| To: | Hospital Chief Nursing Officers, Legal Counsel, and Government Affairs Staff
Please forward to appropriate staff |
| Staff Contact: | Zosia Stanley, Vice President and Associate General Counsel ZosiaS@wsha.org | (206) 216-2511 |
| Subject: | New Requirement to Respond to Record Requests from Overdose, Withdrawal, and Suicide Fatality Review Teams |
Purpose
This bulletin is to inform hospitals of a new requirement to respond to record requests from overdose, withdrawal, and suicide fatality review teams. Local health departments are empowered to create such review teams starting on June 9, 2022.
Under Substitute House Bill 1074, health care providers, health care facilities, and clinics, among many other entities, may be asked by review teams to provide “all medical records related to…overdose, withdrawal, and suicide” along with other records and must comply with such requests.
Throughout the legislative process, WSHA worked to ensure the bill language would protect the confidentiality of records and impose the least possible burden on providers.
Applicability/Scope
This bill applies to all hospitals licensed under RCW 70.41 and psychiatric hospitals licensed under RCW 71.12, as well as to many other entities who have records related to the lives or deaths of people who die by overdose, withdrawal, and suicide.
Recommendations and Next Steps
- Review this bulletin and the new requirements created by SHB 1074.
- Develop a policy determining actions to be taken if and when your hospital receives records requests from a fatality review team, including who will be responsible for the document request and how you will determine what records should be released. Work with legal counsel and compliance managers when developing the policy to ensure subsequent record releases are consistent with federal and state privacy laws.
- Maintain communication with your local health department. The legislation doesn’t require local health departments to set up a review panel, but if a panel is established it must be multidisciplinary. Maintaining communication with local health departments will help hospitals be aware of review panel implementation and offer the potential for involvement.
Overview
The goal of this legislation is to identify and address preventable deaths from overdose, withdrawal, and suicide. To do so, the bill empowers local health departments[1] to establish multidisciplinary teams to review overdose, withdrawal, and suicide deaths and develop strategies to prevent future deaths from these causes.
The teams will be looking for “modifiable medical, socioeconomic, public health, behavioral, administrative, educational, and environmental factors” that contributed to the deaths and will write reports about their findings. These reports will be shared with the Department of Health and entered into a database. Access to the database will be granted to the extent allowed under Washington’s Health Care Information Access and Disclosure law, RCW 70.02, and the Prescription Monitoring Program in RCW 70.225.
Local health departments that establish fatality review teams have the authority to request and receive data related to specific overdose, withdrawal and suicide facilities. When receiving such a request, hospitals must provide, presumably to the extent they hold them,
“all medical records related to the overdose, withdrawal, and suicide, autopsy reports, medical examiner reports, coroner reports, social services records, and other data requested for specific overdose, withdrawal, and suicide fatalities.”
It will be important for hospitals to consider both the state and federal laws that authorize the disclosure of the normally protected records to understand what they can legally release. That is, hospitals will have to determine not only the documents they have, but also what they can release under federal and state privacy law, including federal HIPAA law and the Washington State Uniform Health Care Information Act (RCW 70.02). Hospitals are encouraged to consult with legal counsel and risk managers when establishing a policy for records release to fatality review teams.
The language describing the duty of hospitals to release records in this legislation is similar to the requirement to respond to records requests from maternal mortality review panels. For this reason, you may wish to consult your policy related to responding to requests from maternal mortality review panels for records. However, the fatality review and maternal mortality review legislation are not identical in structure. For instance, the maternal mortality review panels are noted specifically in RCW 70.02.230, which relates to the confidentiality and release of mental health records, while the facility review legislation is not.
WSHA’s 2022 New Law Implementation Guide
Please visit WSHA’s new law implementation guide online. The Government Affairs team is hard at work preparing resources and information on the high priority bills that passed in 2022 to help members implement the new laws, as well as links to resources such as this bulletin. In addition, you will find the Government Affairs team’s schedule for release of upcoming resources on other laws and additional resources for implementation.
References
HB 1074
DOH list of public health jurisdictions
[1] The legislation refers to “local health departments” as opposed to “local health jurisdictions.” “Local health department” is defined in RCW 70.05 (where this legislation is located) as the county or district which provides public health services to persons within the area. The definition indicates it applies to local health departments created under RCW 70.05 (Local Health Departments) and RCW 70.46 (Health Districts, which can be created jointly by multiple counties). The definition does not specifically reference joint city and county health departments created under RCW 70.08, of which there are two in the state according to a DOH website. While the language in the legislation and RCW 70.05 is arguably broad enough to include the city-county health departments, the fact that the definition section specifically references RCW 70.05 and RCW 70.46 but not RCW 70.08 is concerning. Further, elsewhere in the RCW the term “local health jurisdiction” is often used to reference all three types.
