Course Description:

This seminar will first review the standardized HIPAA requirements for patient medical records. From that perspective, the seminar 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.

Learning Objectives:

This continuing education course will:

  • Identify the basics of HIPAA requirements for patient records;
  • Conduct an overview of medical record keeping standards, including electronic records;
  • Compare and contrast state statutes and administrative regulations on professional requirements for confidentiality;
  • Review the most common exceptions to state statutes and administrative regulations for confidentiality;
  • Explore state and federal rules of evidence for legal standards governing the use of client secrets in any legal proceeding;
  • Analyze case law from the courts apply standards of client confidentiality;
  • Discuss individual vignettes and hypothetical dilemmas from the differing perspectives learned during this continuing education, and;
  • Recognize a check-list for successfully handling the client confidentiality dilemmas of the mental health practitioner.

Seminar Fee Includes:

AM-PM Tea/Coffee
Seminar Material
USB with seminar presentation
Hard copy of presentation
Attendance Certificate
$100 Gift Cert for next seminar

Who Will Benefit:

This course is designed for people tasked with developing, maintaining, and improving their understanding of applicable federal and states laws as applied to mental health practitioners.
The following persons will benefit from the continuing education course:

  • Individual mental health care practitioners
  • Psychologists
  • Marriage and family therapists
  • Social workers
  • Professional counselors
  • Pastoral counselors
  • Psychiatrists
  • Advanced practice registered nurses with psychiatric specialty
  • Health care lawyers for individual practitioners and for health care facilities
  • Corporate managers at mental health care facilities

Topic Background:

For many years now, HIPAA has provided a federal right to privacy for patient medical records, including mental health records. However, fearing 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.

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.

Course Outline:

Day 1 (8:30 AM – 5:00 PM) Day 2 (8:30 AM – 4:30 PM)
  • 8:30 – 8:45 AM: Registration
  • 8:45 AM – Opening remarks and introductions - for speaker and all attendees
  • 9:00 AM - 10:30 AM – HIPAA basics: What we should all know and be doing about HIPAA - outline of basic HIPAA mandates, required notices, and mandated disclosures
  • 10:30 AM - 10:45 AM – Break
  • 10:45 AM - 12:15 PM - Medical records retention including electronic records - what constitutes the medical record, how long do you keep it and why, and what special rules may apply to electronic records
  • 12:15 PM - 1:30 PM – Lunch
  • 1:30 PM - 3:00 PM – State statutes and regulations on professional requirements for confidentiality – examination of select state statutes and administrative regulations to compare and to contrast specific state law mandates for confidentiality of medical records and information
  • 3:00 PM - 3:15 PM – Break
  • 3:15 PM - 4:45 PM – Exceptions to state statutes and regulations on professional requirements for confidentiality – examination of select state statutes and administrative regulations on exceptions to confidentiality to compare and to contrast specific state law mandates for breaches of confidentiality of medical records and information
  • 4:45 PM - 5:00 PM – Open discussion – follow up for specific questions not otherwise covered with general discussion for the group.
  • 8:30 AM – 9:00 AM - Opening remarks and summarizing discussion - review content covered so far and outline the remainder of the program
  • 9:00 AM - 10:30 AM – State and federal rules of evidence as applied to confidentiality - review federal and state law rules of evidence as applied by the courts to confidential communications in the health care field
  • 10:30 AM - 10:45 AM – Break
  • 10:45 AM - 12:15 PM - Case law on confidentiality from the courts - review significant cases from federal and state courts regarding confidentiality in communications in the health care field
  • 12:15 PM - 1:30 PM – Lunch
  • 1:30 PM - 3:00 PM – Small group vignettes with 3 vignettes – breakout sessions into groups of 2-3 or 3-4 to discuss 3 vignettes as a case study in each scenario with report back to full group
  • 3:00 PM - 3:15 PM – Break
  • 3:15 PM - 4:00 PM – Checklist of take-aways for follow up in one’s own work – review a checklist of top take-aways for further use in one’s own practice and work
  • 4:00 PM - 4:30 PM – Concluding remarks – summarize content covered, examination of vignettes, and checklist of top take-aways.

Meet Your Instructor

Mark R Brengelman,
Attorney, Law PLLC

Mark worked as the assigned counsel to numerous professional licensure boards as an Assistant Attorney General for the Commonwealth of Kentucky, including the Board of Registration for Professional Geologists. Moving to private practice, he now helps private clients in various professions in a wide variety of contexts.

Mark 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 where he represented multiple boards as General Counsel and Prosecuting Attorney.

Mark is a frequent participant in continuing education and has been a presenter for over twenty national and state organizations and private companies, including webinars and in-person seminars. National and state organizations include the Kentucky Bar Association, the Kentucky Office of the Attorney General, and the National Attorneys General Training and Research Institute.

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