Safety and Sobriety Manual
Best Practices in Domestic Violence and Substance Abuse

January 2005

If you have any questions regarding the documents found in the Appendix Resource, please contact Teresa Tudor via email or at 217-558-6192.


Confidentiality - Legal Protection

 (originally a table but textualized for ease of reading)

Applies to:

Alcohol and Drug Treatment:  Programs in Illinois 'which provide treatment, diagnosis or referral for treatment of alcohol or other drug abuse or addiction, directly or indirectly supported by government or licensed by DHS.

Domestic Violence Victims' Services:  411 programs in Illinois which provide shelter, advocacy, counseling or case management services to victims of domestic violence.

What is prohibited?

Alcohol and Drug Treatment:  Disclosure of any information regarding the presence in treatment, diagnosis, prognosis, treatment or condition of any person obtaining treatment for alcohol or other drug abuse or addiction. Confidential communications, such as therapy sessions, have an additional degree of protection.

Domestic Violence Victims' Services:  Any information pertaining to the victim or the victim's presence in the shelter; communication between the victim and any counselor or advocate.

Can client consent to release of info? How?

Alcohol and Drug Treatment:  Yes. Client must sign and date release, and the release form must satisfy nine conditions set forth in the statute.

Domestic Violence Victims' Services:  Yes. Similar requirements for informed consent to release information.

Exceptions

Alcohol and Drug Treatment:

  1. Emergency medical care
  2. Child abuse/neglect
  3. Appropriately entered court order
  4. Scientific research, management and financial audits.

Domestic Violence Victims' Services:

  1. "...where failure to disclose is likely to result in an imminent risk of serious bodily harm or death of the victim or another person."
  2. Elder and Child abuse/neglect

Can information be obtained by subpoena?

Alcohol and Drug Treatment:  ONLY under very limited circumstances as defined in the statute and ONLY when subpoena is accompanied by court order which meets statute's requirements. Subpoena alone (even judicial subpoena) neither compels nor permits program to disclose client's presence.

Domestic Violence Victims' Services:  Location of shelter, and identity of advocates/counselors, can only be compelled by court order following hearing in judicial chambers to establish good cause. Note that protections are in state law - federal law gives little protection.

What about warrants?

Alcohol and Drug Treatment:  Warrants cannot be served on clients unless accompanied by the same type of court order as mentioned above. Warrant alone neither compels nor permits program to disclose client's presence

Domestic Violence Victims' Services:  Similar protection under state law, but federal law is unclear - there is no comparable federal statute protecting domestic violence victims' privacy, confidentiality, or records.

What laws or regulations spell these rights out?

Alcohol and Drug Treatment:  Law: 42 U.S.C. 99 290dd-2,42 C.F.R. Part 2, incorporated in 77 111. Adm. Code 2060.319

Domestic Violence Victims' Services:  750 ILCS 60-227 and 720 ILCS 5145-2

What penalties are there for violations of the law?

Alcohol and Drug Treatment:
$500 fine for first offense
$5000 fine for each subsequent offense

Domestic Violence Victims' Services:
Class A misdemeanor

Who enforces this?

Alcohol and Drug Treatment:  United States Attorney, local law enforcement authority

Domestic Violence Victims' Services:  Local law enforcement authority


Confidentiality of Drug and Alcohol Patient lnformation

(42 U.S.C. 9 290dd-2; 42 C.F.R. PART 2)

THE GENERAL RULE

The program may not disclose any information about any patient.

Exceptions: Conditions permitting disclosures.

Internal Communication

No patient Identifying information

Proper Consent

  • Proper Form
    • Name of program
    • Name of recipient
    • Name of Patient
    • Purpose/Need
    • Extent/nature
    • Revocation statement
    • Expiration
    • Signature of patient
    • Date
  • Written notice of Prohibition of Redisclosure

Medical Emergency

Research or Audit

Court Order

Crime on program premises or against program personnel

Reporting child abuse and neglect


Prohibition on Redisclosure of lnformation

This notice accompanies a disclosure of information concerning a client in alcohol/drug abuse treatment, made to you with the consent of such client. This information has been disclosed to you from records protected by federal confidentiality rules (42 CFR Part 2). The Federal rules prohibit you from making any further disclosure of this information unless further disclosure is expressly permitted by the written consent of the person to whom it pertains or as otherwise permitted by 42 CFR Part 2. A general authorization for the release of medical or other information is NOT sufficient for this purpose. The Federal rules restrict any use of the information to criminally investigate or prosecute any alcohol or drug abuse patient.


Consent for Release of Confidential lnformation

(Note: A copy of the form can be found on page 64 of Appendix Resource (pdf))

I, (Name of Patient), authorize (Name or general designation of the program making the disclosure) to disclose to (Name of the person or organization to whom disclosure is being made) the following information: (Nature of the information, as limited as possible)

The purpose of the disclosure authorized herein is to: (Purpose of disclosure, as specific as possible)

I understand that my records are protected under the federal regulations governing Confidentiality of Alcohol and Drug Abuse Patient Records, 42 CFR Part 2, and cannot be disclosed without my written consent unless otherwise provided for in the regulations. I also understand that I may revoke this consent at any time except to the extent that action has been taken in reliance upon it, and that in any event this consent expires automatically as follows: (specification of the date, event or condition upon which consent expires)

Date:

Signature of participant

Signature of parent, guardian or authorized to representative. when required

Signature of program staff (Witness - optional)


Sample Mutual Services (Linkage) Agreement

XYZ Additions Treatment Center

The purpose of this document is to formalize the relationship between XYZ Addictions Treatment Center and the ABC Shelter. This cooperative and reciprocal arrangement will expedite referral, admission, and discharge of clients, allowing both agencies to serve clients better.

XYZ Center will provide the following:

  • Referrals of clients in need of safety planning, shelter and support
  • Assessment services for substance abuse and chemical dependence
  • Level I services for women
    Conventional outpatient services
  • Level II services for women
    Intensive outpatient or partial hospitalization services
  • Level Ill services for women
    Residential Treatment services
  • Non-medical detoxification for women
  • Case management services related to substance abuse treatment

ABC Center will provide the following:

  • Referrals of clients in need of substance abuse treatment
  • Assistance with safety planning for XYZ Center clients
  • Shelter on a space-available basis for clients leaving substance abuse treatment who have been identified as victims of domestic violence
  • Weekly support group for XYZ clients who have been identified as victims

Both parties to this agreement consent to abide by federal and Illinois standards regarding the confidentiality of client information, and to defend against efforts to obtain that information without the client's consent. Services will be provided under each party's usual arrangements for payment and/or funding and this agreement is not a guarantee that treatment slots or shelter beds will be available.

This agreement will become effective on the date both parties sign this agreement and may run uninterrupted for a period of one year from this effective date. Either party may terminate this agreement upon thirty days' written notice to the other party.

SIGNATURE LINE: (Name of Director, XYZ Center), Director (or other title)
XYZ Center

Date:

SIGNATURE LINE:  (Name of Director, ABC Shelter), Director (or other title)
ABC Shelter

Date:

(Note: Any such agreement should be reviewed by an attorney - it may be necessary to add further limiting language to make the limitations of the agreement clear.)