D.C. Code §§ 7-1201-1- 1208.07 - Definitions; General Provisions; Disclosures with the Client’s Consent; Exceptions; Court-Related Disclosures

Mental health treatment information is confidential and privileged to the patient, and may only be disclosed according to one of the statutes. All disclosures must be documented in the patient’s file.
 
Disclosure with the Client’s Consent:
A client, or if the client is under 14, the client’s parent, may consent to the disclosure of information relating to their mental health treatment by completing a written release with the following elements:
·      Information to be disclosed
·      Information regarding the client’s right to inspect his or her record
·      Information regarding the client’s right to revoke consent
·      The client’s signature
·      The date
Information cannot be re-disclosed without consent. A person may revoke consent in writing. A mental health professional may refuse or limit disclosure if they believe it necessary to protect the client from “a substantial risk of imminent psychological impairment” or “imminent and serious physical injury.” The mental health professional must notify the client in writing about the refusal or limitation, and provide the purpose behind the refusal or limitation. The client is entitled to a second opinion from another mental health professional of comparable stature; this professional may authorize the disclosure if they determine that disclosure does not produce a substantial risk to the client. A client may also institute an action seeking to compel the disclosure if a professional has refused or limited. Any refusal or limitation must be documented in the client’s file.
 
Disclosure without the Client’s Consent:
Confidential mental health information may be disclosed without the client’s consent between participating providers and individuals employed by the same facility as necessary treatment purposes. Information may be disclosed when required by law, specifically in the contexts of mandatory reporting requirements, and where an individual is legally responsible for paying for hospital care.
Disclosure without consent is permitted in an emergency situation to either seek hospitalization for the client or “protect the client or another individual from a substantial risk of imminent and serious physical injury;” in these instances, information may only be disclosed to the following individuals or entities:
·      The spouse, parent, or guardian of the client
·      A D.C. public health professional
·      The Department of Mental Health
·      A provider
·      D.C. Pretrial Services Agency
·      Court Services and Offender Supervision Agency
·      A Court with jurisdiction in the context of a pending criminal proceeding against the client
·      Emergency medical personnel
·      A D.C. officer with arresting authority
·      An intended victim
Information reported to the Police Department must be maintained separately.
Information may be disclosed for the purpose of obtaining payment for delivered services; the client must be provided the opportunity in writing to pay for the services first. The disclosure must be limited to the information necessary to collect payment, unless in a civil action for payment, the client moves for greater specificity, or more information may be disclosed to dispute a defense or counterclaim.
Confidential mental health information may be disclosed for purposes of research, audit, and program evaluation. The personnel that receive this information must first assure in writing that client-identifying information will not be published; de-identified data may be shared in accordance with HIPAA.
Information may be disclosed to correctional institutions or law enforcement officials only to facilitate the delivery of mental health services to an individual that is in custody.
 
Court-Ordered Disclosure:
Mental health information may be disclosed in connection with a court-ordered examination. Information may be disclosed when the mental health professional is seeking to have the patient civilly committed.
Information may be disclosed in a civil or administrative action in which the client or beneficiary of the client’s mental or emotional condition is an element of a claim or defense initiated by the client. A court may order disclosure in a criminal proceeding when authorized by law, for example, when the defendant’s competence or mental health is at issue. A court may also order disclosure in a criminal proceeding to ensure compliance with “a condition of pretrial release, probation, parole, supervised release, or diversion agreement that the defendant or offender obtain or comply with mental health treatment ordered by a court or the U.S. Parole Commission.” Re-disclosure in this context must be limited to the extent necessary to monitor compliance.
Re-disclosure of information disclosed pursuant to court order is to be governed by the court order, or alternatively, the rules of the D.C. Superior Court.
 
Penalties:
Individuals who negligently disclose information as prohibited by the statute are “liable in an amount equal to the damages sustained by the client plus the costs of the action and reasonable attorney's fees.” If the individual willfully violates the law, the individual is liable for an additional $1,000.
Further, any person who willfully violates the law is guilty of a misdemeanor. Any person who obtains confidential information from a provider through fraud is also guilty of a misdemeanor.