- Review the importance of client confidentiality
- Review Health Insurance Portability and Accountability Act (HIPAA) guidelines related to confidentiality
- Discuss how to maintain the confidentiality of clients in various situations
Why is confidentiality important?
- Patient privacy is an important area of clinical care
- We have the legal and ethical obligation to protect patient confidentiality
- All information regarding a client is privileged and cannot be released without proper written consent
- Written consent can be obtained from the parent or guardian of a minor client
- HIPAA & BACB guidelines call for patient confidentiality as do most credentialing agencies, boards, etc (BACB, APA, etc.)
What is HIPPA? Health Insurance Portability and Accountability Act
HIPPA is a federal law that was designed to protect privacy of a client’s personal and health information. As well as to provide for the security of personal health information (physical and electronic). In addition, HIPPA specifies the clients rights to approve access and use of their medical information.
Protected Health Information (PHI)
PHI reveals the state of a person’s health, physical, mental and emotional in the past, present and future prognosis. It exists in various forms as physical records, oral voicing (phone, voicemail, conversation) and electronic files. It is individually identifiable.
Identifiers as Defined by HIPAA:
- Postal address
- Names of relatives
- Names of employers
- Date of birth
- Telephone number
- Fax number
- Email address
- Social Security Number
- Medical Record Number
- Account Numbers
- License certificate numbers
- Health Plan Beneficiary number
- Wed URL
- IP address
- Biometric identifiers (finger & voice prints)
- Photographic images
- Any other unique identifying number, code or characteristic
The law does require that all health providers and agencies that come into contact with PHI to follow HIPAA guidelines:
- Procedures must be in place to protect PHI
- All employees must be trained in HIPAA safeguards
Please refer to http://www.hhs.gov/ocr/privacy/ for more specific and detailed information on HIPAA
CLIENT CONFIDENTIALITY MUST BE MAINTAINED AT ALL TIMES
There are only specific situations where breech of confidentiality is acceptable:
- Child Abuse
- Risk of Suicide
- Risk of Homicide
- Elder Abuse
There are NO other acceptable breeches of client confidentiality!
Why is client confidentiality so important?
- Ethically it is the right thing to do.
- In addition, BCBA’s, psychologist’s and other professionals are bound by ethics set forth by their governing board to maintain the confidentiality of their clients
- Clients deserve to have their diagnosis protected
- Clients deserve to not be defined by their diagnosis
- Some families are more private about diagnosis than others
How could the client’s confidentiality be compromised?
- The company’s name (If autism is in the company name)
- In a phone call (again, if autism is in the company name, cross-contamination of clients)
- In the community (accidentally revealing diagnosis or role in community settings). Try to pre-plan with the family what their preference is for disclosing your role, in other words who they would like you to say that you are in the public setting.
- At school (same as in community, child’s teacher’s will likely know diagnosis, others may not, peers likely do not)
- The chance meeting
- In photographs
- Attire (advertising autism)
- Casual conversation
The BCBA may have a plan in place for dealing with common surprise questions and situations. Be prepared for anything in any of these situations.
Essentially, use discretion. When unsure it is better to say nothing and err on the side of caution. And above all, use common sense!