House File 448 - Introduced




                                 HOUSE FILE       
                                 BY  COMMITTEE ON HUMAN
                                     RESOURCES

                                 (SUCCESSOR TO HF 231)

                                      A BILL FOR

  1 An Act relating to confidential communications between an
  2    emergency medical care provider and a patient.
  3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA:
    TLSB 1431HV (1) 86
    jh/nh

PAG LIN



  1  1    Section 1.  Section 232.96, subsection 5, Code 2015, is
  1  2 amended by striking the subsection and inserting in lieu
  1  3 thereof the following:
  1  4    5.  Sections 622.9 and 622.10 and any other statute or rule
  1  5 of evidence which excludes or makes privileged the testimony
  1  6 of a husband or wife against the other or the testimony of
  1  7 a health practitioner or mental health professional as to
  1  8 confidential communications do not apply to evidence at an
  1  9 adjudicatory hearing.
  1 10    Sec. 2.  Section 622.10, subsections 1, 2, 3, and 5, Code
  1 11 2015, are amended to read as follows:
  1 12    1.  A practicing attorney, counselor, physician, surgeon,
  1 13 physician assistant, advanced registered nurse practitioner
  1 14  health practitioner, mental health professional, or the
  1 15 stenographer or confidential clerk of any such person, who
  1 16 obtains information by reason of the person's employment,
  1 17 or a member of the clergy shall not be allowed, in giving
  1 18 testimony, to disclose any confidential communication properly
  1 19 entrusted to the person in the person's professional capacity,
  1 20 and necessary and proper to enable the person to discharge the
  1 21 functions of the person's office according to the usual course
  1 22 of practice or discipline.
  1 23    2.  The prohibition does not apply to cases where the
  1 24 person in whose favor the prohibition is made waives the
  1 25 rights conferred; nor does the prohibition apply to physicians
  1 26 or surgeons, physician assistants, advanced registered
  1 27 nurse practitioners health practitioners, mental health
  1 28 professionals, or to the stenographer or confidential clerk
  1 29 of any physicians or surgeons, physician assistants, advanced
  1 30 registered nurse practitioners, or mental health professionals
  1 31  such person, in a civil action in which the condition of the
  1 32 person in whose favor the prohibition is made is an element
  1 33 or factor of the claim or defense of the person or of any
  1 34 party claiming through or under the person. The evidence is
  1 35 admissible upon trial of the action only as it relates to the
  2  1 condition alleged.
  2  2    3.  a.  In a civil action in which the condition of the
  2  3 plaintiff in whose favor the prohibition is made is an element
  2  4 or factor of the claim or defense of the adverse party or of
  2  5 any party claiming through or under the adverse party, the
  2  6 adverse party shall make a written request for records relating
  2  7 to the condition alleged upon the plaintiff's attorney for a
  2  8 legally sufficient patient's waiver under federal and state
  2  9 law. Upon receipt of a written request, the plaintiff shall
  2 10 execute a legally sufficient patient's waiver and release it
  2 11 to the adverse party making the request within sixty days of
  2 12 receipt of the written request. The patient's waiver may
  2 13 require a physician or surgeon, physician assistant, advanced
  2 14 registered nurse practitioner, health practitioner or mental
  2 15 health professional to do all of the following:
  2 16    (1)  Provide a complete copy of the patient's records
  2 17 including but not limited to any reports or diagnostic imaging
  2 18 relating to the condition alleged.
  2 19    (2)  Consult with the attorney for the adverse party prior
  2 20 to providing testimony regarding the plaintiff's medical
  2 21 history and the condition alleged and opinions regarding health
  2 22 etiology and prognosis for the condition alleged subject to the
  2 23 limitations in paragraphs "c" and "e".
  2 24    b.  If a plaintiff fails to sign a waiver within the
  2 25 prescribed time period, the court may order disclosure or
  2 26 compliance. The failure of a party to comply with the court's
  2 27 order may be grounds for dismissal of the action or any other
  2 28 relief authorized under the rules of civil procedure.
  2 29    c.  Any physician or surgeon, physician assistant, advanced
  2 30 registered nurse practitioner, health practitioner or mental
  2 31 health professional who provides records, provides information
  2 32 during consultation, or otherwise responds in good faith to a
  2 33 request pursuant to paragraph "a" shall be immune with respect
  2 34 to all civil or criminal penalties, claims, or actions of any
  2 35 kind with respect to this section.
  3  1    d.  Any physician or surgeon, physician assistant, advanced
  3  2 registered nurse practitioner, health practitioner or mental
  3  3 health professional who provides records or consults with the
  3  4 attorney for any party shall be entitled to charge a reasonable
  3  5 fee for production of the records, diagnostic imaging,
  3  6 and consultation. Any party seeking consultation shall be
  3  7 responsible for payment of all charges. The fees for copies of
  3  8 any records shall be as specified in subsection 6.
  3  9    e.  Defendant's The defendant's counsel shall provide
  3 10 a written notice to the plaintiff's attorney in a manner
  3 11 consistent with the Iowa rules of civil procedure providing for
  3 12 notice of deposition at least ten days prior to any meeting
  3 13 with the plaintiff's physician or surgeon, physician assistant,
  3 14 advanced registered nurse practitioner, health practitioner
  3 15  or mental health professional. Plaintiff's The plaintiff's
  3 16  attorney has the right to be present at all such meetings, or
  3 17 participate in telephonic communication with the physician
  3 18 or surgeon, physician assistant, advanced registered nurse
  3 19 practitioner, health practitioner or mental health professional
  3 20 and the attorney for the defendant. Prior to scheduling
  3 21 any meeting or engaging in any communication with the
  3 22 physician or surgeon, physician assistant, advanced registered
  3 23 nurse practitioner, health practitioner or mental health
  3 24 professional, the attorney for the defendant shall confer with
  3 25 the plaintiff's attorney to determine a mutually convenient
  3 26 date and time for such meeting or telephonic communication.
  3 27 Plaintiff's The plaintiff's attorney may seek a protective
  3 28 order structuring all communication by making application to
  3 29 the court at any time.
  3 30    f.  The provisions of this subsection do not apply to actions
  3 31 or claims brought pursuant to chapter 85, 85A, or 85B.
  3 32    5.  If an adverse party desires either to call as a
  3 33 witness at the trial of the action or the oral deposition,
  3 34 either discovery or evidentiary, of a physician or surgeon,
  3 35 physician assistant, advanced registered nurse practitioner,
  4  1  health practitioner or mental health professional to which
  4  2 the prohibition would otherwise apply, or the stenographer
  4  3 or confidential clerk of a physician or surgeon, physician
  4  4 assistant, advanced registered nurse practitioner, or mental
  4  5 health professional or desires to call a physician or surgeon,
  4  6 physician assistant, advanced registered nurse practitioner,
  4  7 or mental health professional to which the prohibition would
  4  8 otherwise apply or the stenographer or confidential clerk of a
  4  9 physician or surgeon, physician assistant, advanced registered
  4 10 nurse practitioner, or mental health professional as a witness
  4 11 at the trial of the action any such person, the adverse party
  4 12 shall file an application with the court for permission to
  4 13 do so. The court upon hearing, which shall not be ex parte,
  4 14 shall grant permission unless the court finds that the evidence
  4 15 sought does not relate to the condition alleged. At the
  4 16 request of any party or at the request of the deponent, the
  4 17 court shall fix a reasonable fee to be paid to a physician
  4 18 or surgeon, physician assistant, advanced registered nurse
  4 19 practitioner, health practitioner or mental health professional
  4 20 by the party taking the deposition or calling the witness.
  4 21    Sec. 3.  Section 622.10, subsection 6, paragraph e,
  4 22 subparagraph (2), Code 2015, is amended to read as follows:
  4 23    (2)  "Provider" means any physician or surgeon, physician
  4 24 assistant, advanced registered nurse practitioner health
  4 25 practitioner, mental health professional, hospital, nursing
  4 26 home, or other person, entity, facility, or organization that
  4 27 furnishes, bills, or is paid for health care in the normal
  4 28 course of business.
  4 29    Sec. 4.  Section 622.10, subsection 7, Code 2015, is amended
  4 30 to read as follows:
  4 31    7.  For the purposes of this section, "mental health
  4 32 professional":
  4 33    a.  "Emergency medical care provider" means the same as
  4 34 defined in section 147A.1.
  4 35    b.  "Health practitioner" means a physician, surgeon,
  5  1 physician assistant, advanced registered nurse practitioner, or
  5  2 emergency medical care provider.
  5  3    c.  "Mental health professional" means a psychologist
  5  4 licensed under chapter 154B, a registered nurse licensed under
  5  5 chapter 152, a social worker licensed under chapter 154C, a
  5  6 marital and family therapist licensed under chapter 154D, a
  5  7 mental health counselor licensed under chapter 154D, or an
  5  8 individual holding at least a master's degree in a related
  5  9 field as deemed appropriate by the board of behavioral science.
  5 10                           EXPLANATION
  5 11 The inclusion of this explanation does not constitute agreement with
  5 12 the explanation's substance by the members of the general assembly.
  5 13    This bill amends Code section 622.10 to prohibit an
  5 14 emergency medical care provider from disclosing confidential
  5 15 information which a patient disclosed to the emergency
  5 16 medical care provider in the emergency medical care provider's
  5 17 professional capacity. The privilege the bill creates between
  5 18 a patient and an emergency medical care provider is identical
  5 19 to the privilege that exists under current law between a
  5 20 patient and a physician, surgeon, physician assistant, or
  5 21 advanced registered nurse practitioner.
  5 22    The bill defines "emergency medical care provider" as
  5 23 the same as defined in Code section 147A.1, or an individual
  5 24 trained to provide emergency and nonemergency medical care at
  5 25 the emergency medical responder, emergency medical technician,
  5 26 advanced emergency medical technician, paramedic, or other
  5 27 certification levels adopted by rule by the department of
  5 28 public health, who has been issued a certificate by the
  5 29 department.
  5 30    The bill provides several exceptions to the prohibition.
  5 31 First, the patient may waive the prohibition. The prohibition
  5 32 does not apply in a civil action in which the condition of
  5 33 the patient is an element or factor of the claim or defense
  5 34 of the patient. In a civil action in which the patient is a
  5 35 plaintiff and the patient's condition is an element or factor
  6  1 of the claim or defense of the adverse party, the bill provides
  6  2 the procedure by which the adverse party may request or compel
  6  3 the disclosure of the confidential communication made by the
  6  4 patient to the emergency medical care provider.
  6  5    Pursuant to Code section 232.74, the privilege does not
  6  6 apply to evidence regarding a child's injuries or the cause of
  6  7 such injuries in any judicial proceeding, civil or criminal,
  6  8 which results from a report pursuant to Code chapter 232,
  6  9 relating to juvenile justice. Finally, the privilege does not
  6 10 apply in cases involving a petition which alleges that a child
  6 11 is a child in need of assistance.
       LSB 1431HV (1) 86
       jh/nh