BILL ANALYSIS                                                                                                                                                                                                    



                                                                           
           AB 681
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 681 (Hernandez)
          As Amended June 23, 2009
          Majority vote
          
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          |ASSEMBLY:  |78-0 |(May 11, 2009)  |SENATE: |40-0 |(June 29,      |
          |           |     |                |        |     |2009)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :   Permits a health care provider to release otherwise  
          confidential medical information about a patient's participation  
          in outpatient treatment with a psychotherapist if the  
          psychotherapist has disclosed medical information pursuant to an  
          existing exception under circumstance relating to preventing or  
          lessening a serious imminent threat to the health and safety of  
          a reasonably foreseeable victim or victims and is clearly  
          necessary to prevent serious and imminent harm.  The disclosure  
          must be pursuant to a request for information from law  
          enforcement subsequent to the disclosure.

           The Senate amendments  delete the previous exception and recast  
          the language to more specifically address the intended  
          situation. 

           EXISTING LAW  :

          1)Prohibits, under the Confidentiality of Medical Information  
            Act (CMIA), a health care provider, health care service plan,  
            or contractor from releasing medical information to persons or  
            entities authorized by law to receive that information if the  
            requested information specifically relates to the patient's  
            participation in outpatient treatment with a psychotherapist,  
            unless the person or entity requesting that information  
            submits to the patient and to the health care provider, health  
            care service plan, or contractor a written request, signed by  
            the person requesting the information, that includes all of  
            the following:

             a)   The specific information relating to a patient's  
               participation in outpatient treatment with a  
               psychotherapist being requested and its specific intended  








                                                                           
           AB 681
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               use or uses;

             b)   The length of time during which the information will be  
               kept before being destroyed or disposed of;

             c)   A statement that the information will not be used for  
               any purpose other than its intended use; and,

             d)   A statement that the person or entity requesting the  
               information will destroy the information and all copies in  
               the person's or entity's possession or control, will cause  
               it to be destroyed, or will return the information and all  
               copies of it before or immediately after the length of time  
               specified has expired.

          2)Requires the person or entity requesting the information to  
            submit a copy of the required written request to the patient  
            within 30 days of receipt of the information requested, unless  
            the patient has signed a written waiver in the form of a  
            letter signed and submitted by the patient to the health care  
            provider or health care service plan waiving notification.

          3)Exempts from the above requirements the disclosure or use of  
            medical information by a law enforcement agency or a  
            regulatory agency when required for an investigation of  
            unlawful activity or for licensing, certification, or  
            regulatory purposes, unless the disclosure is otherwise  
            prohibited by law.

          4)Permits a psychotherapist to disclose medical information, if  
            the psychotherapist, in good faith, believes the disclosure is  
            necessary to prevent or lessen a serious and imminent threat  
            to the health or safety of a reasonably foreseeable victim or  
            victims, and the disclosure is made to a person or persons  
            reasonably able to prevent or lessen the threat, including the  
            target of the threat.

           AS PASSED BY THE ASSEMBLY  , this bill permitted a provider of  
          health care services to disclose medical information related to  
          a patient's participation in outpatient treatment if the  
          psychotherapist, in good faith, believed the disclosure was  
          necessary to prevent or lessen a serious and imminent threat to  
          the health or safety of a reasonably foreseeable victim or  
          victims, and the disclosure is made to a person or persons  








                                                                           
           AB 681
                                                                  Page  3

          reasonably able to prevent or lessen the threat, including the  
          target of the threat, without having a signed request by the  
          entity requesting the information that must be furnished to the  
          patient and the health care provider, health care service plan,  
          or contractor that meets specified requirements.

           FISCAL EFFECT  :  None

           COMMENTS  :   The Senate amendments are to specifically allow law  
          enforcement to have access to medical records after a  
          psychotherapist has reported a threat.  These amendments advance  
          the sponsor's (California Association of Marriage and Family  
          Therapists (CAMFT), stated purpose to disclose medical  
          information in a more timely fashion when a patient presents a  
          serious or imminent threat to health and safety.  CAMFT argues  
          that an exception to the request and notification requirement is  
          warranted where quick action is required when a disclosure can  
          be made to prevent or lessen a serious imminent threat to the  
          health or safety of a reasonably foreseeable victim or victims

           
          Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916)  
          319-2097 


          FN: 0001584