CA Laws That Guide the Specifics of Clinical Practice: Privacy and Confidentiality

Question 1

______________ is the right that prevents others, esp. the government, from interfering with our lives. This right is found in the U.S. Constitution, the CA Constitution, and the CA Civil Code.

Answer 1

Privacy.

Question 2

______________________ is the patient’s right to have communications kept within the bounds of the professional patient-therapist relationship. These communications are generally not to be revealed to third parties, and include information obtained by examination of the patient, or transmitted between a Patient and therapist. This is both an ethical and legal imperative.

Answer 2

Confidentiality.

Question 3

____________________ is the patient’s right to keep confidential communications from being disclosed in a legal proceeding. When this is invoked, confidential information is kept out of the court, unless the court specifically orders the release of the patient’s records.

Answer 3

Privilege.

Question 4

A therapist may ___________ privilege, but never __________ privilege for a patient.

Answer 4

• Invoke
• Hold

Question 5

There are two basic principles that apply to lawful and ethical disclosure of confidential information:

• Disclosure should never ______________________
• Disclosure should only include information that is ___________________ and ____________________

Answer 5

• Come as a surprise
• Necessary and sufficent

Question 6

Patients must be informed at _____________________ of the limits of confidentiality.

Answer 6

The outset of treatment.

Question 7

When a disclosure of confidential information is required (e.g., a report of child abuse), it is good practice to ________________________ whenever possible.

Answer 7

Involve the patient in making the disclosure.

Question 8

Consent to release medical information must be _________________.

Answer 8

In writing.

Question 9

Consent must be signed and dated by one of the following:

• The patient
• The __________________ of the patient if the patient is incompetent or a minor (except if the minor patient lawfully consented to treatment, in which case the minor may consent to release the information)
• The __________________ or representative of a deceased person

Answer 9

• Guardian
• Beneficiary

Question 10

Written consent must include the:

• Name of the person authorized to disclose information
• _______________ or _______________ to whom the disclosure is being made
• Date of consent
• _______________ on what information may be released or how it may be used

Answer 10

• Individual or agency
• Limitations

Question 11

When a third party contacts a therapist, and there is no prior written consent, the therapist _______________ acknowledge that the patient is in treatment.

Answer 11

May not.

Question 12

Therapists ____________ permitted to receive information from a third party.

Answer 12

Are.

Question 13

Therapists ____________ disclose any information obtained by a third party to the patient.

Answer 13

May.

Question 14

_________________ are situations in which information must be shared with health care providers to protect a patient from immediate physical harm (e.g., a therapist receives a phone call from emergency room personnel stating that the patient attempted a drug overdose). Release of information during this type of event is intended to help provide the patient with the most appropriate treatment.

Answer 14

Treatment emergencies.

Question 15

_____________________ involve situations in which the safety of the patient or another person is of concern; the most common are potential suicide and violence. Grave disability also falls into this category.

Answer 15

Safety emergency.

Question 16

CA law explicitly permits disclosure of confidential information for the purpose of _______________________ review. CA Civil Code (Section 56.10) states that information may be released to for the purposes of ensuring competence/qualifications of health professionals, or reviewing health services provided with respect to medical necessity, level of care, quality of care, or justification of charges.

Answer 16

Quality of care.

Question 17

According to the Welfare and Institutions Code (WIC) Section 5328(a), confidential patient information can be disclosed “between qualified professional persons in the provision of services;” if done without consent, the professionals must be employed ______________________ or be responsible for the same patient’s care.

Answer 17

At the same facility.

Question 18

Confidential info. must be provided when a therapist is _______________________. Other exceptions to confidentiality include when a lawyer subpoenas a mental health professional for the records or to testify under oath, as well as when a court issues a _________ warrant.

Answer 18

• Ordered to do so by the court
• Search

Question 19

According to WIC Section 5328.4, when a ___________________ has been either committed by or perpetrated upon a hospitalized patient, the mental health professional has a duty to disclose this patient information to governmental law enforcement agencies.

Answer 19

Serious crime (e.g., murder, rape).

Question 20

Amended in 2007, the Civil Code (Section 56.10) allows psychologists providing EAP services to an employee at the specific prior written request and expense of the employer to __________________________.

Answer 20

Disclose certain information to an employer

Bonus: Info. that is relevant in a lawsuit (e.g., when a patient has raised the issue of his/her physical/mental health), info. on session attendance, and info. that describes the patient’s functional limitations may be disclosed. The psychologist MAY NOT disclose the basis for a patient’s limitation (e.g., diagnosis), or any other confidential patient info. or communication.

Question 21

______________________ laws require that information about harm or abuse to children, the elderly, and dependent adults must be made to agencies that serve to protect these groups.

Answer 21

Mandated reporting.