Opinion ID: 2575981
Heading Depth: 2
Heading Rank: 3

Heading: Health Care Information

Text: ¶ 38 DOC also redacted all references to medical information concerning inmates, including names, treatments, medical conditions, etc. The basis for these redactions was RCW 70.02.020, as incorporated into the PDA through RCW 42.17.312. [16] RCW 70.02.020 prohibits disclosure of health care information without the patient's written authorization. Health care information is defined as: [A]ny information, whether oral or recorded in any form or medium, that identifies or can readily be associated with the identity of a patient and directly relates to the patient's health care, including a patient's deoxyribonucleic acid and identified sequence of chemical base pairs. The term includes any record of disclosures of health care information. RCW 70.02.010(6) (emphasis added). ¶ 39 Washington courts have recognized the definition of health care information has two requisites  patient identity and information about the patient's health care. Wright v. Jeckle, 121 Wash.App. 624, 630, 90 P.3d 65 (2004). On its face the statute appears to allow for disclosure of information such as maladies, treatments, etc., when the identity of a patient is not disclosed or cannot be readily associated with the patient. PLN has not contested the nondisclosure of patient names or identification numbers. ¶ 40 DOC contends that such information can readily be associated with the identity of a patient. In its briefing, DOC claims that inmates who are in close and continuous contact with each other ... would be able to associate the information to a particular inmate. Supp. Br. of Resp't at 15. However, DOC has not cited to any evidentiary support for this conclusion in the record. [17] ¶ 41 As noted, we construe exemptions to the PDA narrowly, requiring the state agency to bear the burden of proving that a specific exemption applies. RCW 42.17.340(1); Hoppe, 90 Wash.2d at 129-30, 580 P.2d 246. The DOC's blanket approach in redacting all health care information conflicts with the requirement to construe exemptions narrowly. Further, the broad mandate favoring disclosure under the PDA requires the agency demonstrate that each patient's health care information is readily associated with that patient in order to withhold the health care information under RCW 70.02.010(6). Where there is a dispute over whether health care information is readily identifiable with a specific patient even when that patient's identity is not disclosed, the trial court can use in camera review should it need to examine unredacted records to make its independent determination. See, e.g., ACLU of Wash. v. City of Seattle, 121 Wash.App. 544, 89 P.3d 295 (2004). ¶ 42 The Court of Appeals did not decide this issue on the statutory language. Its only comment about DOC's claims was that they were plausible. Prison Legal News v. Dep't of Corr., noted at 118 Wash.App. 1069, 2003 WL 22332994, at . However, the court applied an equity/exhaustion argument to deny PLN disclosure. ¶ 43 At the end of a very confused oral argument, the trial court judge told the parties: I see a big distinction between records entirely withheld and records redacted. And if the parties cannot agree on a process for handling those, then it can be brought back to the court and I'll consider arguments of both sides.... If you can agree, fine; if you can't, then I guess I will lead a second round of hearing to resolve the issues that you've identified that are arising out of my decision here. Report of Proceedings (RP) at 40-41. ¶ 44 The trial court judge was not clear which claims of exemptions (CP at 1520; RP at 37) he was referring to in this conclusory statement, nor whether he was allowing PLN to contest specific redactions based on whether those redactions were within the scope of the trial court's general rulings on the validity of the claimed exemptions. [18] However, the Court of Appeals characterized this exchange as offering PLN an opportunity to clarify the issue, Prison Legal News, 118 Wash.App. 1069, 2003 WL 22332994, at . The Court of Appeals then refused to address whether DOC redacted more than was necessary to protect the patient's identity when PLN chose not to pursue it. Id. ¶ 45 The Court of Appeals did not accurately characterize the trial court's concluding offer at the show cause hearing. The trial court's statement actually appeared to give PLN an opportunity to challenge whether certain records, based on certain exemptions, should have been withheld in their entirety or whether they should have been disclosed in redacted form. [19] ¶ 46 This would not have been reasonably interpreted by PLN's counsel as a chance to argue that specific health care information should have been disclosed because it was not readily identifiable with a patient. Indeed, since all such information had been redacted, along with the patient identity, it is hard to see how the PLN attorney could have discovered which information was or was not readily associated with a patient's identity. ¶ 47 PLN did not forfeit the right to contest whether specific health care information was readily identifiable with specific patients given a proper interpretation of the trial court's statement. We hold that on remand DOC must prove that each patient's health care information would be readily identifiable with that patient even if that patient's identity isn't known, given that PLN has not contested the nondisclosure of patient names or identification numbers.