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DVR Confidentiality

Updated: September 2022

Purpose

To inform staff of the Division of Vocational Rehabiltiation's confidentiality rules.

Rationale

Confidentiality rules and standards apply to all DVR staff and service providers. Consumers should never be surprised when information is released. DVR can define when information can be shared under the administration of the program. DVR is not an entity covered under the Health Insurance Portability and Accountability Act (HIPAA) as determined by the Rehabiltiation Services Administration (RSA). When information is available, staff should not create delays in sharing necessary records. Consumers can independently share any information directly with other agencies.

Background

DVR must follow federal and state regulations regarding confidentiality such as:

All DVR staff members are required to follow these confidentiality standards. DVR’s confidentiality rules do not necessarily align with other departments or agencies.

Throughout the DVR process, DVR staff must educate consumers of their confidentiality rights, discuss when information is being released from their file, and document conversations in the IRIS. Discussions should start at the initial meeting, occur throughout the DVR process as appropriate, and when referring for services.

When releasing information, it is the responsibility of DVR staff to determine what is appropriate and relevant information. Only the specific records indicated on the Authorization for Release of Confidential Information, or Release of Information (ROI), should be provided. Information indicated on the release can be shared through the expiration date, or up to one year after signature if no date was indicated. If the box is checked on the ROI, written/verbal ongoing communication can occur until the ROI expires, or one year after the signature, which ever occurs first.

  1. In the administration of the VR program (i.e., purchasing and/or coordinating services, securing comparable benefits, etc.) with vendors, Department of Workforce Development (DWD) programs, and other professionals. Information must be necessary for the purpose of the VR program and the consumer’s Individualized Plan for Employment (IPE).
    • This includes contact information, confirmation of receipt of services, functional limitations/barriers to employment, possibly disability information, progress updates, and other case information that is determined necessary.
    • Only information that is necessary for the provision and purpose of the service can be released. If the information is unnecessary, a signed ROI is required.

  2. Verification to UI that the consumer is participating in a DVR-sponsored training program leading to an employment goal as outlined in the DVR/UI Data Sharing/Confidentiality Agreement. Reference the UI agreement for details of what can be shared.
  3. Child Support Investigation - Section 49.22 (2m) Wisconsin State Statutes requires disclosure of personal information (including employment information) to the Child Support Program without prior notice or consent of the subject of a record.
  4. Public Safety - In most cases, personal information may be disclosed without the prior knowledge or consent of the subject of the record to protect an individual from harming themselves by their own actions, to protect public safety, or to protect specific individuals (34 CFR 361.38).
  5. To Report Child Abuse or Neglect - In addition to the provisions for protection of public safety, Section 48.981 Wisconsin State Statutes requires professional, medical and human services workers, under certain conditions, to report suspected child abuse. Reporting is mandatory if a Vocational Rehabilitation Counselor suspects child abuse or neglect during a counselor's professional duties.
  6. To Report Elder Abuse or Neglect - The Wisconsin Elder Abuse Law defines elder abuse as – physical abuse, emotional abuse, sexual abuse, treatment without consent, and unreasonable confinement or restraint (Section 46.90 Wisconsin State Statutes). Mandatory reporting is not required, but if a professional counselor becomes aware of an abuse or neglect situation, a voluntary report may be made to the Wisconsin Elder Reporting System.
  7. In response to a valid court orderSection 146.82 (2) (a) (4) Wisconsin State Statutes states information can be released "under a lawful order of a court of record".
  8. For program monitoring purposes - If DVR is audited.
  • A consumer is able to make a verbal request to obtain a copy of their record.
  • In all situations where records are going to be sent electronically a discussion should occur with the consumer upfront ensuring they understand the risk of documents being sent electronically and this conversation and request to send records electronically should be documented in the DVR case record.
  • Before records can be released to the consumer, a counselor or manager must review psychological reports, medical records, and other information to determine if any might cause significant harm to the consumer. If so, the consumer must select a third party to receive the records on their behalf.
  • DWD 68.13 Administrative Code: If no identifying information is disclosed, relevant information from a consumer's case record may be released to a potential employer without consent of the consumer in order to ascertain the possibilities of a job placement. However, it is best practice to obtain the consumer's oral consent to verify that both DVR and the consumer agree the potential employer is a viable option. Case note the consent and discussion in the file.
  • Consumer-identifying information may be released to a potential employer once the consumer provides informed written consent by completing the Employment Records section of the ROI or the Authorization for Release of Employment Records. A DVR consumer can give permission to share their name, job application, resume, cover letter, and/or references. Information-sharing is limited to these documents. Disability information cannot be shared without further written consent from the consumer.
  • Obtain a signed ROI if providing a professional reference or sharing information with an employer or potential employer regarding a consumer.
  • DVR staff should never be a personal reference for a consumer since relationships are on a professional basis, not personal.
  • DVR staff can develop and provide a professional letter of reference to a consumer. An ROI isn't necessary. It is best practice to discuss the pros and cons of serving as a professional reference with the consumer.
  • When sharing information (verbal and/or written) regarding a DVR file outside of DVR, including identification of the person as a consumer. Except in situations listed above, a valid written ROI must be obtained from the consumer, or if appropriate, the consumer’s guardian. If there is no valid ROI, answer questions regarding general procedures on how DVR typically handles those types of situations.
  • If we receive a signed valid ROI and have concerns if the consumer wanted the information to be released, we should contact the consumer for clarification on their intent.
  • When you receive a subpoena. Refer to Accepting Subpoenas Guidance (Internal, Staff Only) for further information.
  • For a Criminal Investigation - DVR should request an ROI.
  1. The name of the consumer whose record is being disclosed.
  2. The type of information to be disclosed. ROI should request specific areas such as medical records, case notes, etc. Listing “entire file or entire case record” to describe the type of information to be disclosed is not a specific or valid description. When this occurs, consult with the consumer to discuss the request – emphasize the ROI's purpose, review what is and isn’t relevant to the purpose, and any concerns. If they still want the entire case file released after explaining what is included, proceed with record request and case note the discussion in the DVR case file. If consumer cannot be reached, the ROI can be sent back to requester asking for more specific items to be identified, a copy of DVR's ROI could be provided. Additionally, if there is concern that the consumer may not understand what they consented to (there may be case file information they may not want released), or it appears the information is unnecessary for the purpose, check with consumer to verify their intent and document this discussion in the DVR case record.
  3. Who is making the disclosure.
  4. The individual, agency or organization to which disclosure may be made.
  5. The signature of the consumer or legal representative or guardian. If not signed by the consumer, the person's relationship to the consumer or the authority of the person.
  6. The date on which the ROI is signed.
  7. The time period during which the consent is effective. If there is no expiration date or action identified (i.e., case closure), the ROI will expire one year from the signature date.

If an ROI is not valid, contact the requestor or consumer to discuss it.

Complete requests for information as soon as possible, but no later than 10 business days. If a request comes in with an unrealistic deadline, notify the requestor with an anticipated completion date.

The following is the procedure for providing a printed or electronic copy of information from a DVR case record:

  • Do not include any materials marked "Do Not Re-release", Veteran's Administration records, Social Security Administration (SSA) records, or Unemployment Insurance (UI) records (including SSA and UI tabs in IRIS). Do not share this information verbally.
  • In response to a valid ROI, check if there is any mention of AIDS/HIV, sexually transmitted diseases, mental illness, alcoholism, drug abuse, brain injury, developmental disabilities, genetics-testing, sickle cell anemia, domestic violence, or sexual assault in the records. If so, remove them unless specifically requested on the ROI (Wisconsin State Statutes Chapter 252 and Chapter 51). Under the administration of the program, this information can be shared if necessary, for the purpose of DVR and it's not marked "do not re-release".
  • Blackout Social Security number if included.

Records Notice Form

  • When a valid ROI was not provided
  • Certified copies
  • When records are withheld:
    • When original agency stamps "do not re-release"
    • Veteran's Administration (VA) records
    • Unemployment Insurance (UI) records
    • Social Security Administration (SSA) records
  • Name of the person or organization to whom the information was released
  • Identification of the information released and date of the release
  • In addition to the case note, send the signed ROI to the central scanning unit.
  1. Can we send the FAR and/or IPE to service providers without a signed ROI?
    • Yes, but it is important to review if the information is necessary on a case-by-case basis. For example, it might be necessary for a job developer to know only functional limitations, not the specific diagnosis. In that case, functional limitations can be copied and pasted into a message to share through the portal.

  2. Who is involved in "coordination of services"? Do we need an ROI for DVR purposes? For example, when can we communicate with the consumer's long-term care staff or other agencies concerning comparable benefits/services?
    • Coordination of services involves any agency or support staff that might be needed to coordinate and/or facilitate a consumer's IPE goal and services. Some examples could be service providers for job development services, vocational evaluators, assistive technology assessors, psychologists, long-term care support staff, case managers, W-2 workers to coordinate employment planning and services, etc.
    • You do not need an ROI to coordinate these services but can complete one as a best practice. The consumer should be aware and not be surprised of what information is shared.
  3. If a consumer designates an individual to be their DVR representative and/or Supported Decision-Maker, does DVR staff need to obtain a signed ROI to share information when the consumer is not present?
    • If the consumer designates a Supported Decision-Maker, obtain and attach a copy of the agreement and a signed ROI.
    • If the consumer designates a DVR Individual Representative, reference the Individual Representative guidance for more information.
  4. When collaborating with a high school, what information can we provide without an ROI (i.e., status of a student's application)?
    • Reference the Administration of the VR Program in this guidance piece.
  5. How do I get approval for ongoing communication?
    • Have the consumer and/or their guardian check the appropriate box when signing the ROI.
  6. If a consumer initials the employment records section of a signed release, can disability information be shared with the employer?
    • No, to share disability information, the Medical Records section should be checked on the Authorization for Release of Information (ROI).
    • If the Employment Records box is checked on the ROI, only those employment records listed can be released.
  7. Can DVR accept another organization's release form?
  8. DVR can accept another organization's release form if it includes the following:

    1. Consumer Name
    2. The type of information to be disclosed (medical records, case notes, etc.)
    3. Who is making the disclosure
    4. The individual, agency or organization to which disclosure may be made
    5. The signature of the consumer or legal representative or guardian. If not signed by consumer, the person's relationship to the consumer or the authority of the person.
    6. The date signed
    7. Expiration Date for the Consent, if none listed or action identified (i.e., case closure), the ROI will expire one year from the signature date.

    Other organizations may request that DVR use their release form because DVR's does not meet their standards. This is appropriate.

  9. What should I do if a consumer asks to revoke an ROI?
    • Case note the conversation.
    • Reattach the original ROI with an updated naming convention of "REVOKEDROI".
    • Delete the original ROI.
  10. Do new ROIs need to be signed when a consumer turns 18 and becomes their own guardian to replace ones previously signed by parent/guardian?
    • Yes. Obtain a new ROI once a consumer turns 18 and becomes their own legal guardian.
  11. Due to Licensed Professional Counselor (LPC) requirements, are DVR counselors required to follow additional confidentiality standards beyond other DVR staff?
    • No, DVR and DSPS share confidentiality standards and counselors do not have additional regulations to follow.
  12. A Job Center staff person calls about a consumer, and we do not have a signed ROI. We are not trying to coordinate services with them. Can we share information about the case?
    • No. Share only general policy/procedure information.
  13. A vendor states that they are Commission on Accreditation of Rehabilitation Facilities (CARF)-accredited and need disability information on consumers for their files. Can we share it with them?
    • Sharing disability information is unnecessary for the purpose of the VR program (i.e., the services the vendor is providing to the consumer). An ROI is required to share this disability information, or the consumer can share the information with the vendor directly.
  14. A legislator contacts DVR regarding a consumer who contacted them. Can we share details with them?
  15. What should we do if a consumer refuses to sign an ROI or doesn't want specific information released under administration of program?
    • Use vocational guidance and counseling to explain to them how it can potentially impact their IPE and services.
    • For example, we may not be able to coordinate services with W-2 (i.e., comparable benefits) or a mental health provider, and this could delay progress towards their employment goal or ability to access some services. It is their informed choice whether they sign an ROI, but staff should help them understand the limitations that could occur as part of their progress.
  16. What should we do if a consumer doesn't initial the specific boxes (or marks them with just an "X" or checkmark) on the ROI but signs it?
    • Contact the consumer to review and confirm the specific records they are requesting. Document the conversation in IRIS and proceed with releasing appropriate records.
  17. Can we share Unemployment Insurance (UI) Data with consumers?
    • We can share that we have access to DWD UI wage and employment information with consumers. However, we cannot provide them a copy of this information. If they would like a copy of their UI information, they can request it directly from the UI Division.