75th OREGON LEGISLATIVE ASSEMBLY--2009 Regular Session
SA to B-Eng. HB 2345 (A to RC)
LC 1153/HB 2345-B12
SENATE AMENDMENTS TO
B-ENGROSSED HOUSE BILL 2345
(INCLUDING AMENDMENTS TO RESOLVE CONFLICTS)
By COMMITTEE ON RULES
June 15
On page 1 of the printed B-engrossed bill, line 2, after ' ORS'
insert '179.505,'.
In line 3, after '687.081' insert 'and section 50, chapter ___,
Oregon Laws 2009 (Enrolled Senate Bill 177)'.
In line 5, after '689.356' insert 'and section 2, chapter ___,
Oregon Laws 2009 (Enrolled Senate Bill 177)'.
On page 2, line 15, delete 'one business day' and insert '
three business days'.
In line 32, after the second comma insert 'the monitoring
entity established under section 1c of this 2009 Act,'.
In line 33, after 'with' insert 'ORS 179.505 and'.
On page 3, line 25, after 'board,' insert 'the monitoring
entity established under section 1c of this 2009 Act,'.
In line 26, after 'with' insert 'ORS 179.505 and'.
In line 29, after '(c)' insert 'Based on an individualized
assessment,'.
On page 4, line 2, delete 'one business day' and insert ' three
business days'.
In line 8, after 'not' insert ', to the best of the licensee's
knowledge,'.
In line 10, after the second 'licensee' insert ', to the best
of the licensee's knowledge,'.
After line 41, insert:
' (3) The weekly lists submitted by the impaired health
professional program under section 1b of this 2009 Act are exempt
from disclosure under public records law.'.
In line 42, delete '(3)' and insert '(4)'.
In line 45, delete '(4)' and insert '(5)'.
On page 5, line 5, delete '(5)' and insert '(6)'.
On page 12, after line 6, insert:
' { + SECTION 12. + } ORS 179.505 is amended to read:
' 179.505. (1) As used in this section:
' (a) 'Disclosure' means the release of, transfer of, provision
of access to or divulgence in any other manner of information
outside the health care services provider holding the
information.
' (b) 'Health care services provider' means:
' (A) Medical personnel or other staff employed by or under
contract with a public provider to provide health care or
maintain written accounts of health care provided to individuals;
or
' (B) Units, programs or services designated, operated or
maintained by a public provider to provide health care or
maintain written accounts of health care provided to individuals.
' (c) 'Individually identifiable health information' means any
health information that is:
' (A) Created or received by a health care services provider;
and
' (B) Identifiable to an individual, including demographic
information that identifies the individual, or for which there is
a reasonable basis to believe the information can be used to
identify an individual, and that relates to:
' (i) The past, present or future physical or mental health or
condition of an individual;
' (ii) The provision of health care to an individual; or
' (iii) The past, present or future payment for the provision
of health care to an individual.
' (d) 'Personal representative' includes but is not limited to:
' (A) A person appointed as a guardian under ORS 125.305,
419B.370, 419C.481 or 419C.555 with authority to make medical and
health care decisions;
' (B) A person appointed as a health care representative under
ORS 127.505 to 127.660 or a representative under ORS 127.700 to
127.737 to make health care decisions or mental health treatment
decisions; and
' (C) A person appointed as a personal representative under ORS
chapter 113.
' (e) 'Psychotherapy notes' means notes recorded in any medium:
' (A) By a mental health professional, in the performance of
the official duties of the mental health professional;
' (B) Documenting or analyzing the contents of conversation
during a counseling session; and
' (C) That are maintained separately from the rest of the
individual's record.
' (f) 'Psychotherapy notes' does not mean notes documenting:
' (A) Medication prescription and monitoring;
' (B) Counseling session start and stop times;
' (C) Modalities and frequencies of treatment furnished;
' (D) Results of clinical tests; or
' (E) Any summary of the following items:
' (i) Diagnosis;
' (ii) Functional status;
' (iii) Treatment plan;
' (iv) Symptoms;
' (v) Prognosis; or
' (vi) Progress to date.
' (g) 'Public provider' means:
' (A) The state institutions for the care and treatment of
individuals with mental illness or developmental disabilities
operated by the Department of Human Services;
' (B) Department of Corrections institutions as defined in ORS
421.005;
' (C) A contractor of the Department of Human Services or the
Department of Corrections that provides health care to
individuals residing in a state institution operated by the
Department of Human Services or the Department of Corrections;
' (D) A community mental health and developmental disabilities
program as described in ORS 430.610 to 430.695 and the public and
private entities with which it contracts to provide mental health
or developmental disabilities programs or services;
' (E) A program or service provided under ORS 431.250, 431.375
to 431.385 or 431.416;
' (F) A program or service licensed, approved, established,
maintained or operated by or contracted with the Department of
Human Services under ORS 430.630 for individuals with
developmental disabilities and individuals with mental or
emotional disturbances;
' (G) A program or facility providing an organized full-day or
part-day program of treatment that is licensed, approved,
established, maintained or operated by or contracted with the
Department of Human Services for alcoholism, drug addiction or
mental or emotional disturbance; { - or - }
' (H) A program or service providing treatment by appointment
that is licensed, approved, established, maintained or operated
by or contracted with the Department of Human Services for
alcoholism, drug addiction or mental or emotional disturbance
{ - . - } { + ; or
' (I) The impaired health professional program established
under section 1b of this 2009 Act. + }
' (h) 'Written account' means records containing only
individually identifiable health information.
' (2) Except as provided in subsections (3), (4), (6), (7),
(8), (9), (11), (12), (14), (15), (16) and (17) of this section
or unless otherwise permitted or required by state or federal law
or by order of the court, written accounts of the individuals
served by any health care services provider maintained in or by
the health care services provider by the officers or employees
thereof who are authorized to maintain written accounts within
the official scope of their duties are not subject to access and
may not be disclosed. This subsection applies to written accounts
maintained in or by facilities of the Department of Corrections
only to the extent that the written accounts concern the medical,
dental or psychiatric treatment as patients of those under the
jurisdiction of the Department of Corrections.
' (3) If the individual or a personal representative of the
individual provides an authorization, the content of any written
account referred to in subsection (2) of this section must be
disclosed accordingly, if the authorization is in writing and is
signed and dated by the individual or the personal representative
of the individual and sets forth with specificity the following:
' (a) Name of the health care services provider authorized to
make the disclosure, except when the authorization is provided by
recipients of or applicants for public assistance to a
governmental entity for purposes of determining eligibility for
benefits or investigating for fraud;
' (b) Name or title of the persons or organizations to which
the information is to be disclosed or that information may be
disclosed to the public;
' (c) Name of the individual;
' (d) Extent or nature of the information to be disclosed; and
' (e) Statement that the authorization is subject to revocation
at any time except to the extent that action has been taken in
reliance thereon, and a specification of the date, event or
condition upon which it expires without express revocation.
However, a revocation of an authorization is not valid with
respect to inspection or records necessary to validate
expenditures by or on behalf of governmental entities.
' (4) The content of any written account referred to in
subsection (2) of this section may be disclosed without an
authorization:
' (a) To any person to the extent necessary to meet a medical
emergency.
' (b) At the discretion of the responsible officer of the
health care services provider, which in the case of any
Department of Human Services facility or community mental health
and developmental disabilities program shall be the Director of
Human Services, to persons engaged in scientific research,
program evaluation, peer review and fiscal audits. However,
individual identities may not be disclosed to such persons,
except when the disclosure is essential to the research,
evaluation, review or audit and is consistent with state and
federal law.
' (c) To governmental agencies when necessary to secure
compensation for services rendered in the treatment of the
individual.
' (5) When an individual's identity is disclosed under
subsection (4) of this section, a health care services provider
shall prepare, and include in the permanent records of the health
care services provider, a written statement indicating the
reasons for the disclosure, the written accounts disclosed and
the recipients of the disclosure.
' (6) The content of any written account referred to in
subsection (2) of this section and held by a health care services
provider currently engaged in the treatment of an individual may
be disclosed to officers or employees of that provider, its
agents or cooperating health care services providers who are
currently acting within the official scope of their duties to
evaluate treatment programs, to diagnose or treat or to assist in
diagnosing or treating an individual when the written account is
to be used in the course of diagnosing or treating the
individual. Nothing in this subsection prevents the transfer of
written accounts referred to in subsection (2) of this section
among health care services providers, the Department of Human
Services, the Department of Corrections or a local correctional
facility when the transfer is necessary or beneficial to the
treatment of an individual.
' (7) When an action, suit, claim, arbitration or proceeding is
brought under ORS 34.105 to 34.240 or 34.310 to 34.730 and
involves a claim of constitutionally inadequate medical care,
diagnosis or treatment, or is brought under ORS 30.260 to 30.300
and involves the Department of Corrections or an institution
operated by the department, nothing in this section prohibits the
disclosure of any written account referred to in subsection (2)
of this section to the Department of Justice, Oregon Department
of Administrative Services, or their agents, upon request, or the
subsequent disclosure to a court, administrative hearings
officer, arbitrator or other administrative decision maker.
' (8)(a) When an action, suit, claim, arbitration or proceeding
involves the Department of Human Services or an institution
operated by the department, nothing in this section prohibits the
disclosure of any written account referred to in subsection (2)
of this section to the Department of Justice, Oregon Department
of Administrative Services, or their agents.
' (b) Disclosure of information in an action, suit, claim,
nonlabor arbitration or proceeding is limited by the relevancy
restrictions of ORS 40.010 to 40.585, 183.710 to 183.725, 183.745
and 183.750 and ORS chapter 183. Only written accounts of a
plaintiff, claimant or petitioner shall be disclosed under this
paragraph.
' (c) Disclosure of information as part of a labor arbitration
or proceeding to support a personnel action taken against staff
is limited to written accounts directly relating to alleged
action or inaction by staff for which the personnel action was
imposed.
' (9)(a) The copy of any written account referred to in
subsection (2) of this section, upon written request of the
individual or a personal representative of the individual, shall
be disclosed to the individual or the personal representative of
the individual within a reasonable time not to exceed five
working days. The individual or the personal representative of
the individual shall have the right to timely access to any
written accounts.
' (b) If the disclosure of psychiatric or psychological
information contained in the written account would constitute an
immediate and grave detriment to the treatment of the individual,
disclosure may be denied, if medically contraindicated by the
treating physician or a licensed health care professional in the
written account of the individual.
' (c) The Department of Corrections may withhold psychiatric or
psychological information if:
' (A) The information relates to an individual other than the
individual seeking it.
' (B) Disclosure of the information would constitute a danger
to another individual.
' (C) Disclosure of the information would compromise the
privacy of a confidential source.
' (d) However, a written statement of the denial under
paragraph (c) of this subsection and the reasons therefor must be
entered in the written account.
' (10) A health care services provider may require a person
requesting disclosure of the contents of a written account under
this section to reimburse the provider for the reasonable costs
incurred in searching files, abstracting if requested and copying
if requested. However, an individual or a personal representative
of the individual may not be denied access to written accounts
concerning the individual because of inability to pay.
' (11) A written account referred to in subsection (2) of this
section may not be used to initiate or substantiate any criminal,
civil, administrative, legislative or other proceedings conducted
by federal, state or local authorities against the individual or
to conduct any investigations of the individual. If the
individual, as a party to an action, suit or other judicial
proceeding, voluntarily produces evidence regarding an issue to
which a written account referred to in subsection (2) of this
section would be relevant, the contents of that written account
may be disclosed for use in the proceeding.
' (12) Information obtained in the course of diagnosis,
evaluation or treatment of an individual that, in the
professional judgment of the health care services provider,
indicates a clear and immediate danger to others or to society
may be reported to the appropriate authority. A decision not to
disclose information under this subsection does not subject the
provider to any civil liability. Nothing in this subsection may
be construed to alter the provisions of ORS 146.750, 146.760,
419B.010, 419B.015, 419B.020, 419B.025, 419B.030, 419B.035,
419B.040 and 419B.045.
' (13) The prohibitions of this section apply to written
accounts concerning any individual who has been treated by any
health care services provider irrespective of whether or when the
individual ceases to receive treatment.
' (14) Persons other than the individual or the personal
representative of the individual who are granted access under
this section to the contents of a written account referred to in
subsection (2) of this section may not disclose the contents of
the written account to any other person except in accordance with
the provisions of this section.
' (15) Nothing in this section prevents the Department of Human
Services from disclosing the contents of written accounts in its
possession to individuals or agencies with whom children in its
custody are placed.
' (16) The system described in ORS 192.517 (1) shall have
access to records, as defined in ORS 192.515, as provided in ORS
192.517.
' (17)(a) Except as provided in paragraph (b) of this
subsection, a health care services provider must obtain an
authorization from an individual or a personal representative of
the individual to disclose psychotherapy notes.
' (b) A health care services provider may use or disclose
psychotherapy notes without obtaining an authorization from the
individual or a personal representative of the individual to
carry out the following treatment, payment and health care
operations:
' (A) Use by the originator of the psychotherapy notes for
treatment;
' (B) Disclosure by the health care services provider for its
own training program in which students, trainees or practitioners
in mental health learn under supervision to practice or improve
their skills in group, joint, family or individual counseling; or
' (C) Disclosure by the health care services provider to defend
itself in a legal action or other proceeding brought by the
individual or a personal representative of the individual.
' (c) An authorization for the disclosure of psychotherapy
notes may not be combined with an authorization for a disclosure
of any other individually identifiable health information, but
may be combined with another authorization for a disclosure of
psychotherapy notes.'.
In line 7, delete '12' and insert '13'.
In line 11, delete '13' and insert '14'.
After line 12, insert:
' { + SECTION 15. + } { + If Senate Bill 177 becomes law,
section 3 of this 2009 Act (amending ORS 675.510) is repealed and
ORS 675.510, as amended by section 1, chapter ___, Oregon Laws
2009 (Enrolled Senate Bill 177), is amended to read: + }
' 675.510. As used in ORS 675.510 to 675.600, unless the
context requires otherwise:
' (1) 'Authorization to practice regulated social work' means a
certificate or license issued by the State Board of Licensed
Social Workers under ORS 675.510 to 675.600.
' (2) 'Clinical social work' means the professional practice of
applying principles and methods with individuals, couples,
families, children and groups, which include, but are not
restricted to:
' (a) Providing diagnostic, preventive and treatment services
of a psychosocial nature pertaining to personality adjustment,
behavior problems, interpersonal dysfunctioning or
deinstitutionalization;
' (b) Developing a psychotherapeutic relationship to employ a
series of problem solving techniques for the purpose of removing,
modifying, or retarding disrupted patterns of behavior, and for
promoting positive personality growth and development;
' (c) Counseling and the use of psychotherapeutic techniques,
such as disciplined interviewing which is supportive, directive
or insight oriented depending upon diagnosed problems,
observation and feedback, systematic analysis, and
recommendations;
' (d) Modifying internal and external conditions that affect a
client's behavior, emotions, thinking, or intrapersonal
processes;
' (e) Explaining and interpreting the psychosocial dynamics of
human behavior to facilitate problem solving; and
' (f) Supervising, administering or teaching clinical social
work practice.
' { - (3) 'Impaired clinical social worker' means a person who
is unable to perform the practice of clinical social work by
reason of mental illness, physical illness or alcohol or other
drug abuse. - }
' { - (4) - } { + (3) + } 'Regulated social worker' means a
clinical social work associate certified under ORS 675.537 or a
clinical social worker licensed under ORS 675.530.
' { - (5) - } { + (4) + } 'Unprofessional conduct' includes,
but is not limited to, any conduct or practice contrary to
recognized standards of ethics of the social work profession or
any conduct that constitutes or might constitute a danger to the
health or safety of a client or the public or in any other manner
fails or might fail to adhere to the recognized standards of the
profession.
' { + SECTION 16. + } { + If Senate Bill 177 becomes law,
section 2, chapter ___, Oregon Laws 2009 (Enrolled Senate Bill
177) (amending ORS 675.510), is repealed and ORS 675.510, as
amended by section 1, chapter ___, Oregon Laws 2009 (Enrolled
Senate Bill 177), and section 15 of this 2009 Act, is amended to
read: + }
' 675.510. As used in ORS 675.510 to 675.600, unless the
context requires otherwise:
' (1) 'Authorization to practice regulated social work' means a
certificate or license issued by the State Board of Licensed
Social Workers under ORS 675.510 to 675.600.
' (2) 'Clinical social work' means the professional practice of
applying principles and methods with individuals, couples,
families, children and groups, which include, but are not
restricted to:
' (a) Providing diagnostic, preventive and treatment services
of a psychosocial nature pertaining to personality adjustment,
behavior problems, interpersonal dysfunctioning or
deinstitutionalization;
' (b) Developing a psychotherapeutic relationship to employ a
series of problem solving techniques for the purpose of removing,
modifying, or retarding disrupted patterns of behavior, and for
promoting positive personality growth and development;
' (c) Counseling and the use of psychotherapeutic techniques,
such as disciplined interviewing which is supportive, directive
or insight oriented depending upon diagnosed problems,
observation and feedback, systematic analysis, and
recommendations;
' (d) Modifying internal and external conditions that affect a
client's behavior, emotions, thinking, or intrapersonal
processes;
' (e) Explaining and interpreting the psychosocial dynamics of
human behavior to facilitate problem solving; and
' (f) Supervising, administering or teaching clinical social
work practice.
' (3) 'Regulated social worker' means a { + baccalaureate
social worker registered under section 6, chapter ___, Oregon
Laws 2009 (Enrolled Senate Bill 177), a master's social worker
licensed under section 7, chapter ___, Oregon Laws 2009 (Enrolled
Senate Bill 177), a + } clinical social work associate certified
under ORS 675.537 or a clinical social worker licensed under ORS
675.530.
' (4) 'Unprofessional conduct' includes, but is not limited to,
any conduct or practice contrary to recognized standards of
ethics of the social work profession or any conduct that
constitutes or might constitute a danger to the health or safety
of a client or the public or in any other manner fails or might
fail to adhere to the recognized standards of the profession.
' { + SECTION 17. + } If Senate Bill 177 becomes law, section
50, chapter ___, Oregon Laws 2009 (Enrolled Senate Bill 177), is
amended to read:
' { + Sec. 50. + } Sections 4a, 6, 7, 12a and 12b { + ,
chapter ___, Oregon Laws 2009 (Enrolled Senate Bill 177), + }
{ - of this 2009 Act - } and the amendments to ORS 675.510 and
675.530 by { + section 16 of this 2009 Act and section 9,
chapter ___, Oregon Laws 2009 (Enrolled Senate Bill 177), + }
{ - sections 2 and 9 of this 2009 Act - } become operative on
January 1, 2011.
' { + SECTION 18. + } { + If Senate Bill 177 becomes law and
House Bill 2059 does not become law, section 4 of this 2009 Act
(amending ORS 675.583) is repealed and ORS 675.583, as amended by
section 18, chapter ___, Oregon Laws 2009 (Enrolled Senate Bill
177), is amended to read: + }
' 675.583. (1) A regulated social worker shall report to the
State Board of Licensed Social Workers any information the
regulated social worker has that appears to show that a regulated
social worker is or may be an impaired { - social worker - }
{ + professional as defined in section 1 of this 2009 Act + },
or may have engaged in unprofessional conduct according to the
guidelines of the code of ethics, to the extent that disclosure
does not conflict with the requirements of ORS 675.580.
' (2) Notwithstanding ORS 676.175, any information that the
board obtains pursuant to subsection (1) of this section is
confidential and may not be disclosed except as provided by the
board by rule.
' (3) A person who reports or provides information to the board
under subsection (1) of this section in good faith is not subject
to an action for civil damages as a result { - thereof - }
{ + of reporting or providing information to the board + }.
' { + SECTION 19. + } { + If both House Bill 2059 and Senate
Bill 177 become law, section 4 of this 2009 Act (amending ORS
675.583) is repealed and ORS 675.583, as amended by section 18,
chapter ___, Oregon Laws 2009 (Enrolled Senate Bill 177), and
section 38, chapter ___, Oregon Laws 2009 (Enrolled House Bill
2059), is amended to read: + }
' 675.583. (1) Unless state or federal laws relating to
confidentiality or the protection of health information prohibit
disclosure, a regulated social worker shall report to the State
Board of Licensed Social Workers any information the regulated
social worker has that appears to show that a regulated social
worker is or may be an impaired { - social worker - } { +
professional as defined in section 1 of this 2009 Act + }, or may
have engaged in unprofessional conduct according to the
guidelines of the code of ethics, to the extent that disclosure
does not conflict with the requirements of ORS 675.580.
' (2) A regulated social worker shall report any prohibited
conduct as defined in section 1 { + , chapter ___, Oregon Laws
2009 (Enrolled House Bill 2059), + } { - of this 2009 Act - }
in the manner provided in section 1 { + , chapter ___, Oregon
Laws 2009 (Enrolled House Bill 2059) + } { - of this 2009
Act - } .
' (3) Notwithstanding ORS 676.175, any information that the
board obtains pursuant to subsection (1) of this section is
confidential and may not be disclosed except as provided by the
board by rule.
' (4) A person who reports or provides information to the board
under subsection (1) of this section in good faith is not subject
to an action for civil damages as a result { - thereof - }
{ + of reporting or providing information to the board + }.
' { + SECTION 20. + } { + If Senate Bill 177 becomes law,
section 5 of this 2009 Act (amending ORS 675.600) is repealed and
ORS 675.600, as amended by section 23, chapter ___, Oregon Laws
2009 (Enrolled Senate Bill 177), is amended to read: + }
' 675.600. (1) The State Board of Licensed Social Workers
shall:
' (a) Pursuant to ORS chapter 183, { - make - } { +
adopt + } rules necessary to carry out the provisions of ORS
675.510 to 675.600.
' (b) Publish annually a list of the names and addresses of all
persons who have been authorized to practice regulated social
work.
' { - (c) Establish a program for impaired social workers to
assist regulated social workers to regain or retain their
authorizations to practice regulated social work and impose the
requirement of participation as a condition to reissuance or
retention of the authorization. - }
' { - (d) - } { + (c) + } Establish a voluntary arbitration
procedure that may be invoked with the consent of clients and
regulated social workers whereby disputes between clients and
workers may be resolved.
' { - (e) - } { + (d) + } Report to the Legislative Assembly
on its activities regarding authorizations to practice regulated
social work during the preceding biennium.
' (2) The board may appoint an administrator who may not be a
member of the board. The board shall fix the compensation for the
administrator.
' { - (3) Any information obtained by the board as part of the
impaired social workers program is confidential and may not be
disclosed except as provided by the board by rule. - } '.
In line 13, delete '14' and insert '21' and after 'ORS ' insert
'179.505,'.
In line 14, delete '11' and insert '12, 15 and 18 to 20'.
In line 16, delete '13' and insert '14'.
In line 23, delete '15' and insert '22' and after 'ORS ' insert
'179.505,'.
In line 25, delete '11' and insert '12, 15 and 18 to 20'.
In line 27, delete '13' and insert '14'.
Delete lines 37 through 42 and insert:
' { + SECTION 23. + } { + (1) Before the operative date
specified in section 22 of this 2009 Act, the Department of Human
Services and the health profession licensing boards that opt to
participate in the impaired health professional program
established under section 1b of this 2009 Act shall collaborate
to transfer existing impaired professional programs and funding,
and licensees who are subject to existing impaired professional
programs, to the impaired health professional program established
under section 1b of this 2009 Act.
' (2) When a licensee is transferred to the impaired health
professional program established under section 1b of this 2009
Act pursuant to subsection (1) of this section, the program shall
honor the terms of the licensee's existing diversion agreement if
the terms of the agreement are consistent with the requirements
of section 1b of this 2009 Act. If the terms of the licensee's
existing diversion agreement are not consistent with the
requirements of section 1b of this 2009 Act, the diversion
agreement entered into by the program and the licensee must
comply with section 1b of this 2009 Act.
' (3) When a licensee who self-referred to an impaired
professional program before the effective date of this 2009 Act
is transferred to the impaired health professional program
established under section 1b of this 2009 Act pursuant to
subsection (1) of this section:
' (a) The program may not disclose the licensee's enrollment in
the program to the licensee's board unless the licensee:
' (A) Ceases to participate in the program before completing
the program; or
' (B) Engages in substantial noncompliance as described in
section 1b (1)(f)(A) to (H) of this 2009 Act.
' (b) The program may not disclose the licensee's successful
completion of the program to the licensee's board. + } ' .
In line 43, delete '16' and insert '24' and delete '12 ' and
insert '13'.
In line 44, delete '17' and insert '25'.
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