Many clinicians misunderstand their ethical and legal obligations with regard to confidentiality for criminal justice clients.

Federal law and most State laws expressly permit substance abuse treatment programs to disclose information about clients to criminal justice officials who have made program participation a condition of the disposition of a criminal proceeding, probation, parole, or conditional release from prison or jail (e.g., Marlowe, 2001). Disclosure must be limited to those individuals who need the information to meet their duty to monitor the client's progress. Notably, Federal law prohibits the use of such information to investigate or prosecute any new charge against the client. The information can be used only to monitor the client's progress during the immediate treatment episode.

The Health Insurance Portability and Accountability Act (HIPAA) does not add substantive restrictions on the sharing of health-related information in this context. Rather, HIPAA requires treatment providers to clearly inform clients about how their personal health information will be used and to give them an opportunity to object to such uses. It is clearly permissible under HIPAA for criminal justice professionals to share information with treatment agencies for purposes of facilitating clients' treatment, payment for treatment, or other healthcare operations.

Conversely, clinicians may ordinarily share treatment information with criminal justice professionals so long as they provide clients with appropriate notice of their agency's privacy practices and the limitations on confidentiality, and they obtain specific authorizations from the client to disclose the information in that manner.