Adolescent Substance Abuse - Federal Confidentiality Law Under Attack

Here's some potentially huge news for adolescent substance abuse treatment providers and juvenile courts across the country. It could mean that sharing information between treatment providers and juvenile courts gets easier -- but it could also seriously jeopardize young people's privacy and the likelihood that they'll get treatment.

 
Background

Anyone who's worked with teens with drug problems (and adults too, for that matter) is familiar with the legal importance of maintaining the confidentiality of the clients.
 
Since the 1970s, the federal statute -- fondly known as "42 C.F.R." -- governed what could be shared, with whom, and when.
 
Then HIPAA was introduced in the 1990s, with the ostensible purpose of helping health care providers share information easily, for the benefit of patients (and the health care providers themselves). HIPAA also has protections for patients receiving alcohol and drug treatment, but 42 C.F.R. is much more stringent.
 
 
Do We Still Need 42 C.F.R.?

Now, according to a brief from the Legal Action Center, it appears that some health reform advocates are saying that 42 C.F.R. should be eliminated in favor of the relevant HIPAA regulations. 
 
Here's the Legal Action Center's take on this. One of their recommendations:

We recommend that a public/private partnership – involving the Substance Abuse and Mental Health Services Administration [SAMHSA], single state authorities, the recovery community, substance use disorder and health care providers and experts and legal experts – engage in a deliberative, consensus-building process to identify how best to improve communication between substance use disorder and other health care professionals while maintaining critical privacy protections.

UPDATE, July 2010: The Substance Abuse and Mental Health Services Administration (SAMHSA) has issued a "frequently-asked questions" document explaining how confidentiality will be protected under health reform. (Follow the link and see the first bullet.)
What do you think?