11

King County Information King County Information Sharing Resource Guide, 2Sharing Resource Guide, 2ndnd

EditionEdition

This guide is a tool This guide is a tool developed by developed by Uniting Uniting for Youth: A for Youth: A partnership of youth-partnership of youth-serving systems in serving systems in King CountyKing County to provide to provide basic answers to basic answers to questions about the questions about the sharing of information sharing of information between staff of between staff of various systems. various systems.

22

If you are a staff in a youth-serving system If you are a staff in a youth-serving system you may feel confused by information you may feel confused by information sharing and confidentiality laws. You might sharing and confidentiality laws. You might feel intimidated by these legal obligations feel intimidated by these legal obligations and even be afraid to share information with and even be afraid to share information with others. This guide is designed to provide a others. This guide is designed to provide a better understanding of information sharing better understanding of information sharing to support effective collaboration in juvenile to support effective collaboration in juvenile dependency, juvenile justice, education, dependency, juvenile justice, education, mental health, and substance abuse mental health, and substance abuse treatment systems in King County. treatment systems in King County.

Who should use this guide?Who should use this guide?

33

How to use this guideHow to use this guideThis guide has five broad content This guide has five broad content

areas to help you better understand areas to help you better understand information sharing laws.information sharing laws.

Information Sharing PrinciplesInformation Sharing Principles A Look at RolesA Look at Roles System Specific Information Sharing System Specific Information Sharing

GuidelinesGuidelines Decision Making Tree and Quick Decision Making Tree and Quick

reference Gridreference Grid AppendicesAppendices

44

A Special Note:A Special Note:

It may be tempting to use the guide It may be tempting to use the guide as a reference and only read certain as a reference and only read certain areas as needed. In order to fully areas as needed. In order to fully understand information sharing understand information sharing across systems and make the most across systems and make the most of the guide we recommend that you of the guide we recommend that you read the entire guide before using read the entire guide before using individual sections.individual sections.

55

Information Sharing Information Sharing PrinciplesPrinciples

This section of the guide describes This section of the guide describes whywhy and and whenwhen information should be information should be shared. When sharing information it shared. When sharing information it is important to have a balance is important to have a balance between protecting a family’s and between protecting a family’s and child’s privacy and allowing systems child’s privacy and allowing systems to exchange information for to exchange information for coordinating services.coordinating services.

66

Roles and ResponsibilitiesRoles and Responsibilities

Each system is responsible to the child Each system is responsible to the child and his or her family, the community, and his or her family, the community, and other stakeholders in very different and other stakeholders in very different ways. While you must consider your ways. While you must consider your own responsibilities and requirements own responsibilities and requirements when sharing information it is helpful to when sharing information it is helpful to know others’ goals to be able to know others’ goals to be able to effectively address natural conflicts effectively address natural conflicts when they arise. when they arise.

77

A Look at RolesA Look at Roles

This section describes the roles and This section describes the roles and responsibilities of: responsibilities of: Juvenile Probation Counselors,Juvenile Probation Counselors,Division of Children and Family Services Division of Children and Family Services (DCFS) social workers, (DCFS) social workers, Juvenile Rehabilitation Counselors,Juvenile Rehabilitation Counselors,School and Education Staff,School and Education Staff,Dependency Court Appointed Special Dependency Court Appointed Special Advocate (CASA) volunteers,Advocate (CASA) volunteers,mental health treatment staff, and mental health treatment staff, and substance abuse treatment staff.substance abuse treatment staff.

88

Overview of Information Overview of Information Sharing LawsSharing Laws

This section briefly identifies the laws This section briefly identifies the laws that govern information sharing and that govern information sharing and confidentiality. The organizations and confidentiality. The organizations and agencies that are covered by these laws agencies that are covered by these laws and the guide are identified. Juvenile and the guide are identified. Juvenile justice and care agencies are defined. justice and care agencies are defined. Additionally, publicly-funded mental Additionally, publicly-funded mental health and substance abuse treatment health and substance abuse treatment agencies are described. Finally, general agencies are described. Finally, general information about Releases of information about Releases of Information is provided.Information is provided.

99

System Specific Information System Specific Information Sharing GuidelinesSharing Guidelines

This section provides detailed guidelines This section provides detailed guidelines for each system of for each system of whenwhen and and whatwhat information can be shared with information can be shared with another system. For instance… “When another system. For instance… “When can the JPC share information with the can the JPC share information with the DCFS social worker?” These guidelines DCFS social worker?” These guidelines can be used to understand what you can be used to understand what you are able to share with others. It can are able to share with others. It can also help you understand what others also help you understand what others are able to share with you. are able to share with you.

1010

Decision-Making TreeDecision-Making Tree

The Decision-The Decision-Making Tree is Making Tree is designed to be designed to be used as a chart used as a chart

to aid you in to aid you in determining determining

when to share when to share information.information.

1111

Decision-Making TreeDecision-Making Tree

The first question to ask yourself when The first question to ask yourself when considering sharing information you considering sharing information you

have is…have is…

1. Is the information I have necessary 1. Is the information I have necessary and relevant and important to the and relevant and important to the child’s and family’s case planning child’s and family’s case planning

and services?and services?

1212

When information should be When information should be sharedshared

Ask the person making the Ask the person making the request why the information request why the information is needed. You need to is needed. You need to discuss discuss whatwhat information is information is necessary and relevant to the necessary and relevant to the scope of their work with the scope of their work with the child. A clear understanding child. A clear understanding will help you disclose will help you disclose onlyonly the the specific information for specific information for serving the needs of the child serving the needs of the child and family. and family.

1313

Next, ask yourself….Next, ask yourself….

2. Is it my information to 2. Is it my information to share?share?

1414

When it is not your When it is not your informationinformation

When it is not information When it is not information that you or your that you or your organization originated it organization originated it is best to direct the person is best to direct the person requesting the information requesting the information to the original source. to the original source. There may be unknown There may be unknown factors that should be factors that should be considered when releasing considered when releasing the information.the information.

1515

Then ask yourself…Then ask yourself…

3. Does the recipient have legal3. Does the recipient have legal

permission to obtain the information?permission to obtain the information?

1616

Proper AuthorizationProper Authorization

The person requesting the The person requesting the information needs proper information needs proper authorization for you to give authorization for you to give them the information. Types them the information. Types of authorization include: of authorization include:

– statutory (authorized by a law)statutory (authorized by a law)

– court order (authorized by a court order (authorized by a judge)judge)

1717

Release of Information (ROI)Release of Information (ROI)

Another type of authorization is a Another type of authorization is a release of information. This must be release of information. This must be signed by the person legally allowed signed by the person legally allowed to share the information, usually the to share the information, usually the parent/guardian or the youth. The parent/guardian or the youth. The person signing must be giving person signing must be giving informed consent for an ROI to be informed consent for an ROI to be valid. valid.

1818

Informed ConsentInformed Consent

The person authorizing the The person authorizing the release must fully understand:release must fully understand:

what information will be disclosedwhat information will be disclosed

who will receive the informationwho will receive the information

how it will be used how it will be used

1919

Special Considerations for Special Considerations for Informed ConsentInformed Consent

When youth are represented by legal When youth are represented by legal counsel the legal counsel should be counsel the legal counsel should be involved when using a release of involved when using a release of information to fully inform youth of information to fully inform youth of possible legal consequences of possible legal consequences of information sharing.information sharing.

2020

Finally, ask yourself Finally, ask yourself

4. Are there any reasons 4. Are there any reasons this information this information should should notnot be released in this be released in this situation?situation?

2121

Consider Collateral Consider Collateral ConsequencesConsequences

Information out of Information out of your hands can be your hands can be used inappropriately. used inappropriately. Once information is Once information is released it may be released it may be impossible to retrieve impossible to retrieve and it may be subject and it may be subject to redisclosure.to redisclosure.

2222

Professional JudgmentProfessional Judgment

It is essential that you use your best It is essential that you use your best professional judgment when sharing professional judgment when sharing information. Consult with your information. Consult with your supervisor, records coordinator, or supervisor, records coordinator, or legal counsel if you are unsure about legal counsel if you are unsure about whether and how to share whether and how to share information. information.

2323

Risks of Information sharingRisks of Information sharing

The information may be used in ways that The information may be used in ways that could negatively effect the youth and their could negatively effect the youth and their family. There could be: family. There could be:

Court sanctions Court sanctions Placement changes for foster youth Placement changes for foster youth Separation from family members Separation from family members School suspension or expulsionSchool suspension or expulsion Peers or community members Peers or community members

learning private information learning private information

2424

Quick Reference GridQuick Reference Grid

The guide contains a quick reference The guide contains a quick reference grid with a crosswalk of the givers grid with a crosswalk of the givers and receivers for each system. It and receivers for each system. It includes a very short summary of the includes a very short summary of the information sharing allowed and the information sharing allowed and the legal citation. There is a section of legal citation. There is a section of the grid for viewing on the next the grid for viewing on the next page.page.

2525

Quick Reference GridQuick Reference Grid

The Receivers of Information are listed in

the top row

The givers of Information are listed in the vertical

row

This box includes a thumbnail description of what schools can share with CASAs

2626

AppendicesAppendices

The guide has 5 appendices to The guide has 5 appendices to provide you with additional provide you with additional information and direct you to other information and direct you to other resources. resources.

2727

Appendix AAppendix A

This is list of the federal and state This is list of the federal and state information sharing and information sharing and confidentiality laws described in the confidentiality laws described in the guide. There are website links to lead guide. There are website links to lead you to these laws. The electronic you to these laws. The electronic version of the guide contains active version of the guide contains active links that can be accessed.links that can be accessed.

2828

Appendix BAppendix B

This includes acronyms and a This includes acronyms and a glossary of terms that are in glossary of terms that are in bold bold throughout the guide. Ever wonder throughout the guide. Ever wonder what IEP, RSN, or PHI is? Appendix B what IEP, RSN, or PHI is? Appendix B will tell you. will tell you.

2929

Appendix CAppendix C

This has some Frequently Asked This has some Frequently Asked Questions. Did you ever wonder what Questions. Did you ever wonder what is the difference between a RCW and is the difference between a RCW and a WAC? The answer is in Appendix C. a WAC? The answer is in Appendix C.

3030

Appendix DAppendix D

This explains the required elements This explains the required elements for a Release of Information and a for a Release of Information and a sample ROI is available. Get detailed sample ROI is available. Get detailed information about what has to be information about what has to be included on an ROI. included on an ROI.

3131

Appendix EAppendix E

This provides additional resources. It This provides additional resources. It includes King County and Washington includes King County and Washington State resources and links to the websites State resources and links to the websites of the Uniting for Youth partners. There of the Uniting for Youth partners. There are national juvenile justice initiative are national juvenile justice initiative website links to find out more about website links to find out more about juvenile justice reform efforts. Finally, juvenile justice reform efforts. Finally, there are links to other information there are links to other information sharing guides and a information sharing sharing guides and a information sharing tool kit .tool kit .

3232

Practice ScenarioPractice Scenario

Next is a scenario included as Next is a scenario included as opportunity for you to walk through opportunity for you to walk through the Decision-making Tree. the Decision-making Tree.

– Refer to the Decision-making Tree on Refer to the Decision-making Tree on Page 14 when completing this activity. Page 14 when completing this activity.

3333

ScenarioScenarioYou are a Juvenile Probation Counselor. You are a Juvenile Probation Counselor. You supervise a youth on probation that is You supervise a youth on probation that is also in foster care. Her Department of Child also in foster care. Her Department of Child and Family Services (DCFS) Social Worker and Family Services (DCFS) Social Worker inquires about the youth's progress in inquires about the youth's progress in mental health and substance abuse mental health and substance abuse treatment.  You receive monthly status treatment.  You receive monthly status reports, however the youth does not want reports, however the youth does not want the social worker to get this information. the social worker to get this information.

What can you share with the social worker? What can you share with the social worker? What should you share with the social What should you share with the social worker?worker?

3434

Walkthrough the Walkthrough the Decision-Making TreeDecision-Making Tree

The first question to ask yourself when The first question to ask yourself when considering sharing information you considering sharing information you

have is…have is…

1. Is the information I have necessary 1. Is the information I have necessary and relevant and important to the and relevant and important to the child’s and family’s case planning child’s and family’s case planning

and services?and services?

3535

The information the Juvenile Probation The information the Juvenile Probation Counselor has is necessary and relevant Counselor has is necessary and relevant and important to the child’s and and important to the child’s and family’s case planning and services. As family’s case planning and services. As the legal custodian of the youth the the legal custodian of the youth the social worker needs the mental health social worker needs the mental health and substance abuse treatment and substance abuse treatment progress information to ensure the progress information to ensure the youth is getting the care she needs. youth is getting the care she needs.

1. The Answer is ‘Yes’ 1. The Answer is ‘Yes’

3636

Then, ask Then, ask yourself….yourself….

2. Is it my information to 2. Is it my information to share?share?

3737

2. The Answer is ‘No’ 2. The Answer is ‘No’

The mental health and substance The mental health and substance abuse treatment information was abuse treatment information was obtained during counseling services obtained during counseling services with the youth not created by the with the youth not created by the Juvenile Probation Counselor. Juvenile Probation Counselor.

3838

Examples of Possible Unknown Examples of Possible Unknown FactorsFactors

In Washington, the age of consent is 13 years old. In Washington, the age of consent is 13 years old. Washington law allows the youth to control his/her own Washington law allows the youth to control his/her own health care information.health care information.

Substance abuse treatment information is protected by a Substance abuse treatment information is protected by a federal law that prohibits re-disclosure (when an individual federal law that prohibits re-disclosure (when an individual or organization discloses information or records it did not or organization discloses information or records it did not originate). 42 CFR, Part 2.32. Generally, this federal law originate). 42 CFR, Part 2.32. Generally, this federal law does notdoes not allow youth agencies to re-disclose this treatment allow youth agencies to re-disclose this treatment information with others even when Washington State laws information with others even when Washington State laws doesdoes allow re-disclosure. This law continues to apply to the allow re-disclosure. This law continues to apply to the treatment information even when other youth systems such treatment information even when other youth systems such as schools or child welfare have it. Other systems may be as schools or child welfare have it. Other systems may be unaware of this continued protection and the legal unaware of this continued protection and the legal consequences of improper re-disclosure.consequences of improper re-disclosure.

3939

Decision-Making Tree FlowDecision-Making Tree Flow

The Decision-Making Tree leads out The Decision-Making Tree leads out of the question process when it is not of the question process when it is not your information. However, there are your information. However, there are many circumstances that may lead many circumstances that may lead to legal permission or requirements to legal permission or requirements to share information that is not to share information that is not yours. This scenario is an example of yours. This scenario is an example of when to continue considering legal when to continue considering legal permission/permission/obligations.obligations.

4040

Next, ask yourself…Next, ask yourself…

3. Does the recipient have legal3. Does the recipient have legalpermission to obtain the information?permission to obtain the information?

Who is the requestor?Who is the requestor? Why is this person requesting information?Why is this person requesting information? How will the information be used?How will the information be used? Is the person presenting with proper Is the person presenting with proper

authorization (statute, court order, ROI)?authorization (statute, court order, ROI)? Is the youth represented by legal counsel?Is the youth represented by legal counsel?

4141

What is legally allowedWhat is legally allowed

Washington State law does allow the JPC to Washington State law does allow the JPC to share documents retained in their records share documents retained in their records even if the agency was not the originating even if the agency was not the originating source of the document when DCFS is source of the document when DCFS is assigned the responsibility for supervising assigned the responsibility for supervising the youth. (see pages 22 and 30 of the the youth. (see pages 22 and 30 of the Guide).Guide).

Since federal law prohibits the re-disclosure of Since federal law prohibits the re-disclosure of substance abuse records the JPC cannot substance abuse records the JPC cannot legally re-disclose those records.legally re-disclose those records.

In this scenario the JPC can legally re-disclose In this scenario the JPC can legally re-disclose the mental health treatment records.the mental health treatment records.

4242

Finally, ask yourself Finally, ask yourself

4. Are there any reasons this 4. Are there any reasons this information information should notshould not be released be released in this situation?in this situation?

4343

Additional ConsiderationsAdditional Considerations

While the JPC can legally re-disclose While the JPC can legally re-disclose the mental health records the youth the mental health records the youth has stated she does not want the has stated she does not want the information released to the social information released to the social worker. Depending on other factors worker. Depending on other factors related to this youth’s situation the JPC related to this youth’s situation the JPC may decide to withhold or release the may decide to withhold or release the information. As mentioned previously information. As mentioned previously there may be conflicting considerations there may be conflicting considerations such as privacy, case planning, and such as privacy, case planning, and safety issues to consider. safety issues to consider.

4444

Benefits and Risks Benefits and Risks of Information Sharingof Information Sharing

Benefits may include:Benefits may include: Social worker may arrange additional Social worker may arrange additional

support such as transportation, or foster support such as transportation, or foster placement located near counseling servicesplacement located near counseling services

Risks may include:Risks may include: Youth could be placed in a more restrictive Youth could be placed in a more restrictive

placementplacement Information could be shared with foster Information could be shared with foster

parent parent

4545

ConclusionConclusion

The Guide can be a useful tool but cannot provide The Guide can be a useful tool but cannot provide answers for all the many complicated scenarios answers for all the many complicated scenarios you will encounter. As you have seen information you will encounter. As you have seen information sharing is complex and challenging. There will sharing is complex and challenging. There will always be new thought-provoking situations always be new thought-provoking situations requiring in-depth review of information sharing requiring in-depth review of information sharing and confidentiality laws. The Decision-making Tree and confidentiality laws. The Decision-making Tree can be used as a compass to help you through can be used as a compass to help you through these information sharing mazes. Consultation these information sharing mazes. Consultation with peers, supervisors, and legal counsel may be with peers, supervisors, and legal counsel may be needed. We hope the Guide and this training have needed. We hope the Guide and this training have provided you with the opportunity to gain provided you with the opportunity to gain understanding and direction when navigating understanding and direction when navigating information sharing. information sharing.

4646

Printing the PDFPrinting the PDF

You may wish to print the guide You may wish to print the guide without the full-page pictures. In the without the full-page pictures. In the print window this can be done by print window this can be done by selecting “pages” in the “print selecting “pages” in the “print range.” Enter range.” Enter 1-3,5-7,9-14,16-1-3,5-7,9-14,16-31,33,35-42,44 31,33,35-42,44 in the box next to in the box next to “pages.”“pages.”

4747

Scenario TwoScenario Two

A youth in the Juvenile Detention Health Clinic is A youth in the Juvenile Detention Health Clinic is presenting as disorganized (speech moves quickly presenting as disorganized (speech moves quickly through multiple topics), confused, with difficulty through multiple topics), confused, with difficulty tracking (staying on topic during conversation). A tracking (staying on topic during conversation). A drug screen is negative. Detention Health Clinic drug screen is negative. Detention Health Clinic staff are unsure about the cause of the youth’s staff are unsure about the cause of the youth’s behavior. The youth is enrolled at a community behavior. The youth is enrolled at a community mental health agency, and has a case worker and mental health agency, and has a case worker and a psychiatrist. The mental health professionals in a psychiatrist. The mental health professionals in the Detention Health Clinic want to find out the the Detention Health Clinic want to find out the youth’s1) psychiatric hospitalization history, 2) youth’s1) psychiatric hospitalization history, 2) prescribed medications, 3) medication prescribed medications, 3) medication compliance, 4) treatment attendance, and 5) compliance, 4) treatment attendance, and 5) treatment plan. They need the information quickly treatment plan. They need the information quickly in order to appropriately manage the youth. in order to appropriately manage the youth.