La. Admin. Code tit. 48 § I-509

Current through Register Vol. 50, No. 11, November 20, 2024

Section I-509 - Disclosures without the Patient's Consent

A. Disclosures among Office and Department Employees

1. Disclosure of medical information among the employees of an agency is authorized without the consent of the patient where the employee has a legitimate need for the information in connection with his duties. For purposes of this rule, "employees of an agency" shall include persons under contract with the agency and the employees of private contractors providing services to an agency. The superintendent is authorized to determine what constitutes legitimate need.

2. Disclosure of medical information from one agency to an employee of another agency is authorized without the consent of the patient only in the following situations:

a. when the disclosing agency is required by state law or regulation to provide medical information to the receiving agency;

b. when the disclosing agency and the receiving agency participate in a cooperative program and the medical information is maintained for the purposes of the cooperative program;

c. when an agency has referred one of its patients, clients or residents to another agency for evaluation or treatment; and

d. when an agency cannot perform its function without access to medical information and consent to disclosure of medical information cannot reasonably be obtained.

3. The superintendent of the disclosing agency shall determine whether one of the four enumerated situations exists.

B. Disclosures in Case of Medical Emergencies. Disclosure of medical information to medical personnel and law enforcement personnel is authorized without the consent of the patient to the extent necessary to meet a genuine medical emergency.

C. Disclosures to Qualified Personnel for the Purpose of Scientific Research, Statistical Compilation, Audit or Evaluation

1. Disclosure of medical information to qualified personnel is authorized without the consent of the patient, for the purposes of scientific research, statistical compilation, audit and evaluation when the information disclosed does not contain patient identifying information. The term qualified personnel means persons whose training and experience are appropriate to the nature and level of the work in personnel. The superintendent shall use reasonable means to determine the qualifications of the personnel requesting disclosure under this rule. If the person compiling the scientific research, statistical analysis, audit or evaluation report believes that patient identifying information is essential to his compilation, he shall direct his request for information in writing to the secretary of the department. This request shall contain an explanation of the nature and purpose of the compilation and of the reason patient identifying information is deemed essential. The secretary shall review the request and shall authorize the disclosure of the medical information containing patient identifying information only if he determines that the value of the compilation outweighs the patient's right to privacy. If the request is granted, the secretary shall advise the person making the request that his request is granted subject to the following conditions:

a. that the final compilation will not contain any patient identifying information;

b. that the recipient will be given access, during regular working hours, to medical information containing patient identifying information from which he may abstract the information sought, but that he will not be allowed to remove medical records containing patient identifying information or copies thereof from the agency's premises;

c. that, as soon as the compilation is complete, the recipient will either destroy the abstracts of the medical information in its entirety or will remove the patient identifying information therefrom and will destroy the patient identifying information;

d. that the person receiving the medical information will assume all civil responsibility for invasion of privacy if he violates either of the above conditions;

e. that the person receiving the medical information will sign an agreement to abide by these conditions.

2. Upon receipt of the agreement of compliance, the secretary shall authorize the agencies involved to release the medical information. If the secretary determines that the value of the compilation does not outweight the patient's right to privacy he may either deny the request or may authorize disclosure of the medical records with the patient identifying information deleted.

D. Disclosures to Law Enforcement Personnel. When a patient commits or threatens to commit a crime on an agency's premises, disclosure of the following information to law enforcement personnel is authorized without the consent of the patient: the patient's name, location at the time the crime was threatened or committed, address and last known whereabouts. When an agency receives for treatment a child who has been the subject of abuse or neglect, as is determined by the treating physician or mental health professional, the agency may disclose to law enforcement personnel, without the consent of the child or his parent or tutor, the name and address of the child, the name and address of the person presenting the child for treatment, and such medical information about the child that would support the conclusion that the child had been abused or neglected. Nothing in this rule shall be construed as limiting the right of law enforcement personnel to medical information where such information is needed to meet a genuine medical or law enforcement emergency.

E. Disclosures for Purposes of Disciplinary Action. When the appointing authority of an agency seeks to take disciplinary action against an employee of the agency on the grounds of inadequate or improper patient care, the appointing authority shall describe the inadequate or improper patient care in the letter effecting or confirming the disciplinary action. The letter shall refer to the patient by number only. Upon the request of the attorney representing the agency or of the disciplined employee or his attorney, the agency shall provide copies of the medical records relied upon for the disciplinary action. These copies shall contain the patient number, but shall not contain the name of the patient. Thereafter, these copies may be filed as exhibits with the Civil Service Commission or a court of competent jurisdiction. Disclosures under this rule do not require the consent of the patient to whom the information pertains.

F. Disclosures Pursuant to Court Orders and Subpoenas. Nothing in these rules in intended to impede the disclosure of medical information pursuant to an order of a court of competent jurisdiction, a subpoena, or other discovery device including, but not limited to, interrogatories, depositions, requests for production, and requests for admissions, where a patient's condition is at issue in or relevant to a judicial proceeding. The superintendent shall take reasonable measures to ascertain whether a patient's condition is at issue or relevant before disclosure is made.

G. Disclosures Required by State or Federal Law. Nothing in these rules is intended to impede the disclosure of medical information when such disclosure is required by state or federal law. (Cross references: R.S. 14:403, 40:18, 40:39; 40:1065; 40:1065.1, 40:1095, 40:1096, 40:1102, 40:1299.21, 40:1299.76, 40:2013.3, 40:2014.1, 40:2017.9, 40:2124,40:2143, 44:7).

La. Admin. Code tit. 48, § I-509

Promulgated by the Department of Health and Human Resources, Office of the Secretary, LR 13:246 (April 1987).

AUTHORITY NOTE: Promulgated in accordance with R.S. 44:7.