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marvin19372 · Jun 17, 2013, 05:59 PM

My daughter, who is a minor, was expelled from a private school for drug use. One of the condition of her acceptance back to the school was a completion of a drug treatment program. We enrolled her in a 5 week out patient program. We signed a paper giving authorization for the program director to contact the school as the school required a letter from the program. We also signed a separate paper allowing medical information about her treatment to be released only to us, her parents. Because of many issues with the director we decided to remove her from treatment in that program to another one.
The director did contact the school to state that she was not longer in treatment in the program but also told the school that she required continued treatment immediately. Was the disclosure about her requiring continued treatment a disclosure of confidential medical information? The school has now denied her re-admittance despite the fact that she is current enrolled into another program.
We also found out that the director placed several phone calls to the school although only a letter was required. We have no idea of knowing what was discussed in the phone calls.

J_9 · Jun 17, 2013, 06:03 PM

It doesn't appear that HIPAA, not HAPAA, was violated since terms of the acceptance was successful completion of the program. Since she did not successfully complete this program, it was proper, according to the terms, for the rehab to report back to the school.

ScottGem · Jun 17, 2013, 06:25 PM

I agree. The condition of acceptance back to the school was completion of the program. The director told the scholl that she hadn't completed the program. Seems reasonable to me.

marvin19372 · Jun 17, 2013, 06:36 PM

I agree. I am not arguing the school decision.

My actual questions involves the discloser from the director to the school that my daughter required further treatment elsewhere? This seems like a medical opinion that he was not authorized to disclose ( I believe).

marvin19372 · Jun 17, 2013, 06:40 PM

Originally Posted by J_9

It doesn't appear that HIPAA, not HAPAA, was violated since terms of the acceptance was successful completion of the program. Since she did not successfully complete this program, it was proper, according to the terms, for the rehab to report back to the school.

I agree. I am not arguing the school decision.

My actual questions involves the discloser from the director to the school that my daughter required further treatment elsewhere? This seems like a medical opinion that he was not authorized to disclose ( I believe).

J_9 · Jun 17, 2013, 06:40 PM

Sorry, since she did not finish the original program it was within his rights, as per the agreement, that he notify the school that she did not complete his program and that she was undergoing further treatment in order to comply with the school's requirement.

marvin19372 · Jun 17, 2013, 06:40 PM

Originally Posted by ScottGem

I agree. The condition of acceptance back to the school was completion of the program. The director told the scholl that she hadn't completed the program. Seems reasonable to me.

I agree. I am not arguing the school decision.

My actual questions involves the discloser from the director to the school that my daughter required further treatment elsewhere? This seems like a medical opinion that he was not authorized to disclose ( I believe).

ScottGem · Jun 17, 2013, 06:43 PM

Originally Posted by marvin19372

I agree. I am not arguing the school decision.

My actual questions involves the discloser from the director to the school that my daughter required further treatment elsewhere? This seems like a medical opinion that he was not authorized to disclose ( I believe).

How do you know exactly what was said? She was ordered to undergo a 5 week program. She left the program early. All he could have said was that she needed to complete a program.

marvin19372 · Jun 17, 2013, 06:49 PM

Originally Posted by ScottGem

How do you know exactly what was said? She was ordered to undergo a 5 week program. She left the program early. All he could have said was that she needed to complete a program.

The letter sent to the school stated that she left the program, which is true.
The letter also stated that the director recommended further treatment immediately.

The requirement to "complete a program" only came from the school.

It just seems to me that we only gave authorization for him to contact the school as to her status in the program, as enrolled or not enrolled.

His opinion as to her needing further treatment immediately is, in my mind, a medical opinion and he was not authorized to give that info to the school.

ScottGem · Jun 17, 2013, 06:52 PM

I don't see it that way. But if you think so, then report it.

marvin19372 · Jun 17, 2013, 06:56 PM

Originally Posted by J_9

Sorry, since she did not finish the original program it was within his rights, as per the agreement, that he notify the school that she did not complete his program and that she was undergoing further treatment in order to comply with the school's requirement.

He did not tell that school that she had enrolled into another program, only that she required further drug and alcohol treatment.

This to me just seems like medical information that should not have been released.

J_9 · Jun 17, 2013, 07:02 PM

She required further treatment. The doctor recommended it. If there was no mention of a specific diagnosis and in depth treatment, then no violation occurred.

The fact that the doctor recommended further treatment is not a violation. The school has the right to know that she required further treatment since they are the ones that there is an agreement with.

marvin19372 · Jun 17, 2013, 07:07 PM

Originally Posted by J_9

She required further treatment. The doctor recommended it. If there was no mention of a specific diagnosis and in depth treatment, then no violation occurred.

The fact that the doctor recommended further treatment is not a violation. The school has the right to know that she required further treatment since they are the ones that there is an agreement with.

Thank you, that was the crux of my question, if the recommendation of further treatment was considered a disclosure of medical info.

My daughter is doing well in another treatment program which we required her to complete despite not be re-admitted to the school.

J_9 · Jun 17, 2013, 07:14 PM

No, the recommendation of further treatment is not a violation. Now, IF the director or the doctor gave the school the details of her treatment, therapy notes, discussions with the doctor, etc. that would be a violation.

The information here was required for her to be readmitted to school despite your desires, that is what was required for her to be readmitted. They complied according to the agreement.

marvin19372 · Jun 17, 2013, 07:17 PM

Originally Posted by J_9

No, the recommendation of further treatment is not a violation. Now, IF the director or the doctor gave the school the details of her treatment, therapy notes, discussions with the doctor, etc., that would be a violation.

The information here was required for her to be readmitted to school despite your desires, that is what was required for her to be readmitted. They complied according to the agreement.

Thank you for your help!

J_9 · Jun 17, 2013, 07:23 PM

You are very welcome. If I can be of further help, please feel free to post on the boards.

I hope your daughter does well.

marvin19372 · Jun 18, 2013, 04:55 AM

Originally Posted by J_9

You are very welcome. If I can be of further help, please feel free to post on the boards.

I hope your daughter does well.

Here is a somewhat related question, although it doesn't involve a HIPPA violation. The director reported to us that he felt that my daughter showed up for a group session under the influence. This was reported to us several weeks after this supposedly happened and only after we really pressed the director for information about how our daughter was doing. My daughter was driving herself to that session and apparently he allowed her to leave?

When I really pressed for info about this and asked for any evidence ( like a positive drug test) he backed down rather quickly. Apparently no drug test was given. This still was rather disturbing to us as parents and is one of many reasons we switched to another program.

Are you aware of any legal responsibilities that the director had to report this to us ( as our daughter is a minor and also signed authorization that medical info could be released to us) ? What are the legal issues involved with him allowing her to leave if he felt she was under the influence?

I apologize for all the questioning, this was our first experience with one of these programs so maybe we are just unfamiliar with how it was supposed to work?

At no point did we as parents expect any specific information about what my daughter discussed during individual sessions/therapy or anything like that but it just seemed that critical information was not given to us in a timely manner.

ScottGem · Jun 18, 2013, 05:49 AM

This was a judgment call on the part of the director. My question is was he in the session or was the issue reported to him by the staffer who led the session. In other words did he feel she was under the influence or was it just reported to him.

The program may not have had the facilities to test nor was the behavior overt enough to take action at the time. I can't say whether the program acted irresponsibly or not. I do agree that it provided sufficient justification for you to switch to a different program. Also, since nothing apparently happened on the drive home, there is no liability issue.

Since you already took reasonable action in switching her to a different program, I see nothing more that you need to or should do at this point.

marvin19372 · Jun 18, 2013, 06:27 AM

Originally Posted by ScottGem

This was a judgment call on the part of the director. My question is was he in the session or was the issue reported to him by the staffer who led the session. In other words did he feel she was under the influence or was it just reported to him.

The program may not have had the facilities to test nor was the behavior overt enough to take action at the time. I can't say whether the program acted irresponsibly or not. I do agree that it provided sufficient justification for you to switch to a different program. Also, since nothing apparently happened on the drive home, there is no liability issue.

Since you already took reasonable action in switching her to a different program, I see nothing more that you need to or should do at this point.

The director is the person who runs all the sessions and the facility does perform testing. I am assuming that if he really felt she was under the influence that he would have tested her right there. It is just an example of the inconsistency in information that was related to us, the conversation started with us being told she was high when she came for a session, when challenged and asked why she wasn't tested and also was allowed to leave the story we were by the director that he didn't have any proof, he then just started tell us she just " seemed off"
Unfortunately our first experience with one of these programs was not good, but we seemed to have found a much better situation that is working for everyone

ScottGem · Jun 18, 2013, 07:04 AM

I agree you made the right move in switching programs. Did you inform the school first?

However, I don't see anything actionable. If there is an agency that licenses or certifies these programs, I might report this to them. They may want to pull the license. If your daughter got in an accident, while driving after the session, then you might have a cause of action. But since there is none, I would just forget it and move on.