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Use the Consent for Release of Confidential Information Form, DSS-8219 to authorize the exchange of information between the county DSS and the Local Management Entity providing substance abuse services for the applicant/recipient.
Have the applicant/recipient sign the DSS-8219 prior to referral for an assessment by QPSA.
This consent form is in compliance with the Federal Confidentiality for Alcohol and Drug Records Laws (U.S.C., Title 42, §§290 dd-2 {1991}) and the federal regulations that implement it (42 C.F.R. 42 Part 2).
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For questions or clarification on any of the policy contained in these manuals, please contact your local county office. |
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