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Community Intervention & Educational Services follows all General Statutes in regard to the obtaining and release of confidential information regarding a person receiving services. Confidential information regarding substance abusers will only be released and/or disclosed with the federal regulations 42 C.F.R Part 2., “Confidentially of Alcohol and Drug Abuse” Patient Records.

All information concerning an individual’s use of Agency services will be considered confidential, and will not be released to anyone except under the following conditions:

• The person receiving services (parent or legal guardian, if person is a minor or legal dependent) has consented in writing to the release of information to a specified person or agency. This release may be valid for a specified length of time and is subject to revocation by the consenting individual. The purpose for the disclosure, and the nature of information to be released, must be specified in writing.

A Consent to Release Information should be signed:

• When child abuse or neglect is suspected.
• When in the service provider’s opinion there is imminent danger to the health or safety of the person receiving services or another individual, or there is a likelihood of the commission of a felony or violent misdemeanor.
• When a physician or other health care provider is providing emergency services to a client. A service provider may exchange only information, which is necessary for the emergency services to be provided.
• In response to a request from a Guardian Ad Litem, Guardian Ad Litems are covered by a blanket court order mandating the release of information regarding a child and/or family members. It is proper to ask for a copy of this release prior to releasing information, verbal or written.
• When a service provider has determined that it is in the best interest of the individual to pursue involuntary commitment or adjudication of incompetence, confidential information may be disclosed for purposes of filing a petition.
• In response to a request from the NC Crime Control and Public Safety, information concerning a victim who is filing a Victim’s Compensation claim. This information includes the person’s name, social security number, address, date of birth, and/or billing information. Personnel may not confirm or deny that an individual is receiving services at the Agency to an unauthorized person, unless permission to do so has been given by the person.

Agency personnel will take affirmative action to safeguard confidentiality. Information may be shared among Agency personnel only as necessary to facilitate effective services. This includes the Case Records Review committee, who during their course of responsibility have access to case records in order to conduct case record audits and utilization reviews.

Consultants, volunteers, interns, auditors, contractors, and other outside agents who in their relationship with the Agency may be exposed to confidential material will be required to sign an agreement stating they will treat the information in a confidential manner.

Information obtained from a third party (i.e. psychological evaluations, records from a previous therapist at another agency, etc.) cannot be released, with or without written Consent to Release Information.

All personnel are required to know and strictly follow all procedures involving the protection of client confidentiality.

Effective Date: April 14, 2003
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

PER THE HIPAA ACT OF 1996, WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION.

• We will protect the privacy of the health information that we maintain that identifies you, whether it deals with the provision or payment of your health care.
• We must provide you with this Notice about our privacy practices.
• It explains how, when, and why we may use and disclose your health information.
• With some exceptions, we will avoid using or disclosing any more of your health information than is necessary to accomplish the purpose of the use of disclosure.
• We are legally required to follow the privacy practices that are described in this Notice, which is currently in effect.
• However, we reserve the right to change the terms of this Notice and our privacy practices at any time.
• Any changes will apply to any of your health information that we already have.
• Before we make an important change to our policies, we will promptly change this Notice and post a new Notice in your location of service.
• You may also request, at any time, a copy of our Notice of Privacy Practices that is in effect at any given time, from our complaint officer, who can be reached at 336-682-2331.