Breaking Down Barriers to the Sharing of Behavioral Health - PowerPoint PPT Presentation

Breaking Down Barriers to the Sharing of Behavioral Health Information Ch Chri rist sty A Avery ry, Client Service Manager Nich chola olas P s Pry rys, Behavioral Health Care Consultant October 2, 2019

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Pres esen enter er’s ’s C Contac act Informat atio ion Christy A. Avery Client Service Manager Center for Appropriate Care | Altarum christy.avery@altarum.org (734) 302-5680 Nicholas A. Prys, MSW Behavioral Health Care Consultant Center for Behavioral Health | Altarum nicholas.prys@altarum.org (734) 302-5632

Polling Question

Agenda nda  Physical and Behavioral Health Legislation  Substance Use Disorder Legislation  Use of Consent Forms  PHI Consent Tool  How to Increase Sharing with Health Information Technology

Beha ehavio ioral al Heal ealth h Consen ent P Projec ject Go Goal al  Breaking down unnecessary barriers to sharing behavioral health and substance use disorder (SUD) protected health information (PHI) across the State of Michigan

Pres esen entat atio ion Go Goal als  Develop a better understanding of state and federal laws that affect the sharing of behavioral health, SUD, and domestic violence PHI  Increase familiarity with MDHHS-5515  Learn how to navigate the PHI Consent Tool  Learn how one might leverage Health Information Technology to increase sharing of BH and SUD PHI

Ph Physic ical al an and Beha ehavio ioral al H Heal ealth L h Leg egis islat atio ion

Substan ance e Use e Dis isorder er L Leg egis islat atio ion  Michi chiga gan n Mental Health C Code ode  Title le 42 C 42 CFR FR Part rt 2  MDHHS-5515 (or equivalent) is required, unless the disclosure falls under any one of the following statutory exceptions: Medical emergencies  De-identified information for research  De-identified information for financial audits  De-identified information for program evaluations  Specific court orders 

MDH MDHHS-551 515

MDHHS-551 MDH 515  What is MDHHS-5515? MDHHS-5515 is the Michigan Behavioral Health Standard Consent Form developed by  the Michigan Department of Health and Human Services (MDHHS)  Why was MDHHS-5515 created? Public Act 129 of 2014 

When hen is is MDHHS HHS-5515 15 (or eq equiv ival alen ent) req equir ired ed?  Behavioral health or mental health services for purposes other than: Treatment  Payment  Coordination of care   Substance use disorders (SUDs) services for a r all: Diagnosis  Referral  Treatment 

When hen is is MDHHS HHS-5515 15 (or eq equiv ival alen ent) not ot req equir ired ed?  MDHHS-5515 (or equivalent) is not required when the disclosure falls under any one of the following exceptions: Medical emergencies  De-identified information for research  De-identified information for financial audits  De-identified information for program evaluation  Specific court orders (i.e., to determine if an individual is under treatment; treatment  hearings for minors)

Polling Question

Domes estic ic Vio Violen ence e Leg egis islat atio ion  Family Vi Viol olenc nce Prevention on a and nd Services A Act ct (FVP VPSA)  Vi Vict ctims o of C Crim ime Act ct ( (VOCA CA)  Vi Viol olenc nce Aga gain inst Wom omen A Act ct ( (VAWA)  Specialized consent form is required, unless the disclosure falls under any of the following statutory exceptions: De-identified information for research  “Duty to warn” situations  Mandatory reporting  Specific court orders 

Spec ecial ializ ized ed Consen ent F Form  Must be written and limited to a specific time and purpose  Individuals should be fully informed about the form and timing of any disclosure  The National Network to End Domestic Violence Sample Client Limited Release of Information form Federal domestic violence grantees  Available in English and Spanish  Designed to address the heightened safety and privacy concerns 

Intr trodu ducti tion n to to P PHI C I Cons nsent t Tool  PHI Consent Tool Addresses most common PHI requests  Helps to determine if consent is required  References both state and federal laws   More protective law followed

Ex Exam ample #1: e #1:  Adult  Spouse requesting  Behavioral health information without any mention of SUD

Ex Exam ample #2 e #2:  Adult  A health plan/Integrated Care Organization (ICO) forwarding a physical assessment to Prepaid Inpatient Health Plan (PIHP)/CMH for BH assessment to be conducted.  The PIHP/CMH must send the assessment summary/proposed care plan back to the ICO for creation of a comprehensive, integrated, person-centered care plan that supports both physical & BH.  BH info without mention of SUD

Ex Exam ample #3 e #3:  Adult asking for their own records  BH without mention of SUD

Ca Caveat eats – Yello llow T Tri riangle gles In the Legislation Grids, a yellow triangle mean the law allows for sharing PHI if it is in the best interest of the individual and what may be shared will be based on the minimum necessary standard as well as what the law calls for. In each Caveat, the orange highlighted legislation(s) appears to be the most protective and, therefore, should be followed.

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Ex Exam ample #4: e #4:  Adult  Facility operations  SUD

Ca Caveat eats- Purple rple D Diamonds In the Legislation Grids, purple diamonds mean the sharing of PHI depends on whether the information requested deals with SUD treatment. In each Caveat, the orange highlighted legislation(s) appears to be the most protective and, therefore, should be followed.

Domes estic ic Vio Violen ence e Grid id

Polling Question

Shar hare e wit with H h Heal ealth I h Informat atio ion Tec echn hnology  Patient Portal House copy of Standard Consent Form (MDHHS-5515)  Print, sign, scan, send back  Increased patient engagement  Ease of health record access   Direct Messaging Send copy of completed Consent to other entities  Send PHI securely from one EHR system to another 

Heal ealth h Informat atio ion Ex Exchan hanges es  Facilitate sharing of health information  Michigan Health Information Network Shared Services (MiHIN)  Improve communication surrounding patient care

Mi MiHIN eC eConsen ent Pil Pilot  Project to collect electronic versions of MDHHS 5515  Please reach out to shreya.patel@mihin.org if interested in piloting the eCMS service.

Poten ential ial Impac acts o of Not S Shar harin ing  Patient safety and cost of care  Potential Negative Publicity  “Ciitizen” reporting database (Yes: “ii”)  CMS Wall of Shame  Potential Financial Impact  Information Blocking from 21 st Century Cures Act  Medicaid PI  MIPS

Rec ecap ap  Consent tool house on MDHHS website  3 scenarios when consent is not required to share BH and general medical PHI: Treatment, Payment, & Coordination of Care  5 scenarios when consent is not necessary for sharing of BH PHI: Medical Emergencies, De-identified information: Financial Audits, Program Evaluation, Research, 2 Types of Specific Court Order 3