In re Miguel M.

950 N.E.2d 107, 17 N.Y.3d 37
CourtNew York Court of Appeals
DecidedMay 10, 2011
StatusPublished
Cited by15 cases

This text of 950 N.E.2d 107 (In re Miguel M.) is published on Counsel Stack Legal Research, covering New York Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
In re Miguel M., 950 N.E.2d 107, 17 N.Y.3d 37 (N.Y. 2011).

Opinion

OPINION OF THE COURT

Smith, J.

We hold that the Privacy Rule adopted by the federal government pursuant to the Health Insurance Portability and Accountability Act (HIPAA) prohibits the disclosure of a patient’s medical records to a state agency that requests them for use in a proceeding to compel the patient to accept mental health treatment, where the patient has neither authorized the disclosure nor received notice of the agency’s request for the records.

I

Dr. Charles Barron, as designee of the New York City Department of Health and Mental Hygiene, applied for an order under Mental Hygiene Law § 9.60 requiring “assisted outpatient treatment” (ACT) for Miguel M. The petition alleged that Miguel was suffering from a mental illness; that he was unlikely to survive safely in the community without supervision; that he had a history of failing to comply with treatment; that he was unlikely to participate in necessary treatment voluntarily; and that he needed, and would benefit from, AOT to prevent a relapse or deterioration of his mental status, which would be likely to result in serious harm to Miguel or to others.

At the hearing on the petition, Barron offered in evidence records from two hospitals relating to three occasions on which Miguel was hospitalized. A witness called by Barron testified that the hospitals had furnished the records in response to a request — a request made, it is clear from the record, without [41]*41notice to Miguel. The witness acknowledged that Miguel had not authorized the release of the records, and that no court order for their disclosure had been sought or obtained.

The records were received in evidence over Miguel’s objection (Matter of M.M., 18 Misc 3d 696 [2007]), and Barron’s witness described their contents. After the hearing, Supreme Court directed that Miguel “receive and accept assisted outpatient treatment” for a period of six months. The Appellate Division affirmed (66 AD3d 51 [2009]). We granted leave to appeal (14 NY3d 712 [2010]), and now reverse.

II

The six-month duration of Supreme Court’s order expired before the Appellate Division decided this case, and the immediate controversy is therefore moot. Neither party challenges, however, the Appellate Division’s conclusion that the case presents a novel and substantial issue that is likely to recur and likely to evade review, and that therefore the exception to the rule against deciding moot disputes applies here (see Matter of Hearst Corp. v Clyne, 50 NY2d 707, 714-715 [1980]). We agree, and proceed to the merits.

Mental Hygiene Law § 9.60, known as “Kendra’s Law,” was enacted in 1999. It is named for Kendra Webdale, who was killed by a mentally ill man who pushed her off a subway platform. It says that, on a proper showing, a mentally ill person whose lack of compliance with treatment has, twice within the last 36 months, caused him or her to be hospitalized may be the subject of ACT pursuant to a plan stated in a court order (see Mental Hygiene Law § 9.60 [c], [j] [2]). Public officials identified as “directors of community services” are given the duty of enforcing Kendra’s Law (Mental Hygiene Law § 9.47 [b]), and a petition to require AOT may be filed by a director of community services or his or her designee (Mental Hygiene Law § 9.60 [e] [1] [vii]). Mental Hygiene Law § 33.13 (c) (12) permits disclosure of medical records to a director of community services who requests it in the exercise of his or her duties. Thus, the disclosure of a patient’s medical records for purposes of an AOT proceeding is permitted by state law, unless the applicable state law is preempted. Miguel argues that it is.

Miguel says that preemption is found in HIPAA (Pub L 104-191, 110 US Stat 1936 [codified in various titles of the United States Code]) and the Privacy Rule (45 CFR parts 160, 164) promulgated by the United States Department of Health and [42]*42Human Services under authority granted by HIPAA § 264 (c) (1) (see Historical and Statutory Notes following 42 USCA § 1320d-2). The Privacy Rule prohibits disclosure of an identifiable patient’s health information without the patient’s authorization, subject to certain exceptions (45 CFR 164.508 [a] [1]). HIPAA § 264 (c) (2) (see Historical and Statutory Notes following 42 USCA § 1320d-2) and the Privacy Rule (45 CFR 160.203 [b]) say that contrary state laws are preempted unless they offer privacy protections that are “more stringent” than those of the federal law; New York does not offer any more stringent protection that is relevant here. The preemption issue thus comes down to whether the disclosure of Miguel’s medical records was permitted by one of the exceptions to the Privacy Rule.

Barron relies on two exceptions, those permitting disclosure for purposes of “public health” and “treatment.” It is possible to read the language of both exceptions as covering the disclosure now at issue, but in both cases the reading is strained. Considering the apparent purposes of these two exceptions, we conclude that neither fits these facts.

The public health exception permits disclosure of protected information to:

“A public health authority that is authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury, or disability, including, but not limited to, the reporting of disease, injury, vital events such as birth or death, and the conduct of public health surveillance, public health investigations, and public health interventions” (45 CFR 164.512 [b] [1] [i]).

Barron reasons that disclosure of a mentally ill person’s hospital records for purposes of requiring that person to accept ACT protects the public health, because mentally ill people might kill or injure other people — like Kendra Webdale — who, of course, are members of the public. Thus Barron, a person designated to enforce Kendra’s Law, would be a “public health authority,” collecting information for the “purpose of preventing . . . injury,” and his action to require ACT in Miguel’s case could be called a public health intervention. We are not convinced, however, that the authors of the Privacy Rule meant “public health” in this literal, but counterintuitive, sense.

The apparent purpose of the public health exception is to facilitate government activities that protect large numbers of [43]*43people from epidemics, environmental hazards, and the like, or that advance public health by accumulating valuable statistical information. To disclose private information about particular people, for the purpose of preventing those people from harming themselves or others, effects a very substantial invasion of privacy without the sort of generalized public benefit that would come from, for example, tracing the course of an infectious disease. The disclosure to Barron of Miguel’s hospital records was not within the scope of the public health exception.

The treatment exception permits disclosure of protected health information “for treatment activities of a health care provider” (45 CFR 164.506 [c] [2]).

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Cite This Page — Counsel Stack

Bluebook (online)
950 N.E.2d 107, 17 N.Y.3d 37, Counsel Stack Legal Research, https://law.counselstack.com/opinion/in-re-miguel-m-ny-2011.