Ohio Admin. Code 5122-27-06 - Release of information
(A) Each request for information regarding a
current or previous client shall be accompanied by an authorization for release
of information, except as specified in sections
5119.27,
5119.28, and
5122.31 of the Revised
Code.
(B) The authorization for
release of information shall include, but not be limited to, the following:
(8)(9) The dated signature
of the client or, as appropriate, a legally authorized agent and the agent's
relationship to the client.
(9)(10) For clients
receiving addiction services treatment, the either of
the following statement
statements :
(1) The full name of the client.
(2) Date of birth of the client.
(3) The specific information to be
disclosed, and the purpose of the
disclosure .
(4) The name of
the person or entity disclosing the information.
(5) The name of the person or entity
receiving the information.
(6) The
date, event, or condition upon which the authorization shall expire.
(7) Statement that the consent is subject to
revocation at any time except to the extent the provider or person who is to
make the disclosure has already acted in reliance on it.
(8)
Either a
statement that the provider will not condition treatment, payment, enrollment,
or eligibility on client's authorization for the release of information, or a
statement of the consequences to the client if client refuses to sign an
authorization for the release of information.
(a)
"This information has been disclosed to you from
records protected by federal confidentiality rules ( 42 CFR part 2 ). The
federal rules prohibit you from making any further disclosure of information in
this record that identifies a patient as having or having had a substance use
disorder either directly, by reference to publicly available information, or
through verification of such identification by another person unless further
disclosure is expressly permitted by the written consent of the individual
whose information is being disclosed or as otherwise permitted by 42 CFR part
2. A general authorization for the release of medical or other information is
not sufficient for this purpose (see
42 CFR 2.31
). The federal rules restrict any use of the information to investigate or
prosecute with regard to a crime any patient with a substance use disorder,
except as provided at
42
CFR 2.12(c)(5) and
42
CFR 2.65."; or,
(b)
" 42 CFR part 2
prohibits unauthorized disclosure of these records."
"This information has been disclosed
to you from records protected by federal confidentiality rules. The federal
rules prohibit you from making any further disclosure of this information
unless further disclosure is expressly permitted by the written consent of the
person to whom it pertains or as otherwise permitted by 42 C.F.R. part 2 . A
general authorization for the release of medical or other information is not
sufficient for this purpose. The federal rules restrict any use of information
to criminally investigate or prosecute any alcohol or drug abuse
client."
(11)
For records
relating to mental health services, information from other providers that is
contained in the individual client record may be released from the individual
client record with the written authorization provided in accordance with the
provisions of this rule. For records relating to addiction services,
information from other providers that is contained in the individual client
record may be released from the individual client record only if the written
authorization provided in accordance with this rule explicitly authorizes both
the disclosure of provider's records and the re-disclosure of the other
provider's records.
(C) If the client is a minor, the release of
information shall either:
(2)(3) In the case of
providers who are certified to provide AoD
addiction treatment services, be signed by the
client and the client's parent or legal guardian; or,
(3)(4) In
the case of providers who are certified to provide AoD
addiction
treatment services and minor client's providing consent to treatment pursuant
to section 3719.012 of the Revised Code,
the client shall sign the release of information.
(1) Be signed by the
client's parent or legal guardian;
(2)
In the case of
providers who are certified to provide mental health services, may be signed by
a client of fourteen years of age or older if all other requirements of section
5122.04 of the Revised Code are
met;
(D) In the case of providers who are
certified to provide AoD
addiction treatment services, when providing
services to clients who are minors but who are not providing consent pursuant
to section 3719.012 of the Revised code;
the provider must either obtain the client's authorization to contact the
client's parent or legal guardian or find the minor lacks in capacity to make a
rational choice in accordance with
42 C.F.R. part
2.14(c)(2).
Notes
Promulgated Under: 119.03
Statutory Authority: 5119.36
Rule Amplifies: 5119.36
Prior Effective Dates: 09/04/2003, 04/01/2016
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