Title: Message
Several people on our HIPAA implementation team are hoping others input might help in resolving our question about HIPAA's instructions to avoid compound authorizations and how that relate to the use of multi-agency authorization forms. 
 
The final HIPAA Privacy regulations - 164.508 (b)(3) - prohibit the use of compound authorizations (i.e., combining with any other document an authorization for use or disclosure of phi...except for limited and specific exceptions).  
 
We are a county-operated yet multi-jurisdictional behavioral health organization that plans, contracts, and directly provides treatment & prevention services. We are one of several covered health care components of our County government's hybrid entity. Much of the clinical work we do is as part of collaborative teams with other organizations (i.e., court staff, county social service staff, coordinating offices that serve as fundors, and other community groups, agencies & service providers).
 
In the past, the local human service organizations that staffed such efforts agreed to use a multi-agency "Universal" authorization form. This form includes checkboxes for the various organizations involved, and then all of the other listed elements of a valid authorization. The clinical staff point out the obvious benefit that staff and the client need only sign one form. 
 
The other point of view is that proffered by our MIS vendor and endorsed by several groups similar to ours in the state is the single purpose release forms, which allow for only one-on-one exchanges of information between entities. This option assuries that the system records the limits of each release individually. Primarily the technical staff consider the single agent/purpose release form to conform to the spirit of the regulations...but clinicians believe that they will create an overwhelming paperwork burden on staff & clients. 
 
I've found the language of this section confusing, and would be interested in knowing how others have interpreted this section and resolved the issue of handling releases of information when working with clients involved with numerous organizations. 
 
Thanks in advance for any insights you can offer.
 
Laura Schmitt, Business Analyst
Fairfax-Falls Church Community Services Board

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