By Kristie Wilson
“I can neither confirm nor deny.” That may sound odd, but it’s what I would say if anyone asked me about you—my client.
Or about any client here at Fairwinds. If a client’s friend or neighbor asked, “Did Sally make it to her appointment today?” I would respond: “I can neither confirm nor deny.”
Why? It is not anyone’s business if Sally had an appointment, whether she came to it or not.
At Fairwinds, we take your confidentiality very seriously. Not only do we believe your confidentiality is vital to the success of your treatment with us, but it is protected by the law. The Health Insurance Portability and Accountability Act is the first comprehensive federal protection for the privacy of personal health information.
But sometimes you want your primary care doctor to give and receive important information about your care. That decision is in your hands. You can sign a written release of information. Just telling us, “It’s okay, you can talk to my doctor,” is not enough. We are not allowed to release information without a signature. The release lets you be extremely specific. You can specify not only who you are allowing us to discuss your case with, but also what we are able to discuss.
For example, what if you want a friend to be able to pick up your child for you after an appointment. You don’t want the provider to discuss anything about your child’s case with her, but are okay with the front desk acknowledging that your child is in the building. In this example, you’ll just sign this release for presence in treatment.
Or maybe you want the Fairwinds’ clinician and your child’s teacher to share information and discuss treatment. In that case, you will check off exactly what Fairwinds staff are able to discuss with exactly what person (e.g. the teacher) or agency (e.g. the school).
For clients with a substance use disorder, there is an extra layer of protection called 42 CFR. This is a specific sign-off on the release of information stating that we may discuss substance use with the identified person or agency.
Why would you sign a release of information allowing us to talk to the key players in your life? It’s so we can provide excellent and coordinated care. For example, we will always ask for a release of information for your primary care physician. Though you do not have to sign it, it is always best if we can coordinate with your doctor.
If someone in your life can help you better navigate the issues that you are facing, we will ask if you want to sign a release allowing communication between us and them. You can always say no, and you can always change your mind later.
Will we ever discuss your case without permission? The answer is no, with a very important exception: someone’s life is in imminent danger.
If you tell one of our staff that you are planning to harm yourself or another specific person or people, we would be legally obligated to protect your safety or the safety of others.
How much do we share in a case like this? Just enough to prevent a tragedy.
The other example of imminent risk is child or elder abuse or neglect. Any suspicion of such must be reported to the proper authorities. And we are mandated to discuss someone’s case with the Department of Children and Family if there is an open investigation, or in court if ordered to by a judge.
If somebody approaches us at Fairwinds and says, “My brother Fred is seeing one of your counselors. How’s he doing?”
What is our response? “I can neither confirm nor deny.” Our standard response leaves no room for interpretation.
Your privacy is our priority—and your right, and we take it very seriously here at Fairwinds.
Kristie Wilson is the Para-clinical and Billing Director and the Psychiatric Case Manager for the doctors at Fairwinds. She supervises several programs, including Peer Recovery Coaching, Therapeutic Training and Support, and Therapeutic Mentoring. Prior to this, she was employed full time for over 8 years as a Mental Health Counselor at Fairgrounds House on Nantucket, working with adults with significant and chronic mental illness in a residential setting. She is a certified suicide prevention trainer, providing community members with education on how to be suicide alert helpers. In addition, she is sub-contacted by Department of Children and Families to be the on-call assistant in emergencies. Kristie is passionate about assisting the members of the community.