CA Court Pulls Hospital Citations Out of Hiding

     SAN FRANCISCO (CN) – California’s public-health agency redacted too much from records requested by journalists investigating mistreatment of patients at state hospitals, the California Supreme Court ruled Thursday.
     During an ongoing investigation into alleged mistreatment of mentally ill and developmentally disabled patients at state-owned hospitals, the Center for Investigative Reporting filed a public records request with the Department of Public Health in 2011 for all citations issued by the agency to the facilities under examination.
     Although the Long-Term Care Act – passed in 1973 – expressly states that citations issued by DPH are public records, the agency turned over heavily redacted copies to the journalists. It said another state law prevented it from releasing confidential information obtained while providing care to the patients which was included on the citations as required by the aforementioned act.
     The matter ended up in a Sacramento County court, which ruled that the Long-Term Care Act – passed later and containing more specifics – trumped the health-and-welfare statute called the Lanterman Act of 1967, which DPH relied on to redact the citations.
     An appeals court, believing the two laws could be harmonized to protect vulnerable patients, ordered DPH to disclose anything that did not contain what it considered to be confidential or sensitive patient information.
     But the trial court got it right, according to a ruling issued on Thursday by the California Supreme Court.
     “The Long-Term Care Act’s provisions are the later-enacted provisions, and they announce with detail and specificity the information that must be included in DPH citations in the public record,” Justice Goodwin Liu wrote for the unanimous, 7-justice panel. “Because it is both the more specific and the later-enacted statute, the Long-Term Care Act is properly construed as a limited exception to the health and welfare code’s general rule of patient and resident confidentiality. Accordingly, DPH citations issued under the Long-Term Care Act are public records and must be disclosed subject only to the specific redactions mandated by the Long-Term Care Act.”
     And those specific redactions involve only the names of patients jeopardized by the facilities’ alleged violations, to protect the patients’ privacy, the court added.
     “Thus, the Long-Term Care Act’s detailed provisions mandate the contents and public nature of DPH citations, as well as the information that must be redacted before the citations are made public,” Liu wrote. “By specifying that names must be redacted from the public copies of citations but not mentioning any other information that may be redacted, the act leaves little room for concluding that any further redaction is permitted.”
     In fact, the appeals court’s approach – while trying to balance two competing statutes and protect patients – could actually reveal a patient’s identity, the high court said.
     “The Court of Appeal’s compromise leaves in the public record enough facts for a patient or resident who was the victim of the misconduct to know that he or she is the subject of the citation,” Liu wrote. “It is hard to see how such results would protect patients from the embarrassment of seeing their suffering disclosed in the public record or advance the Long-Term Care Act’s goal of specifically and publicly identifying the full scope of a facility’s misconduct.”
     It would have also forced facilities to walk a tightrope between their obligations to protect patient privacy and publicly post the citations, the court said – potentially opening them up to “significant civil liability” if the wrong information got out.
     Accordingly, the high court ordered the appeals court to deny DPH’s challenge of the trial court’s disclose order.

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