Reporting Child Abusers and Protecting Substance Abusers

SUGGESTED RESOLUTIONS Every state requires certain people, inspecifically allowed. Breach of the nonpractice who receive no Medicare or Medic eluding social workers, to report suspected disclosure requirements is made a crime.2 aid reimbursement,7 could be covered by cases of child abuse or neglect to desigThe federal regulations adopted pursuthe Acts and could be precluded by them nated authorities, and many impose crimant to the Acts provide that substance from reporting all suspected cases of child inal and civil liability on those who fail abuse "programs" that are connected with abuse involving clients who are substance to make the required reports.1 Social workthe federal government may not disclose abusers unless they were allowed to do so ers, however, may be precluded from child "information" from the "records" of those by the regulations Unfortunately for those abuse reporting as required by state laws on whom substance abuse "prevention who seek resolution of the quandary, the because of sweeping federal laws that profunctions" are performed except as authorregulations do not specifically allow dis hibit disclosures about substance abuse ized.3 "Federally connected" is broadly closures for the purpose of child abuse clients and that impose criminal liability defined to include: (1) not only those proreporting and narrow the four exceptions and potential civil liability on those who grams receiving direct federal funding, but to the disclosure prohibitions in the Acts, breach the disclosure prohibitions. These also those receiving indirect federal fundmaking it difficult, if not impossible, to use sweeping federal laws place social workers ing through state or local revenue sharing, them for child abuse reporting.8 in almost any practice setting in a quan(2) not only those programs receiving some dary if they have clients who are substance sort of federal funding, but also those that abusers: If they fail to report suspected have any licenses, registrations, certifica incidents of child abuse involving clients tions, or authorizations from the federal A federal policy statement, issued jointly who are substance abusers, they may be government, including certification of proby the directors of the National Center on criminally prosecuted by state authorities vider status under Medicare or Medicaid Child Abuse and Neglect, the National Insti or face civil liability for their failure to or authorization to dispense methadone or tute on Alcohol Abuse and Alcoholism, and report; if they report such suspected inciother controlled substances, and (3) what the National Institute on Drug Abuse, as dents of child abuse, they may be crimis most significant, those programs whose serts that substance abuse workers covered inally prosecuted by federal authorities or only connection with the federal governby tfie Acts may report child abuse in face civil liability for their breach of federal ment is a federal tax exemption.4 A subvolving their substance abuse patients if confidentiality requirements. stance abuse "program" is also broadly they first obtain a court order.9 This is defined as "either an individual or an not a satisfactory resolution of the quan organization furnishing diagnosis, treatdary. Beyond the usual difficulties involved ment, or referral for alcohol abuse or drug in petitioning a court, restrictions on is abuse" or "a plan or procedure, whether suing these court orders mean that so The federal alcohol and drug abuse confunctional or organizational,... for dealing cial workers may not be able to obtain fidentiality acts (hereafter, the "Acts") prowith alcohol abuse or drug abuse probthem. Furthermore, the disclosures that vide that patients' records maintained in lems from either an individual or social can be made pursuant to court orders are connection with any substance abuse "prestandpoint" and includes projects whose limited.10 vention function which is conducted, regu"primary mission... is unrelated to alcohol Perhaps because of these unacknowl lated, or directly or indirectly assisted by or drugs"; "prevention function" is similarly edged problems, and unquestionably be any department or agency of the United broadly defined as any "activity relating cause of the acknowledged need to address States shall ... be confidential and [may] to alcohol abuse or drug abuse education, the serious national problem of child abuse, be disclosed only for the purposes and training, treatment, rehabilitation or rethe joint policy statement suggests that a under the circumstances expressly authorsearch."5 Finally, "information" and "recsubstance abuse program could enter into ized" in the Acts. Disclosures of records ords" are broadly defined to include everya "qualified service organization agree are expressly authorized only (1) if the thing related to a patient whether recorded ment" with a child protection agency and patient consents to the disclosure in writor not, acquired by anyone, whether emcould, under the agreement, refer all cases ing, (2) for medical emergencies, (3) for reployed by a program or not, in connecof child abuse coming to its attention to search, audit, or evaluation purposes, protion with a program's substance abuse the agency. This suggestion is also not a vided that identities of patients are not prevention function, including "negative" satisfactory resolution of the quandary, disclosed, and (4) if authorized by a court information that someone is not a patient.6 Because the child protection agency would after a showing of good cause. Disclosures These broad definitions intensify the be bound by the same confidentiality for the purpose of complying with state quandary created by the Acts. All social restrictions as the substance abuse pro laws on child abuse reporting are not workers, except those in for-profit private gram insofar as it operated under the