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When to Disclose Confidential Information
Protecting the confidentiality of clients’ personal health information is a key component of the counseling profession’s Code of Ethics and Standards of Practice. It’s also mandated by HIPAA’s privacy provision and state privacy laws. But there are important exceptions to these rules, outlined in federal and state statutes. Disclosures are generally allowed under the following circumstances, and should be done in accordance with state law and your employer’s policies and procedures.
Consulting with other practitioners. Counselors can share pertinent information with key members of the healthcare team as needed for continuity of care. Inform your clients that such disclosure may be necessary in order to provide complete assessment and appropriate treatment. Be sure to obtain and to document the client’s consent.
Court or disciplinary actions. A court can order a counselor to release confidential health information without a client’s permission—unless the counselor can compel the court to reconsider because of potential harm to the client-counselor relationship. In some cases, a counselor may also be able to disclose confidential client information as part of a defense against a civil, criminal or disciplinary action.
Dangerous clients. If you believe your client is suicidal or is a “clear and imminent danger” to himself or others, you have an obligation to report it to your supervisor, the client’s primary care provider or the appropriate authorities. If a client threatens to harm someone, you may also be required to warn or attempt to protect that person from danger.
Additionally, the American Counseling Association’s Code of Ethics stipulates that a counselor may be justified in disclosing the health information of a client who has a communicable and potentially fatal disease, such as HIV, to third parties at high risk of contracting it. The counselor would be justified in disclosing this information, however, only after ascertaining that the client had not informed the third party about the disease and had no intention of doing so in the immediate future.
Abused or abusive clients. You may also be required by state law to disclose information about a client. In suspected instances of abuse, you are obligated to file a report with the appropriate state agency or the police. This includes child and elder abuse or neglect, and may apply whether the client is the abuser or the one being abused.