Confidentiality Issues at New Beginnings Center for Children and Families, San Diego, California

The New Beginnings Center for Children and Families, an integrated services initiative in San Diego, California, has published a comprehensive report on confidentiality issues and guidelines titled Tackling the Confidentiality Barrier: A Practical Guide for Integrated Family Services (Hobbs, 1993). The report was initiated when the director of the Department of Social Services in San Diego County requested a review of pertinent confidentiality laws and regulations in order to provide technical assistance to staff at New Beginnings. As the report was being written, its original purpose expanded to include information to assist other initiatives develop confidentiality policy and procedures for their integrated service programs. The first edition of the report was published in 1991 and a revised edition appeared in 1993.

The report concludes that management issues and confidentiality procedures, rather than federal or state regulations and statutes, are the major barriers to information sharing among agencies:

The report recommends the following management directives to ensure ease and appropriateness in information sharing:

• "Design sound management strategies for handling confidential information and records in all phases of program development. Confirm that action has been taken to assure that simple, efficient, and secure exchange of confidential information or records can be achieved prior to finalizing any facility, staff, or program information management plans.

• Install confidential record-keeping systems that support requirements for secure exchange of confidential records but also serve the program objective of operating with the least complex procedural requirements.

• Review and revise all administrative policy to eliminate overly restrictive interpretations of the laws and regulations regarding the exchange of confidential information and records among other programs and/or professionals.

• Facilitate collaboration among managers and line staff by providing special training on confidentiality requirements. The training should stress common legal requirements. It should clarify also that differences in interpretation or emphasis frequently are based on differences in program mission, not differences in the law. Institutional goals and/or programmatic differences tend to magnify the perception that legal barriers cannot be overcome." (p. 4)

The report provides the following sample release forms and agreements:

• Comprehensive Release Form
• Staff Confidentiality Oath
• Interagency Memorandum of Agreement

For further information on New Beginnings, refer to New Beginnings Center for Children and Families, San Diego, California.