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CARN-AP study materials
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CARN-AP: Care Coordination, Referral, and Collaborative/Interprofessional Practice

CARN-AP · Work through your exam, one topic at a time.

All guide sections

Care Coordination, Referral, and Collaborative/Interprofessional Practice

Core knowledge

Care coordination in addictions depends on warm handoffs (in-person or live telephone transfer), closed-loop referrals in which the receiving team confirms engagement, and discharge planning that begins at admission. Integrated models include the collaborative care model, integrated dual diagnosis treatment with assertive outreach, and case management or ACT for high-acuity patients. Peer recovery coaches extend the workforce and support linkage. Medication continuity across transitions - hospital, jail, residential program - is a safety issue: interruption of methadone or buprenorphine raises overdose risk, particularly after release from incarceration when tolerance has fallen. 42 CFR Part 2 governs records of federally assisted SUD programs. It is stricter than HIPAA, generally requires written patient consent naming the recipient, purpose, and expiration (or event), prohibits redisclosure, and allows only narrow exceptions such as bona fide medical emergency, court order, and audit or evaluation. HIPAA permissions for treatment, payment, and operations do not automatically override Part 2. Screening for social determinants and arranging interpreter services, transportation, and childcare belong in the plan.

Traps

  • Assuming HIPAA permits disclosure of SUD records to a treating physician without Part 2 consent.
  • Treating a general consent-to-treat form as sufficient for Part 2 disclosure.
  • Answering a family member's questions without documented consent.
  • Federal rules are revised periodically; confirm the current Part 2 text rather than relying on memory.

Rule of thumb

Before disclosing anything, ask three questions: is the program federally assisted; is there a valid written consent naming recipient, purpose, and expiration; does the consent include the redisclosure prohibition? Worked example: a probation officer calls for records. Absent a valid consent or court order, decline, document the request, and offer to help obtain consent.