CIP Legal & Confidentiality Issues in Intervention 1 — Questions and Answers
Question 1: Under 42 CFR Part 2, which of the following is required before a substance use disorder treatment program may disclose patient records to a third party?
- A signed written consent from the patient (Correct answer)
- Verbal authorization from the patient's family member
- A request from the patient's primary care physician
- Proof of insurance coverage for treatment
Correct answer: A signed written consent from the patient
42 CFR Part 2 requires a specific written consent signed by the patient before any disclosure of substance use disorder treatment records, even to other providers.
Question 2: A CIP intervention specialist learns during an intervention that a client has made a credible, specific threat to harm a named individual. Under the duty-to-warn doctrine, the specialist is legally obligated to:
- Warn the identifiable potential victim and notify law enforcement (Correct answer)
- Document the threat and discuss it only at the next clinical team meeting
- Maintain confidentiality because it was disclosed during a session
- Notify the client's insurer about the threat
Correct answer: Warn the identifiable potential victim and notify law enforcement
The Tarasoff duty-to-warn doctrine requires mental health and substance use professionals to protect identifiable third parties from credible threats, typically by warning the potential victim and notifying authorities.
Question 3: Which federal law provides the primary framework for protecting the privacy of individually identifiable health information held by covered entities, including most substance use treatment providers?
- Health Insurance Portability and Accountability Act (HIPAA) (Correct answer)
- Americans with Disabilities Act (ADA)
- Mental Health Parity and Addiction Equity Act (MHPAEA)
- Substance Abuse and Mental Health Services Administration Act
Correct answer: Health Insurance Portability and Accountability Act (HIPAA)
HIPAA's Privacy Rule establishes national standards for protecting individually identifiable health information held by covered health care providers, health plans, and clearinghouses.
Question 4: A CIP specialist is planning an intervention for a 16-year-old. Regarding consent for substance use treatment, which statement is most accurate in most U.S. states?
- Many states allow minors to consent to substance use treatment without parental permission (Correct answer)
- Minors can never consent to any form of health treatment without parental approval
- Parental consent is only required if the minor is under age 14
- Federal law uniformly sets the age of consent for treatment at 18 in all states
Correct answer: Many states allow minors to consent to substance use treatment without parental permission
Most states have passed statutes permitting minors to consent to substance use disorder evaluation and treatment without parental consent to encourage help-seeking behavior.
Question 5: Which of the following situations represents a mandatory reporting obligation that would override normal confidentiality protections for a CIP professional?
- A client discloses ongoing abuse of a child in the household (Correct answer)
- A client admits to past recreational marijuana use
- A family member shares concerns about the client's spending habits
- A client expresses general dissatisfaction with their job
Correct answer: A client discloses ongoing abuse of a child in the household
All U.S. states require professionals to report known or reasonably suspected child abuse or neglect, which supersedes standard confidentiality protections.
Question 6: Under HIPAA, which of the following is NOT considered a covered entity required to comply with the Privacy Rule?
- A life insurance company that does not conduct standard electronic health transactions (Correct answer)
- A hospital that submits insurance claims electronically
- A substance use disorder treatment clinic accepting Medicaid
- A health plan providing employee benefits
Correct answer: A life insurance company that does not conduct standard electronic health transactions
HIPAA covered entities are health plans, health care clearinghouses, and health care providers who transmit health information electronically; life insurers not conducting standard electronic transactions are not covered entities.
Question 7: When a court issues a subpoena for a client's substance use disorder treatment records protected under 42 CFR Part 2, a CIP specialist's program should:
- Notify the client and seek a court order or client consent before releasing records (Correct answer)
- Comply immediately because court orders supersede all privacy protections
- Release only records created prior to the current treatment episode
- Deny all records because 42 CFR Part 2 prohibits any court-ordered disclosure
Correct answer: Notify the client and seek a court order or client consent before releasing records
A subpoena alone is insufficient under 42 CFR Part 2; the program must notify the patient and either obtain consent or wait for a court order that meets the specific standards of Part 2 before releasing records.
CIP Legal & Confidentiality Issues in Intervention 1
Under 42 CFR Part 2, which of the following is required before a substance use disorder treatment program may disclose patient records to a third party?