N.H. Code Admin. R. He-A 507.01
(d) The initial intake shall include the following steps:
(1) Each client shall provide the IDCMP with the following documentation at the time of intake, which shall then be reviewed:
a. A current original certified copy of the client’s driver’s license record, printed within the past 60 days, from all of the following, as applicable:
(j) At the time of intake, the IDCMP shall inform the client, in writing, of the following information, and obtain the client’s written acknowledgment that such information was provided and agreed to:
(l) Each client shall sign a 42 CFR Part 2 compliant release of information for each of the following:
(m) Each client shall sign and date a “Web Information Technology System (WITS) Information Use Acknowledgement for Clients Not Receiving Bureau of Drug and Alcohol Services (BDAS) Funded Services” form (December 2023), acknowledging the following:
“You are receiving services from a provider that utilizes the WITS system for client record keeping purposes. Any client information entered into the WITS system is protected by federal law (42 CFR, Part 2) and the department of health and human services (DHHS), which prohibits disclosure of the information without client consent except in very limited circumstances.
Because the WITS system is maintained by BDAS, certain DHHS employees are authorized to access the information that is entered into the WITS system. These DHHS employees are bound by State and Federal law (42 CFR, Part 2) to keep the information in WITS confidential and to only access it for legitimate business purposes. In general, once information is entered into WITS, it cannot be removed. As stated above, the sharing of client identifiable information outside of the Department without written consent from the client is prohibited by 42 CFR, Part 2. Some examples of when client information is accessed and how it is used are:
if !supportLists?• endif?Technical assistance with utilizing the WITS system;
if !supportLists?• endif?Technical assistance with clinical decision making upon provider request; and
if !supportLists?• endif?Reporting of deidentified client data to meet legislative and other administrative requests.
You have the right to choose whether or not your personal information is entered into the WITS system.
By signing below, I indicate that I understand that having my personal information entered into the WITS system will result in DHHS employees having access to that information for legitimate business purposes. I also attest that I have completed a 42 CFR, Part 2 compliant consent to allow my provider to release my personal information to BDAS through use of the WITS system.”
Source. #10240, eff 1-1-13; ss by #13846, eff 1-6-24, EXPIRES: 1-6-34