The federal confidentiality rules in 42 CFR Part 2 would not apply to primary care health homes in most cases because they do not normally meet the definition of a “program” (i.e., substance abuse treatment is not their principal practice) and do not hold themselves out as providers of alcohol and drug abuse treatment services:

Further, while the term “general medical care facility” is not defined in the definitions section of 42 CFR 2.11, hospitals, trauma centers, or federally qualified health centers would generally be considered “general medical care” facilities. Therefore, primary care providers who work in such facilities would only meet Part 2’s definition of a program if 1) they work in an identified unit within such general medical care facility that holds itself out as providing, and provides, alcohol or drug abuse diagnosis, treatment or referral for treatment, or 2) the primary function of the provider is alcohol or drug abuse diagnosis, treatment or referral for treatment and they are identified as providers of such services.  [Source:  http://www.samhsa.gov/about/laws/SAMHSA_42CFRPART2FAQII_Revised.pdf.]

Of course, the lines in some cases are not clear, and any agency in question should seek legal counsel.

MARK STRINGER
Director
Division of Comprehensive Psychiatric Services
Division of Alcohol & Drug Abuse
Department of Mental Health
1706 E. Elm St.
Jefferson City, MO  65101
Phone (573) 751-9499
Fax (573) 751-7814
Mark.Stringer@dmh.mo.gov