Current through Register Vol. 50, No. 9, September 20, 2024
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).
AUTHORITY NOTE:
Promulgated in accordance with
R.S.
44:7.
