otherwise disclose the identity of a patient in a report or in any other manner. (c) The exception in Subsection (a)(8) applies only to records created by the state hospital or state school or by the employees of the hospital or school. Information or records that identify a patient may be released only with the patient’s proper consent. (d) A person who receives information from confidential communications or records may not disclose the information except to the extent that disclosure is consistent with the authorized purposes for which the person first obtained the information. This subsection does not apply to a person listed in Subsection (a)(4) or (a)(5) who is acting on the patient’s behalf. Sec. 611.0041. Required Disclosure of Confidential Information other Than in Judicial or Administrative Proceeding. This section allows for disclosure of information to a descendant of a patient in a state hospital that has been deceased for 50 years and there is not documentation that indicates the disclosure is inconsistent with the wishes of the patient, their representative, or their estate. Sec. 611.0045. Right to Mental Health Record (a) Except as otherwise provided by this section, a patient is entitled to have access to the content of a confidential record made about the patient. (b) The professional may deny access to any portion of a record if the professional determines that release of that portion would be harmful to the patient’s physical, mental, or emotional health. (c) If the professional denies access to any portion of a record, the professional shall give the patient a signed and dated written statement that having access to the record would be harmful to the patient’s physical, mental, or emotional health and shall include a copy of the written statement in the patient’s records. The statement must specify the portion of the record to which access is denied, the reason for denial, and the duration of the denial. (d) The professional who denies access to a portion of a record under this section shall redetermine the necessity for the denial at each time a request for the denied portion is made. If the professional again denies access, the professional shall notify the patient of the denial and document the denial as prescribed by Subsection (c). (e) If a professional denies access to a portion of a confidential record, the professional shall allow examination and copying
of the record by another professional if the patient selects the professional to treat the patient for the same or a related condition as the professional denying access. (f) The content of a confidential record shall be made available to a person listed by Section 611.004(a)(4) or (5) who is acting on the patient’s behalf.(See first section). (g) A professional shall delete confidential information about another person who has not consented to the release but may not delete information relating to the patient that another person has provided, the identity of the person responsible for that information, or the identity of any person who provided information that resulted in the patient’s commitment. (h) If a summary or narrative of a confidential record is requested by the patient or other person requesting release under this section, the professional shall prepare the summary or narrative. (i) The professional or other entity that has possession or control of the record shall grant access to any portion of the record to which access is not specifically denied under this section within a reasonable time and may charge a reasonable fee. Sec. 611.004. Authorized Disclosure of Confidential Information Other Than in Judicial or Administrative Proceeding. Duty to Warn: The Texas Health and Safety Code This section includes the following Texas law regulations that cover this topic (Texas.gov, 2021): (a) A professional may disclose confidential information only: (2) to medical, mental health, or law enforcement personnel if the professional determines that there is a probability of imminent physical injury by the patient to the patient or others or there is a probability of immediate mental or emotional injury to the patient. This section has an important distinction to consider, particularly in the case of warning third parties. Texas limits disclosure to medical or law enforcement personnel only, and it would be up to those agencies to decide to warn if there is a probability of physical injury to others. Texas does not extend the duty to warn to third parties directly. This is considered as a permissive standard because the mental health practitioner is permitted to contact medical or law enforcement personnel in cases of probability of imminent physical injury to others. They cannot directly warn the third party under the state’s confidentiality law.
The Texas Statute Health. and Safety Code Chapter 181, Medical Records Privacy Sec. 181.001 (Tex.gov, 2015). Definitions. (a) Unless otherwise defined in this chapter, each term that is used in this chapter has the meaning assigned by the Health Insurance Portability and Accountability Act and Privacy Standards. (2) “Covered entity” means any person who: (A) for commercial, financial, or professional gain, monetary fees, or dues, or on a cooperative, (B) comes into possession of protected health information; (C) obtains or stores protected health information under this chapter; or (D) is an employee, agent, or contractor of a person described by Paragraph (A), (B), or (C) insofar as the employee, agent, or contractor creates, receives, obtains, maintains, uses, or transmits protected health information.
nonprofit, or pro bono basis, engages, in whole or in part, and with real or constructive knowledge, in the practice of assembling, collecting, analyzing, using, evaluating, storing, or transmitting protected health information. The term includes a business associate, health care payer, governmental unit, information or computer management entity, school, health researcher, health care facility, clinic, health care provider, or person who maintains an Internet site.
(2-a) “Disclose” means to release, transfer, provide access to, or otherwise divulge information outside the entity holding the information. (3) “Health Insurance Portability and Accountability Act and
Privacy Standards” means the privacy requirements in existence on September 1, 2011, of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT AND PRIVACY STANDARDS
Counselors and other mental health care providers are considered covered entities, so they are required to follow Health Insurance Portability and Accountability Act (HIPAA) regulations to protect the privacy and security of health care information. The TAC references HIPAA regulations that must be
followed throughout the statutes. HIPAA covers the electronic transmission of protected health care information. HIPPA was modified and strengthened in 2013 by the addition of the Health Information Technology for Economic and Clinical Health (HITECH) Act.
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