BILL REQ. #: H-0969.1
| State of Washington | 63rd Legislature | 2013 Regular Session |
Read first time 02/05/13. Referred to Committee on Health Care & Wellness.
AN ACT Relating to disclosure of health care information; amending RCW 70.02.010, 70.02.020, 70.02.050, 70.02.060, 71.05.660, 71.05.680, 71.05.690, and 71.24.035; adding new sections to chapter 70.02 RCW; repealing RCW 70.24.105, 71.05.390, 71.05.640, 71.05.385, 71.05.420, 71.05.440, 71.05.427, 71.05.510, 71.34.340, 71.34.345, and 71.34.350; prescribing penalties; and providing an effective date.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF WASHINGTON:
Sec. 1 RCW 70.02.010 and 2006 c 235 s 2 are each amended to read
as follows:
The definitions in this section apply throughout this chapter
unless the context clearly requires otherwise.
(1) "Audit" means an assessment, evaluation, determination, or
investigation of a health care provider by a person not employed by or
affiliated with the provider to determine compliance with:
(a) Statutory, regulatory, fiscal, medical, or scientific
standards;
(b) A private or public program of payments to a health care
provider; or
(c) Requirements for licensing, accreditation, or certification.
(2) "Department" means the department of social and health
services."
(3) "Directory information" means information disclosing the
presence, and for the purpose of identification, the name, location
within a health care facility, and the general health condition of a
particular patient who is a patient in a health care facility or who is
currently receiving emergency health care in a health care facility.
(((3))) (4) "Federal, state, or local law enforcement authorities"
means an officer of any agency or authority in the United States, a
state, a tribe, a territory, or a political subdivision of a state, a
tribe, or a territory who is empowered by law to: (a) Investigate or
conduct an official inquiry into a potential criminal violation of law;
or (b) prosecute or otherwise conduct a criminal proceeding arising
from an alleged violation of law.
(((4))) (5) "General health condition" means the patient's health
status described in terms of "critical," "poor," "fair," "good,"
"excellent," or terms denoting similar conditions.
(((5))) (6) "Health care" means any care, service, or procedure
provided by a health care provider:
(a) To diagnose, treat, or maintain a patient's physical or mental
condition; or
(b) That affects the structure or any function of the human body.
(((6))) (7) "Health care facility" means a hospital, clinic,
nursing home, laboratory, office, or similar place where a health care
provider provides health care to patients.
(((7))) (8) "Health care information" means any information,
whether oral or recorded in any form or medium, that identifies or can
readily be associated with the identity of a patient and directly
relates to the patient's health care, including a patient's
deoxyribonucleic acid and identified sequence of chemical base pairs.
The term includes any required accounting of disclosures of health care
information.
(((8))) (9) "Health care operations" means any of the following
activities of a health care provider, health care facility, or third-party payor to the extent that the activities are related to functions
that make an entity a health care provider, a health care facility, or
a third-party payor:
(a) Conducting: Quality assessment and improvement activities,
including outcomes evaluation and development of clinical guidelines,
if the obtaining of generalizable knowledge is not the primary purpose
of any studies resulting from such activities; population-based
activities relating to improving health or reducing health care costs,
protocol development, case management and care coordination, contacting
of health care providers and patients with information about treatment
alternatives; and related functions that do not include treatment;
(b) Reviewing the competence or qualifications of health care
professionals, evaluating practitioner and provider performance and
third-party payor performance, conducting training programs in which
students, trainees, or practitioners in areas of health care learn
under supervision to practice or improve their skills as health care
providers, training of nonhealth care professionals, accreditation,
certification, licensing, or credentialing activities;
(c) Underwriting, premium rating, and other activities relating to
the creation, renewal, or replacement of a contract of health insurance
or health benefits, and ceding, securing, or placing a contract for
reinsurance of risk relating to claims for health care, including stop-loss insurance and excess of loss insurance, if any applicable legal
requirements are met;
(d) Conducting or arranging for medical review, legal services, and
auditing functions, including fraud and abuse detection and compliance
programs;
(e) Business planning and development, such as conducting cost-management and planning-related analyses related to managing and
operating the health care facility or third-party payor, including
formulary development and administration, development, or improvement
of methods of payment or coverage policies; and
(f) Business management and general administrative activities of
the health care facility, health care provider, or third-party payor
including, but not limited to:
(i) Management activities relating to implementation of and
compliance with the requirements of this chapter;
(ii) Customer service, including the provision of data analyses for
policy holders, plan sponsors, or other customers, provided that health
care information is not disclosed to such policy holder, plan sponsor,
or customer;
(iii) Resolution of internal grievances;
(iv) The sale, transfer, merger, or consolidation of all or part of
a health care provider, health care facility, or third-party payor with
another health care provider, health care facility, or third-party
payor or an entity that following such activity will become a health
care provider, health care facility, or third-party payor, and due
diligence related to such activity; and
(v) Consistent with applicable legal requirements, creating
deidentified health care information or a limited dataset and fund-raising for the benefit of the health care provider, health care
facility, or third-party payor.
(((9))) (10) "Health care provider" means a person who is licensed,
certified, registered, or otherwise authorized by the law of this state
to provide health care in the ordinary course of business or practice
of a profession.
(((10))) (11) "Information and records related to mental health
services" means a type of health care information that relates to all
information and records, including mental health treatment records,
compiled, obtained, or maintained in the course of providing services
by a mental health service agency, as defined in this section. This
may include documents of legal proceedings under chapter 71.05, 71.34,
or 10.77 RCW, or somatic health care information.
(12) "Information and records related to sexually transmitted
diseases" means a type of health care information that relates to the
identity of any person upon whom an HIV antibody test or other sexually
transmitted infection test is performed, the results of such tests, and
any information relating to diagnosis of or treatment for any confirmed
sexually transmitted infections.
(13) "Institutional review board" means any board, committee, or
other group formally designated by an institution, or authorized under
federal or state law, to review, approve the initiation of, or conduct
periodic review of research programs to assure the protection of the
rights and welfare of human research subjects.
(((11))) (14) "Maintain," as related to health care information,
means to hold, possess, preserve, retain, store, or control that
information.
(((12))) (15) "Mental health service agency" means a public or
private agency that provides services to persons with mental disorders
as defined under RCW 71.05.020 and 71.34.020 and receives funding from
public sources. This includes evaluation and treatment facilities as
defined in RCW 71.34.020, community mental health service delivery
systems, or community mental health programs, as defined in RCW
71.24.025, and facilities conducting competency evaluations and
restoration under chapter 10.77 RCW.
(16) "Mental health treatment records" include registration
records, as defined in RCW 71.05.020, and all other records concerning
persons who are receiving or who at any time have received services for
mental illness, which are maintained by the department, by regional
support networks and their staff, and by treatment facilities. "Mental
health treatment records" include mental health information contained
in a medical bill including, but not limited to, mental health drugs,
a mental health diagnosis, provider name, and dates of service stemming
from a medical service. "Mental health treatment records" do not
include notes or records maintained for personal use by a person
providing treatment services for the department, regional support
networks, or a treatment facility if the notes or records are not
available to others.
(17) "Patient" means an individual who receives or has received
health care. The term includes a deceased individual who has received
health care.
(((13))) (18) "Payment" means:
(a) The activities undertaken by:
(i) A third-party payor to obtain premiums or to determine or
fulfill its responsibility for coverage and provision of benefits by
the third-party payor; or
(ii) A health care provider, health care facility, or third-party
payor, to obtain or provide reimbursement for the provision of health
care; and
(b) The activities in (a) of this subsection that relate to the
patient to whom health care is provided and that include, but are not
limited to:
(i) Determinations of eligibility or coverage, including
coordination of benefits or the determination of cost-sharing amounts,
and adjudication or subrogation of health benefit claims;
(ii) Risk adjusting amounts due based on enrollee health status and
demographic characteristics;
(iii) Billing, claims management, collection activities, obtaining
payment under a contract for reinsurance, including stop-loss insurance
and excess of loss insurance, and related health care data processing;
(iv) Review of health care services with respect to medical
necessity, coverage under a health plan, appropriateness of care, or
justification of charges;
(v) Utilization review activities, including precertification and
preauthorization of services, and concurrent and retrospective review
of services; and
(vi) Disclosure to consumer reporting agencies of any of the
following health care information relating to collection of premiums or
reimbursement:
(A) Name and address;
(B) Date of birth;
(C) Social security number;
(D) Payment history;
(E) Account number; and
(F) Name and address of the health care provider, health care
facility, and/or third-party payor.
(((14))) (19) "Person" means an individual, corporation, business
trust, estate, trust, partnership, association, joint venture,
government, governmental subdivision or agency, or any other legal or
commercial entity.
(((15))) (20) "Reasonable fee" means the charges for duplicating or
searching the record, but shall not exceed sixty-five cents per page
for the first thirty pages and fifty cents per page for all other
pages. In addition, a clerical fee for searching and handling may be
charged not to exceed fifteen dollars. These amounts shall be adjusted
biennially in accordance with changes in the consumer price index, all
consumers, for Seattle-Tacoma metropolitan statistical area as
determined by the secretary of health. However, where editing of
records by a health care provider is required by statute and is done by
the provider personally, the fee may be the usual and customary charge
for a basic office visit.
(((16))) (21) "Sexually transmitted infection" or "sexually
transmitted disease" has the same meaning as "sexually transmitted
disease" in RCW 70.24.017.
(22) "Third-party payor" means an insurer regulated under Title 48
RCW authorized to transact business in this state or other
jurisdiction, including a health care service contractor, and health
maintenance organization; or an employee welfare benefit plan; or a
state or federal health benefit program.
(((17))) (23) "Treatment" means the provision, coordination, or
management of health care and related services by one or more health
care providers or health care facilities, including the coordination or
management of health care by a health care provider or health care
facility with a third party; consultation between health care providers
or health care facilities relating to a patient; or the referral of a
patient for health care from one health care provider or health care
facility to another.
Sec. 2 RCW 70.02.020 and 2005 c 468 s 2 are each amended to read
as follows:
(1) Except as authorized ((in RCW 70.02.050)) elsewhere in this
chapter, a health care provider, an individual who assists a health
care provider in the delivery of health care, or an agent and employee
of a health care provider may not disclose health care information
about a patient to any other person without the patient's written
authorization. A disclosure made under a patient's written
authorization must conform to the authorization.
(2) A patient has a right to receive an accounting of disclosures
of health care information made by a health care provider or a health
care facility in the six years before the date on which the accounting
is requested, except for disclosures:
(a) To carry out treatment, payment, and health care operations;
(b) To the patient of health care information about him or her;
(c) Incident to a use or disclosure that is otherwise permitted or
required;
(d) Pursuant to an authorization where the patient authorized the
disclosure of health care information about himself or herself;
(e) Of directory information;
(f) To persons involved in the patient's care;
(g) For national security or intelligence purposes if an accounting
of disclosures is not permitted by law;
(h) To correctional institutions or law enforcement officials if an
accounting of disclosures is not permitted by law; ((and))
(i) Of a limited data set that excludes direct identifiers of the
patient or of relatives, employers, or household members of the
patient; and
(j) As provided in RCW 71.05.425.
Sec. 3 RCW 70.02.050 and 2007 c 156 s 12 are each amended to read
as follows:
(1) A health care provider or health care facility may disclose
health care information, except for information and records related to
sexually transmitted diseases, about a patient without the patient's
authorization to the extent a recipient needs to know the information,
if the disclosure is:
(a) To a person who the provider or facility reasonably believes is
providing health care to the patient;
(b) To any other person who requires health care information for
health care education, or to provide planning, quality assurance, peer
review, or administrative, legal, financial, actuarial services to, or
other health care operations for or on behalf of the health care
provider or health care facility; or for assisting the health care
provider or health care facility in the delivery of health care and the
health care provider or health care facility reasonably believes that
the person:
(i) Will not use or disclose the health care information for any
other purpose; and
(ii) Will take appropriate steps to protect the health care
information;
(c) ((To any other health care provider or health care facility
reasonably believed to have previously provided health care to the
patient, to the extent necessary to provide health care to the patient,
unless the patient has instructed the health care provider or health
care facility in writing not to make the disclosure;)) To an official of a penal or other custodial institution in
which the patient is detained;
(d) To any person if the health care provider or health care
facility reasonably believes that disclosure will avoid or minimize an
imminent danger to the health or safety of the patient or any other
individual, however there is no obligation under this chapter on the
part of the provider or facility to so disclose;
(e) To immediate family members of the patient, including a
patient's state registered domestic partner, or any other individual
with whom the patient is known to have a close personal relationship,
if made in accordance with good medical or other professional practice,
unless the patient has instructed the health care provider or health
care facility in writing not to make the disclosure;
(f) To a health care provider or health care facility who is the
successor in interest to the health care provider or health care
facility maintaining the health care information;
(g) For use in a research project that an institutional review
board has determined:
(i) Is of sufficient importance to outweigh the intrusion into the
privacy of the patient that would result from the disclosure;
(ii) Is impracticable without the use or disclosure of the health
care information in individually identifiable form;
(iii) Contains reasonable safeguards to protect the information
from redisclosure;
(iv) Contains reasonable safeguards to protect against identifying,
directly or indirectly, any patient in any report of the research
project; and
(v) Contains procedures to remove or destroy at the earliest
opportunity, consistent with the purposes of the project, information
that would enable the patient to be identified, unless an institutional
review board authorizes retention of identifying information for
purposes of another research project;
(h) To a person who obtains information for purposes of an audit,
if that person agrees in writing to:
(i) Remove or destroy, at the earliest opportunity consistent with
the purpose of the audit, information that would enable the patient to
be identified; and
(ii) Not to disclose the information further, except to accomplish
the audit or report unlawful or improper conduct involving fraud in
payment for health care by a health care provider or patient, or other
unlawful conduct by the health care provider;
(i)
(((j) To provide directory information, unless the patient has
instructed the health care provider or health care facility not to make
the disclosure;)) or
(k) To fire, police, sheriff, or another public authority, that
brought, or caused to be brought, the patient to the health care
facility or health care provider if the disclosure is limited to the
patient's name, residence, sex, age, occupation, condition, diagnosis,
estimated or actual discharge date, or extent and location of injuries
as determined by a physician, and whether the patient was conscious
when admitted;
(l) To federal, state, or local law enforcement authorities and the
health care provider, health care facility, or third-party payor
believes in good faith that the health care information disclosed
constitutes evidence of criminal conduct that occurred on the premises
of the health care provider, health care facility, or third-party
payor;
(m) To another health care provider, health care facility, or
third-party payor for the health care operations of the health care
provider, health care facility, or third-party payor that receives the
information, if each entity has or had a relationship with the patient
who is the subject of the health care information being requested, the
health care information pertains to such relationship, and the
disclosure is for the purposes described in RCW 70.02.010(8) (a) and
(b);
(((n))) (d) For payment, including information necessary for a
recipient to make a claim, or for a claim to be made on behalf of a
recipient for aid, insurance, or medical assistance to which he or she
may be entitled.
(2) A health care provider shall disclose health care information,
except for information and records related to sexually transmitted
diseases, about a patient without the patient's authorization if the
disclosure is((:)) to federal, state, or local public health authorities, to the
extent the health care provider is required by law to report health
care information; when needed to determine compliance with state or
federal licensure, certification or registration rules or laws; or when
needed to protect the public health((
(a);)).
(b) To federal, state, or local law enforcement authorities to the
extent the health care provider is required by law;
(c) To federal, state, or local law enforcement authorities, upon
receipt of a written or oral request made to a nursing supervisor,
administrator, or designated privacy official, in a case in which the
patient is being treated or has been treated for a bullet wound,
gunshot wound, powder burn, or other injury arising from or caused by
the discharge of a firearm, or an injury caused by a knife, an ice
pick, or any other sharp or pointed instrument which federal, state, or
local law enforcement authorities reasonably believe to have been
intentionally inflicted upon a person, or a blunt force injury that
federal, state, or local law enforcement authorities reasonably believe
resulted from a criminal act, the following information, if known:
(i) The name of the patient;
(ii) The patient's residence;
(iii) The patient's sex;
(iv) The patient's age;
(v) The patient's condition;
(vi) The patient's diagnosis, or extent and location of injuries as
determined by a health care provider;
(vii) Whether the patient was conscious when admitted;
(viii) The name of the health care provider making the
determination in (c)(v), (vi), and (vii) of this subsection;
(ix) Whether the patient has been transferred to another facility;
and
(x) The patient's discharge time and date;
(d) To county coroners and medical examiners for the investigations
of deaths;
(e) Pursuant to compulsory process in accordance with RCW
70.02.060.
(3) All state or local agencies obtaining patient health care
information pursuant to this section shall adopt rules establishing
their record acquisition, retention, and security policies that are
consistent with this chapter
NEW SECTION. Sec. 4 A new section is added to chapter 70.02 RCW
to read as follows:
(1) A health care provider or health care facility may disclose
health care information, except for information and records related to
sexually transmitted diseases and information related to mental health
services, about a patient without the patient's authorization, to:
(a) Any other health care provider or health care facility
reasonably believed to have previously provided health care to the
patient, to the extent necessary to provide health care to the patient,
unless the patient has instructed the health care provider or health
care facility in writing not to make the disclosure;
(b) Any person if the health care provider or health care facility
reasonably believes that disclosure will avoid or minimize an imminent
danger to the health or safety of the patient or any other individual.
However, there is no obligation under this chapter on the part of the
provider or facility to so disclose;
(c) Immediate family members of the patient, including a patient's
state registered domestic partner, or any other individual with whom
the patient is known to have a close personal relationship, if made in
accordance with good medical or other professional practice, unless the
patient has instructed the health care provider or health care facility
in writing not to make the disclosure;
(d) A health care provider or health care facility who is the
successor in interest to the health care provider or health care
facility maintaining the health care information;
(e) A person who obtains information for purposes of an audit, if
that person agrees in writing to:
(i) Remove or destroy, at the earliest opportunity consistent with
the purpose of the audit, information that would enable the patient to
be identified; and
(ii) Not to disclose the information further, except to accomplish
the audit or report unlawful or improper conduct involving fraud in
payment for health care by a health care provider or patient, or other
unlawful conduct by the health care provider;
(f) Provide directory information, unless the patient has
instructed the health care provider or health care facility not to make
the disclosure;
(g) Fire, police, sheriff, or other public authority, that brought,
or caused to be brought, the patient to the health care facility or
health care provider if the disclosure is limited to the patient's
name, residence, sex, age, occupation, condition, diagnosis, estimated
or actual discharge date, or extent and location of injuries as
determined by a physician, and whether the patient was conscious when
admitted;
(h) Federal, state, or local law enforcement authorities and the
health care provider, health care facility, or third-party payor
believes in good faith that the health care information disclosed
constitutes evidence of criminal conduct that occurred on the premises
of the health care provider, health care facility, or third-party
payor; and
(i) Another health care provider, health care facility, or third-party payor for the health care operations of the health care provider,
health care facility, or third-party payor that receives the
information, if each entity has or had a relationship with the patient
who is the subject of the health care information being requested, the
health care information pertains to such relationship, and the
disclosure is for the purposes described in RCW 70.02.010(9) (a) and
(b).
(2) A health care provider shall disclose health care information,
except for information related to sexually transmitted diseases and
information related to mental health services, about a patient without
the patient's authorization if the disclosure is:
(a) To federal, state, or local law enforcement authorities to the
extent the health care provider is required by law;
(b) To federal, state, or local law enforcement authorities, upon
receipt of a written or oral request made to a nursing supervisor,
administrator, or designated privacy official, in a case in which the
patient is being treated or has been treated for a bullet wound,
gunshot wound, powder burn, or other injury arising from or caused by
the discharge of a firearm, or an injury caused by a knife, an ice
pick, or any other sharp or pointed instrument which federal, state, or
local law enforcement authorities reasonably believe to have been
intentionally inflicted upon a person, or a blunt force injury that
federal, state, or local law enforcement authorities reasonably believe
resulted from a criminal act, the following information, if known:
(i) The name of the patient;
(ii) The patient's residence;
(iii) The patient's sex;
(iv) The patient's age;
(v) The patient's condition;
(vi) The patient's diagnosis, or extent and location of injuries as
determined by a health care provider;
(vii) Whether the patient was conscious when admitted;
(viii) The name of the health care provider making the
determination in (b)(v), (vi), and (vii) of this subsection;
(ix) Whether the patient has been transferred to another facility;
and
(x) The patient's discharge time and date;
(c) Pursuant to compulsory process in accordance with RCW
70.02.060.
NEW SECTION. Sec. 5 A new section is added to chapter 70.02 RCW
to read as follows:
(1) A health care provider or health care facility may disclose
health care information about a patient without the patient's
authorization to the extent a recipient needs to know the information,
if the disclosure is for use in a research project that an
institutional review board has determined:
(a) Is of sufficient importance to outweigh the intrusion into the
privacy of the patient that would result from the disclosure;
(b) Is impracticable without the use or disclosure of the health
care information in individually identifiable form;
(c) Contains reasonable safeguards to protect the information from
redisclosure;
(d) Contains reasonable safeguards to protect against identifying,
directly or indirectly, any patient in any report of the research
project; and
(e) Contains procedures to remove or destroy at the earliest
opportunity, consistent with the purposes of the project, information
that would enable the patient to be identified, unless an institutional
review board authorizes retention of identifying information for
purposes of another research project.
(2) A health care provider or health care facility shall disclose
health care information about a patient without the patient's
authorization if the disclosure is to county coroners and medical
examiners for the investigations of deaths.
NEW SECTION. Sec. 6 A new section is added to chapter 70.02 RCW
to read as follows:
(1) No person may disclose or be compelled to disclose the identity
of any person who has investigated, considered, or requested a test or
treatment for a sexually transmitted disease, except as authorized by
this section, section 5 of this act, or chapter 70.24 RCW.
(2) No person may disclose or be compelled to disclose information
and records related to sexually transmitted diseases. A person may
disclose information related to sexually transmitted diseases about a
patient without the patient's authorization, to the extent a recipient
needs to know the information, if the disclosure is to:
(a) The subject of the test or the subject's legal representative
for health care decisions in accordance with RCW 7.70.065, with the
exception of such a representative of a minor fourteen years of age or
over and otherwise competent;
(b) The state public health officer, a local public health officer,
or the centers for disease control of the United States public health
service in accordance with reporting requirements for a diagnosed case
of a sexually transmitted disease;
(c) A health facility or health care provider that procures,
processes, distributes, or uses: (i) A human body part, tissue, or
blood from a deceased person with respect to medical information
regarding that person; (ii) semen, including that was provided prior to
March 23, 1988, for the purpose of artificial insemination; or (iii)
blood specimens;
(d) Any state or local public health officer conducting an
investigation pursuant to RCW 70.24.024, so long as the record was
obtained by means of court-ordered HIV testing pursuant to RCW
70.24.340 or 70.24.024;
(e) A person allowed access to the record by a court order granted
after application showing good cause therefor. In assessing good
cause, the court shall weigh the public interest and the need for
disclosure against the injury to the patient, to the physician-patient
relationship, and to the treatment services. Upon the granting of the
order, the court, in determining the extent to which any disclosure of
all or any part of the record of any such test is necessary, shall
impose appropriate safeguards against unauthorized disclosure. An
order authorizing disclosure must: (i) Limit disclosure to those parts
of the patient's record deemed essential to fulfill the objective for
which the order was granted; (ii) limit disclosure to those persons
whose need for information is the basis for the order; and (iii)
include any other appropriate measures to keep disclosure to a minimum
for the protection of the patient, the physician-patient relationship,
and the treatment services;
(f) Persons who, because of their behavioral interaction with the
infected individual, have been placed at risk for acquisition of a
sexually transmitted disease, as provided in RCW 70.24.022, if the
health officer or authorized representative believes that the exposed
person was unaware that a risk of disease exposure existed and that the
disclosure of the identity of the infected person is necessary;
(g) A law enforcement officer, firefighter, health care provider,
health care facility staff person, department of correction's staff
person, jail staff person, or other persons as defined by the board in
rule pursuant to RCW 70.24.340(4), who has requested a test of a person
whose bodily fluids he or she has been substantially exposed to,
pursuant to RCW 70.24.340(4), if a state or local public health officer
performs the test;
(h) Claims management personnel employed by or associated with an
insurer, health care service contractor, health maintenance
organization, self-funded health plan, state administered health care
claims payer, or any other payer of health care claims where such
disclosure is to be used solely for the prompt and accurate evaluation
and payment of medical or related claims. Information released under
this subsection must be confidential and may not be released or
available to persons who are not involved in handling or determining
medical claims payment; and
(i) A department of social and health services worker, a child
placing agency worker, or a guardian ad litem who is responsible for
making or reviewing placement or case-planning decisions or
recommendations to the court regarding a child, who is less than
fourteen years of age, has a sexually transmitted disease, and is in
the custody of the department of social and health services or a
licensed child placing agency. This information may also be received
by a person responsible for providing residential care for such a child
when the department of social and health services or a licensed child
placing agency determines that it is necessary for the provision of
child care services.
(3) No person to whom the results of a test for a sexually
transmitted disease have been disclosed pursuant to subsection (2) of
this section may disclose the test results to another person except as
authorized by that subsection.
(4) The release of sexually transmitted disease information
regarding an offender or detained person, except as provided in
subsection (2)(d) of this section, is governed as follows:
(a) The sexually transmitted disease status of a department of
corrections offender who has had a mandatory test conducted pursuant to
RCW 70.24.340(1), 70.24.360, or 70.24.370 must be made available by
department of corrections health care providers and local public health
officers to the department of corrections health care administrator or
infection control coordinator of the facility in which the offender is
housed. The information made available to the health care
administrator or the infection control coordinator under this
subsection (4)(a) may be used only for disease prevention or control
and for protection of the safety and security of the staff, offenders,
and the public. The information may be submitted to transporting
officers and receiving facilities, including facilities that are not
under the department of corrections' jurisdiction according to the
provisions of (d) and (e) of this subsection.
(b) The sexually transmitted disease status of a person detained in
a jail who has had a mandatory test conducted pursuant to RCW
70.24.340(1), 70.24.360, or 70.24.370 must be made available by the
local public health officer to a jail health care administrator or
infection control coordinator. The information made available to a
health care administrator under this subsection (4)(b) may be used only
for disease prevention or control and for protection of the safety and
security of the staff, offenders, detainees, and the public. The
information may be submitted to transporting officers and receiving
facilities according to the provisions of (d) and (e) of this
subsection.
(c) Information regarding the sexually transmitted disease status
of an offender or detained person is confidential and may be disclosed
by a correctional health care administrator or infection control
coordinator or local jail health care administrator or infection
control coordinator only as necessary for disease prevention or control
and for protection of the safety and security of the staff, offenders,
and the public. Unauthorized disclosure of this information to any
person may result in disciplinary action, in addition to the penalties
prescribed in RCW 70.24.080 or any other penalties as may be prescribed
by law.
(d) Notwithstanding the limitations on disclosure contained in (a),
(b), and (c) of this subsection, whenever any member of a jail staff or
department of corrections staff has been substantially exposed to the
bodily fluids of an offender or detained person, then the results of
any tests conducted pursuant to RCW 70.24.340(1), 70.24.360, or
70.24.370, must be immediately disclosed to the staff person in
accordance with the Washington Administrative Code rules governing
employees' occupational exposure to bloodborne pathogens. Disclosure
must be accompanied by appropriate counseling for the staff member,
including information regarding follow-up testing and treatment.
Disclosure must also include notice that subsequent disclosure of the
information in violation of this chapter or use of the information to
harass or discriminate against the offender or detainee may result in
disciplinary action, in addition to the penalties prescribed in RCW
70.24.080, and imposition of other penalties prescribed by law.
(e) The staff member must also be informed whether the offender or
detained person had any other communicable disease, as defined in RCW
72.09.251(3), when the staff person was substantially exposed to the
offender's or detainee's bodily fluids.
(f) The test results of voluntary and anonymous HIV testing or HIV-related condition may not be disclosed to a staff person except as
provided in this section and RCW 70.02.050(1)(d) and 70.24.340(4). A
health care administrator or infection control coordinator may provide
the staff member with information about how to obtain the offender's or
detainee's test results under this section and RCW 70.02.050(1)(d) and
70.24.340(4).
(5) The requirements of this section do not apply to the customary
methods utilized for the exchange of medical information among health
care providers in order to provide health care services to the patient,
nor do they apply within health care facilities where there is a need
for access to confidential medical information to fulfill professional
duties.
(6) Upon request of the victim, disclosure of test results under
this section to victims of sexual offenses under chapter 9A.44 RCW must
be made if the result is negative or positive. The county prosecuting
attorney shall notify the victim of the right to such disclosure. The
disclosure must be accompanied by appropriate counseling, including
information regarding follow-up testing.
NEW SECTION. Sec. 7 A new section is added to chapter 70.02 RCW
to read as follows:
(1) Except as provided in this section, RCW 70.02.050, 71.05.445,
70.96A.150, 74.09.295, sections 5 and 8 of this act, or pursuant to a
valid authorization under RCW 70.02.030, the fact of admission to a
provider for mental health services and all information and records
compiled, obtained, or maintained in the course of providing mental
health services to either voluntary or involuntary recipients of
services at public or private agencies must be confidential.
(2) Information and records related to mental health services,
other than those obtained through treatment under chapter 71.34 RCW,
may be disclosed only:
(a) In communications between qualified professional persons to
meet the requirements of chapter 71.05 RCW, in the provision of
services or appropriate referrals, or in the course of guardianship
proceedings if provided to a professional person:
(i) Employed by the facility;
(ii) Who has medical responsibility for the patient's care;
(iii) Who is a designated mental health professional;
(iv) Who is providing services under chapter 71.24 RCW;
(v) Who is employed by a state or local correctional facility where
the person is confined or supervised; or
(vi) Who is providing evaluation, treatment, or follow-up services
under chapter 10.77 RCW;
(b) When the communications regard the special needs of a patient
and the necessary circumstances giving rise to such needs and the
disclosure is made by a facility providing services to the operator of
a facility in which the patient resides or will reside;
(c)(i) When the person receiving services, or his or her guardian,
designates persons to whom information or records may be released, or
if the person is a minor, when his or her parents make such a
designation;
(ii) A public or private agency shall release to a person's next of
kin, attorney, personal representative, guardian, or conservator, if
any:
(A) The information that the person is presently a patient in the
facility or that the person is seriously physically ill;
(B) A statement evaluating the mental and physical condition of the
patient, and a statement of the probable duration of the patient's
confinement, if such information is requested by the next of kin,
attorney, personal representative, guardian, or conservator; and
(iii) Other information requested by the next of kin or attorney as
may be necessary to decide whether or not proceedings should be
instituted to appoint a guardian or conservator;
(d)(i) To the courts as necessary to the administration of this
chapter or to a court ordering an evaluation or treatment under chapter
10.77 RCW solely for the purpose of preventing the entry of any
evaluation or treatment order that is inconsistent with any order
entered under this chapter.
(ii) To a court or its designee in which a motion under chapter
10.77 RCW has been made for involuntary medication of a defendant for
the purpose of competency restoration.
(iii) Disclosure under this subsection is mandatory for the purpose
of the federal health insurance portability and accountability act;
(e)(i) When a mental health professional is requested by a
representative of a law enforcement or corrections agency, including a
police officer, sheriff, community corrections officer, a municipal
attorney, or prosecuting attorney to undertake an investigation or
provide treatment under RCW 71.05.150, 10.31.110, or 71.05.153, the
mental health professional shall, if requested to do so, advise the
representative in writing of the results of the investigation including
a statement of reasons for the decision to detain or release the person
investigated. The written report must be submitted within seventy-two
hours of the completion of the investigation or the request from the
law enforcement or corrections representative, whichever occurs later.
(ii) Disclosure under this subsection is mandatory for the purposes
of the federal health insurance portability and accountability act;
(f) To the attorney of the detained person;
(g) To the prosecuting attorney as necessary to carry out the
responsibilities of the office under RCW 71.05.330(2), 71.05.340(1)(b),
and 71.05.335. The prosecutor must be provided access to records
regarding the committed person's treatment and prognosis, medication,
behavior problems, and other records relevant to the issue of whether
treatment less restrictive than inpatient treatment is in the best
interest of the committed person or others. Information must be
disclosed only after giving notice to the committed person and the
person's counsel;
(h)(i) To appropriate law enforcement agencies and to a person,
when the identity of the person is known to the public or private
agency, whose health and safety has been threatened, or who is known to
have been repeatedly harassed, by the patient. The person may
designate a representative to receive the disclosure. The disclosure
must be made by the professional person in charge of the public or
private agency or his or her designee and must include the dates of
commitment, admission, discharge, or release, authorized or
unauthorized absence from the agency's facility, and only any other
information that is pertinent to the threat or harassment. The agency
or its employees are not civilly liable for the decision to disclose or
not, so long as the decision was reached in good faith and without
gross negligence.
(ii) Disclosure under this subsection is mandatory for the purposes
of the federal health insurance portability and accountability act;
(i)(i) To appropriate corrections and law enforcement agencies all
necessary and relevant information in the event of a crisis or emergent
situation that poses a significant and imminent risk to the public.
The mental health service agency or its employees are not civilly
liable for the decision to disclose or not so long as the decision was
reached in good faith and without gross negligence.
(ii) Disclosure under this subsection is mandatory for the purposes
of the health insurance portability and accountability act;
(j) To the persons designated in RCW 71.05.425 for the purposes
described in those sections;
(k) Upon the death of a person. The person's next of kin, personal
representative, guardian, or conservator, if any, must be notified.
Next of kin who are of legal age and competent must be notified under
this section in the following order: Spouse, parents, children,
brothers and sisters, and other relatives according to the degree of
relation. Access to all records and information compiled, obtained, or
maintained in the course of providing services to a deceased patient
are governed by RCW 70.02.140;
(l) To mark headstones or otherwise memorialize patients interred
at state hospital cemeteries. The department of social and health
services shall make available the name, date of birth, and date of
death of patients buried in state hospital cemeteries fifty years after
the death of a patient;
(m) To law enforcement officers and to prosecuting attorneys as are
necessary to enforce RCW 9.41.040(2)(a)(ii). The extent of information
that may be released is limited as follows:
(i) Only the fact, place, and date of involuntary commitment, an
official copy of any order or orders of commitment, and an official
copy of any written or oral notice of ineligibility to possess a
firearm that was provided to the person pursuant to RCW 9.41.047(1),
must be disclosed upon request;
(ii) The law enforcement and prosecuting attorneys may only release
the information obtained to the person's attorney as required by court
rule and to a jury or judge, if a jury is waived, that presides over
any trial at which the person is charged with violating RCW
9.41.040(2)(a)(ii);
(iii) Disclosure under this subsection is mandatory for the
purposes of the federal health insurance portability and accountability
act;
(n)(i) When a patient would otherwise be subject to the provisions
of this section and disclosure is necessary for the protection of the
patient or others due to his or her unauthorized disappearance from the
facility, and his or her whereabouts is unknown, notice of the
disappearance, along with relevant information, may be made to
relatives, the department of corrections when the person is under the
supervision of the department, and governmental law enforcement
agencies designated by the physician or psychiatric advanced registered
nurse practitioner in charge of the patient or the professional person
in charge of the facility, or his or her professional designee.
(ii) Except as otherwise provided in this chapter, the uniform
health care information act, chapter 70.02 RCW, applies to all records
and information compiled, obtained, or maintained in the course of
providing services;
(o) Pursuant to lawful order of a court;
(p) To qualified staff members of the department, to the director
of regional support networks, to resource management services
responsible for serving a patient, or to service providers designated
by resource management services as necessary to determine the progress
and adequacy of treatment and to determine whether the person should be
transferred to a less restrictive or more appropriate treatment
modality or facility. The information must remain confidential;
(q) Within the treatment facility where the patient is receiving
treatment, confidential information may be disclosed to persons
employed, serving in bona fide training programs, or participating in
supervised volunteer programs, at the facility when it is necessary to
perform their duties;
(r) Within the department as necessary to coordinate treatment for
mental illness, developmental disabilities, alcoholism, or drug abuse
of persons who are under the supervision of the department;
(s) To a licensed physician or psychiatric advanced registered
nurse practitioner who has determined that the life or health of the
person is in danger and that treatment without the information
contained in the treatment records could be injurious to the patient's
health. Disclosure must be limited to the portions of the records
necessary to meet the medical emergency;
(t) Consistent with the requirements of the federal health
information portability and accountability act, to a licensed mental
health professional, as defined in RCW 71.05.020, or a health care
professional licensed under chapter 18.71, 18.71A, 18.57, 18.57A,
18.79, or 18.36A RCW who is providing care to a person, or to whom a
person has been referred for evaluation or treatment, to assure
coordinated care and treatment of that person. Psychotherapy notes, as
defined in 45 C.F.R. Sec. 164.501, may not be released without
authorization of the person who is the subject of the request for
release of information;
(u) To administrative and office support staff designated to obtain
medical records for those licensed professionals listed in (j) of this
subsection;
(v) To a facility that is to receive a person who is involuntarily
committed under chapter 71.05 RCW, or upon transfer of the person from
one treatment facility to another. The release of records under this
subsection is limited to the treatment records required by law, a
record or summary of all somatic treatments, and a discharge summary.
The discharge summary may include a statement of the patient's problem,
the treatment goals, the type of treatment which has been provided, and
recommendation for future treatment, but may not include the patient's
complete treatment record;
(w) To the person's counsel or guardian ad litem, without
modification, at any time in order to prepare for involuntary
commitment or recommitment proceedings, reexaminations, appeals, or
other actions relating to detention, admission, commitment, or
patient's rights under chapter 71.05 RCW;
(x) To staff members of the protection and advocacy agency or to
staff members of a private, nonprofit corporation for the purpose of
protecting and advocating the rights of persons with mental disorders
or developmental disabilities. Resource management services may limit
the release of information to the name, birthdate, and county of
residence of the patient, information regarding whether the patient was
voluntarily admitted, or involuntarily committed, the date and place of
admission, placement, or commitment, the name and address of a guardian
of the patient, and the date and place of the guardian's appointment.
Any staff member who wishes to obtain additional information must
notify the patient's resource management services in writing of the
request and of the resource management services' right to object. The
staff member shall send the notice by mail to the guardian's address.
If the guardian does not object in writing within fifteen days after
the notice is mailed, the staff member may obtain the additional
information. If the guardian objects in writing within fifteen days
after the notice is mailed, the staff member may not obtain the
additional information;
(y) To all current treating providers of the patient with
prescriptive authority who have written a prescription for the patient
within the last twelve months. For purposes of coordinating health
care, the department may release without written authorization of the
patient, information acquired for billing and collection purposes as
described in RCW 70.02.050(1)(d). The department shall notify the
patient that billing and collection information has been released to
named providers, and provide the substance of the information released
and the dates of such release. The department may not release
counseling, inpatient psychiatric hospitalization, or drug and alcohol
treatment information without a signed written release from the client.
(3) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for chemical dependency, the department
may restrict the release of the information as necessary to comply with
federal law and regulations.
(4) Civil liability and immunity for the release of information
about a particular person who is committed to the department of social
and health services under RCW 71.05.280(3) and 71.05.320(3)(c) after
dismissal of a sex offense as defined in RCW 9.94A.030, is governed by
RCW 4.24.550.
(5) The fact of admission to a provider of mental health services,
as well as all records, files, evidence, findings, or orders made,
prepared, collected, or maintained pursuant to chapter 71.05 RCW are
not admissible as evidence in any legal proceeding outside that chapter
without the written authorization of the person who was the subject of
the proceeding except as provided in section 12 of this act, in a
subsequent criminal prosecution of a person committed pursuant to RCW
71.05.280(3) or 71.05.320(3)(c) on charges that were dismissed pursuant
to chapter 10.77 RCW due to incompetency to stand trial, in a civil
commitment proceeding pursuant to chapter 71.09 RCW, or, in the case of
a minor, a guardianship or dependency proceeding. The records and
files maintained in any court proceeding pursuant to chapter 71.05 RCW
must be confidential and available subsequent to such proceedings only
to the person who was the subject of the proceeding or his or her
attorney. In addition, the court may order the subsequent release or
use of such records or files only upon good cause shown if the court
finds that appropriate safeguards for strict confidentiality are and
will be maintained.
NEW SECTION. Sec. 8 A new section is added to chapter 70.02 RCW
to read as follows:
The fact of admission and all information and records related to
mental health services obtained through treatment under chapter 71.34
RCW is confidential. Such confidential information may be disclosed
only:
(1) In communications between mental health professionals to meet
the requirements of chapter 71.34 RCW, in the provision of services to
the minor, or in making appropriate referrals;
(2) In the course of guardianship or dependency proceedings;
(3) To the minor, the minor's parent, and the minor's attorney,
subject to RCW 13.50.100;
(4) To the courts as necessary to administer this chapter;
(5) To law enforcement officers or public health officers as
necessary to carry out the responsibilities of their office. However,
only the fact and date of admission, and the date of discharge, the
name and address of the treatment provider, if any, and the last known
address must be disclosed upon request;
(6) To law enforcement officers, public health officers, relatives,
and other governmental law enforcement agencies, if a minor has escaped
from custody, disappeared from an evaluation and treatment facility,
violated conditions of a less restrictive treatment order, or failed to
return from an authorized leave, and then only such information as may
be necessary to provide for public safety or to assist in the
apprehension of the minor. The officers are obligated to keep the
information confidential in accordance with chapter 71.34 RCW;
(7) To the secretary of social and health services for assistance
in data collection and program evaluation or research so long as the
secretary adopts rules for the conduct of such evaluation and research.
The rules must include, but need not be limited to, the requirement
that all evaluators and researchers sign an oath of confidentiality
substantially as follows:
"As a condition of conducting evaluation or research concerning
persons who have received services from (fill in the facility, agency,
or person) I, . . . . . ., agree not to divulge, publish, or otherwise
make known to unauthorized persons or the public any information
obtained in the course of such evaluation or research regarding minors
who have received services in a manner such that the minor is
identifiable.
I recognize that unauthorized release of confidential information
may subject me to civil liability under state law.
/s/ . . . . . . ";
(8) To appropriate law enforcement agencies, upon request, all
necessary and relevant information in the event of a crisis or emergent
situation that poses a significant and imminent risk to the public.
The mental health service agency or its employees are not civilly
liable for the decision to disclose or not, so long as the decision was
reached in good faith and without gross negligence;
(9) To appropriate law enforcement agencies and to a person, when
the identity of the person is known to the public or private agency,
whose health and safety has been threatened, or who is known to have
been repeatedly harassed, by the patient. The person may designate a
representative to receive the disclosure. The disclosure must be made
by the professional person in charge of the public or private agency or
his or her designee and must include the dates of admission, discharge,
authorized or unauthorized absence from the agency's facility, and only
any other information that is pertinent to the threat or harassment.
The agency or its employees are not civilly liable for the decision to
disclose or not, so long as the decision was reached in good faith and
without gross negligence;
(10) To a minor's next of kin, attorney, guardian, or conservator,
if any, the information that the minor is presently in the facility or
that the minor is seriously physically ill and a statement evaluating
the mental and physical condition of the minor as well as a statement
of the probable duration of the minor's confinement;
(11) Upon the death of a minor, to the minor's next of kin;
(12) To a facility in which the minor resides or will reside;
(13) To law enforcement officers and to prosecuting attorneys as
are necessary to enforce RCW 9.41.040(2)(a)(ii).
(a) The extent of information that may be released is limited as
follows:
(i) Only the fact, place, and date of involuntary commitment, an
official copy of any order or orders of commitment, and an official
copy of any written or oral notice of ineligibility to possess a
firearm that was provided to the person pursuant to RCW 9.41.047(1),
must be disclosed upon request;
(ii) The law enforcement and prosecuting attorneys may only release
the information obtained to the person's attorney as required by court
rule and to a jury or judge, if a jury is waived, that presides over
any trial at which the person is charged with violating RCW
9.41.040(2)(a)(ii);
(iii) Disclosure under this subsection is mandatory for the
purposes of the federal health insurance portability and accountability
act;
(b) This section may not be construed to prohibit the compilation
and publication of statistical data for use by government or
researchers under standards, including standards to assure maintenance
of confidentiality, set forth by the secretary. The fact of admission
and all information obtained pursuant to chapter 71.34 RCW are not
admissible as evidence in any legal proceeding outside this chapter,
except guardianship or dependency, without the written consent of the
minor or the minor's parent;
(14) For the purpose of a correctional facility participating in
the postinstitutional medical assistance system supporting the
expedited medical determinations and medical suspensions as provided in
RCW 74.09.555 and 74.09.295;
(15) Pursuant to a lawful order of a court.
NEW SECTION. Sec. 9 A new section is added to chapter 70.02 RCW
to read as follows:
(1) Information related to mental health services delivered to a
person subject to chapter 9.94A or 9.95 RCW must be released, upon
request, by a mental health service agency to department of corrections
personnel for whom the information is necessary to carry out the
responsibilities of their office. The information must be provided
only for the purpose of completing presentence investigations,
supervision of an incarcerated person, planning for and provision of
supervision of a person, or assessment of a person's risk to the
community. The request must be in writing and may not require the
consent of the subject of the records.
(2) The information to be released to the department of corrections
must include all relevant records and reports, as defined by rule,
necessary for the department of corrections to carry out its duties,
including those records and reports identified in subsection (1) of
this section.
(3) The department shall, subject to available resources,
electronically, or by the most cost-effective means available, provide
the department of corrections with the names, last dates of services,
and addresses of specific regional support networks and mental health
service agencies that delivered mental health services to a person
subject to chapter 9.94A or 9.95 RCW pursuant to an agreement between
the departments.
(4) The department and the department of corrections, in
consultation with regional support networks, mental health service
agencies as defined in RCW 70.02.010, mental health consumers, and
advocates for persons with mental illness, shall adopt rules to
implement the provisions of this section related to the type and scope
of information to be released. These rules must:
(a) Enhance and facilitate the ability of the department of
corrections to carry out its responsibility of planning and ensuring
community protection with respect to persons subject to sentencing
under chapter 9.94A or 9.95 RCW, including accessing and releasing or
disclosing information of persons who received mental health services
as a minor; and
(b) Establish requirements for the notification of persons under
the supervision of the department of corrections regarding the
provisions of this section.
(5) The information received by the department of corrections under
this section must remain confidential and subject to the limitations on
disclosure outlined in chapter 71.34 RCW, except as provided in RCW
72.09.585.
(6) No mental health service agency or individual employed by a
mental health service agency may be held responsible for information
released to or used by the department of corrections under the
provisions of this section or rules adopted under this section.
(7) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for alcoholism or drug dependency, the
release of the information may be restricted as necessary to comply
with federal law and regulations.
(8) This section does not modify the terms and conditions of
disclosure of information related to sexually transmitted diseases
under this chapter.
NEW SECTION. Sec. 10 A new section is added to chapter 70.02 RCW
to read as follows:
(1)(a) A mental health service agency shall release to the persons
authorized under subsection (2) of this section, upon request:
(i) The fact, place, and date of an involuntary commitment, the
fact and date of discharge or release, and the last known address of a
person who has been committed under chapter 71.05 RCW.
(ii) Information related to mental health services, in the format
determined under subsection (9) of this section, concerning a person
who:
(A) Is currently committed to the custody or supervision of the
department of corrections or the indeterminate sentence review board
under chapter 9.94A or 9.95 RCW;
(B) Has been convicted or found not guilty by reason of insanity of
a serious violent offense; or
(C) Was charged with a serious violent offense and the charges were
dismissed under RCW 10.77.086.
(b) Legal counsel may release such information to the persons
authorized under subsection (2) of this section on behalf of the mental
health service agency, so long as nothing in this subsection requires
the disclosure of attorney work product or attorney-client privileged
information.
(2) The information subject to release under subsection (1) of this
section must be released to law enforcement officers, personnel of a
county or city jail, designated mental health professionals, public
health officers, therapeutic court personnel, or personnel of the
department of corrections, including the indeterminate sentence review
board and personnel assigned to perform board-related duties, when such
information is requested during the course of business and for the
purpose of carrying out the responsibilities of the requesting person's
office. No mental health service agency or person employed by a mental
health service agency, or its legal counsel, may be liable for
information released to or used under the provisions of this section or
rules adopted under this section except under RCW 71.05.680.
(3) A person who requests information under subsection (1)(a)(ii)
of this section must comply with the following restrictions:
(a) Information must be requested only for the purposes permitted
by this subsection and for the purpose of carrying out the
responsibilities of the requesting person's office. Appropriate
purposes for requesting information under this section include:
(i) Completing presentence investigations or risk assessment
reports;
(ii) Assessing a person's risk to the community;
(iii) Assessing a person's risk of harm to self or others when
confined in a city or county jail;
(iv) Planning for and provision of supervision of an offender,
including decisions related to sanctions for violations of conditions
of community supervision; and
(v) Responding to an offender's failure to report for department of
corrections supervision;
(b) Information may not be requested under this section unless the
requesting person has reasonable suspicion that the individual who is
the subject of the information:
(i) Has engaged in activity indicating that a crime or a violation
of community custody or parole has been committed or, based upon his or
her current or recent past behavior, is likely to be committed in the
near future; or
(ii) Is exhibiting signs of a deterioration in mental functioning
which may make the individual appropriate for civil commitment under
chapter 71.34 RCW; and
(c) Any information received under this section must be held
confidential and subject to the limitations on disclosure outlined in
this chapter, except:
(i) The information may be shared with other persons who have the
right to request similar information under subsection (2) of this
section, solely for the purpose of coordinating activities related to
the individual who is the subject of the information in a manner
consistent with the official responsibilities of the persons involved;
(ii) The information may be shared with a prosecuting attorney
acting in an advisory capacity for a person who receives information
under this section. A prosecuting attorney under this subsection is
subject to the same restrictions and confidentiality limitations as the
person who requested the information; and
(iii) As provided in RCW 72.09.585.
(4) A request for information related to mental health services
under this section does not require the consent of the subject of the
records. The request must be provided in writing, except to the extent
authorized in subsection (5) of this section. A written request may
include requests made by e-mail or facsimile so long as the requesting
person is clearly identified. The request must specify the information
being requested.
(5) In the event of an emergency situation that poses a significant
risk to the public or the offender, a mental health service agency, or
its legal counsel, shall release information related to mental health
services delivered to the offender and, if known, information regarding
where the offender is likely to be found to the department of
corrections or law enforcement upon request. The initial request may
be written or oral. All oral requests must be subsequently confirmed
in writing. Information released in response to an oral request is
limited to a statement as to whether the offender is or is not being
treated by the mental health service agency and the address or
information about the location or whereabouts of the offender.
(6) Disclosure under this section to state or local law enforcement
authorities is mandatory for the purposes of the federal health
insurance portability and accountability act.
(7) Whenever federal law or federal regulations restrict the
release of information contained in the treatment records of any
patient who receives treatment for alcoholism or drug dependency, the
release of the information may be restricted as necessary to comply
with federal law and regulations.
(8) This section does not modify the terms and conditions of
disclosure of information related to sexually transmitted diseases
under this chapter.
(9) In collaboration with interested organizations, the department
shall develop a standard form for requests for information related to
mental health services made under this section and a standard format
for information provided in response to the requests. Consistent with
the goals of the health information privacy provisions of the federal
health insurance portability and accountability act, in developing the
standard form for responsive information, the department shall design
the form in such a way that the information disclosed is limited to the
minimum necessary to serve the purpose for which the information is
requested.
Sec. 11 RCW 70.02.060 and 1991 c 335 s 205 are each amended to
read as follows:
(1) ((Before service of)) A discovery request or compulsory process
((on a health care provider for health care information, an attorney
shall provide advance notice to the health care provider and the
patient or the patient's attorney involved through service of process
or first-class mail, indicating the health care provider from whom the
information is sought, what health care information is sought, and the
date by which a protective order must be obtained to prevent the health
care provider from complying. Such date shall give the patient and the
health care provider adequate time to seek a protective order, but in
no event be less than fourteen days since the date of service or
delivery to the patient and the health care provider of the foregoing.
Thereafter the request for discovery or compulsory process shall be
served on the health care provider.)) for health care information must be made in accordance with
the appropriate civil rules of superior court and include service of a
copy of the subpoena on the patient whose records are being sought for
disclosure.
(2) Without the written consent of the patient, the health care
provider may not disclose the health care information sought under
subsection (1) of this section if the requestor has not complied with
the requirements of subsection (1) of this section. In the absence of
a protective order issued by a court of competent jurisdiction
forbidding compliance, the health care provider shall disclose the
information in accordance with this chapter. In the case of
compliance, the request for discovery or compulsory process shall be
made a part of the patient record.
(3) Production of health care information under this section, in
and of itself, does not constitute a waiver of any privilege,
objection, or defense existing under other law or rule of evidence or
procedure
(2) Upon receipt of such a request or process, the health care
provider shall provide a copy to the patient at the patient's last
known address, to the patient's attorney, if known, unless after
reasonable inquiry the health care provider is unable to determine the
last known address of the patient.
(3) On sending a copy of the request or process as provided in
subsection (2) of this section, the health care provider has no further
obligation to assert a state or federal privilege pertaining to the
records or to appear or respond to a motion to compel production of
records, and shall produce the records if ordered by a court. If an
objection is timely filed by the patient, the patient or the patient's
attorney is responsible for asserting or waiving any state or federal
privilege that pertains to the records.
NEW SECTION. Sec. 12 A new section is added to chapter 70.02 RCW
to read as follows:
All state or local agencies obtaining patient health care
information pursuant to RCW 70.02.050 and sections 4 through 7 of this
act shall adopt rules establishing their record acquisition, retention,
and security policies that are consistent with this chapter.
NEW SECTION. Sec. 13 A new section is added to chapter 70.02 RCW
to read as follows:
Whenever disclosure is made of information and records related to
sexually transmitted diseases pursuant to this chapter, except for RCW
70.02.050(1)(a) and section 7(2)(a) of this act, it must be accompanied
by a statement in writing which includes the following or substantially
similar language: "This information has been disclosed to you from
records whose confidentiality is protected by state law. State law
prohibits you from making any further disclosure of it without the
specific written authorization of the person to whom it pertains, or as
otherwise permitted by state law. A general authorization for the
release of medical or other information is NOT sufficient for this
purpose." An oral disclosure must be accompanied or followed by such
a notice within ten days.
NEW SECTION. Sec. 14 A new section is added to chapter 70.02 RCW
to read as follows:
(1) Resource management services, as defined in chapter 71.24 RCW,
shall establish procedures to provide reasonable and timely access to
individual mental health treatment records. However, access may not be
denied at any time to records of all medications and somatic treatments
received by the person.
(2) Following discharge, a person who has received mental health
services has a right to a complete record of all medications and
somatic treatments prescribed during evaluation, admission, or
commitment and to a copy of the discharge summary prepared at the time
of his or her discharge. A reasonable and uniform charge for
reproduction may be assessed.
(3) Mental health treatment records may be modified prior to
inspection to protect the confidentiality of other patients or the
names of any other persons referred to in the record who gave
information on the condition that his or her identity remain
confidential. Entire documents may not be withheld to protect such
confidentiality.
(4) At the time of discharge resource management services shall
inform all persons who have received mental health services of their
rights as provided in this chapter and RCW 71.05.620.
NEW SECTION. Sec. 15 A new section is added to chapter 70.02 RCW
to read as follows:
When disclosure of information and records related to mental
services pertaining to a minor, as defined in RCW 71.34.020, is made,
the date and circumstances under which the disclosure was made, the
name or names of the persons or agencies to whom such disclosure was
made and their relationship if any, to the minor, and the information
disclosed must be entered promptly in the minor's clinical record.
NEW SECTION. Sec. 16 A new section is added to chapter 70.02 RCW
to read as follows:
Any person who requests or obtains confidential information and
records related to mental health services pursuant to this chapter
under false pretenses is guilty of a gross misdemeanor.
NEW SECTION. Sec. 17 A new section is added to chapter 70.02 RCW
to read as follows:
The department of social and health services shall adopt rules
related to the disclosure of mental health treatment records in this
chapter.
NEW SECTION. Sec. 18 A new section is added to chapter 70.02 RCW
to read as follows:
In addition to any other information required to be released under
this chapter, the department of social and health services is
authorized, pursuant to RCW 4.24.550, to release relevant information
that is necessary to protect the public, concerning a specific person
committed under RCW 71.05.280(3) or 71.05.320(3)(c) following dismissal
of a sex offense as defined in RCW 9.94A.030.
Sec. 19 RCW 71.05.660 and 2009 c 217 s 9 are each amended to read
as follows:
Nothing in this chapter or chapter 70.02, 70.96A, ((71.05,)) 71.34,
or 70.96B RCW shall be construed to interfere with communications
between physicians, psychiatric advanced registered nurse
practitioners, or psychologists and patients and attorneys and clients.
Sec. 20 RCW 71.05.680 and 2005 c 504 s 713 are each amended to
read as follows:
Any person who requests or obtains confidential information
pursuant to RCW 71.05.620 ((through 71.05.690)) under false pretenses
shall be guilty of a gross misdemeanor.
Sec. 21 RCW 71.05.690 and 2005 c 504 s 714 are each amended to
read as follows:
The department shall adopt rules to implement RCW 71.05.620
((through 71.05.680)).
Sec. 22 RCW 71.24.035 and 2011 c 148 s 4 are each amended to read
as follows:
(1) The department is designated as the state mental health
authority.
(2) The secretary shall provide for public, client, and licensed
service provider participation in developing the state mental health
program, developing contracts with regional support networks, and any
waiver request to the federal government under medicaid.
(3) The secretary shall provide for participation in developing the
state mental health program for children and other underserved
populations, by including representatives on any committee established
to provide oversight to the state mental health program.
(4) The secretary shall be designated as the regional support
network if the regional support network fails to meet state minimum
standards or refuses to exercise responsibilities under RCW 71.24.045,
until such time as a new regional support network is designated under
RCW 71.24.320.
(5) The secretary shall:
(a) Develop a biennial state mental health program that
incorporates regional biennial needs assessments and regional mental
health service plans and state services for adults and children with
mental illness. The secretary shall also develop a six-year state
mental health plan;
(b) Assure that any regional or county community mental health
program provides access to treatment for the region's residents,
including parents who are respondents in dependency cases, in the
following order of priority: (i) Persons with acute mental illness;
(ii) adults with chronic mental illness and children who are severely
emotionally disturbed; and (iii) persons who are seriously disturbed.
Such programs shall provide:
(A) Outpatient services;
(B) Emergency care services for twenty-four hours per day;
(C) Day treatment for persons with mental illness which includes
training in basic living and social skills, supported work, vocational
rehabilitation, and day activities. Such services may include
therapeutic treatment. In the case of a child, day treatment includes
age-appropriate basic living and social skills, educational and
prevocational services, day activities, and therapeutic treatment;
(D) Screening for patients being considered for admission to state
mental health facilities to determine the appropriateness of admission;
(E) Employment services, which may include supported employment,
transitional work, placement in competitive employment, and other work-related services, that result in persons with mental illness becoming
engaged in meaningful and gainful full or part-time work. Other
sources of funding such as the division of vocational rehabilitation
may be utilized by the secretary to maximize federal funding and
provide for integration of services;
(F) Consultation and education services; and
(G) Community support services;
(c) Develop and adopt rules establishing state minimum standards
for the delivery of mental health services pursuant to RCW 71.24.037
including, but not limited to:
(i) Licensed service providers. These rules shall permit a county-operated mental health program to be licensed as a service provider
subject to compliance with applicable statutes and rules. The
secretary shall provide for deeming of compliance with state minimum
standards for those entities accredited by recognized behavioral health
accrediting bodies recognized and having a current agreement with the
department;
(ii) Regional support networks; and
(iii) Inpatient services, evaluation and treatment services and
facilities under chapter 71.05 RCW, resource management services, and
community support services;
(d) Assure that the special needs of persons who are minorities,
elderly, disabled, children, low-income, and parents who are
respondents in dependency cases are met within the priorities
established in this section;
(e) Establish a standard contract or contracts, consistent with
state minimum standards, RCW 71.24.320 and 71.24.330, which shall be
used in contracting with regional support networks. The standard
contract shall include a maximum fund balance, which shall be
consistent with that required by federal regulations or waiver
stipulations;
(f) Establish, to the extent possible, a standardized auditing
procedure which minimizes paperwork requirements of regional support
networks and licensed service providers. The audit procedure shall
focus on the outcomes of service and not the processes for
accomplishing them;
(g) Develop and maintain an information system to be used by the
state and regional support networks that includes a tracking method
which allows the department and regional support networks to identify
mental health clients' participation in any mental health service or
public program on an immediate basis. The information system shall not
include individual patient's case history files. Confidentiality of
client information and records shall be maintained as provided in this
chapter and ((in RCW 71.05.390, 71.05.420, and 71.05.440)) chapter
70.02 RCW;
(h) License service providers who meet state minimum standards;
(i) Certify regional support networks that meet state minimum
standards;
(j) Periodically monitor the compliance of certified regional
support networks and their network of licensed service providers for
compliance with the contract between the department, the regional
support network, and federal and state rules at reasonable times and in
a reasonable manner;
(k) Fix fees to be paid by evaluation and treatment centers to the
secretary for the required inspections;
(l) Monitor and audit regional support networks and licensed
service providers as needed to assure compliance with contractual
agreements authorized by this chapter;
(m) Adopt such rules as are necessary to implement the department's
responsibilities under this chapter;
(n) Assure the availability of an appropriate amount, as determined
by the legislature in the operating budget by amounts appropriated for
this specific purpose, of community-based, geographically distributed
residential services;
(o) Certify crisis stabilization units that meet state minimum
standards;
(p) Certify clubhouses that meet state minimum standards; and
(q) Certify triage facilities that meet state minimum standards.
(6) The secretary shall use available resources only for regional
support networks, except to the extent authorized, and in accordance
with any priorities or conditions specified, in the biennial
appropriations act.
(7) Each certified regional support network and licensed service
provider shall file with the secretary, on request, such data,
statistics, schedules, and information as the secretary reasonably
requires. A certified regional support network or licensed service
provider which, without good cause, fails to furnish any data,
statistics, schedules, or information as requested, or files fraudulent
reports thereof, may have its certification or license revoked or
suspended.
(8) The secretary may suspend, revoke, limit, or restrict a
certification or license, or refuse to grant a certification or license
for failure to conform to: (a) The law; (b) applicable rules and
regulations; (c) applicable standards; or (d) state minimum standards.
(9) The superior court may restrain any regional support network or
service provider from operating without certification or a license or
any other violation of this section. The court may also review,
pursuant to procedures contained in chapter 34.05 RCW, any denial,
suspension, limitation, restriction, or revocation of certification or
license, and grant other relief required to enforce the provisions of
this chapter.
(10) Upon petition by the secretary, and after hearing held upon
reasonable notice to the facility, the superior court may issue a
warrant to an officer or employee of the secretary authorizing him or
her to enter at reasonable times, and examine the records, books, and
accounts of any regional support network or service provider refusing
to consent to inspection or examination by the authority.
(11) Notwithstanding the existence or pursuit of any other remedy,
the secretary may file an action for an injunction or other process
against any person or governmental unit to restrain or prevent the
establishment, conduct, or operation of a regional support network or
service provider without certification or a license under this chapter.
(12) The standards for certification of evaluation and treatment
facilities shall include standards relating to maintenance of good
physical and mental health and other services to be afforded persons
pursuant to this chapter and chapters 71.05 and 71.34 RCW, and shall
otherwise assure the effectuation of the purposes of these chapters.
(13) The standards for certification of crisis stabilization units
shall include standards that:
(a) Permit location of the units at a jail facility if the unit is
physically separate from the general population of the jail;
(b) Require administration of the unit by mental health
professionals who direct the stabilization and rehabilitation efforts;
and
(c) Provide an environment affording security appropriate with the
alleged criminal behavior and necessary to protect the public safety.
(14) The standards for certification of a clubhouse shall at a
minimum include:
(a) The facilities may be peer-operated and must be
recovery-focused;
(b) Members and employees must work together;
(c) Members must have the opportunity to participate in all the
work of the clubhouse, including administration, research, intake and
orientation, outreach, hiring, training and evaluation of staff, public
relations, advocacy, and evaluation of clubhouse effectiveness;
(d) Members and staff and ultimately the clubhouse director must be
responsible for the operation of the clubhouse, central to this
responsibility is the engagement of members and staff in all aspects of
clubhouse operations;
(e) Clubhouse programs must be comprised of structured activities
including but not limited to social skills training, vocational
rehabilitation, employment training and job placement, and community
resource development;
(f) Clubhouse programs must provide in-house educational programs
that significantly utilize the teaching and tutoring skills of members
and assist members by helping them to take advantage of adult education
opportunities in the community;
(g) Clubhouse programs must focus on strengths, talents, and
abilities of its members;
(h) The work-ordered day may not include medication clinics, day
treatment, or other therapy programs within the clubhouse.
(15) The department shall distribute appropriated state and federal
funds in accordance with any priorities, terms, or conditions specified
in the appropriations act.
(16) The secretary shall assume all duties assigned to the
nonparticipating regional support networks under chapters 71.05((,))
and 71.34((,)) RCW and ((71.24 RCW)) this chapter. Such
responsibilities shall include those which would have been assigned to
the nonparticipating counties in regions where there are not
participating regional support networks.
The regional support networks, or the secretary's assumption of all
responsibilities under chapters 71.05((,)) and 71.34((,)) RCW and
((71.24 RCW)) this chapter, shall be included in all state and federal
plans affecting the state mental health program including at least
those required by this chapter, the medicaid program, and P.L. 99-660.
Nothing in these plans shall be inconsistent with the intent and
requirements of this chapter.
(17) The secretary shall:
(a) Disburse funds for the regional support networks within sixty
days of approval of the biennial contract. The department must either
approve or reject the biennial contract within sixty days of receipt.
(b) Enter into biennial contracts with regional support networks.
The contracts shall be consistent with available resources. No
contract shall be approved that does not include progress toward
meeting the goals of this chapter by taking responsibility for: (i)
Short-term commitments; (ii) residential care; and (iii) emergency
response systems.
(c) Notify regional support networks of their allocation of
available resources at least sixty days prior to the start of a new
biennial contract period.
(d) Deny all or part of the funding allocations to regional support
networks based solely upon formal findings of noncompliance with the
terms of the regional support network's contract with the department.
Regional support networks disputing the decision of the secretary to
withhold funding allocations are limited to the remedies provided in
the department's contracts with the regional support networks.
(18) The department, in cooperation with the state congressional
delegation, shall actively seek waivers of federal requirements and
such modifications of federal regulations as are necessary to allow
federal medicaid reimbursement for services provided by freestanding
evaluation and treatment facilities certified under chapter 71.05 RCW.
The department shall periodically report its efforts to the appropriate
committees of the senate and the house of representatives.
NEW SECTION. Sec. 23 The following acts or parts of acts are
each repealed:
(1) RCW 70.24.105 (Disclosure of HIV antibody test or testing or
treatment of sexually transmitted diseases -- Exchange of medical
information) and 2011 c 232 s 1;
(2) RCW 71.05.390 (Confidential information and records--Disclosure) and 2011 c 305 s 4;
(3) RCW 71.05.640 (Treatment records -- Access procedures) and 2005
c 504 s 712, 2005 c 504 s 113, 2000 c 94 s 11, & 1999 c 13 s 9;
(4) RCW 71.05.385 (Information subject to disclosure to authorized
persons -- Restrictions) and 2011 1st sp.s. c 40 s 23 & 2009 c 320 s 2;
(5) RCW 71.05.420 (Records of disclosure) and 2009 c 217 s 7, 2005
c 504 s 110, 1990 c 3 s 113, & 1973 1st ex.s. c 142 s 47;
(6) RCW 71.05.440 (Action for unauthorized release of confidential
information -- Liquidated damages -- Treble damages -- Injunction) and 1990
c 3 s 114, 1974 ex.s. c 145 s 28, & 1973 1st ex.s. c 142 s 49;
(7) RCW 71.05.427 (Persons committed following dismissal of sex
offense -- Release of information authorized) and 1990 c 3 s 110;
(8) RCW 71.05.510 (Damages for excessive detention) and 1974 ex.s.
c 145 s 30 & 1973 1st ex.s. c 142 s 56;
(9) RCW 71.34.340 (Information concerning treatment of minors
confidential -- Disclosure -- Admissible as evidence with written consent)
and 2011 c 305 s 9, 2005 c 453 s 6, 2000 c 75 s 7, & 1985 c 354 s 18;
(10) RCW 71.34.345 (Mental health services information -- Release to
department of corrections -- Rules) and 2004 c 166 s 8, 2002 c 39 s 1, &
2000 c 75 s 2; and
(11) RCW 71.34.350 (Disclosure of information or records -- Required
entries in minor's clinical record) and 1985 c 354 s 22.
NEW SECTION. Sec. 24 This act takes effect August 1, 2013.