Chapter 2...more more more.

Minors and the Infirm

take special care to protect the confidentiality of minors and the infirm (individuals who are frail, sick, and are unable to fully participate in decisions about their care.) Not all systems respect confidentiality to the degree that we are in the helping professions are committed to doing it.

FAILURE TO FOLLOW HIPAA*

can result in fines from $100 to $250,000. And from 1 to 10 years in prision for those individuals and institutions with the ultimate responsibility for safeguarding patient privacy..

When you can break confidentiality

1. When you must warn and protect others from possible harmful actions by the client. For instance, you or your agency must warn another party if your client is intent on harming that other party. In addition you should notify the police.; 2. When the person needs professional services. For instance, if the person has take an overdose of medication and is int he emergency room, the E.R staff may call, needing to know what prescriptions the client was taking in order to give him the proper antidote.; 3. When you must protect people from harming themselves. An example might be people who are threatening to take an overdose of their medications with the intention of committing suicide. or people who appear so depressed or desperate that they are talking about ending their lives.; 5. When obtaining a professional consultation from your supervisor regarding how best to proceed with a case in the course of normal supervision.

Guarding Confidentiality on the phone & other conversations

Ex; a person receiving services from your agency may also be receiving services from a local physician. Suppose someone calls, claiming to be the physician's nurse and needing to know at once what the medications the client is taking. She may really be the physician's nurse, or she may be a person posing as the nurse in order to determine that the person is using your services and the level of his problem; Even if she IS the nurse, the person may wish to keep his physician uniformed about the involvement with your agency.

Collegial sharing

You should ask individuals for permission before sharing information with colleagues from whom you are getting opinions or superivsion, unless the case is going to be discussed in the normal course of supervision, unless the case is going to be discussed in the normal course of supervisory meetings with a regular supervisor. You cannot share information with student interns without making certain the students have signed agreements to observe strict confidentiality while acting as part of the agency.

(HIPAA)

also known as the health insurance portability and accountability act; was passed in 1996; in part to ensure people did not lose medical coverage when they changed jobs. Title 2. of the act contains the security and privacy mandates. These contain stringent rules for protecting a client's health information. And most social service agencies must adhere to these rules. Where state laws are more stringent than this federal act, state laws take precedence. F

Sometimes-Workers*

have informally notified their freinds and other people of the persons HIV status, thinking they were doing these people a favor. In fact this behavior is entirely unethical, and can lull other workers into believing they know who is and who is not HIV. We can never actually know this for certain bc of the length of time it takes for the disease to register positive on a blood test.

All agencies

have procedures for such situations in the event of a real emergency. you, however must never openly or automatically acknowledge that an individual is being seen in your agency, no matter how important and official the other person seems to be. In the case of a seeming emergency, refer the call to your supervisor unless you know the emergency workers or emergency room personnel well enough to recognize their voices.

Social Services

in this field, privacy is invaded or altered under some circumstances, and people need to be informed of those circumstances. The point you should stress with the people you serve is the fact that third-party payers will have access to diagnoses and in some cases to actual records or summaries of records. The agency must provide this access in order to be paid for the services it has rendered.

Release of information regarding HIV/AIDS

it must specifically state that you may release information regarding the person's HIV status, all references to this must be deleted from the record unless the client signs a separate form that specifically states that you have permission to release this information. If you are asked to release information about a person who is HIV positive and the other person signs a release form, the law in most states specifies that it is not good enough to simply remind that person that his case contains references to his HIV status and get his verbal permission to release the information anyway.

People***

people can make informed decisions about whether to pay for services themselves and not involve the insurance company.

Another way to violate confidentiality

talk about your cases with your friends and relatives, leaving out names. Others may be able to piece together the identity of the person you are talking about based on other information they possess. In this way, they may disco er far more about a person that than that person ever intended them to know

Oral communications

the law states that agencies are to make "reasonable efforts" to "safeguard clients " information. Taking precautions to protect this means : 1. not discussing a person's personal health information where others can hear 2. avoiding situations with clients where there is no privacy, particularly privacy from other clients . 3. Lowering your voice when discussing clietns with others in the agency.

Privacy

this is very much related to confidentiallity. Siegal,calls it "the freedom of individuals to choose for themselves and the time and the circumstances under which and the extent to which their beliefs, behaviors, and opinions are to be shared. Stadler calls it "The right of persons to choose and what others may know about them and under what circumstances." Kirst-ashman and hull "the condition of being free from unauthorized observation or intrusion. "

What if the state does not have such a law

you (as the worker) is still responsible for pprotecting your client and must be alert to the possible harm such a release might causethe person. In a situation, it is wise to involve the person in a discussion about the release of this sort of information, or if the individual is unable to participate in such a discussion, to take steps to protect that individual from undue bias.