title: Navigating the legal and ethical foundations of informed consent and confidentiality in integrated primary care.
abstract: This article describes findings from ongoing research and analysis of current literature in addition to discussions with leaders in the field, communications with lawyers and administrators of advocacy and government agencies pertaining to integrated primary care (IPC). Standards of care are established based on a myriad of factors, including professional codes of ethics, case law, state and federal laws, professional standards, existing best practices, current professional guidelines, administrative rules and regulations, and licensing board regulations. Regulations may differ for behavioral health and medical providers, posing challenges in IPC settings. This article provides a review of these regulations, particularly 42CFR Part 2, a federal law governing confidentiality for substance abuse programs, Health Insurance Portability and Accountability Act (HIPAA), and state laws relevant to patient care in IPC settings. On the basis of findings from the study, the authors make recommendations related to patient care practices concerning informed consent and release of information procedures, treatment and warm hand-off protocols, documentation and electronic record keeping, agreements with other providers, and billing.
authors.affiliation: Department of Counselor Education, Radford University, 801 East Main Street, Radford, VA 24142, USA. cmhudgins@radford.edu
authors.forename: Cathy
authors.initials: C
authors.lastname: Hudgins
authors.forename: Sandra
authors.initials: S
authors.lastname: Rose
authors.forename: Peter Y
authors.initials: PY
authors.lastname: Fifield
authors.forename: Steve
authors.initials: S
authors.lastname: Arnault
mesh_terms: D001524:Behavioral Medicine / Q000941:ethics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D059019:Clinical Coding / Q000331:legislation & jurisprudence; D003219:Confidentiality / Q000941:ethics / Q000331:legislation & jurisprudence*; D057286:Electronic Health Records / Q000941:ethics / Q000331:legislation & jurisprudence / Q000592:standards; D033161:Government Regulation; D020408:Health Insurance Portability and Accountability Act; D006801:Humans; D033181:Information Dissemination / Q000941:ethics / Q000331:legislation & jurisprudence; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence*; D033183:Interdisciplinary Communication; D010350:Patient Credit and Collection / Q000331:legislation & jurisprudence; D062209:Patient Handoff / Q000331:legislation & jurisprudence / Q000592:standards; D011320:Primary Health Care / Q000941:ethics / Q000331:legislation & jurisprudence* / Q000458:organization & administration; D011368:Professional-Family Relations / Q000941:ethics; D012051:Reimbursement Mechanisms / Q000331:legislation & jurisprudence; D059039:Standard of Care / Q000941:ethics / Q000331:legislation & jurisprudence; D019966:Substance-Related Disorders / Q000628:therapy; D014481:United States