Policy

The Orchard Recovery protects the privacy of individuals served. Federal confidentiality regulations regarding substance addiction treatment are very specific and override any conflicting state/local mandates. There are also strict resident/therapist restraints on disclosing resident identity and related clinical and health information that applies to our resident. These laws and regulations exist to provide residents with the assurance that their problems, their treatment, and their confidences will not be disclosed to anyone without their prior knowledge and consent unless records are under an issued subpoena and court order.

Confidentiality is not under the Duty to Warn clause allowing disclosure of information in cases where prevention of or lessening imminent, serious threat to the health or safety of person served or for a crime on the premises or against program personnel.

These resident rights are incorporated in the following policies:

1. Phone Inquiries – Telephone inquiries regarding a resident’s participation in treatment typically comes from significant others and family members. Releasing any information to a third party may only be done with prior, written consent of the resident. This includes all information regarding the resident.
2. Written Releases – Any information regarding a resident currently or in the past receiving treatment from The Orchard Recovery may only be released with prior, written consent from the resident. Written consents should specify the party to whom the information is to be released. The release should be signed by the resident and witnessed by the counselor.
3. Any release of information or inquiries regarding release of information will be noted in the resident’s case file.
4. Resident Records – All resident records will be maintained in the Electronic Medical Record (EMR) systems records online, or in locking file cabinets and/or behind locked doors. Requests for information from most sources (including subpoenas and court orders) should follow clinical protocols for Responding to a Request for Resident Records. No records are to be released without consent unless it is mandated by the courts with an appropriate court order. Every effort should be made to verify the authenticity of the resident signature by speaking with the resident prior to releasing the records if an authorization for records is received by an outside source. All resident charts are maintained in EMR systems or a locked facility for six (6) years and the sixth year after a resident’s18th birthday (see Policies and Procedures on Safeguard of Records).
   Duplicate information is maintained in the resident chart or shredded to protect confidentiality. Disposal of resident records after the sixth year will occur by destroying all paper documents or electronic records. Additional disclosures of residents’ privacy information are prohibited unless authorized in writing by the resident. The Orchard Recovery cannot and will not use resident information in directories, marketing materials, and fundraising materials or events. Clinical notes are protected under the current federal laws (Title 42, Sections 2.1 — 2.67-1, Code of Federal Regulations) and will be protected by The Orchard Recovery.
5. All records revealing resident identities must always be protected from public view.

Procedure

1. Business matters should not be discussed in the open areas, waiting rooms, and hallways of The Orchard Recovery facilities. Discussions regarding residents or other Orchard business should occur in private offices behind closed doors or in some other location where confidentiality is guaranteed. Discussions should be done quietly to ensure professionalism and the protection of our residents.
2. The Orchard Recovery ensures that confidential information acquired during delivery of services will be safeguarded from illegal or inappropriate use, access and disclosure from loss, destruction or tampering. All written or taped material regarding residents must be guarded with utmost caution. These include charts; weekly therapists caseload sheets; UA results; phone messages; letters; audio or video tapes; supervision notes; and evaluation/treatment forms. Resident records are to be stored in the EMR systems or locking cabinets. Disposal of records should be done in a manner that maintains confidentiality. No verbal or written information regarding Orchard residents, including the fact that the individual is or has been a resident at the office, may be given in any form to anyone who is not a an Orchard team member without direct written permission (release) from the resident.
3. The Orchard Recovery clinical and non-clinical staff do not disclose resident confidences, including the names or identities of their residents, to anyone except:
   1. as mandated by law via a signed court order.
   2. as permitted by law (including medical emergencies);
   3. where an Orchard resident is a defendant in a civil, criminal or disciplinary action arising from the treatment (in which case resident confidences may only be disclosed in the course of that action and following the procedures outlined in the “Confidentiality Policy”); or
   4. if there is a release previously obtained in writing, and then such information may only be revealed in accordance with the terms of the release. All residents entering treatment are given at intake and requested to sign a Notice of Confidentiality which outlines the above stated Federal Confidentiality Law and Regulations. The original Notice of Confidentiality is maintained in the resident’s chart and a copy is given to the resident.
4. The Orchard Recovery clinical and non-clinical staff will never access, use or disclose any confidential health or personal information of any family member, friend, relative, co-worker or significant other who may be a resident of a The Orchard Recovery. In the event a counselor or staff member has a family member, friend, relative, co-worker, or significant other who is a resident of The Orchard, the counselor or staff will provide written acknowledgement of his/her agreement to respect the confidentiality of the individual receiving services at a The Orchard by signing the Acknowledgement of Confidentiality form upon hire.
5. The Orchard consultants and volunteers will not discuss or divulge information obtained in clinical or consulting relationships except in appropriate settings and for professional purposes that demonstrably relate to the case.
6. The Orchard clinical staff use clinical materials in teaching, writing and public presentation only if a written release has been received or when appropriate steps have been taken to protect resident identity.
7. In circumstances where more than one person in a family is receiving therapy and where a third party seeks information related to any aspect of such treatment, each family member receiving treatment who is legally competent to execute a release must sign the release before facility clinical or non-clinical staff will disclose information received from any family member.
8. All information shared within therapeutic groups at The Orchard Recovery is confidential and may not be released without prior, written consent from the resident(s). Residents participating in clinical group services are routinely reminded after every session to keep information shared during groups confidential. Residents who do not respect other residents’ confidentiality may be expelled from a group and/or treatment at each Orchard facility. Entrance doors are secured 15 minutes after group start time to further ensure confidentiality.
9. The Orchard will not disclose confidential information without expressed written consent, except as permitted or required by State and Federal laws.
10. The Orchard Recovery Board of Directors, facility staff, and volunteers will remain knowledgeable of, and obey, all State and Federal laws and regulations relating to confidentiality of records relating to the provision of services.
11. The Orchard staff and volunteers will not discuss or divulge information obtained in clinical or consulting relationships except in appropriate settings and for professional purposes that demonstrably relate to the case.
12. Every Orchard Team Member ensures that confidential information acquired during delivery of services will be safeguarded from illegal or inappropriate use, access and disclosure or from loss, destruction or tampering.
13. Every Orchard Team Member ensures that these safeguards protect against verbal disclosure, prevent unsecured maintenance of records, or recording of an activity or presentation without appropriate releases.