Improving the Quality of Health Care for Mental and Substance-Use Conditions (2006) / Chapter Skim
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Appendix B: Contraints on Sharing Mental Health and Substance Use Treatment Information Imposed by Federal and State Medical Records Privacy Laws
Appendix B: Contraints on Sharing Mental Health and Substance Use Treatment Information Imposed by Federal and State Medical Records Privacy Laws
Pages 405-422
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From page 405... ...
One of the less studied aspects of this statute, however, is the constraints that exist on the sharing of treatment information among mental health treatment providers when it is applied in tandem with other state and federal medical records confidentiality laws. This paper examines the interaction between these bodies of law, reviewing the federal HIPAA regulations, state statutes that govern mental health medical records privacy, and the federal statute governing confidentiality of substance abuse records.
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From page 406... ...
Psychotherapy notes are a special form of treatment information: Psychotherapy notes means notes recorded (in any medium) by a health care provider who is a mental health professional documenting or analyz ing the contents of conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of the individual's medical record.
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From page 407... ...
. Some types of mental health records are also independently governed by the federal substance abuse treatment confidentiality law, 42 U.S.C.
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From page 408... ...
· However, the HIPPA regulations only permit sharing of psychotherapy notes with authorization. · Moreover, the substance abuse confidentiality law does not permit sharing of records relating to substance abuse treatment or rehabilitation organizations conducted, regulated, or funded by the federal government,
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From page 409... ...
. STATE LAWS GOVERNING MENTAL HEALTH RECORDS It is more common for a state to have several specific statutes governing different types of medical records and information.
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From page 410... ...
there is a likeli hood that the discharge will be subject to the outpatient treatment obliga tion of this part, AND (3) the person refuses to give consent to disclose information which is legally confidential under this title to the proposed outpatient qualified mental health professional, THEN (4)
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From page 411... ...
STATE LAWS GOVERNING THE CONFIDENTIALITY OF SUBSTANCE ABUSE RECORDS Most states also have statutes governing substance abuse records. These in general roughly approximate the federal statute in their terms (see Cal.
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From page 412... ...
Most state laws governing medical records or mental health records, however, make some provision for sharing of information for treatment purposes. The wording of these statutes varies from state to state.
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From page 413... ...
. The Arizona statute similarly permits disclosure of mental health records to "physicians and providers of health, mental health or social and welfare services involved in caring for, treating or rehabilitating the patient" (Ariz.
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From page 414... ...
) , on the other hand, permits disclosure "in communications among qualified medical or mental health professionals in the provision of services or appropriate referrals"(though Rhode Island only permits disclosure of mental health treatment in community residences within the same residence (R.I.
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From page 415... ...
(f) Within the treatment facility where the patient is receiving treatment, confidential information may be disclosed to individuals employed, serv ing in bona fide training programs, or participating in supervised volun teer programs, at the facility when it is necessary to perform their duties.
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From page 416... ...
a designated receiving facility may request, and any health care provider which previously provided services to any person involuntarily admitted to the facility may provide, informa tion about such person limited to medications prescribed, known medica tion allergies or other information essential to the medical or psychiatric care of the person admitted. Prior to requesting such information the facility shall in writing request the person's consent for such request for information.
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From page 417... ...
. CONCLUSION In sum, state laws vary widely in terms of authorizing the disclosure of mental health records without consent for treatment purposes.
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From page 418... ...
(a1) Any State or area facility or the psychiatric service of the University of North Carolina Hospitals at Chapel Hill may share confidential information regarding any client of that facility with the Secretary, and the Secretary may share confidential information regarding any client with an area or State facility or the psychiatric service of the University of North Carolina Hospitals at Chapel Hill when the responsible professional or the Secretary determines that disclosure is necessary to coordinate appropriate and effective care, treatment or habilitation of the client.
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From page 419... ...
The Department of Correction may furnish to a facility confidential information in its possession about treatment for mental illness, developmental disabilities, or substance abuse that the Department of Correction has provided to any present or former inmate if the inmate is presently seeking treatment from the requesting facility or if the inmate has been involuntarily committed to the requesting facility for inpatient or outpatient treatment. Under the circumstances described in this subsection, the consent of the client or inmate shall not be required in order for this information to be furnished and the information shall be furnished despite objection by the client or inmate.
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From page 420... ...
(e) A responsible professional may exchange confidential information with a physician or other health care provider who is providing emergency medical services to a client.
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From page 421... ...
(j) Upon request of the next of kin or other family member who has a legitimate role in the therapeutic services offered, or other person designated by the client or his legally responsible person, the responsible professional shall provide the next of kin or other family member or the designee with notification of the client's diagnosis, the prognosis, the medications prescribed, the dosage of the medications prescribed, the side effects of the medications prescribed, if any, and the progress of the client, provided that the client or his legally responsible person has consented in writing, or the client has consented orally in the presence of a witness selected by the client, prior to the release of this information.
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From page 422... ...
(m) The Commission for Mental Health, Developmental Disabilities, and Substance Abuse Services shall adopt rules specifically to define the legitimate role referred to in subsections (j)
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