| mental
health (Florida)
Provisions of the
Florida Mental Health Act (FMHA) generally govern the use
and disclosure of medical
records related to mental health.
FMHA designates
the Department of Children and Family Services (DCF) as the
"Mental Health Authority" of Florida. That department
and the Agency for Health Care Administration (AHCA) have
the authority to supervise all mental health facilities, programs,
and services. (FL Stat 394.457)
Among other patient
rights, the FMHA stipulates a "right to dignity"
-- and though not expressly mentioned there, a right to dignity
includes a right to confidentiality under the provisions of
the Florida Patient's Bill of Rights and Responsibilities.
(381.026)
Under FMHA, clinical
records related to mental health diagnosis and treatment are
confidential, exempt from the state public records access
laws (e.g., under 119.07), and may be released only when:
- the patient
or the patient's guardian authorizes the release;
- the patient
is represented by counsel and the records are needed by
the patient's counsel for adequate representation;
- a court orders
such release;
- the patient
is committed to, or is to be returned to, the Department
of Corrections from the DCF, and the Department of Corrections
requests such records. (394.4615)
Information from
the clinical record (as opposed to the entire record) may
be released:
- when a patient
has declared an intention to harm other persons, in which
case the administrator of a facility may make available
"sufficient information to provide adequate warning
to the person threatened with harm by the patient";
- where "the
administrator of the facility or secretary of the department
deems release to a qualified researcher as defined in administrative
rule, an aftercare treatment provider, or an employee or
agent of the department is necessary for treatment of the
patient, maintenance of adequate records, compilation of
treatment data, aftercare planning, or evaluation of programs";
- to be used "for
statistical and research purposes if the information is
abstracted in such a way as to protect the identity of individuals";
- to the Agency
for Health Care Administration, the Department of Health,
and the Florida advocacy councils "for the purpose
of monitoring facility activity and complaints concerning
facilities";
- to the Medicaid
Fraud Control Unit in the Department of Legal Affairs, upon
request, to evaluate the claims for a Medicaid patient.
(394.4615)
Any person, agency,
or entity receiving such information must maintain it as confidential
(it is also exempt from the provisions of 119.07). Any facility
or private mental health practitioner who acts in good faith
in releasing information under these criteria is not subject
to civil or criminal liability for such release. (394.4615)
The parent or next
of kin of a person who is held in or treated in a mental health
facility or program may request and receive a summary of that
person's treatment plan and current physical and mental condition.
Release of such information shall be in accordance with the
code of ethics of the profession involved. (394.4615)
Patients must have
reasonable access
to their clinical records, unless such access is deemed by
the patient's physician to be harmful. If the patient's right
to inspect his or her clinical record is restricted, written
notice of that restriction must be given to the patient and
the patient's guardian, guardian advocate, attorney, and representative.
The restriction must also be recorded in the clinical record,
along with the reasons for it. Such an access restriction
expires after 7 days but may be renewed, after review, for
subsequent 7-day periods. (394.4615)
Agencies with jurisdiction
over a person who may be a "sexually violent predator"
must provide information to a multidisciplnary team organized
to evaluate the suitability of that designation. The information
can include "[m]ental health, mental status, and medical
records, including all clinical records and notes concerning
the person." (394.913)
"Psychological
or psychiatric reports, drug and alcohol reports, treatment
records, medical records, or victim impact statements"
that have been submitted to a court or admitted into evidence
become part of the record but must be sealed and may be opened
only pursuant to a court order. (394.921)
Any facility designated
as a receiving or treatment facility must allow access to
any patient and the clinical and legal records of any patient
admitted pursuant to the provisions of this act by members
of the Florida statewide and local mental health advocacy
councils. (394.4595)
DCF and ACHA may
enter and inspect any mental health treatment facility, to
determine if it is in compliance with the relevant statutes
and administrative rules. This right of inspection may include
access to any and all clinical records. (394.90)
See also:
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