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SAMHSA Provides Guidance on 42 CFR Part 2
Over the summer, the Substance Abuse and Mental Health Services Administration (SAMHSA) hosted a webinar series on health information technology (IT). The purpose of these webinars was for providers, consumers, states, organizations and vendors to be educated on the regulations and usage of health IT and to explore the innovative ways this technology is being used to improve the quality of care delivery, support patient engagement and self-management, improve the efficiency of the workforce and expand access to care.
The second webinar in the series addressed the myths and scenarios regarding 42 CFR Part 2, the federal regulation governing the confidentiality of drug and alcohol use treatment and prevention records. As an organization dedicated to the treatment and recovery of those with substance use disorders, ASAM took part in this webinar because 42 CFR Part 2 applies directly to the work being done by members.
The webinar featured expert public health and policy advisors, attorneys and consultants who explained the applicability of 42 CFR Part 2, permitted disclosures of protected data and the ways in which the adoption of electronic health records (EHRs) and health information exchanges (HIE) impacts compliance. The federal regulations that implement this law were last updated in 1987 and over the past 25 years there have been significant changes within the US health care system that were not addressed by these regulations. These changes include new models of integrated care built on a foundation of information-sharing to support coordination of patient care, the development of an electronic infrastructure for managing and exchanging patient data, the expansion of prescription drug monitoring programs and a new focus on performance measurement within the health care system.
SAMHSA has been working closely with the Office of the National Coordinator for Health Information Technology to promote the inclusion of behavioral health information in HIE efforts while protecting patient privacy and confidentiality. These efforts include the development of two sets of guidance documents on applying the substance abuse confidentiality regulations to electronic HIE. The webinar consistently touched upon this issue, addressing the ways in which a 42 CFR Part 2 program can include and share alcohol and drug records information into EHR systems. This can be done either through written patient consent, an exception due to medical emergency or an agreement with a Qualified Service Organization. These are also the same ways alcohol and drug records protected by 42 CFR Part 2 can be integrated into EHR systems with providers not covered by 42 CFR Part 2.
The webinar on 42 CFR Part 2 was just one of three important webinars in SAMHSA’s summer series. The first webinar in June was on behavioral health and health IT innovation, specifically the health IT tools that SAMHSA utilizes in the field. SAMHSA’s health IT portfolio includes a range of strategies, such as e-therapy and e-recovery, telehealth and telepsychiatry, web-based virtual recovery services, among others. The final webinar was in September and the focus was on the Opioid Treatment Programs (OTP) Service Continuity Pilot, a project that addresses facilitating patients’ ability to share specific opioid treatment information in cases of care discontinuity in a manner that is sensitive to privacy concerns under 42 CFR Part 2 regulations, through a HIE organization. SAMHSA supported the pilot for the electronic exchange of health information among OTPs through a HIE in cases of service discontinuity, such as those due to natural disasters or other unforeseen disruptions.
Health IT encompasses health systems integration, health information exchange, and the use of EHR. It also encompasses the use of electronic training, assessment, treatment, monitoring, and recovery support tools. There are many benefits from the utilization of health IT by providing integrated treatment through linking together programs, services and providers. Health IT can help behavioral health providers communicate and work with other providers and programs, track the progress of those who leave a program and monitor when additional services are necessary, reduce redundancy between programs and providers, improve the quality of care and increase access to services and support.
ASAM has long collaborated with SAMHSA to increase the quality of and access to addiction treatment services and we applaud their efforts to accomplish this goal by improving health information technology. If you are interested in reviewing one of these webinars, please email Brad Bachman, ASAM’s Advocacy, Policy and Payer Relations Coordinator, and he will provide the slides from any of the three presentations. ASAM hopes you find this information as intriguing and important as we have!
