Iowa Code r. 441-9.7 - Consent to disclosure by the subject of a confidential record
To the extent permitted by any applicable provision of law, the subject of a confidential record may have a copy of the portion of that record concerning the subject disclosed to a third party. A request for such a disclosure must be in writing and must identify the particular record or records to be disclosed, the particular person or class of persons to whom the record may be disclosed, and the time period during which the record may be disclosed. The subject of the record and, where applicable, the person to whom the record is to be disclosed may be required to provide proof of identity. Appearance of counsel before the department on behalf of a person who is the subject of a confidential record is deemed to constitute consent for the department to disclose records about that person to the person's attorney. No confidential information about clients of the department shall be released without the client's consent, except as otherwise provided by law. Release of confidential information includes granting access to or allowing the copying of a record, providing information either in writing or orally, or acknowledging information to be true or false.
(1)
Release forms.
a.
Releases allowing the department to provide confidential
information. Subjects should complete the Authorization for the
Department to Release Information for releases that do not involve protected
health information.
b.
Releases allowing the department to provide protected health
information under HIPAA. The department shall not require a subject to
sign a HIPAA authorization form as a condition of treatment, payment,
enrollment in a health plan, or eligibility for benefits. The department as a
health care provider may require a subject to sign a HIPAA authorization form
for the use or disclosure of protected health information for research, as a
condition of the subject's receiving research-related treatment. A subject may
revoke a HIPAA authorization at any time, provided that the revocation is in
writing using a form that meets the requirements of applicable law, except to
the extent that the department has taken action in reliance thereon.
c.
Releases allowing the department
to obtain confidential information from a third party. The department
is required to obtain confidential information from third parties. The
department may make these requests unless prohibited by applicable law or when
the client has authorized the release on one of the following forms:
(1) Authorization for Release of
Information.
(2) Household Member
Questionnaire.
(3) Bank or Credit
Union Information.
(4) Addendum for
Application and Review Forms for Release of Information.
(5) Request for School
Verification.
(6) Employer's
Statement of Earnings.
(7)
Verification of Educational Financial Aid.
(8) Financial Institution
Verification.
(9) Authorization to
Obtain or Release Health Care Information.
d.
Releases for photographs and
recordings. The department may seek permission to use photographs in
department publications on a form that meets the requirements of applicable
law. The department will obtain authorization from the subject or person
responsible (such as a guardian, custodian, or personal representative) for the
subject before taking photographs or making any type of recording for any
purpose other than those specifically allowed by law or for internal use within
an institution.
(2)
Exceptions to use of release forms.
a.
Public official. A letter
from the subject to a public official that seeks the official's intervention on
behalf of the subject in a matter that involves the department shall be treated
as an authorization to release information upon receipt of appropriate
authorization from the subject to do so. The department shall release only the
minimum amount of information necessary about the subject to the official to
resolve the matter. If the information includes protected health information,
the department may only provide the protected health information if, in the
exercise of professional judgment, the department determines that disclosure is
in the best interest of the subject. When the department determines that
disclosure is in the subject's best interest, the department may disclose only
the protected health information that is directly relevant to the public
official's intervention with the matter involving the department.
b.
Medical emergency.
Department staff may authorize release of confidential information to medical
personnel in a medical emergency if the subject is unable to give or withhold
consent. As soon as possible after the release of information, the subject
shall be advised of the release.
c.
Abuse information. Consent to release information is not
required to gather information for investigations of child abuse or dependent
adult abuse.
(3)
Opportunity for subject to agree or object. This subrule
describes when the department may use or disclose protected health information,
without a written authorization, to persons involved in the subject's care and
for notification purposes. However, the department shall give the subject an
opportunity to agree or object, unless this requirement is waived as specified
in paragraph 9.7(3)"e."
a.
Involvement in the subject's care. The department may, in
accordance with paragraphs 9.7(3)"c,""e," and
"f," disclose protected health information that is directly
relevant either to a subject's care or to payment related to the subject's
care, provided payment is relevant to the person's involvement in the subject's
care. The person involved must be:
(1) A
family member;
(2) Another
relative;
(3) A close personal
friend of the subject; or
(4) Any
other person identified by the subject.
b.
Notification purposes.
The department may use or disclose protected health information to notify, or
assist in notifying, identifying or locating a family member, a personal
representative of the subject, or another person responsible for the care of
the subject of the subject's location, general condition or death. For disaster
relief purposes, the use or disclosure shall be in accordance with paragraph
9.7(3)"f."
c.
Uses and disclosures with the subject present. If the subject
is present for, or available before, a use or disclosure permitted by this
subrule and has the capacity to make health care decisions, the department may
use or disclose the protected health information if the department:
(1) Obtains the subject's
agreement;
(2) Provides the subject
with the opportunity to object to the disclosure, and the subject does not
express an objection; or
(3)
Reasonably infers from the circumstances, based on the exercise of professional
judgment, that the subject does not object to the disclosure.
d.
Informing the
subject. The department may orally inform the subject of and obtain
the subject's oral agreement or objection to a use or disclosure permitted by
this subrule.
e.
Limited
uses and disclosures when the subject is not present. When the subject
is not present, or the opportunity to agree or object to the use or disclosure
cannot practicably be provided because of the subject's incapacity or an
emergency circumstance, the department may, in the exercise of professional
judgment, determine that disclosure is in the best interest of the subject.
(1) When the department determines that
disclosure is in the subject's best interest, the department may disclose only
the protected health information that is directly relevant to the person's
involvement with the subject's health care.
(2) The department may use professional
judgment and its experience with common practice to make reasonable inferences
of the subject's best interest in allowing a person to act on behalf of the
subject to pick up filled prescriptions, medical supplies, X-rays, or other
similar forms of protected health information.
f.
For disaster relief
purposes. The department may use protected health information or
disclose protected health information to a public or private organization
authorized by law or by its charter to assist in disaster relief efforts for
the purpose of coordinating with these organizations the uses or disclosures
permitted by paragraph 9.7(3)"b." The requirements in
paragraphs 9.7(3)"c" and "d" apply to these
uses and disclosures to the extent that the department, in the exercise of
professional judgment, determines that the requirements do not interfere with
the ability to respond to the emergency circumstances.
Notes
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