Paulette, as I'm reading Colorado statute as it is being currently modified: http://www.leg.state.co.us/2003a/inetcbill.nsf/fsbillcont/12872ADAA2C72AF087256C5A00624B00?Open&file=051_ren.pdf
 
I think Colorado law may be more stringent.  It reads to me that all 'mental health records' are restricted from access by the patient -- at least while therapy is occurring.
 
-----Original Message-----
From: Matthew Rosenblum [mailto:[EMAIL PROTECTED]
Sent: Friday, March 21, 2003 9:27 PM
To: WEDI SNIP Privacy Workgroup List
Subject: RE: psych notes

Paulette,

 

Among most behavioral health professionals "process" notes (referred to by HIPAA as "psychotherapy" notes) are those pieces of documentation that therapists write, basically for their own use, to remind themselves of what the patient has said, for example, the content of a dream, or the experience of guilt associated with a "forbidden" feeling.  HHS has given us the opportunity to strictly limit the availability of this information by providing a higher order of protection for these "process" notes, and with few exceptions, disclosures may be made only if the CE obtains a signed-authorization.

 

Under HIPAA psychotherapy notes are defined as those notes:

 

1) Recorded by a health care provider who is a mental health professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint, or family counseling session, and,

 

2) Maintained separate from the medical record, and

 

3) That exclude:

 

a. Medication prescription and monitoring

b. Counseling session start and stop times

c. The modalities and frequencies of treatment furnished

d. Results of clinical tests

e. Any summary of diagnosis, functional status, the treatment plan, symptoms, prognosis, and progress to date

 

Note, that #3 (above) delineates most of the information that we normally put into our "progress notes" to substantiate treatment, and consequently, we must separate that information from the "psychotherapy or process notes" (that is, if we want to further protect the "process" information.)

 

So, under HIPAA, "psychotherapy notes" must be SEPARATED from the rest of the record if they are to be afforded the additional protections provided by the Privacy Rules.  In the “paper” world, this probably means the “psychotherapy notes” should remain under the lock-and-key of the writer of the note.  In the “electronic” world, user ID and password protections would probably be the minimum.

 

I hope that this helps.

 

Your questions are always welcome.

 

Matt

 

Matthew Rosenblum

Chief Operations Officer

Privacy, Quality Management & Regulatory Affairs

http://www.CPIdirections.com

 

CPI Directions, Inc.

10 West 15th Street, Suite 1922

New York, NY 10011

 

(212) 675-6367

[EMAIL PROTECTED]

 

CONFIDENTIALITY NOTICE: This E-Mail is intended only for the use of the individual or entity to which it is addressed and may contain information that is privileged, confidential and exempt from disclosure under applicable law. If you have received this communication in error, please do not distribute it.  Please notify the sender by E-Mail at the address shown and delete the original message. Thank you.

 

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-----Original Message-----
From: [EMAIL PROTECTED] [mailto:[EMAIL PROTECTED]
Sent:
Tuesday, March 18, 2003 4:11 PM
To: WEDI SNIP Privacy Workgroup List
Subject: psych notes

 

Our practice is family practice.  We contract in a LCSW who uses our charts for her progress notes.  I understand that mental health is handled differently than that of a PCP as far as authorizations for release of info. (we need specific auth to release).  I also remember reading somewhere that mental health needs to be "seperately identifiable" in the chart.  Can someone help me out with this?  We do not have a seperate divider in the chart for mental health however we do have the LCSW use blue progress notes.  This seems reasonable to me to satisfy the "seperately identifiable".  Any words of advise?

Paulette Ortega
Practice Administrator
Comprehensive Family Care Center
2002 Lake Ave., Ste. D
Pueblo, CO  81004
(719) 562-1122
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