Beyond HIPAA: Patient Medical Records And Client Confidentiality In Mental Health

Date: Thursday October 8, 2020

10:00 AM PDT | 01:00 PM EDT

Duration: 60 Minutes
Instructor: Mark Brengelman
Webinar Id: 802153
11 Days Left To Register


One Attendee
Unlimited Attendees


One Attendee
Unlimited Attendees ?


Live + Recorded
$269 $318  
One Attendee
Live + Recorded
$599 $678  
Unlimited Attendees ?

This program allows the mental health care practitioner to avoid sanctions and to defend against legal actions which may result in ruinous practice and career consequences for the mental health practitioner due to issues of client confidentiality, and overview of patient medical record keeping, including electronic records, will provide the basic framework to understand the emerging issues in client confidentiality.


Learn to identify and apply differing and conflicting rules with respect to the specific health care practitioner, the specific health care facility practice, and the emerging rules and regulations for electronic medical records confidentiality, security, and disposition.

A basic overview of all medical records standards is necessary to set forth the confidentiality that exists now in the records of the health care practitioner.

In addition to these clinical requirements of a specific profession, additional state laws set forth the content and retention of other types of records, other than clinical records of a patient, that are also kept by the professional, such as supervisory agreements with other professionals subordinate to them as well as their own unique record content requirements.

One area covered specifically about electronic record recognizes that while psychotherapy and mental health services are ideal treatments to offer over the internet, that is, by simultaneous audio-visual transmission between the doctor and the patient, the risks of breaches of confidentiality also vastly increase. And when the successful doctor-patient relationship is over, how does the health care practitioner providing a mental health service dispose of these electronic records?

In addition to state law requirements for the specific retention and disposition of clinical medical records, how long should the health care practitioner retain records for the possible, future defense of a malpractice claim for negligent treatment? Or to retain such medical records when the patient is a minor? Or to defend a possible complaint and disciplinary action by a state regulatory agency which could revoke the professional license of the practitioner?

Finally, while HIPAA provides for broad protections of privacy, state laws govern the confidentiality of the information provided in the context of a doctor-patient relationship. Tour the applicable evidentiary rules that cover confidentiality under state law.

Know the most common exceptions to confidentiality where a law may allow a practitioner to breach confidentiality or may mandate the specific breach of confidentiality. Review common missteps in failing to ensure patience confidentiality even when disclosure is mandated or permitted by the law.

Why you should Attend: This webinar addresses the fear regarding patient confidentiality beyond the privacy and other protections required by HIPAA. An in-depth overview of medical records keeping starts this webinar to confront those fears by examining the state law sources and even contractual requirements of medical record keeping.

The webinar proceeds to review exceptions to confidentiality that are most frequently encountered by mental health professionals who practice in a high-risk setting where the consequences of a misstep can be very high. These uncertain areas are brought into focus.

For many years now, HIPAA has provided a federal right to privacy for patient medical records, including mental health records.However, uncertainty in issues not with federal mandates but with state laws, the mental health care practitioner must know and comply with individual state laws and ethics governing the confidentiality of client information in the context of a doctor-patient relationship. This is apart and beyond the technical components of HIPAA.

HIPAA has standardized office medical record keeping, releases, and professional communications with third parties. But how is client confidentiality addressed beyond mere record keeping? Competing interests and privacy mandates create tension with these differing mandates.

Mere compliance with HIPAA allows risk the practitioner is HIPAA-compliant but liable to other confidentiality issues.Not only do state laws and codes of ethics mandate confidentiality, but there are many state law exceptions recognized by HIPAA. The exceptions sometimes allow and sometimes mandate what would otherwise be a confidentiality breach. While the sanctity of the doctor-patient relationship is most important, many state laws allow, or even require, a breach of the confidentiality of that relationship.

The sanctity of the doctor-patient relationship then moves to uncertain territory where client confidentiality meets a duty to act, such as, a duty to warn of impending harm or a duty to report suspected child abuse or neglect. Such duties to act do not require the permission of the client, or even the notification to the client, that information about them is being disclosed and reported. This uncertainty exists at a time when the practitioner is most vulnerable - when the practitioner must decide whether and how to act.

Doubtful conduct by practitioners will be examined to their detriment by patients suing for malpractice and licensure boards investigating breaches of confidentiality. This webinar will first review the standardized HIPAA requirements for patient medical records. From that perspective, the webinar will answer the issues presented by expanding to review state laws on patient confidentiality, evidentiary privileges, and exceptions mandated by law.

Erase the uncertainty of situations where multiple sources of client confidentiality conflict that govern the secrets held in confidence by mental health practitioners - beyond HIPAA.

Areas Covered in the Session:

  • Sources of legal and contractual requirements for medical records retention
  • What information is mandated to be in a specific health care practitioner's medical record
  • Electronic records confidentiality, retention, and disposition
  • State laws creating evidentiary privileges covering the doctor-patient relationship under applicable rules of evidence
  • Exceptions to confidentiality that may merely allow a breach of confidentiality or my indeed mandate a breach

Who Will Benefit:
  • Health Care Attorneys
  • Corporate Compliance Officers in Health Care
  • Medical Records Staff of Medical Offices
  • Health Care Entities
  • Hospital Attorneys
  • Health Care Practitioners who are covered Entities
  • Law Enforcement Officers in Health Care Compliance
  • State boards and Agencies with Jurisdiction over state Licenses to Practice a Health care Profession

Speaker Profile
Mark Brengelman became interested in the law when he graduated with both Bachelor’s and Master’s degrees in Philosophy from Emory University in Atlanta. He then earned a Juris Doctorate from the University of Kentucky College of Law. In 1995, Mark became an Assistant Attorney General and focused in the area of administrative and professional law. He represented multiple boards as General Counsel and Prosecuting Attorney.

Mark retired from state government in the summer of 2012. Also in 2012, he became certified as a hearing officer. He then opened his own law practice to focus on government services and consulting, continuing education, and the representation of health care practitioners before licensure boards and in other professional regulatory matters.

Expanding his health law experience, he was a registered legislative agent (lobbyist) for the Kentucky Association of Pastoral Counselors for the successful passage of Senate Bill 61 passed by the Kentucky General Assembly and signed by the Governor into law on April 9, 2014.

Mark is a frequent participant in continuing education and has been a presenter for over a dozen national and state organizations including the Kentucky Bar Association, the Kentucky Office of the Attorney General, and the National Attorneys General Training and Research Institute.

He is the founding presenter for "Navigating Ethics and Law for Mental Health Professionals," a continuing education training approved by five Kentucky mental health licensure boards, which was presented at Midway College with a licensed clinical social worker in 2013 and 2014.

Since October 2013, Mark has practiced law with the firm of Hazelrigg & Cox, LLP, as partner - an established law firm tracing its history in Frankfort, Kentucky, over one hundred years.

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