HIPAA and Transitions Protected Health Information PHI

Disclosure I still have not figured out a way to profit from these activities

In General HIPAA does not restrict communication about patients between clinicians that is related to treatment HIPAA does not mandate patient consent for such communication Institutions/practices may set policies aimed at assuring patient or parent knowledge of and consent for transfer of records

Mental Health Information Mental health records, per se, are not subject to any more restrictions than other health records However, records of treatment for drug and alcohol addiction are governed by 42 CFR Part 2, which says that patients, of any age, must authorize, in writing, release of such records

Mental Health Information Psychotherapy notes are restricted, but such notes are defined narrowly: – Kept separate from the rest of the patient’s records – Developed and maintained by a mental health professional – Taken in a therapeutic context – Contain information that would not be needed by a call-covering therapist Release of psychotherapy notes requires a specific signed authorization form

Other Restricted Information Utah State law stipulates that Minors may consent to treatment for sexually transmitted diseases and access to records of that treatment can be restricted Emancipation requires a court order that may be applied for by those ≥16 years; once emancipated, they are treated as adults

Non-restricted Information Except as mentioned, records of care for individuals under 18 years of age are accessible by the parent or legal guardian – responses to screening questions, including questions about substance abuse, sexual activity, etc. – policies to limit access or raise barriers may be reasonable

After 18 Once they reach the age of majority, an individual’s parents have no right of access to their medical records unless legal guardianship has been established

Risks Patients/families can not sue for HIPAA violations They may file a complaint to the Office of Civil Rights, US Department of Health and Human Services A state’s Attorney General may sue on an individual’s behalf, using HIPAA to establish the standard of care, and share any proceeds with the individual

Suggestions Develop and make readily available policies related to information that takes into account the laws, and train everyone Though not required by HIPAA, develop and have readily available forms for parents/patients to sign to enable communications between you and other health care providers – 1 copy to parent to give to provider – keep a copy to enable faxing

Suggestions Develop strategies to allow you to safely assure confidentiality to adolescents for disclosure of important information – think thru how you record screening and discussion of sexual activity/substance use – cover in written and oral communications Develop policy for access by parents/guardians to records of cognitively impaired adolescents