North DakotaSelected Statutes & RegulationsAffecting Confidentiality

[Note:  This information is provided for training purposes
and is not a substitute for knowing all of the ethical standards
and current laws regulating the practice of one’s profession.] 

I. LEGAL PROTECTIONS OF CONFIDENTIALITY

 A. Non-Disclosure Laws (Requiring that Confidentiality be Maintained)

CC 43-47-09  – Counselors may not disclose information without client consent unless “authorized by law” (and per Title 97-02-03-01, counselors must comply with non-disclosure requirements of the ACA Ethics Code )

Title 4.5-02.1-05-01  – Addiction Counselors do not disclose without client consent except in cases of risk to self or others (per NAADAC Code of Ethics)

Title 66-02-01-07  – Psychologists and Behavior Analysts disclose without consent only as mandated or permitted by law (per APA Ethics Code and BACB Guidelines for Responsible Conduct for Behavioral Analysts)

Title 75.5-02-06.1  – Social Workers disclose without client consent only for “compelling professional reasons” and protect confidentiality in legal proceedings “to the extent permitted by law”

Title 111-02-01-05 (6)  –  Marriage and Family Therapists disclose without client consent only “as provided by law”

B. Privilege Laws (Protecting Confidentiality in Court Cases)

N.D. Supreme Court Rule of Evidence 503 – “psychotherapist-patient privilege”

CC 31-01-06.1 – privilege for School Counselors

CC 31-01-06.3 –  privilege for Addiction Counselors

CC 43-53-11 – Marriage & Family Therapists may not testify in divorce or support actions if both parties obtained marriage/family therapy

II. POTENTIAL LEGAL LIMITATIONS OF CONFIDENTIALITY

 A. Legally Required Disclosure of Confidential Information

CC 43-53-11 – Marriage and Family Therapists have duty to warn potential victim and contact law enforcement if client/patient makes “serious threat of physical violence against a reasonably identifiable victim or victims”

CC 50-25.1-03 – Mandated reporting of child abuse

CC 50-25.2- 03 – Mandated reporting of “vulnerable adult” abuse.  (NOTE: Until recently, this statute provided for only “voluntary” reporting, but an amendment  [via Senate Bill #2323] was signed by the governor on April 15, 2013, making reporting mandatory for all mental health professionals.)

B. Legally Permitted Release of Information Without Client Consent

CC 25-03.1-25 – allows mental health professionals may disclose individually identifiable health information if necessary for involuntarily hospitalizing a client who poses a serious risk of harm of an immediate nature

CC 43-47-09  – Counselors may disclose information without client consent if “authorized by law;”

Title 97-02-03-01 legally requires counselors to comply with the ACA Ethics Code , which permits disclosure in certain circumstances (See ACA Ethical Standards A.9, B.1, B.2)

Title 4.5-02.1-05-01  – Addiction Counselors may disclose without client consent in cases of risk to self or others (per NAADAC Code of Ethics)

Title 66-02-01-07  – Psychologists and Behavior Analysts may disclose without consent as mandated by law or permitted by law for a valid purpose (as allowed by APA Ethics Code and BACB Guidelines for Responsible Conduct for Behavioral Analysts)

Title 75.5-02-06.1  – Social Workers may disclose without client consent for “compelling professional reasons” and protect confidentiality in legal proceedings “to the extent permitted by law”

Title 111-02-01-05 (6)  –  Marriage and Family Therapists may disclose without client consent “as provided by law”

C. Exceptions to Privileged Communications

N.D. Supreme Court Rule of Evidence 503 – exceptions to “psychotherapist-patient privilege” :
(1) procedures for hospitalization
(2) court-ordered examinations
(3) condition at issue is an element of person’s claim or defense in the case 

CC 31-01-06.1 – exceptions to privilege for School Counselors (same as above)

CC 31-01-06.3 – exceptions to privilege for Addiction Counselor (same as above)

D. Other Laws Allowing Access to Information Without Client/Patient Consent
?
?

III.  REQUIREMENT TO
INFORM PROSPECTIVE CLIENTS/PATIENTS
ABOUT LIMITS OF CONFIDENTIALITY

A. Federal:

HIPAA Regulations:  “Privacy Rule” – 45 CFR 164.520
(a) (1) Right to notice. . . An individual has a right to adequate notice of the uses and disclosures of protected health information that may be made by the covered entity, and of the individual’s rights and the covered entity’s legal duties with respect to protected health information.
B. North Dakota:

Addiction Counselors – NAADAC Code of Ethics – Standard III

Counselors – ACA Ethics Code – Standards  A.2.b; B.1.d

Behavior Analysts –

APA Ethics Code – Standards 4.02b; 10.01a
BACB Guidelines for Responsible Conduct  – Standards 2.05a; 2.07(b); 10.04a

Marriage & Family Therapists –

Title 111-02-01-05 (6b) – “A therapist must be responsible for informing clients of the limits of confidentiality;”

Title 111-02-01-05 (6d)  – “When seeing a couple or a family, a therapist must inform the client, at the beginning of the relationship, what the therapist’s procedures are for handling con?dences from individual members of the family and for protecting individuals’ privacy while safeguarding the integrity of the therapy process. ”

Psychologists – APA Ethics Code – Standards 4.02b; 10.01a

Social Workers – Title 75.5-02-06.1-01(3) – “Informed Consent”

IV.  ETHICAL & LEGAL REQUIREMENTS FOR
STAFF TRAINING ABOUT CONFIDENTIALITY

A. Federal:

HIPAA Regulations:  (45 CFR 164.530 (b) (1) ;  45 CFR 160.103 )
“A covered entity must train all members of its workforce on the policies and procedures with respect to protected health information [PHI]. . . as necessary and appropriate for the members of the workforce to carry out their function within the covered entity” (45 CFR 164.530 (b) (1)).  [Workforce is defined as employees, volunteers, trainees, and other persons whose conduct, in the performance of work for a covered entity, is under the direct control of such entity, whether or not they are paid by the covered entity (45 CFR 160.103).]

B. North Dakota:

Addiction Counselors – NAADAC Code of Ethics) – Standard VII – “Supervision & Consultation”

 Counselors – ACA Ethics Code – Standards B.3a; D.1.d,e,f

 Behavior Analysts –

APA Ethics Code – Standards 2.05; 9.07
BACB Guidelines for Responsible Conduct – 5.0; 5.1

 Marriage & Family Therapists – Title 111-02-01-05 (6a); (6f) – “Code of Ethics”

 Psychologists – APA Ethics Code – Standards 2.05; 9.07

 Social Workers – Title 75.5-02-06.1-03  – “Ethical Responsibilities in Practice Settings’

V. DUTIES IF LAWS OR ORGANIZATIONAL REQUIREMENTS
CONFLICT WITH ETHICAL RESPONSIBILITIES

Addiction Counselors – NAADAC Code of Ethics  – Standard VIII.1

Counselors – ACA Ethics Code – Standards H.1.b; H.2.e

 Behavior Analysts –

APA Ethics Code – Standards 1.02; 1.03 (as amended 2010)
BACB Guidelines for Responsible Conduct  – Standards 1.04d; 1.06; 2.05b; 6.06

Marriage & Family Therapists – Title 111-02-01-05 (4); (6)  “Code of Ethics”

Psychologists – APA Ethics Code – Standards 1.02; 1.03 (as amended 2010)

Social Workers – Title 75.5-02-06.1(6) – “Code of Ethics”

   [Note:  This information was provided for training purposes
and is not a substitute for knowing all of the ethical standards
and current laws regulating the practice of one’s profession.]