recovery Coaches

Some Areas of Ethical Risk: ● Recoveree’s Rights● Confidentiality and Privacy ● Informed Consent● Service Delivery ● Boundary Issues● Conflict of Interest ● Documentation● Discrimination against Recovees ● Supervision and Training● Impairment ● Termination of Services● Consultation and Referral ● Staff Relationships● Discrimination against Staff

Major Areas of Ethical Complaints Boundaries – mostly sexual; Sub-Standard or Denial of Services; Violations of Confidentiality; Exploitation (financial, goods and “favors”); and Responsibility to Colleagues

Things to Consider Do you have any questions about what was presented – general or specific? What type of difficult confidentiality scenarios have you encountered? Where do you go for support and resolution?

Action Steps Does your organization have a policy pertaining to confidentiality? If yes does it meet the standards of 42 CFR? If no what will be your next for insuring confidentiality? What is your process for addressing breaches of confidentiality?

And now for next month... Topics generated from Learning Community: Pilot Specific Information Sustainability Thinking about Medicaid Certification – Accreditation – where are “we” heading – what does it mean Sharing Resources - Development of Resource Bank Engagement and Outreach of Recoverees – how to reach out to referrals and make the connection Engagement and Outreach of Coaches Boundaries in the Coaching Relationship – Issues of Safety Limits of the Coaching Relationship – Knowing when and how to make a referral Recoveree Scenarios – Discussions of success and challenges Cultural Competency Supervision

This is a Learning Community not a training Identify your needs Additional training Additional Resources Review your curriculum Supervision Local Support Additional TA On-going support

NEXT Learning Community Date:Thursday,January 9, :00-11:30 Webinar:Log- in information will be ed to everyone Topic: Let’s discuss This is your community!

¡Gracias! Thanks!