Wash. Rev. Code § 71.05.630 (as amended by 2009c 398)

Treatment records — Confidential — Release

Washington amended § 71.05.630 three times during the 2009 legislative session without referencing the other amendments. According to Washington’s rules of construction, each amended provision is valid unless there is a conflict in the purpose of the provisions. If such a conflict exists, then the last filed amendment will control. 

Patients must authorize, in writing, the release of their mental illness treatment records. However, Washington permits the release of treatment records without the patient’s written consent in the following situations:

•        To an individual, organization, or agency that needs the records for management purposes, to conduct financial audits, or to monitor and evaluate programs.
•        To the department of social and health services, the regional support network director, or a regional support network director acting pursuant to the director’s orders that needs the treatment records for “billing or collection purposes.”
•        To an individual or entity conducting research as authorized in chapter 42.48.

       To an individual or entity in compliance with a court order.

•        To department staff members, the regional support networks director, or resource management services for that need the information to serve a patient.
•        To “service providers designated by resource management services” that need the information to assess the “progress and adequacy of treatment” and to determine whether a change in treatment or facility is appropriate.
•        To facility employees, trainees, and volunteers that need the information to “perform their duties.”
•        To department employees pursuant to the coordination of “mental illness, developmental disabilities, alcoholism, [and] drug abuse” treatments.

       To physicians or psychiatric advanced registered nurse practitioners that need the information because the patient’s life or health is in danger and failure to obtain the information could cause the patient further harm. Such physicians or nurse practitioners may only access information relevant to providing emergency care.

•        Information may be disclosed, for the purpose of coordinating care, to mental health professionals and health care professionals that are either caring for the patient or will care for the patient pursuant to a referral as well as to designated members of these professionals’ administrative and office staffs. Disclosure must occur in compliance with HIPAA and the patient must authorize, in writing, the disclosure of psychotherapy notes.
•        To facilities upon receiving person that has transferred from another facility or been involuntarily committed (71.05). Such facilities may only obtain the “treatment records required by law, a record or summary of all somatic treatments, and a discharge summary.” A “discharge summary” may include information about the patient’s problem and treatment plan, but the summary cannot contain the patient’s entire treatment record. 
•        To a correctional facility or corrections officer that is supervising the outpatient or inpatient treatment of an individual. Such facilities or officers may only obtain (1) “An evaluation report provided pursuant to a written supervision plan;” (2) a discharge summary; and (3) when an individual is released from a treatment facility to a correctional facility, “any information necessary to” implement or change their treatment plan.
•        To an individual’s legal representative that needs the information to prepare for involuntary commitment or other actions relating to detention, admission, commitment, or patient's rights under the law.
•        To protection and advocacy agency employees and members of public and private advocacy organizations that need the information to advocate for the rights of persons with mental illness and developmental disorders. Resource management services may choose to release a limited amount of information regarding the identity of the patient, the contact information of the patient’s guardian, and whether their commitment was voluntary or involuntary. An organization that desires more information must submit a request to the resource management services who will then send the patient’s guardian notice. Resource management services my subsequently release the additional information if the guardian does not raise an objection within 15 days.
•        Information obtained “for billing and collection purposes” may be released to all providers that have written a prescription for the patient within the previous 12 months. The department must notify the patient when such disclosure occurs. This provision does not allow the department to release information regarding “counseling, inpatient psychiatric hospitalization, or drug and alcohol treatment” with the patient’s written authorization.

Individuals must keep information they receive pursuant to this section confidential.

The department may restrict the disclosure of information regarding chemical dependency treatments in order to comply with federal laws and regulations.