HAR §11-175-31. Right to confidentiality of the clinical record

(a) Information in the clinical record of a consumer of mental health or substance abuse services shall be confidential and shall not be shared outside the mental health division, outside a contract program, or by a private provider, except information shall be disclosed: (1) When there is an emergency which requires immediate sharing of information; however, a consumer of substance abuse services shall not be identified directly or indirectly as a substance abuser; (2) When it is determined that a consumer poses a serious danger or threat of violence toward another. Information shall be released in keeping with the duty to exercise reasonable care to protect foreseeable victims; however, a consumer of substance abuse services shall not be identified directly or indirectly as a substance abuser: (3) When there is suspected abuse or neglect of a minor as provided in chapter 350, HRS, and when there is suspected abuse or neglect of an elderly or vulnerable adult as provided in chapter 349C, HRS; however, any person named in such a report who is a consumer of substance abuse services shall not be identified directly or indirectly as a substance abuser; (4) When disclosure is deemed necessary by the director or the administrator of a private 175 - 26 2762 11-175-31 psychiatric facility to carry out the provisions of chapter 334, HRS, and after justification has been placed in the consumer's clinical record, except for consumers of substance abuse services, for which informed consent to release of information is required; (5) When specific information is ordered to be disclosed by a court, and is deemed by the court to be necessary in connection with the proceedings before it; (6) For management information purposes to the mental health division by the department's direct and contract services; (7) For monitoring purposes to authorized mental health division monitors by the department's direct and contract services; (8) When required by federal or state statutes; or (9) When the holder of the record has obtained informed consent to release of information from the consumer or the consumer's legal guardian. (b) Information about a consumer requested by a member of the consumer's family shall only be released after informed consent to release information has been obtained from the consumer or the consumer's legal guardian. (c) Information disclosed shall be only information relevant to the purpose stated in the request for disclosure, and redisclosure shall be prohibited. (d) Information shared about a consumer among staff members within a program shall be restricted to information needed in order to provide adequate services and shall be conveyed in a manner which maintains its confidentiality. (e) If information is released without informed consent, there lease shall be documented in the consumer's record. Documentation shall include to whom the information was released the purpose for which it was released, who authorized the release, when it was released, what was released, why consent could not be obtained, and the name of the person releasing the 175 - 27 27.82 11-175-31 information. When information is released with informed consent, the consent form shall be filed in the consumer's clinical record. (f) Informed consent to release information shall be obtained in order to release information to another service setting when a consumer transfers from one mental health program to another or when a consumer receiving substance abuse services transfers to another program. Informed consent is not required when the consumer transfers between programs having the same direct administrative control over the programs. When consent is required, the referring program shall attempt to obtain consent to release information essential to ensure continuity of treatment and which is germane to the purpose of the new setting. (g) Any substance abuse program which provides maintenance or detoxification treatment shall provide consumer identifying information to another maintenance or detoxification treatment program upon request for the purpose of determining whether an applicant for maintenance or detoxification services is currently enrolled in the program, provided that: (1) The programs have an agreement to share identifying information; and (2) The consumer has agreed in writing at the time of admission to release identifying information to the other program listed by name and address [Eff. and comp DEC 30 1988; comp OCT 19 2007 ] (Auth: HRS §321-9) (Imp: HRS §§334-5, 334E-2)