Purpose of Disclosure

Department of Mental Health Routine Disclosures – Chart # 4 Court Proceedings, Legal & Fiduciary Representation, Client Advocacy Purpose of Disclosure Disclosed to Authority for Disclosure Permitted Amount of Special Requirements (When the authority is a Information to be document, a copy of the Disclosed (May be authorizing document verbal or written unless must be in the DMH limited by the authority records for the for disclosure) disclosure to occur) Administer deceased Nearest relative; probate court, G.L. c.123, §27; Probate Court Name, address, facility, date See also Fiduciary Activities patient's estate voluntary appointment of death, known heirs, estate on Chart #4 administrator/executor value and any other information required by the Probate Court Commitment hearings and Court, patient’s attorney G.L. c.123, §§7&8, 8B, 12(b), Petitions, affidavits, and Information to be disclosed §8B treatment order hearings 15(e), 16(b), 16(c) and 18(a) related documents; testimony may be limited by at hearings psychotherapy privilege and other applicable confidentiality requirements Court clinic determination of Private hospitals G.L. c.123, §12(e) order De-identified information only bed availability and referral when surveying for bed for inpatient admission availability; 12(e) report to accompany patient to facility Court clinic inquiry to Partnership/Insurers G.L. c.123, §12(e) order Identifying information only determine insurance coverage Court order response Court, attorney involved in the Court Order that meets the The minimal amount of PHI A “proper judicial order” is an court proceeding, probation DMH standard for a “Proper specified in the court order order signed by a judge of a officer, guardian ad-litem, etc. Judicial Order”. See G.L. court, not an administrative c123, §36, 104 CMR 27.17(6) tribunal, or the clerk or (a) and 28.09(2)(a) assistant clerk of a court acting upon the instruction of a judge. A subpoena is not a proper judicial order. Individual or Personal VERIFICATION Prior to making any permitted disclosure of Protected Health Information (PHI), DMH must (1) verify the identity of the party to whom the PHI is to be disclosed and (2) confirm that the party has the proper authority to receive the PHI. See Chapter 10, Verification of the Identity and Authority of the Requester. If there is any doubt about the identity of the receiver and/or the authority to disclose the PHI, the PHI should not be disclosed and the DMH Privacy Officer or Legal Office should be contacted for assistance.

Appendix C 4/14/03 Chart #4, page 1 Department of Mental Health Routine Disclosures – Chart # 4 Court Proceedings, Legal & Fiduciary Representation, Client Advocacy Purpose of Disclosure Disclosed to Authority for Disclosure Permitted Amount of Special Requirements (When the authority is a Information to be document, a copy of the Disclosed (May be authorizing document verbal or written unless must be in the DMH limited by the authority records for the for disclosure) disclosure to occur) Representative should be notified that PHI is being released pursuant to a Court Order; however, order should be honored even when notification cannot take place Fiduciary activities ` Court order or decree As requested by fiduciary, A fiduciary’s authority is appointing fiduciary unless restricted by law or limited to the authority terms of Order of Decree granted to such fiduciaries by law, and this authority can be further limited by the particular order or decree appointing the fiduciary Forensic patients: District Attorney G.L. c.123, §§7&8, 8B, 15(e), Notice of filing of petition commitment hearings and § 16(b), 16(c) and 18(a) 8B treatment order hearings Forensic patients: forensic Court, place of detention G.L. c.123, §§15, 16, 17 and As required by the evaluation evaluations 18 order

Forensic patients: Court with criminal jurisdiction G.L. c.123, §16(e) Intention to discharge or not notification of DA and Court and District Attorney with seek recommitment, and regarding intention to criminal jurisdiction current competence to stand discharge or intention to lift trial, if applicable, or intention court ordered building and to lift or modify buildings and grounds restriction grounds restriction

VERIFICATION Prior to making any permitted disclosure of Protected Health Information (PHI), DMH must (1) verify the identity of the party to whom the PHI is to be disclosed and (2) confirm that the party has the proper authority to receive the PHI. See Chapter 10, Verification of the Identity and Authority of the Requester. If there is any doubt about the identity of the receiver and/or the authority to disclose the PHI, the PHI should not be disclosed and the DMH Privacy Officer or Legal Office should be contacted for assistance.

Appendix C 4/14/03 Chart #4, page 2 Department of Mental Health Routine Disclosures – Chart # 4 Court Proceedings, Legal & Fiduciary Representation, Client Advocacy Purpose of Disclosure Disclosed to Authority for Disclosure Permitted Amount of Special Requirements (When the authority is a Information to be document, a copy of the Disclosed (May be authorizing document verbal or written unless must be in the DMH limited by the authority records for the for disclosure) disclosure to occur) Forensic patients: Court with criminal jurisdiction G.L. c.123, §17(a) Notice that patient has been notification to court that restored to competence patient is no longer incompetent Filing for guardianship and Court, patient’s attorney and/or G.L. c.201, §§6, 6B, 7, 14 16B, Petitions, affidavits, medical Information to be disclosed hearing guardian ad-litem; 17 and 21; G.L. c.123, §25 certificates and related may be limited by guardian/monitor, if any; next documents; testimony at psychotherapy privilege and of kin (as required by law); hearings; notices as required other applicable confidentiality newspaper legal notice by law requirements publication if required by Court Legal representation Attorney, Representing a Court appointment, letter Information as requested or If attorney represents a Client/Patient acknowledging relationship authorized Personal Representative, signed by documentation of Personal Client/Patient/Personal Representative status Representative or an required if not known (See Authorization Personal Representative, below) Legal representation Attorney (not representing Authorization by individual or As specified in the individual, Personal Personal Representative or authorization or court order Representative, or District court order Attorney’s Office) Legislative/Governor’s Legislator; Governor’s office Authorization individual or As specified in the Office: Requests for Personal Representative authorization services, interventions or required inquiries regarding specific clients/patients. VERIFICATION Prior to making any permitted disclosure of Protected Health Information (PHI), DMH must (1) verify the identity of the party to whom the PHI is to be disclosed and (2) confirm that the party has the proper authority to receive the PHI. See Chapter 10, Verification of the Identity and Authority of the Requester. If there is any doubt about the identity of the receiver and/or the authority to disclose the PHI, the PHI should not be disclosed and the DMH Privacy Officer or Legal Office should be contacted for assistance.

Appendix C 4/14/03 Chart #4, page 3 Department of Mental Health Routine Disclosures – Chart # 4 Court Proceedings, Legal & Fiduciary Representation, Client Advocacy Purpose of Disclosure Disclosed to Authority for Disclosure Permitted Amount of Special Requirements (When the authority is a Information to be document, a copy of the Disclosed (May be authorizing document verbal or written unless must be in the DMH limited by the authority records for the for disclosure) disclosure to occur) Monitoring medication Court appointed medication Court appointment Relevant documents and treatment monitor (Rogers monitor) verbal information Personal Representative Personal Representative – a Document of appointment as As specified in the Access * Disclosure to Personal (PR) duties* person authorized under law to Personal Representative **, Request Form, with certain Representatives is more fully make health care decisions for except for parents; proof of exceptions* covered in the Chapter on an individual* relationship for parents; Access Access in this Privacy Request Form required Handbook ** Appropriate documentation of the individual’s incompetence must be in the record for a Health Care Proxy Agent status to be activated Protection and Advocacy Protection and Advocacy G.L. c. 221, §34E; (MHLAC) As specified in authorization, if Program attorney or legal 42 USC 10806; (P&A) required. In some advocate (includes MHLAC) 104 CMR 27.17(6)(b); and/or circumstances, advocates authorization have rights to access without authorization. Consult with DMH Legal Office, if needed, for clarification. Subpoena response Subpoenaing party No disclosure without As specified in authorization or PHI may be disclosed in authorization or court order court order response to a subpoena only when the Individual or Personal Representative, if applicable provides an authorization, or when VERIFICATION Prior to making any permitted disclosure of Protected Health Information (PHI), DMH must (1) verify the identity of the party to whom the PHI is to be disclosed and (2) confirm that the party has the proper authority to receive the PHI. See Chapter 10, Verification of the Identity and Authority of the Requester. If there is any doubt about the identity of the receiver and/or the authority to disclose the PHI, the PHI should not be disclosed and the DMH Privacy Officer or Legal Office should be contacted for assistance.

Appendix C 4/14/03 Chart #4, page 4 Department of Mental Health Routine Disclosures – Chart # 4 Court Proceedings, Legal & Fiduciary Representation, Client Advocacy Purpose of Disclosure Disclosed to Authority for Disclosure Permitted Amount of Special Requirements (When the authority is a Information to be document, a copy of the Disclosed (May be authorizing document verbal or written unless must be in the DMH limited by the authority records for the for disclosure) disclosure to occur) subpoena is accompanied by a court order. In these circumstances, the authorization or order, rather than the subpoena control the amount of PHI to be disclosed. See the section of this chart concerning “court order responses” Warrant of apprehension Court G.L. c.123, §12(e); G.L. c.123, Information relevant to the Information to be disclosed §36B, if applicable; 104 CMR need for a warrant of may be limited by 27.17(6)(f) and/or 28.09(2)(d), apprehension psychotherapy privilege and if applicable other applicable confidentiality requirements Defense of litigation Attorney General G.L. c. 12, §§3, 3E Information relevant to litigation

Tort investigation Attorney General/EOHHS G. L. c. 258 Information relevant to tort claim

VERIFICATION Prior to making any permitted disclosure of Protected Health Information (PHI), DMH must (1) verify the identity of the party to whom the PHI is to be disclosed and (2) confirm that the party has the proper authority to receive the PHI. See Chapter 10, Verification of the Identity and Authority of the Requester. If there is any doubt about the identity of the receiver and/or the authority to disclose the PHI, the PHI should not be disclosed and the DMH Privacy Officer or Legal Office should be contacted for assistance.

Appendix C 4/14/03 Chart #4, page 5