The Broad Application of 4 Pa. Code 255.5 Regarding Confidentiality of Substance Use Disorder Records

Pennsylvania’s Drug and Alcohol Abuse Control Act, 71 P.S. § 1690.101, et seq., contains a provision at Section 108 addressing the confidentiality of records related to the diagnosis and treatment of a substance abuse disorder (“SUD”). Through the use of passive voice, Section 108 has broad application on its face. For example, subsection (b) states that, “[a]ll patient records . . . shall remain confidential, and may be disclosed only with the patients’ consent and only . . .” subject to additional conditions.

Implementing that statutory provision is 4 Pa. Code 255.5, which employs active voice. That is, the subject (and consequently, the application) of the regulatory provision is ostensibly limited to “projects.” Though not defined in Title 4 of the PA Administrative Code, “projects” are defined at 28 Pa. Code § 701.1 as the organizations that administer and deliver drug and alcohol services as part of a Single County Authority drug and alcohol program. If you’ve clicked on this article, you probably know this already, so I will get to the issue advertised in the title.

Is the application of 4 Pa. Code 255.5 limited to projects? No. The website for the PA Department of Drug and Alcohol Programs contains a page on SUD Confidentiality. On that page is a link to a November 20, 2019 report prepared by George Washington University’s Health Information & the Law project. This report is an invaluable resource for understanding PA’s laws and regulations regarding SUD information disclosure. Among the topics covered by this report is the application of 4 Pa. Code 255.5.

Specifically, the report organizes into a few pages (including a helpful graphic) the various facility licensure provisions elsewhere in the PA Administrative Code that incorporate Section 255.5 by reference. The following Code provisions require compliance with Section 255.5:

  1. Outpatient Activities, 28 Pa. Code 711.93;
  2. Psychiatric Rehabilitation Services, 55 Pa. Code 5230.17;
  3. Transitional Living Facilities, 28 Pa. Code 711.72;
  4. Residential Treatment and Rehabilitation, 28 Pa. Code 711.43;
  5. Intake Evaluation and Referral Activities, 28 Pa. Code 711.43;
  6. Mental Health Services Providers, 28 Pa. Code 709.28;
  7. Short-term Detoxification, 28 Pa. Code 711.62;
  8. Freestanding Treatment Facilities, 28 Pa. Code 709.28 (and Narcotic Treatment Programs, 28 Pa. Code 715.11);
  9. Inpatient Hospital Detoxification, 28 Pa. Code 710.23; and
  10. Partial Hospitalization Activities, 28 Pa. Code 711.83.

You’d know nothing about that list looking at 4 Pa. Code 255.5 alone. So when reviewing any issue in PA involving the disclosure of SUD information, it’s important to remember the broad application (through reference) of Section 255.5.

Pennsylvania’s Drug and Alcohol Abuse Control Act, 71 P.S. § 1690.101, et seq., contains a provision at Section 108 addressing the confidentiality of records related to the diagnosis and treatment of a substance abuse disorder (“SUD”). Through the use of passive voice, Section 108 has broad application on its face. For example, subsection (b) states that, “[a]ll patient records . . . shall remain confidential, and may be disclosed only with the patients’ consent and only . . .” subject to additional conditions.

Implementing that statutory provision is 4 Pa. Code 255.5, which employs active voice. That is, the subject (and consequently, the application) of the regulatory provision is ostensibly limited to “projects.” Though not defined in Title 4 of the PA Administrative Code, “projects” are defined at 28 Pa. Code § 701.1 as the organizations that administer and deliver drug and alcohol services as part of a Single County Authority drug and alcohol program. If you’ve clicked on this article, you probably know this already, so I will get to the issue advertised in the title.

Is the application of 4 Pa. Code 255.5 limited to projects? No. The website for the PA Department of Drug and Alcohol Programs contains a page on SUD Confidentiality. On that page is a link to a November 20, 2019 report prepared by George Washington University’s Health Information & the Law project. This report is an invaluable resource for understanding PA’s laws and regulations regarding SUD information disclosure. Among the topics covered by this report is the application of 4 Pa. Code 255.5.

Specifically, the report organizes into a few pages (including a helpful graphic) the various facility licensure provisions elsewhere in the PA Administrative Code that incorporate Section 255.5 by reference. The following Code provisions require compliance with Section 255.5:

  1. Outpatient Activities, 28 Pa. Code 711.93;
  2. Psychiatric Rehabilitation Services, 55 Pa. Code 5230.17;
  3. Transitional Living Facilities, 28 Pa. Code 711.72;
  4. Residential Treatment and Rehabilitation, 28 Pa. Code 711.43;
  5. Intake Evaluation and Referral Activities, 28 Pa. Code 711.43;
  6. Mental Health Services Providers, 28 Pa. Code 709.28;
  7. Short-term Detoxification, 28 Pa. Code 711.62;
  8. Freestanding Treatment Facilities, 28 Pa. Code 709.28 (and Narcotic Treatment Programs, 28 Pa. Code 715.11);
  9. Inpatient Hospital Detoxification, 28 Pa. Code 710.23; and
  10. Partial Hospitalization Activities, 28 Pa. Code 711.83.

You’d know nothing about that list looking at 4 Pa. Code 255.5 alone. So when reviewing any issue in PA involving the disclosure of SUD information, it’s important to remember the broad application (through reference) of Section 255.5.

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