California Code of Regulations › Title 15 - Crime Prevention and Corrections › Division 3 - Adult Institutions, Programs and Parole › Chapter 2 - Rules and Regulations of Health Care Services › Subchapter 2 - Patient's Entitlements and Responsibilities › Article 4 - Access and Disclosure of Health Information › Section 3999.217 - Authorization for Release of Information

Current through Register 2024 Notice Reg. No. 28, July 12, 2024
(a) Patients may
					 authorize the release of their health care information by completing the CDCR 7385,
					 Authorization for Release of Protected Health Information, to allow a family member
					 or friend to request and receive an update when there is a significant change in the
					 patient's health care condition. A CDCR 7385 and instructions can be obtained in the
					 medical clinics and in health care settings. A CDCR 7385 will remain in force until
					 its expiration date or until it is updated, changed, or revoked by written request
					 of the patient at any time.
(b) A
					 patient's (or their personal representative's) authorization is considered valid if
					 it contains at least the following elements:
(1) A
					 description of the information to be used or disclosed that identifies the
					 information in specific terms.
(2) The
					 name or other specific identification of the persons(s) authorized to make the
					 requested use or disclosure.
(3) The
					 name or other specific identification of the person(s) to whom the California
					 Department of Corrections and Rehabilitation (CDCR) may make the requested use or
					 disclosure.
(4) A description of each
					 purpose of the requested use or disclosure and the specific uses and limitations on
					 the use of the health information by the persons or entities authorized to receive
					 it. The statement "at the request of the individual" is a sufficient description of
					 the purpose when a patient initiates the authorization and does not, or elects not
					 to, provide a statement of the purpose.
(5) An expiration date or an expiration event
					 (e.g., conclusion of litigation, completion of surgery) that relates to the patient
					 or the purpose of the use or disclosure after which disclosure is no longer
					 authorized.
(6) A signature which serves
					 no other purpose than to execute the document and date. If the authorization is
					 signed by a personal representative of the patient, a description of such
					 representative's authority to act for the patient must also be provided.
(7) A statement that the patient has the right to
					 revoke the authorization in writing and a description of how the individual may
					 revoke the authorization.
(8) A
					 statement that CDCR may not condition treatment on whether the patient signs the
					 authorization.
(9) A statement
					 concerning the potential for the information disclosed to be subject to
					 re-disclosure by the recipient and no longer protected by federal or state
					 law.
(10) A statement advising the
					 patient of their right to receive a copy of the authorization.
(11) The authorization is in writing in at least
					 14 point type and clearly separate from any other language present in the same
					 document.