Florida Senate - 2019 (PROPOSED BILL) SPB 7048
FOR CONSIDERATION By the Committee on Children, Families, and
Elder Affairs
586-02187-19 20197048pb
1 A bill to be entitled
2 An act relating to disclosure of confidential records;
3 amending s. 394.4615, F.S.; requiring service
4 providers to disclose information from a clinical
5 record under certain circumstances relating to threats
6 to cause seriously bodily injury or death; amending s.
7 456.059, F.S.; requiring, rather than authorizing,
8 psychiatrists to disclose certain patient
9 communications for purposes of notifying potential
10 victims and law enforcement agencies of certain
11 threats; amending s. 490.0147, F.S.; requiring, rather
12 than authorizing, psychologists to disclose certain
13 patient and client communications for purposes of
14 notifying potential victims and law enforcement
15 agencies of certain threats; providing psychologists
16 with immunity from specified liability and actions
17 under certain circumstances; amending s. 491.0147,
18 F.S.; requiring, rather than authorizing, certain
19 license holders and certificate holders to disclose
20 certain patient and client communications for purposes
21 of notifying potential victims and law enforcement
22 agencies of certain threats; providing such persons
23 with immunity from specified liability and actions;
24 reenacting s. 490.009, F.S., relating to discipline of
25 psychiatrists; reenacting s. 491.009, F.S., relating
26 to discipline of psychologists; providing an effective
27 date.
28
29 Be It Enacted by the Legislature of the State of Florida:
30
31 Section 1. Present subsections (4) through (11) of section
32 394.4615, Florida Statutes, are redesignated as subsections (5)
33 through (12), respectively, a new subsection (4) is added to
34 that section, and subsection (3) of that section is amended, to
35 read:
36 394.4615 Clinical records; confidentiality.—
37 (3) Information from the clinical record must may be
38 released in the following circumstances:
39 (a) when a patient has communicated to a service provider a
40 specific threat to cause serious bodily injury or death to an
41 identified or a readily available person, if the service
42 provider reasonably believes, or should reasonably believe
43 according to the standards of his or her profession, that the
44 client has the apparent intent and ability to imminently or
45 immediately carry out such threat declared an intention to harm
46 other persons. When such communication declaration has been
47 made, the administrator must may authorize the release of
48 sufficient information to provide adequate warning to the person
49 threatened with harm by the patient and communicate the threat
50 to law enforcement.
51 (4)(a)(b) Information from the clinical record may be
52 released when the administrator of the facility or secretary of
53 the department deems release to a qualified researcher as
54 defined in administrative rule, an aftercare treatment provider,
55 or an employee or agent of the department is necessary for
56 treatment of the patient, maintenance of adequate records,
57 compilation of treatment data, aftercare planning, or evaluation
58 of programs.
59 (b) For the purpose of determining whether a person meets
60 the criteria for involuntary outpatient placement or for
61 preparing the proposed treatment plan pursuant to s. 394.4655,
62 the clinical record may be released to the state attorney, the
63 public defender or the patient’s private legal counsel, the
64 court, and to the appropriate mental health professionals,
65 including the service provider identified in s.
66 394.4655(7)(b)2., in accordance with state and federal law.
67 Section 2. Section 456.059, Florida Statutes, is amended to
68 read:
69 456.059 Communications confidential; exceptions.
70 Communications between a patient and a psychiatrist, as defined
71 in s. 394.455, shall be held confidential and may shall not be
72 disclosed except upon the request of the patient or the
73 patient’s legal representative. Provision of psychiatric records
74 and reports are shall be governed by s. 456.057. Notwithstanding
75 any other provision of this section or s. 90.503, when where:
76 (1) A patient is engaged in a treatment relationship with a
77 psychiatrist;
78 (2) Such patient has communicated to the psychiatrist a
79 specific threat to cause serious bodily injury or death to an
80 identified or a readily available person made an actual threat
81 to physically harm an identifiable victim or victims; and
82 (3) The treating psychiatrist makes a clinical judgment
83 that the patient has the apparent intent and ability to
84 imminently or immediately carry out such threat capability to
85 commit such an act and that it is more likely than not that in
86 the near future the patient will carry out that threat,
87
88 the psychiatrist shall may disclose patient communications to
89 the extent necessary to warn any potential victim or to
90 communicate the threat to a law enforcement agency. A
91 psychiatrist’s disclosure of confidential communications when
92 communicating a threat pursuant to this section may not be the
93 basis of any legal action or criminal or civil liability against
94 the psychiatrist No civil or criminal action shall be
95 instituted, and there shall be no liability on account of
96 disclosure of otherwise confidential communications by a
97 psychiatrist in disclosing a threat pursuant to this section.
98 Section 3. Section 490.0147, Florida Statutes, is amended
99 to read:
100 490.0147 Confidentiality and privileged communications.—
101 (1) Any communication between a psychologist any person
102 licensed under this chapter and her or his patient or client is
103 shall be confidential.
104 (a) This privilege may be waived under the following
105 conditions:
106 1.(1) When the psychologist person licensed under this
107 chapter is a party defendant to a civil, criminal, or
108 disciplinary action arising from a complaint filed by the
109 patient or client, in which case the waiver shall be limited to
110 that action; or.
111 2.(2) When the patient or client agrees to the waiver, in
112 writing, or when more than one person in a family is receiving
113 therapy, when each family member agrees to the waiver, in
114 writing.
115 (2) Such privilege must be waived, and the psychologist
116 shall disclose patient and client communications to the extent
117 necessary to warn any potential victim and to communicate the
118 threat to a law enforcement agency, if a patient or client has
119 communicated to the psychologist a specific threat to cause
120 serious bodily injury or death to an identified or readily
121 available person, and the psychologist makes a clinical judgment
122 that the patient or client has the apparent intent and ability
123 to imminently or immediately carry out such threat. A
124 psychologist’s disclosure of confidential communications when
125 communicating a threat pursuant to this subsection may not be
126 the basis of any legal action or criminal or civil liability
127 against the psychologist
128 (3) When there is a clear and immediate probability of
129 physical harm to the patient or client, to other individuals, or
130 to society and the person licensed under this chapter
131 communicates the information only to the potential victim,
132 appropriate family member, or law enforcement or other
133 appropriate authorities.
134 Section 4. Section 491.0147, Florida Statutes, is amended
135 to read:
136 491.0147 Confidentiality and privileged communications.—Any
137 communication between any person licensed or certified under
138 this chapter and her or his patient or client is shall be
139 confidential.
140 (1) This privilege secrecy may be waived under the
141 following conditions:
142 (a)(1) When the person licensed or certified under this
143 chapter is a party defendant to a civil, criminal, or
144 disciplinary action arising from a complaint filed by the
145 patient or client, in which case the waiver shall be limited to
146 that action.
147 (b)(2) When the patient or client agrees to the waiver, in
148 writing, or, when more than one person in a family is receiving
149 therapy, when each family member agrees to the waiver, in
150 writing.
151 (2) This privilege must be waived, and the person licensed
152 or certified under this chapter shall disclose patient and
153 client communications to the extent necessary to warn any
154 potential victim and to communicate the threat to a law
155 enforcement agency, if a patient or client has communicated to
156 such person a specific threat to cause serious bodily injury or
157 death to an identified or readily available person, and the
158 person licensed or certified under this chapter makes a clinical
159 judgment that the patient or client has the apparent intent and
160 ability to imminently or immediately carry out such threat. A
161 disclosure of confidential communications by a person licensed
162 or certified under this chapter when communicating a threat
163 pursuant to this subsection may not be the basis of any legal
164 action or criminal or civil liability against such person
165 (3) When, in the clinical judgment of the person licensed
166 or certified under this chapter, there is a clear and immediate
167 probability of physical harm to the patient or client, to other
168 individuals, or to society and the person licensed or certified
169 under this chapter communicates the information only to the
170 potential victim, appropriate family member, or law enforcement
171 or other appropriate authorities. There shall be no liability on
172 the part of, and no cause of action of any nature shall arise
173 against, a person licensed or certified under this chapter for
174 the disclosure of otherwise confidential communications under
175 this subsection.
176 Section 5. For the purpose of incorporating the amendment
177 made by this act to section 490.0147, Florida Statutes, in a
178 reference thereto, paragraph (u) of subsection (1) of section
179 490.009, Florida Statutes, is reenacted to read:
180 490.009 Discipline.—
181 (1) The following acts constitute grounds for denial of a
182 license or disciplinary action, as specified in s. 456.072(2):
183 (u) Failing to maintain in confidence a communication made
184 by a patient or client in the context of such services, except
185 as provided in s. 490.0147.
186 Section 6. For the purpose of incorporating the amendment
187 made by this act to section 491.0147, Florida Statutes, in a
188 reference thereto, paragraph (u) of subsection (1) of section
189 491.009, Florida Statutes, is reenacted to read:
190 491.009 Discipline.—
191 (1) The following acts constitute grounds for denial of a
192 license or disciplinary action, as specified in s. 456.072(2):
193 (u) Failure of the licensee, registered intern, or
194 certificateholder to maintain in confidence a communication made
195 by a patient or client in the context of such services, except
196 as provided in s. 491.0147.
197 Section 7. This act shall take effect July 1, 2019.