540 

LEGAL ACTION CENTER TEMPLATE FOR SAMHSA COMMENTS 

VIA EMAIL 

June 23, 2014 

Frances Patterson, PhD, MAC, BCPC, CCJAS, QSAP, QCS 

Footprints Consulting Services, LLC 

4053 Farmingham. Woods Dr. 

Hermitage, TN 37076 

U.S. Substance Abuse and Mental Health Services Administration 

1 Choke Cherry Road 

Room 5-1011 

Rockville, MD 20857 

RE:	 Confidentiality of Alcohol & Drug Abuse Patient Records Regulations, 42 C.F.R. 

Part 2. 79 Fed. Reg. 26929; Docket No. 2014-10913. 

To Whom It May Concern: 

I am a licensed substance abuse counselor in the state of Tennessee. I have had a private 

consulting service since 2008 and have been in the substance abuse field for 25 years. I have 

worked in VA and TN in different venues, including being the director of Behavioral Health 

Services at our local public health department for 10 years. 

While I support updating the mechanics of the federal alcohol and drug confidentiality 

regulations to facilitate more effective integration of care and needed communication in the 

electronic age, 42 C.F.R. Part 2’s core privacy protections MUST be maintained. 

Over the years, I have had many situations where the privacy and safety of clients would have 

been violated had it not been for the protection of 42 C.F.R. Part 2. For instance, while at the 

health department, on many occasions the medical records division would receive a request for 

the medical records of a person who had sought services at the health department through 

services other than behavioral health (BH). We also had records for the same person in our BH 

division. Medical records personnel would demand I surrender BH files without the proper 

1 
release of information for substance abuse patient records. I was able to show them the federal 

regulations protecting those records. 

Additionally, I have had many occasions when lawyers have wanted client records, without a 

release of information, from programs where I have worked. In many instances it would not have 

been in the best interest of the client for them to have the records. They have threatened me with 

legal action if I refused to turn over records and I have been able to quote the law protecting 

patient records. They then understood the seriousness of what they were requesting. 

I have worked with the criminal justice clients throughout my career and without the federal law 

protecting them, many of those clients would suffer at the hands of ill intentioned persons. 

These are just three examples of how I believe clients have been best served by having the 

protection of 42 C.F.R. Part 2, 

With regard to the modifications to 42 C.F.R. Part 2 proposed in SAMHSA’s May 12, 2014 

Notice of Public Listening Session (79 Fed. Reg. 26929), I support the following principles: 

• Addiction treatment should be integrated with mental and physical health care, and 

communication among health care providers should be encouraged. I support maximizing 

inclusion of substance use disorder (SUD) records in electronic health record (EHR) 

systems and health information exchanges (HIEs) while maintaining 42 C.F.R. Part 2’s 

core privacy protections. 

• 42 C.F.R. Part 2’s heightened privacy protections are as critical today as they were when 

they were enacted more than 40 years ago, and a move toward HIPAA’s looser privacy 

standards would not sufficiently protect people seeking and receiving substance use 

disorder treatment. If patient records can be easily accessed in order to criminally 

investigate or prosecute a patient, or deny them insurance or a job, or be used against 

them in a divorce or child custody proceeding, many patients will be afraid to enter 

treatment in the first place. 

• LAC continues to believe that patients in alcohol and drug programs should retain the 

power to decide when and to whom their records are disclosed, even for treatment and 

payment purposes, given the continued prevalence of discrimination in our society. This 

includes disclosures to the general health care system, HIEs, health homes, ACOs, and 

CCOs. The best way for patients to retain that power is by requiring patient consent for 

most disclosures, together with a strong prohibition on redisclosure. 

2 
• It is both necessary and technologically possible to integrate addiction and other health 

care and effectively exchange addiction treatment data while maintaining the core 

protections of 42 C.F.R. Part 2. I urge the continued development of technical solutions 

for consent management. 

• Since HIPAA requires compliance with state and federal laws that mandate greater 

privacy protections, electronic health record systems (EHRs) must be designed so as to 

comply with the many state statutes that require heightened protections for information 

related to mental health, HIV/AIDS, reproductive health, domestic violence and other 

types of sensitive health information, as well as with 42 C.F.R. Part 2. It is important to 

keep in mind, therefore, that EHRs would be required to accommodate enhanced 

protections for the medical records of some illnesses in order to be HIPAA-compliant 

even if 42 C.F.R. Part 2 did not exist. 

I also support the comments submitted by the Legal Action Center. 

Thank you for your consideration. 

Sincerely, 

Frances!A.!Patterson

Frances Patterson, PhD, MAC 

Owner, Footprints Consulting Services, LLC 

3 
AN 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient records be maintained. I am a person in 

recovery from addiction and I also have a criminal record. While I take the responsibility for 

the actions I took that resulted in my addiction treatment and criminal record, I do not want 

my addiction treatment record to become a lifelong burden. 

I understand some have argued that good medical care for me will be compromised if all 

medical professionals can not see my addiction treatment records. 
A 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
B 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
C 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

1 Choke Cherry Road 

Rockville, MD 20857 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
D 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

1 Choke Cherry Road 

Rockville, MD 20857 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
E 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
F 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
G 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
H 
 

RE: Privacy Regulations 

Dear Administrator Hyde. 

Please see it fit to conserve the privacy rights of such people in addiction. WE all struggle, some 

more than most. It is not common knowledge that we of Alcoholics Anonymous have a disease, 

which I had to learn the hard way. We will prevail if you help us! I promise! 

Sincerely, 
I! 
 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to ask that the privacy protections for alcohol and drug abuse patient records 

be maintained. I do not wish this record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect my privacy. 

Sincerely, 
J 
 

Dear Administrator Hyde, 

Your interest concerning helping people like me to maintain a certain amount of privacy 

about my treatment Records, mainly my alcohol and drug usage is being well received by me 

and my family today. 

Yes, I support what you are doing and thank you as well. 

Sincerely, 
K 
 

Pamela Hyde, Administrator 

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011 

RE: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

I understand some have argued that good medical care for me will be compromised if all 

medical professionals cannot see my addiction treatment records. 

Sincerely, 
L

Dear Administrator Hyde, 

I will support you 100% concerning having certain regulations for privacy on certain 

treatment records. Mainly when it comes to people like me with alcohol and drug abuse records. 

I don’t want certain people to use that information against me. 

Sincerely, 
M 
 

Dear Administrator Hyde, 

I am writing to you today, because I believe in your quest to maintain privacy for keeping 

my treatment records of alcohol and drugs abuse out of the hands of those who could and would 

use that information to hurt me or others like me, such as losing our children, jobs or housing. 

You have my full support. 

Sincerely, 
N! 
 

Dear Sir, 

I am thrilled to be able to support this petition concerning privacy regulation. 

You have my permission to go to the limit if that is what it will take to maintain my 

desire to not let certain people read or make judgements on me based on my alcohol or drug 

abuse treatment record. 

Sincerely, 
O 
 

Dear Sir, 

I am showing my support today by writing to you concerning the protection of my 

treatment record about my using alcohol and drugs. 

I agree with the information I have read that left us protected. Certain people may or 

would use this information to take away my children, the loss of my job and the loss of housing. 

I do not want this to happen. 

You have my support Mr. Hyde to address this issue on my behalf. 

Sincerely, 
P 
 

Dear Administrator Hyde 

This letter is to ask for your support in making sure people like will not be subject to 

losing our children, job or hosing as a result from reviewing our alcohol and drug abuse records. 

The odds are already stacked against us in other areas of life because of our usage. We do 

not need to continue to let this issue be a lifelong burden. 

Thank you sir for reading this letter. 

Sincerely, 
Q

Dear Administrator Hyde, 

Today I am writing on behalf of me and my family concerning the privacy protections for 

alcohol and drug abuse patient records being maintained in an orderly way that will not require 

those people who wish to use certain information about those records to make certain judgements 

not in favor of me and my family’s best interest. Such decisions could cause me (and people like 

me) to lose their children, job or housing. 

I am asking you Mr. Hyde to do all that is in your power to not let this happen. 

Sincerely, 
R 
 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

I understand some have argued that good medical care for me will be compromised if all 

medical professionals cannot see my addiction treatment records. I do not want my medical 

records to be used against me just because I did the right thing and sought to get help for my 

addiction. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
S

Dear Administrator Hyde, 

Privacy Regulations is very important to me, since I am one of those people with an 

alcohol and drug abuse problems. 

You have my support in helping to protect my interest. 

Thank you so much. 
T 
 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

I understand some have argued that good medical care for me will be compromised if all 

medical professionals cannot see my addiction treatment records. I do not want my medical 

records to be used against me just because I did the right thing and sought to get help for my 

addiction. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
U 
 

Re: Privacy Regulations 

Dear Admin Hyde, 

Please consider helping protecting those that I serve in recovery. I aim to have a family 

and great job one day. Please help my dream for starting a new life possible. 

Thank you for your consideration. 

Humbly yours, 
V 
 

To Whom It May Concern, (Mr. Hyde) 

I don’t think a person’s personal history concerning alcohol and drug abuse records 

should be explored neither their cranial record. 

I am taking full responsibility for my action, paying my dues to society for my 

misfortunes. I don’t want my record of addictions or criminal past to become a lifelong burden. 

I would prefer these matters be kept in private unless it’s a very serious or professional 

reason that these matters may surface. Meaning if there is some prejudice or bias reason for such. 

I am hoping and praying that you7 understand my situation. 
W 
 

Dear Whomever, (Mr. Hyde) 

I am writing to let you know that my personal concerns about my alcohol and drug abuse 

patient records stay a private matter, also any criminal history. 

I wouldn’t want anything to hold up on any of my infractions that occurred as a result of 

my drug abuse, alcoholic or criminal record. 

We are already being denied by certain agencies because of the truth telling; being real 

and being denied. 

I would like it to be me call if such information needs to be known. 
X 
 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

I understand some have argued that good medical care for me will be compromised if all 

medical professionals cannot see my addiction treatment records. I do not want my medical 

records to be used against me just because I did the right thing and sought to get help for my 

addiction. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
Y 
 

Dear Administrator Hyde, 

I am writing to let you7 know how important it is to me and my family that this privacy 

protections for alcohol and drug abuse patient records be maintained. I’m in long term recovery 

from addiction and I also have a criminal record. I do take responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to haunt me the rest of my life. 

The treat to me and people like me is too great to risk doing away with these essential 

privacy protections. People like me already have enough of the odds stacked against us. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addition 

records. 

Sincerely, 
Z

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery from 

addiction and I also have a criminal record. While I take the responsibility for the actions I took 

that resulted in my addiction treatment and criminal record, I do not want my addiction treatment 

record to become a lifelong burden. 

The treat to me and people like me is too great to risk doing away with these essential 

privacy protections. People like me already have enough of the odds stacked against us. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addition 

records. 

Thanks for your attention to this matter. 

Sincerely, 
GX 

Re: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient records be maintained. I am a person in 

recovery from addiction and I also have a criminal record. I do not want my addiction 

treatment record to become a life long burden. 

I understand some have argued that good medical care for me will be compromised if all 

medical professionals cannot see my addiction treatment records. I think in this day and age 

with all of the technological advances that software companies can figure out how to keep 

that information available for those who must see it and unavailable to those who don’t need 

to see it. 

I threat to me and people like me is too great to risk doing away with these essential 

privacy protections. People like me already have enough of the odds stacked against us. I do 

not want to risk losing my kids, or face the loss of a job or my housing all due to someone 

finding out that I had been treated for addiction. I do not want my family to go without health 

or life insurance or worse to risk criminal prosecution, arrest or incarceration. I do not want 

my medical records to be used against me just because I did the right thing and sought to get 

the help for my addiction. 

Administrator Hyde, I hope you will do all you can to protect the privacy act of my 

addiction records. 
IY 

Dear Administrator Hyde, 

I’m writing to you to let you know that my privacy protections for my Alcohol & Drug 

Records be maintained. I would not like my records to be held against me in my future life. 

Administrator Hyde, I hope we can resolve this issue. 

Sincerely, 
IZ 

Dear Administrator Hyde, 

I am writing to let you know how important to my family to my privacy for my alcohol 

and drug records. 

Administrator Hyde, please protect my privacy. 

Sincerely, 
IZ 

Dear Administrator Hyde, 

I am writing to let you know how Important to my Family to my privacy for my alcohol 

& Drug Records. 

Dear Administrator Hyde, please protect my privacy 

Sincerely, 
MA 

Re: Privacy Regulations 

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient records be maintained. I am a person in 

recovery from addiction and I also have a criminal record. Which I take responsibility for the 

actions I took that resulted in my addiction treatment and criminal record, I do not want my 

addiction treatment record to become a lifelong burden. 
MB

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery 

from addiction and I also have a criminal record. While I take the responsibility for the 

actions I took that resulted in my addiction treatment and criminal record, I do not want my

addiction treatment record to become a lifelong burden. 
MC
 

Dear Pamela Hyde, 

I am a person in recovery from addiction and I also have a criminal record. I am writing 

to let you know how important it is to me and my family that the privacy protections for 

alcohol and drug abuse patient records be maintained. I think in this day and age with all of 

the technological advances that software companies can figure out how to keep that 

information available for those who must see it and unavailable to those who don’t need to 

see it. People like me already have enough of the odds stacked against us. I do not want my 

family to go without health or life insurance or worse to risk criminal prosecution, arrest or 

incarceration. 

Administrator Hyde, I hope you will do all you can to protect the privacy act of my addiction 

records. 
ML

Pamela Hyde, Administrator

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011

RE: Privacy Regulations

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient records be maintained. I am a person in 

recovery from addiction and I also have a criminal record. People like me already have 

enough of the odds stacked against us. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
MY

Pamela Hyde, Administrator

Substance Abuse of Mental Health Service 

Administration 

Room 5-1011

RE: Privacy Regulations

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient act be maintained. I am a person in recovery 

from addiction and I also have a criminal record. While I take the responsibility for the 

actions I took that resulted in my addiction treatment and criminal record, I do not want my 

addiction treatment record to become a lifelong burden. 
MZ

Pamela Hyde, Administrator

Substance Abuse of Mental Health Service Administration, Room 5-1011

RE: Privacy Regulations

Dear Administrator Hyde, 

I am writing to let you know how important it is to me and my family that the privacy 

protections for alcohol and drug abuse patient records be maintained. I am a person in 

recovery from addiction and I also have a criminal record. While I take the responsibility for 

the actions I took that resulted in my addiction treatment and criminal record, I do not want 

my addiction treatment record to become a lifelong burden. 

Administrator Hyde, I hope you will do all you can to protect the privacy of my addiction 

records. 

Sincerely, 
NU

Dear Administrator Hyde, 

I am in recovery like many people of all races, and from all kinds of backgrounds. It is of 

great concern that the thought of the privacy act is even a topic. One reason is look at how 

many people trying to get help, that may have the chance to save there life’s, there family, 

and be productive citizens. Contribute to life, community, be a asset. Beside anybody that 

needs to see that information in this day and time can access it. The threat, and damage this 

could cause to me and people like me is to great to risk. Just for one second think about if 

anybody could find out anything you done in life, or people you know. How do people 

separate what they learn from the person you are now, or are on the job. Look at how many 

opportunities you may have never had and how many you will be denied in the future. It’s 

not logical to punish or discourage someone for trying to do the right thing. Some times the 

answer to problems is just using common sense. 

I hope and trust you will do all you can to protect my privacy right about my addiction.