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