Confidentiality of Substance Use Disorder Patient Records
2019-09-19 2019-09-19 2019-09-19 2019-09-19 2019-09-19 2019-09-19 2019-09-19 2019-09-19 2019-09-19 2019-09-19
HHS-OS-2019-0010-0112 HHS-OS-2019-0010-0054 HHS-OS-2019-0010-0080 HHS-OS-2019-0010-0038 HHS-OS-2019-0010-0037 HHS-OS-2019-0010-0018 HHS-OS-2019-0010-0050 HHS-OS-2019-0010-0055 HHS-OS-2019-0010-0012 HHS-OS-2019-0010-0040
04:00:00 04:00:00 04:00:00 04:00:00 04:00:00 04:00:00 04:00:00 04:00:00 04:00:00 04:00:00
https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0112 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0054 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0080 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0038 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0037 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0018 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0050 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0055 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0012 https://api.regulations.gov/v4/comments/HHS-OS-2019-0010-0040
Anonymous Lisa Anonymous Jacqueline Catherine m Anonymous Najla Anonymous Loftin Michael
Anonymous Schultz Anonymous Lebel Simon Anonymous Hasic Anonymous Wilson Mccartney
I disagree with this proposal. It violates CFR and is being implemented without consent of Congress.I am afraid to sign my name because of the discrimination Ive experienced. This rule is so important to keep in place. Save lives by keeping 42CFR as it is. I do not agree with the changes to Section 2.63 in this NPRM and ask that SAMHSA does not change this section or finalize this proposal. This statue was put in place to protect the rights of people who have sought drug treatment and allowing this change will deter people from seeking treatment during an opioid epidemic- when treatment is literally life and death for so many. I have been on methadone maintenance for 17 years. Being on treatment has evened the playing field and has given me the ability to fight and overcome my addiction to heroin. Even after over a decade and a half of sobriety, of hard work, of growth, of progress and contributing to society, as soon as someone finds out I am on treatment- Im labeled a junkie. My credibility becomes non- existent, my opinion worthless, Im automatically the guilty party in any dispute and all the good Ive done for society and in life becomes irrelevant. All of who I am- a medical and health writer, a loving wife, a Silversmith, President and Co- Founder of a non- profit that builds water wells in Uganda, an artist, an entrapuener, a leader, a GOOD influence on children as well as adults, an animal rescuer, an activist, a critical thinker- is replaced by one singular thing- a junkie. I am not to be trusted or believed. Im weak and worthless, a liar and a burden on society. And thats what this change will do- in the eyes of the world, turn someone like me back in to the addict I once was. It takes away everything Ive fought so hard for. We need people to seek treatment, not to be afraid of it because they will forever be labeled, defined and judged by the worst part of them and nothing more. Seeking treatment will become feared because the negative consequences of it will be life long. People will hesitate to seek treatment, people will decide not to seek treatment and instead try it on their own and people will die because of that decision. People will die because of this change of statue.  I strongly oppose this. I am alive today thanks to medication assisted treatment taking methadone daily for the past three years. My personal medical treatment information must be kept in the highest privacy and protection. Stigma and ignorance especially amongst the medical professional community as well as law enforcement can and will negattively impact interactions amongst people with substance use disorder. I have peraonally experienced negative treatment from doctors and nurses once they became aware I was a patient on methadone. I was immediately treated cold, less-than, and even with eye rolls and sighs. If the medical community is treating mmt patients this way, imagine what law enforcement will do with this information where stigma prevails and lack of knowledge regarding mat is the norm. Stigma is killing our generation. Stigmatized languange is still used even amongst doctors and mesical professionals. Once stigma is completely eradicated then we can loudly and proudly tell the world we take methadone. Unfortunately, many, do not even have basic knowledge of what methadone even is let alone get to know someone that is maintained successfully with it. Again, Stigma is just too prevalent to risk peoples recovery over it. I have had friends get off of their maintenance medications before they were ready due to pressures from family, friends, and even society and they relapsed within a month and overdosed and died. Stigma is killing an entire generation of my peers and I can not sit by and let more people die. I will fight stigma in anyway i can in every way i can. Please protect our privacy and protect our need for treatment without fear of being stigmatized by everyone we encounter. Our interactions with doctors and law enforcement shouldnt revolve around their feelings and knowledge of medication assisted therapy but unfortunately it does where stigma always prevails.  I am appalled by this suggested change to substance treatment patients confidentiality rights. This would allow my personal health information to be shared with law enforcement, exacerbating the costs of the disastrously failed War on Drugs and creating a chilling effect when it comes to treatment access in the middle of an overdose/opioid crisis. I am heartbroken that a government agency would even consider such a rule change motivated by Big Data lobby greed. As both a substance treatment patient and a harm reduction activist of many years experience, I feel that this rule change would have horrific consequences.  With all we have and are learning about addiction, it is disheartening and appalling that this change is being proposed.  The only shame in seeking treatment for a mental health disorder will be with authorities for using the treatment against them if this is passed. Yet again, the sick will be forced to decide if they should die in hiding.  We never learn.    I do not agree with the changes to Section 2.63 in this NPRM and ask that SAMHSA does not change this section or finalize this proposal. This change is a fundamental and substantive change to privacy regulations that will allow personal health information to be shared outside the healthcare system for criminal justice purposes. This regulations purpose is to protect patients and their health data, this proposed change is not in line with the best interests of patients seeking treatment for substance use disorders and their families. A change of this nature will deter people in need of treatment from seeking care out of fear of law enforcement involvement, which goes against the fundamental purpose of 42 CFR part 2. Part 2 was created to encourage people to seek care without fear of legal repercussions or stigma. SAMHSA should also extend the comment period immediately, as this change is significant, the citizenry needs more than 30 days to analyze and respond to this NPRM. Dear Department of Health and Human Services:This comment is in response to the proposed amendment to the Confidentiality of Substance Use Disorder Patient Records regulation that intends to remove allegedly committed by the patient from Section 2.63. This amendment is premised on the theory that the phrase allegedly committed by the patient was erroneously added to the rule in the 2017 final rule. I disagree with this proposition. Although the Rule does not explicitly define communications, it is evidence that patient communications are distinct from patient records. I bring this issue to your attention for two reasons: 1. there are no safeguards in place to protect patients against public disclosure of such information following the disclosure of  confidential communications where such safeguards do exist following the disclosure of records (Sec. 2.66 (d)); and 2. this amendment is unnecessary to achieve the alleged purpose proposed and will hinder open communication. Despite some overlap, records and communications are two distinct sets of information. This proposition is supported by the fact that the words appear in separate sections covering essentially the same issue, whereas if the two were the same these sections would be redundant and futile (see Sec. 2.63 confidential communications disclosed for criminal investigation against patient and Sec. 2.65 patient records disclosed for criminal investigation against patient). Including the phrase allegedly committed by the patient authorizes confidential communication to be disclosed only when the patient is suspected of a crime--directly in line with general doctor-patient confidentiality rules. Furthermore, communications made by the patient will contain much broader personal information than what is generally recorded for medical files. While disclosing these communications in criminal proceedings against the patient him/herself may sometimes be in their favor and thus, acceptable, disclosing such information in proceedings against doctors or other employees will serve little to no purpose, but will expose the personal details of an individuals life to the public (as trials are open to the public). On the other hand, when patient records are disclosed for the purposes of investigating or convicting an employee holding the records, steps are taken to remove identifying information, securing patient privacy. It is much more difficult to make unidentifiable confidential communication because the patient will likely have to testify to such statements, and thus subject him/herself to public scrutiny.  Finally, the proposed purpose for this amendment is to aid law enforcement in eradicating the opioid crisis. It is unclear how patient communications will help investigation any more so than simply obtaining patient records pursuant to Section 2.66. The purpose of confidentiality rules, in general, is to encourage open communication with ones doctor, attorney, spouse, etc., authorizing disclose of confidential communication will stunt open communication and thus impede treatment efforts. If law enforcement need information regarding the frequency opioids are being prescribed by rogue doctors, that information may be gathered from pharmacy records or medical records with safeguards in place to protect privacy interests of the patient.For the foregoing reasons, I respectfully disagree with the proposition that the phrase allegedly committed by the patient was erroneous and recommend that the phrase be kept as is, due to patient privacy and open communication concerns.  I do not agree with the changes to Section 2.63 in this NPRM and ask that SAMHSA does not change this section or finalize this proposal. This change is a fundamental and substantive change to privacy regulations that will allow (my) personal health information to be shared outside the healthcare system for criminal justice purposes. This regulations purpose is to protect patients and their health data, this proposed change is not in line with the best interests of patients seeking treatment for substance use disorders and their families. A change of this nature will deter people in need of treatment from seeking care out of fear of law enforcement involvement, which goes against the fundamental purpose of 42 CFR part 2. Part 2 was created to encourage people to seek care without fear of legal repercussions or stigma. SAMHSA should also extend the comment period immediately, as this change is significant, the citizenry needs more than 30 days to analyze and respond to this NPRM.  I do not agree with the changes to Section 2.63 in this NPRM and ask that SAMHSA does not change this section or finalize this proposal. This change is a fundamental and substantive change to privacy regulations that will allow my personal health information to be shared outside the healthcare system for criminal justice purposes. This regulations purpose is to protect patients and their health data, this proposed change is not in line with the best interests of patients seeking treatment for substance use disorders and their families. A change of this nature will deter people in need of treatment from seeking care out of fear of law enforcement involvement, which goes against the fundamental purpose of 42 CFR part 2. Part 2 was created to encourage people to seek care without fear of legal repercussions or stigma. SAMHSA should also extend the comment period immediately, as this change is significant, the citizenry needs more than 30 days to analyze and respond to this NPRM. As a person in recovery and an outreach worker advocating to connect vulnerable people to treatment, I know that they last thing we need to do in this time of crisis is to make treatment less accessible and safe for those who seek it. Thank you. I do not agree with the changes to Section 2.63 in this NPRM and ask that SAMHSA does not change this section or finalize this proposal. This change is a fundamental and substantive change to privacy regulations that will allow personal health information to be shared outside the healthcare system for criminal justice purposes. This regulations purpose is to protect patients and their health data, this proposed change is not in line with the best interests of patients seeking treatment for substance use disorders and their families. A change of this nature will deter people in need of treatment from seeking care out of fear of law enforcement involvement, which goes against the fundamental purpose of 42 CFR part 2. Part 2 was created to encourage people to seek care without fear of legal repercussions or stigma. SAMHSA should also extend the comment period immediately, as this change is significant, the citizenry needs more than 30 days to analyze and respond to this NPRM.I have helped people seek treatment in the past, and if there was any fear of their privacy being violated, I believe they would have not sought treatment.  As an attorney, I view this as an abomination and against everything the United States and the Constitution stands for.  It is more in line with a country like China or Russia than the USA.