LOS ANGELES COUNTY
DEPARTMENT OF MENTAL HEALTH
  Policy 500.08 Uses and Disclosures of Protected Health Information Requiring an Authorization from Legal or Personal Representatives
 
  PROCEDURES
  1. Legal or Personal Representatives of Deceased Clients, Dependent Adults, and/or Minors
     
    1. If under applicable law an executor, administrator, or other person has the authority to act on behalf of a client or the client's estate, DMH shall treat such person as a representative in making decisions regarding the client's PHI.
       
    2. DMH shall verify the identity and authority of a person claiming to be the executor, administrator, or person with authority to act on behalf of the client in accordance with DMH Policy 500.06.
       
    3. After the person has been properly identified as the legal or personal representative, DMH shall obtain a signed Authorization for Use or Disclosure of Protected Health Information (MH 602) from the legal or personal representative.
       
  2. Exceptions for Personal Representatives of Deceased Clients
     
    1. DMH workforce members are permitted to disclose the PHI of a deceased client for purposes outside the scope of treatment, payment, and health care operations without an authorization from the personal representative when the disclosure of PHI is to/for:
       
      1. Coroners;
         
      2. Medical examiners;
         
      3. Law enforcement officials when there is a suspicion the client's death may have resulted from criminal conduct; and
         
      4. Approved research purposes (DMH Policy 500.05)
         
    2. If any of the above exceptions apply, DMH shall document the disclosure using the Disclosure of Protected Health Information of Deceased Client Without Authorization (MH 621).
       
  3. Exceptions for Legal Representatives of Minors
     
    1. A parent cannot act as the minor's legal representative if:
       
      1. The minor consents to health care service(s) and has not requested that any other person be treated as the legal representative;
         
      2. The minor lawfully obtains health care service(s) without the consent of a parent, a court, or another person authorized by law consents to such health care service(s); 
         
      3. The parent or guardian assents to an agreement of confidentiality between DMH and the minor with respect to health care service(s) provided; or
         
      4. Parental rights have been terminated by court order.
         
    2. If any of the exceptions set forth above apply, DMH shall obtain an Authorization for Use or Disclosure of Protected Health Information (MH 602) from the minor in accordance with DMH Policy 500.03.
       
  4. Situations Warranting Disregard of Legal or Personal Representative
     
    1. If a DMH workforce member, in their professional judgment, has a reasonable belief that a legal or personal representative does not have the best interest of the client or could be endangering the client, the following steps shall be taken:
       
      1. Notify the person claiming to be the legal or personal representative that DMH will not consider them the client's legal or personal representative.
         
      2. Immediately document the reasons why they have chosen not to consider the person as the legal or personal representative and clearly state the basis of the reasonable belief that warrants disregard of the legal or personal representative.
         
      3. Consult with the DMH HIPAA Privacy Officer (DMHHIPAAPrivacyUnit@dmh.lacounty.gov) who shall:
         
        1. Consult with the Health Information Management (HIM)
           
  5. Prior to sharing client record information, contact the DMH HIPAA Privacy Officer.