Calif. Agency Must Turn Over Facility Citations

     SACRAMENTO (CN) – California’s Department of Public Health must turn over citations it issued to state-run facilities treating people with mental illness or developmental disabilities, an appeals court ruled.
     The Center for Investigative Reporting filed a Public Records Act request in 2011, seeking copies of citations issued to seven of the state’s residential facilities for violations of patient care standards. Although the news agency sought records going back to 2002, the Department of Public Health answered that it was only required to keep citations for four years.
     The agency also noted at the time that any records it produced would be heavily redacted as required by the Lanterman Developmental Disabilities Services Act. Eventually, it turned over 55 citations from 2007 to 2011 but removed most of the factual information – including facility names and specific reasons for the citations.
     Center for Investigative Reporting then filed a petition in Sacramento Superior Court, arguing that another piece of legislation – 1973’s Long-Term Care, Health, Safety and Security Act – mandated the release of unredacted or minimally redacted citations in response to a PRA request. The Long-Term Care Act requires that citations of health care facilities be publicly available, minus the names of patients and facility employees.
     The trial court found that “where mental health records are involved, there is an irreconcilable conflict between the Lanterman Act’s confidentiality provisions and the Long-Term Care Act’s accessibility provisions.” However, the court concluded that lawmakers intended that accessibility prevail over confidentiality and ordered Public Health to turn over the records.
     In a review prompted by Public Health, the Sacramento panel of the Third Appellate District agreed that the two laws conflict but noted that in such cases “we strive to effectuate the purpose of each by harmonizing them in a way that allows both to be given effect.”
     At the outset, however, the panel rejected Public Health’s argument that while the Long-Term Care Act authorizes PRA requests subject to limitations set forth in the PRA, the Lanterman Act invokes those limitations through its confidentiality requirement.
     “The problem with this argument is that it uses the Long-Term Care Act to defeat the Long-Term Care Act with respect to the mentally ill and the developmentally disabled,” Judge M. Kathleen Butz wrote for the panel. “Public Health’s argument uses one of the Long-Term Care Act’ public accessibility provisions – PRA requests – to foreclose, almost completely, public accessibility to Long-Term Care Act citations issued to state facilities housing the mentally ill and the developmentally disabled. In making this argument Public Health notes that, since nearly everything that happens to a patient in one of the state facilities at issue happens ‘in the course of providing services’ to that patient, the Lanterman Act’s general confidentiality rule conceivably applies to nearly all patient-related mental health records. Through this argument, Public Health completes a hat trick of public oversight denial, by effectively nullifying the public accessibility of Long-Term Care Act citations via facility posting, public request, and PRA request; and Public Health does so in the context of one of the most vulnerable populations protected by the Long-Term Care Act.”
     Butz said that while the two statutes protect the same population – those with mental illness or developmental disabilities – they come from opposite directions. While the Lanterman Act seeks to protect patients through confidentiality, the Long-Term Care Act uses transparency to raise awareness of patient care standards and publicly shames violators.

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