disclosures Flashcards
explain disclosures with client consent
Be sure to have informed consent
-Informed means no surprises for the client
explain HIPAA and release of information
-HIPAA requires that CEs obtain written valid authorization from the individual or personal representative before releasing PHI
-CEs have an obligation to agree to patient’s request unless request is reasonably likely to be associated with harm
-PA licensure regulations requires release only after full disclosure to client
disclosures permitted by law
Standard 4.05 permits disclosure of confidentiality information without consent if the disclosure is permitted by law and the disclosure is a valid purpose
valid reasons for disclosures
-To provide needed professional services
-To obtain appropriate professional consultation
-To protect the client/patient, psychologist or others from harm
-To obtain payment for services
explain pennsylvania psychologist patient privileged communication statue
-No person licensed to practice psychology without consent of client can be examined in any civil or criminal matter on behalf of the client
-Privilege belongs to the patient
-Communications made by an agent of the psychologist are also privileged
-Do not have to testify without consent, but you might be held in contempt
-Subpoena is just a legal request for information
exceptions and waivers to limits on release of information
1) When patient places their mental health into the issue, they have waived their privilege
-They do not have to consent, but best practice would be talking to the client about it first
-E.g. temporary insanity
2) Patients seeking redress for emotional harm by citing the need for psychotherapy have waived privilege
if you put mental health into the equation you have waived privilege, but it is best practice to talk with them about it first
3) Psychologist can refuse if information may harm the patient
4) What if a third party is present during the interaction with the psychologist and patient? At times privilege is waived
-Privilege waived mean they are okay with it being not confidential
-Times it could be waived: with spouse, collateral, groups
what can you be subpoenaed to do
release information, show up at a deposition, show up in court, testify
what matters to subpoenas usually come up
Client is involved in a legal matter
-Child custody/divorce
-Have to have information about this in policies and how you testify in court
-Personal injury
-Worker’s compensation
-Criminal case
-Child welfare investigation
Other reasons for requests
-Client’s personal use
-Education/employment accommodations
steps to do after receiving subpoena
1) Is it valid?
-Contact your lawyer to see, consult with someone and check
2) What is it requesting?
-Does it want records, to show up, whole file, pieces of file?
3) Contact client
-Letting them know that you received a subpoena for their records; tell them who is requesting it
4) Contact requesting attorney
-Who is the attorney for
5) Contact the court
-See what they are looking for
6) Challenge the subpoena
-Say you are unable to follow through with this, it may harm the client
-If it happens when you are a trainee the goal is to get you out of it because they are often wanting a witness to testify about the mental health of a client
7) Comply with subpoena
-You have to respond, but the repercussions are not that intense if you do not respond
fact witness vs. expert witness
Fact witness: says facts related to the case
-PHI
Expert witness: clinical impressions; trainees can probably not function in this realm
explain court order
demand not a request you have to show up, more serious; can be sent for similar reasons; court orders are sent by judges
If someone else’s information is at risk or if it causes substantial harm
They might hold you in contempt if you do not talk, rare that it gets this far, but you have to know what you are able to ethically and legally do
what things impact 4.05 disclosures without consent (permitted by law)
-PA Duty to Report Laws Cheat Sheet
-Mandated Reporting (PA Regulations)
-Discretionarily disclosures (depends on setting
-Tarasoff/ duty to warn/ protect
-PA Code Principle 5
explain what you are required to mandated report
Child Abuse
Intentionally knowingly or recklessly causing physical injury
-Must have occurred within the last two years
Serious physical neglect
-Witnessing domestic abuse counts as a reason to report, counts as neglect
Sexual abuse or exploitation
Mandatory reporting of infants
-Illegal substance abuse by the child’s mother
-Withdrawal symptoms resulting from prenatal drug exposure
-A fetal alcohol system disorder
what is considered child abuse
Child Abuse: Intentionally, knowingly, or recklessly doing…
Causing bodily injury
Fabricating, feigning or intentionally exaggerating or inducing a medical symptom or disease which results in harmful medical evaluation
Causing or substantially contributing to serious mental injury
Creating likelihood of sexual abuse or exploitation of a child
Causing physical neglect of a child
Engaging in any of the following
-Kicking, biting, burning, stabbing, cutting
-Unreasonably restraining a child
-Forcefully shaking a child under one year of age
-Forcefully slapping or otherwise striking a child under one
-Interfering with the breathing of a child
-Leaving a child unsupervised with an individual other than the child’s parent, who the actor knows or should have known has been determined a sexually violent predator
All include act or failure to act
explain corporal punishment and child abuse
if a child has been hit in a way that is leaving marks this counts as abuse
