Title: In re B.S.

State: vermont

Issuer: Vermont Supreme Court

Document:

IN_RE_BS.94-036; 163 Vt 445; 659 A.2d 1137

[Filed 31-Mar-1995]


NOTICE:  This opinion is subject to motions for reargument under V.R.A.P. 40
as well as formal revision before publication in the Vermont Reports. 
Readers are requested to notify the Reporter of Decisions, Vermont Supreme
Court, 109 State Street, Montpelier, Vermont 05609-0801 of any errors in
order that corrections may be made before this opinion goes to press. 


                                 No. 94-036


In re B.S., Juvenile                              Supreme Court

                                                  On Appeal from
                                                  Chittenden Family Court

                                                  October Term, 1994


Ronald F. Kilburn, J.

Robert Appel, Defender General, and Anna Saxman, Appellate Defender,
 Montpelier, for appellant 

Jeffrey L. Amestoy, Attorney General, Montpelier, and Michael O. Duane,
 Assistant Attorney General, Waterbury, for appellee SRS 

Charles S. Martin of Martin & Paolini, Barre, for appellee juvenile

O. Whitman Smith of Kochman and Smith, Burlington, for amicus curiae
 Champlain Drug and Alcohol Services 


PRESENT:  Allen, C.J., Gibson, Dooley, Morse and Johnson, JJ.


     DOOLEY, J.   Appellant P.S., mother of juvenile B.S., appeals an order
of the Chittenden Family Court terminating her parental rights.  Appellant
claims that the family court erroneously ordered disclosure of her
confidential communications to an alcohol counselor, and the counselor's
treatment records, in violation of federal law; and that the court's
conclusion that she could not resume her parenting duties within a reasonable
time was error.  She is joined in her claim of violation of federal law by
amicus curiae Champlain Drug and Alcohol Services (CDAS), which runs the
alcohol abuse treatment program in which she participated.  Although we
conclude that it was error to require disclosure of the communications and
records, we affirm the termination of appellant's parental rights. 

     On April 15, 1992, six-month-old B.S. was taken into custody by the
Vermont 

 

Department of Social and Rehabilitation Services (SRS) because on two
occasions appellant left the child with neighbors and returned to retrieve
him several hours late and in an intoxicated condition.  The family court
later found B.S. to be a child in need of care and supervision (CHINS), and
shortly thereafter, SRS filed a petition to terminate appellant's parental
rights. During the termination proceedings, SRS issued a subpoena to CDAS to
compel production of appellant's treatment records, and to compel the
testimony of her alcohol counselor.  CDAS moved to quash the subpoena,
asserting that federal law forbids disclosure of alcohol counseling records
and the testimony of the counselor without the patient's consent, except in
limited circumstances.  The family court's order compelling the disclosure of
appellant's records and the testimony of her alcohol counselor prompted this
appeal. 

     Appellant's appeal is based primarily on federal law, which prohibits
the disclosure of alcohol and drug abuse treatment records and confidential
communications made by patients, where the treatment is "directly or
indirectly assisted by any department or agency of the United States," 42
U.S.C.  290dd-2(a) (1994).  See id.  290dd-2 (FN1); 42 C.F.R. 
2.1-2.67 (1993). It is undisputed that CDAS receives funds from an agency
of the federal government to support its alcohol abuse treatment program and
that appellant was enrolled in this program.  Thus, the disclosure
restrictions of federal law were applicable to this case. 

     The purpose of the federal statute is to encourage patients to seek
treatment for substance abuse by assuring them that their privacy will not be
compromised.  See Whyte v. Connecticut Mutual Life Ins. Co., 818 F.2d 1005,
1010 (1st Cir. 1987) ("[c]onfidentiality is necessary to ensure successful
alcoholism treatment.  Without guarantees of confidentiality, many
individuals with alcohol problems would be reluctant to participate fully in
alcoholism programs."); 

 

Commissioner of Social Services v. David R.S., 436 N.E.2d 451, 454, 451 N.Y.S.2d 1, 4 (N.Y. 1982) ("Broad interpretation furthers the objectives of
the Federal statute . . . by not chilling the willingness or discouraging the
readiness of individuals to come to facilities operated under the statute.").
 The basic confidentiality rule is set forth by statute, 42 U.S.C. 
290dd-2. The statute contains a broad authorization for rule-making.  See id.
 290dd-2(g).  Pursuant to this authorization, the Secretary of Health and
Human Services has adopted comprehensive regulations.  See 42 C.F.R. 
2.1-2.67. 

     Two aspects of the confidentiality requirements are relevant to this
appeal.  The first involves the patient records maintained by CDAS on
appellant. (FN2) These records are not subject to subpoena unless the court
finds good cause for disclosure.  See 42 U.S.C.  290dd- 2(b)(2)(C); 42
C.F.R.  2.64(d).  Appellant and amicus argue that the court failed to
follow proper procedures in determining whether good cause was present, and
erred in finding good cause.  Thus, appellant and amicus assert the court
erred in requiring the records to be produced and used in the proceeding. 

     The regulations describe the procedures and criteria that a court must
employ before authorizing a disclosure of patient records.  See 42 C.F.R. 
2.64 (1993).  First, the party seeking the information must file an
application for a production order with the court, using a fictitious name to
identify the patient.  See id.  2.64(a).  The court must provide adequate
notice to the patient and the person possessing the records at issue, id. 
2.64(b)(1), and must give an opportunity for these persons to respond either
in writing or at a hearing, id.  2.64(b)(2).  Normally, this means the
court must conduct a hearing on the application.  All of 

 

these procedures must be conducted in a manner that protects the patient's
privacy.  Id.  2.64(a), (c). 

     A disclosure order may be entered only if the court determines that good
cause exists. See 42 U.S.C.  290dd-2(b)(2)(C); 42 C.F.R.  2.64(d).  This
determination is to be made only upon a finding that alternative means of
obtaining the information are not available, and that the interest in
disclosure outweighs "the potential injury to the patient, the
physician-patient relationship and the treatment services."  42 C.F.R. 
2.64(d)(2).   Even if disclosure is authorized, the court must limit the
order's scope of disclosure to minimize the impact on the patient's privacy. 
Id.  2.64(e). 

     It is undisputed that SRS failed to use the procedure in the
regulations.  It began by issuing a subpoena to the CDAS alcohol counselor
instead of to appellant.  As such, the hearing came on CDAS's motion to
quash. (FN3) As discussed below, the court did not view the records in camera
before ruling on whether disclosure would be ordered. 

     The court's good cause determination rests on two findings: (1) SRS "has
no other means of obtaining the information contained in the . . . treatment
files" because appellant has not consented to disclosure; and (2) the "public
interest in production is great, and far exceeds the minor threat of
embarrassment to" appellant.  In making the latter finding, the court was
heavily influenced by the fact that the juvenile hearing in which the files
would be used is not a public proceeding. 

     The record production order was "limited to those parts of the records .
. . which are essential to determine whether [appellant's] parental rights
should be terminated" and required the file to be sealed to limit disclosure.
 In fact, the entire file was produced by the counselor, and no attempt was
made to redact extraneous matter to comply with the order.  It is unclear

 

whether SRS or others used the records.(FN4) At one point during his
testimony, the counselor did use the records to refresh his recollection. 

     We agree with appellant and amicus that the family court misapplied the
good cause requirements in two important respects.   First, the court could
find good cause for production of the patient records only if an alternative
means of obtaining the information contained within them was not available. 
Good cause cannot be demonstrated when production of the records is merely
cumulative.  See, e.g., United States v. Smith, 789 F.2d 196, 205-06 (3d
Cir. 1986) (disclosure request denied because other sources of competent
evidence available); Bell v. State,