By: Parker S.R. No. 1158
SENATE RESOLUTION
1-1 BE IT RESOLVED by the Senate of the State of Texas, That Rule
1-2 12.03, Rules of the Senate, 73rd Legislature, is suspended, as
1-3 provided by Senate Rule 12.08, to the extent described in this
1-4 Resolution, to enable the conference committee appointed to adjust
1-5 the differences between the House and Senate versions of S.B. No.
1-6 1061, relating to the continuation and functions of the Texas Board
1-7 of Chiropractic Examiners and to the regulation of the practice of
1-8 chiropractic, to successfully conclude the committee's
1-9 deliberations, by authorizing the conferees to consider and take
1-10 action on the following specific matters:
1-11 (1) Senate Rule 12.03(4) is suspended to permit the
1-12 committee to add the following new SECTION to the bill to read as
1-13 follows:
1-14 SECTION 22. Chapter 94, Acts of the 51st Legislature,
1-15 Regular Session, 1949 (Article 4512b, Vernon's Texas Civil
1-16 Statutes), is amended by adding Section 1b to read as follows:
1-17 Sec. 1b. (a) Communications between one licensed to
1-18 practice chiropractic, relative to or in connection with any
1-19 professional services as a chiropractor to a patient, are
1-20 confidential and privileged and may not be disclosed except as
1-21 provided in this section.
1-22 (b) Records of the identity, diagnosis, evaluation, or
1-23 treatment of a patient by a chiropractor that are created or
2-1 maintained by a chiropractor are confidential and privileged and
2-2 may not be disclosed except as provided in this section.
2-3 (c) Any person who receives information from confidential
2-4 communications or records as described in this section other than
2-5 the persons listed in Subsection (h) of this section who are acting
2-6 on the patient's behalf may not disclose the information except to
2-7 the extent that disclosure is consistent with the authorized
2-8 purposes for which the information was first obtained.
2-9 (d) The prohibitions of this section continue to apply to
2-10 confidential communications or records concerning any patient
2-11 irrespective of when the patient received the services of a
2-12 chiropractor.
2-13 (e) The privilege of confidentiality may be claimed by the
2-14 patient or chiropractor acting on the patient's behalf.
2-15 (f) The chiropractor may claim the privilege of
2-16 confidentiality, but only on behalf of the patient. The authority
2-17 to do so is presumed in the absence of evidence to the contrary.
2-18 (g) Exceptions to confidentiality or privilege in court or
2-19 administrative proceedings exist:
2-20 (1) when the proceedings are brought by the patient
2-21 against a chiropractor, including but not limited to malpractice
2-22 proceedings, and any criminal or license revocation proceeding in
2-23 which the patient is a complaining witness and in which disclosure
2-24 is relevant to the claims or defense of a chiropractor;
2-25 (2) when the patient or someone authorized to act on
3-1 the patient's behalf submits a written consent to the release of
3-2 any confidential information, as provided in Subsection (j) of this
3-3 section;
3-4 (3) when the purpose of the proceedings is to
3-5 substantiate and collect on a claim for chiropractic services
3-6 rendered to the patient;
3-7 (4) in any civil litigation or administrative
3-8 proceeding, if relevant, brought by the patient or someone on his
3-9 behalf if the patient is attempting to recover monetary damages for
3-10 any physical or mental condition including death of the patient;
3-11 any information is discoverable in any court or administrative
3-12 proceeding in this state if the court or administrative body has
3-13 jurisdiction over the subject matter, pursuant to rules of
3-14 procedure specified for the matters;
3-15 (5) in any disciplinary investigation or proceeding of
3-16 a chiropractor conducted under or pursuant to this Act, provided
3-17 that the Board shall protect the identity of any patient whose
3-18 chiropractic records are examined, except for those patients
3-19 covered under Subdivision (1) of this subsection or those patients
3-20 who have submitted written consent to the release of their
3-21 chiropractic records as provided by Subsection (j) of this section;
3-22 (6) in any criminal investigation of a chiropractor in
3-23 which the Board is participating or assisting in the investigation
3-24 or proceeding by providing certain records obtained from the
3-25 chiropractor, provided that the Board shall protect the identity of
4-1 any patient whose records are provided in the investigation or
4-2 proceeding, except for those patients covered under Subdivision (1)
4-3 of this subsection or those patients who have submitted written
4-4 consent to the release of their chiropractic records as provided by
4-5 Subsection (j) of this section; this subsection does not authorize
4-6 the release of any confidential information for the purpose of
4-7 instigating or substantiating criminal charges against a patient;
4-8 and
4-9 (7) in any criminal prosecution where the patient is a
4-10 victim, witness, or defendant; records are not discoverable until
4-11 the court in which the prosecution is pending makes an in camera
4-12 determination as to the relevancy of the records or communications
4-13 or any portion thereof; such determination shall not constitute a
4-14 determination as to the admissibility of such records or
4-15 communications or any portion thereof.
4-16 (h) Exceptions to the privilege of confidentiality, in other
4-17 than court or administrative proceedings, allowing disclosure of
4-18 confidential information by a chiropractor, exist only for the
4-19 following:
4-20 (1) governmental agencies if the disclosures are
4-21 required or permitted by law, provided that the agency shall
4-22 protect the identity of any patient whose chiropractic records are
4-23 examined;
4-24 (2) medical or law enforcement personnel if the
4-25 chiropractor determines that there is a probability of imminent
5-1 physical injury to the patient, to himself, or to others or if
5-2 there is a probability of immediate mental or emotional injury to
5-3 the patient;
5-4 (3) qualified personnel for the purpose of management
5-5 audits, financial audits, program evaluations, or research, but the
5-6 personnel may not identify, directly or indirectly, a patient in
5-7 any report of the research, audit, or evaluation or otherwise
5-8 disclose identity in any manner;
5-9 (4) those parts of the records reflecting charges and
5-10 specific services rendered when necessary in the collection of fees
5-11 for services provided by a chiropractor or chiropractors or
5-12 professional associations or other entities qualified to render or
5-13 arrange for services;
5-14 (5) any person who bears a written consent of the
5-15 patient or other person authorized to act on the patient's behalf
5-16 for the release of confidential information, as provided by
5-17 Subsection (j) of this section;
5-18 (6) individuals, corporations, or governmental
5-19 agencies involved in the payment or collection of fees for services
5-20 rendered by a chiropractor;
5-21 (7) other chiropractors and personnel under the
5-22 direction of the chiropractor who are participating in the
5-23 diagnosis, evaluation, or treatment of the patient; or
5-24 (8) in any official legislative inquiry regarding
5-25 state hospitals or state schools, provided that no information or
6-1 records which identify a patient or client shall be released for
6-2 any purpose unless proper consent to the release is given by the
6-3 patient, and only records created by the state hospital or school
6-4 or its employees shall be included under this subsection.
6-5 (i) Exceptions to the confidentiality privilege in this Act
6-6 are not affected by any statute enacted before the effective date
6-7 of this Act.
6-8 (j)(1) Consent for the release of confidential information
6-9 must be in writing and signed by the patient; a parent or legal
6-10 guardian if the patient is a minor; a legal guardian if the patient
6-11 has been adjudicated incompetent to manage his personal affairs; an
6-12 attorney ad litem appointed for the patient, as authorized by the
6-13 Texas Mental Health Code (Subtitle C, Title 7, Health and Safety
6-14 Code); the Persons with Mental Retardation Act (Subtitle D, Title
6-15 7, Health and Safety Code); Subtitle B, Title 6, Health and Safety
6-16 Code; Subtitle E, Title 7, Health and Safety Code; Chapter 5, Texas
6-17 Probate Code; and Chapter 11, Family Code; or other applicable
6-18 provision or a personal representative if the patient is deceased,
6-19 provided that the written consent specifies the following:
6-20 (A) the information records to be covered by the
6-21 release;
6-22 (B) the reasons or purposes for the release; and
6-23 (C) the person to whom the information is to be
6-24 released.
6-25 (2) The patient or other person authorized to consent
7-1 has the right to withdraw his consent to the release of any
7-2 information. Withdrawal of consent does not affect any information
7-3 disclosed prior to the written notice of the withdrawal.
7-4 (3) Any person who receives information made
7-5 confidential by this Act may disclose the information to others
7-6 only to the extent consistent with the authorized purposes for
7-7 which consent to release the information was obtained.
7-8 (k) A chiropractor shall furnish copies of chiropractic
7-9 records requested or a summary or narrative of the records pursuant
7-10 to a written consent for release of the information as provided by
7-11 Subsection (j) of this section, except if the chiropractor
7-12 determines that access to the information would be harmful to the
7-13 physical, mental, or emotional health of the patient, and the
7-14 chiropractor may delete confidential information about another
7-15 person who has not consented to the release. The information shall
7-16 be furnished by the chiropractor within a reasonable period of
7-17 time, and reasonable fees for furnishing the information shall be
7-18 paid by the patient or someone on the patient's behalf. In this
7-19 subsection, "chiropractic records" means any records pertaining to
7-20 the history, diagnosis, treatment, or prognosis of the patient.
7-21 (l) "Patient" for the purposes of this section means any
7-22 person who consults or is seen by a person licensed to practice
7-23 chiropractic to receive chiropractic care.
7-24 This action is necessary to specify confidentiality
7-25 provisions and to protect the confidentiality of patients of
8-1 chiropractors.
8-2 (2) Senate Rule 12.03(1) is suspended to permit the
8-3 committee to amend the added language of House Amendment No. 3 to
8-4 strike "Using an accident report prepared by a peace officer in a
8-5 manner prohibited by law" and substitute "Using an accident report
8-6 prepared by a peace officer in a manner prohibited by Section
8-7 38.12, Penal Code".
8-8 This action is necessary to specify the use of an accident
8-9 report intended to be prohibited.
8-10 _____________________________________
8-11 President of the Senate
8-12 I hereby certify that the
8-13 above Resolution was adopted by
8-14 the Senate on May 29, 1993.
8-15 _____________________________________
8-16 Secretary of the Senate