Tjane Health portal

Confidentiality in the Community

Module 14: Ethics, Confidentiality, and Cultural Humility · Lesson 1 of 3

13 min Back to module

Story opener

Thursday, 4:40 p.m. A participant is sitting across from you, your supervisor wants three notes before you leave, and the answer you need is not in any binder on the shelf. This lesson is the part of the job nobody handed you in orientation.

Learning objectives

  • Be able to agree on public greeting and introductions in advance
  • Be able to substance use records have stricter release rules

Lesson

Field work creates disclosure risks an office never does.

Decide with each participant in advance how you will greet them in public and how you will be introduced to a landlord, employer, or neighbor. Never assume permission to identify your agency.

Substance use records carry heightened protection under 42 CFR Part 2. Know which of your records that touches and route release questions to your privacy officer.

Maryland guidance & authority labels

Every statement below is labeled so you know what is binding regulation, what is only proposed, what is professional guidance, and what is our house standard.

  • PRA guidance

    PRA's code of ethics centers dignity, self-determination, competence, and honesty in documentation and billing.

  • COMAR — current

    Confidentiality obligations under HIPAA and Maryland law apply to community settings — including who can see a participant's file in your car.

Common mistakes

  • Describing what you did without describing what the participant did.

    Do this instead — Record the intervention and the participant's observable response to it.

  • Treating regulation as a filing chore separate from practice.

    Do this instead — Let the required elements shape the session itself, so documentation writes itself.

Practical examples

Practical example

Instead of 'met with participant to discuss goals,' write: 'Reviewed the transportation objective; participant identified the #22 route unassisted and named one back-up plan. Verbal prompt needed once. Next session: practice the transfer at Mondawmin.'

Key takeaways

  • Agree on public greeting and introductions in advance
  • Substance use records have stricter release rules

Reflection prompts

  1. 1Which part of this lesson describes something you are already doing differently in practice?
  2. 2What would an auditor see in your last five notes that contradicts this standard?

Bring your answers to supervision — the case-study workspace in this module saves written notes to your account.

Knowledge check

4 questions drawn from a bank of 7 · 75% to pass · instant feedback on every answer

1. Which additional point does "Confidentiality in the Community" emphasize?

2. You see a participant at the grocery store with friends. You should:

3. Which statement is a key takeaway from "Confidentiality in the Community"?

4. How should you treat this statement? "Confidentiality obligations under HIPAA and Maryland law apply to community settings — including who can see a participant's file in your car."