Court Opinion

ID: 9960954
Source: CourtListenerOpinion
Date Created: 2024-04-17 16:11:16.262617+00
Date Added: 2024-06-11T08:20:05.467839
License: Public Domain

No. 232               April 17, 2024                    25

          IN THE COURT OF APPEALS OF THE
                  STATE OF OREGON

                  In the Matter of C. H.,
                          a Child.
          DEPARTMENT OF HUMAN SERVICES,
                  Petitioner-Respondent,
                             v.
                         M. A. H.,
                         Appellant.
             Clackamas County Circuit Court
                   22JU02272; A181606

  Cody M. Weston, Judge.
  Submitted January 9, 2024.
   Shannon Storey, Chief Defender, Juvenile Appellate
Section, and Holly Telerant, Deputy Public Defender, Office
of Public Defense Services, filed the brief for appellant.
   Ellen F. Rosenblum, Attorney General, Benjamin Gutman,
Solicitor General, and Stacy M. Chaffin, Assistant Attorney
General, filed the brief for respondent.
  Before Ortega, Presiding Judge, Powers, Judge, and
Hellman, Judge.
  ORTEGA, P. J.
  Affirmed.
26                             Dept. of Human Services v. M. A. H.

           ORTEGA, P. J.
         Father appeals from a juvenile court order directing
the Oregon Department of Corrections (DOC) to disclose his
mental health records to the Department of Human Services
(DHS) for use in dependency proceedings involving father’s
child, C.1 In a single assignment of error, father argues that
the court erred in issuing that order because DHS failed to
establish that his mental health records, which were gen-
erally protected under federal and state law,2 were neces-
sary or relevant to the purpose for which DHS sought their
disclosure. We conclude that, under the circumstances of
this case, father has not provided a basis on which we could
reverse the juvenile court’s order based on a lack of stat-
utory authority to issue the order. Further, DHS complied
with its own rule to “limit requests to those that are rea-
sonably necessary to accomplish the purposes for which the
request is made.” OAR 407-014-0040(5). Thus, we affirm.
        The juvenile court asserted jurisdiction over C, who
was then about seven years old, pursuant to ORS 419B.100,
on two admitted bases: that father was convicted of second-
and third-degree sex abuse of a minor child and that father
was incarcerated (with an anticipated release from DOC
custody in 2026) and unavailable as a custodial resource.3
The case plan at jurisdiction was reunification of C with
mother and father. About seven months later, the court
issued a review judgment indicating that father “ha[d] not
made sufficient progress,” that C “c[ould] not be * * * safely
returned to father’s care,” and that there was a concurrent
     1
       “A final order adversely affecting the rights or duties of a party and made
in a proceeding after judgment” is a judgment and is appealable. ORS 419A.205
(1)(d); see also ORS 419A.200(1) (appellate review of such orders is mandatory).
     2
       The Health Insurance Portability and Accountability Act of 1996 (HIPAA)
and its implementing regulations, including 45 CFR Parts 160 and 164, protect
the privacy and confidentiality of health information. See 42 USC §§ 1320d-2,
1320d-4 (establishing that protection); see also 45 CFR § 164.512 (providing stan-
dards of use and exceptions to the disclosure prohibition); ORS 179.505(2) (pro-
tecting “written accounts of the individuals served by any health care services
provider,” “unless otherwise permitted or required by state or federal law or by
order of the court”); ORS 192.558(2)(b) (same); ORS 179.495(1) (same).
     3
       The jurisdictional bases also included that mother was “the subject of a
criminal investigation for alleged sexual abuse of [C] and alleged sexual exploita-
tion of children” and was “unable to be a custodial resource.” Mother is not a
party to this appeal.
Cite as 332 Or App 25 (2024)                                                   27

plan for C’s adoption. DHS was unable to obtain information
concerning father’s participation in services at DOC, though
it had learned that he had been housed in what DOC staff
referred to as a “specialized behavioral unit.”
         DHS then moved for the order at issue, requiring
DOC and associated institutions to disclose father’s records,
including protected health information, for use at the pend-
ing permanency hearing. The motion specifically sought dis-
closure of any and all diagnoses, treatment, and assessment
records concerning father. In the motion and its accompany-
ing memorandum, DHS asserted, among other things, that
father’s mental health records were “the minimum necessary
to enable the court to plan for [C]” and to make the findings
required under ORS 419B.476 at the permanency hearing.4
DHS argued that, despite HIPAA’s general protection of such
records, it authorizes such disclosures, which are also autho-
rized under Oregon law. DHS relied on, among other legal
provisions, 45 CFR section 164.512(e)(1)(i), ORS 179.505, and
ORS 192.558, all of which indicate that otherwise protected
information is disclosable pursuant to a court order.5
         During a hearing on DHS’s motion, father argued
that DHS had “set forth [no] basis upon which to disclose
these specifically protected records” and suggested that “the
standard for disclosure of [such] information should be par-
ticularly high,” though he did not identify a particular stan-
dard to be applied. DHS argued that it “need[ed] the records
     4
       ORS 419B.476(2)(a) requires that, if the case plan at the time of a per-
manency hearing is to “reunify the family,” the court “shall,” “at the hearing,”
determine whether DHS has made “reasonable efforts * * * to make it possible
for the ward to safely return home and whether the parent has made sufficient
progress to make it possible for the ward to safely return home.” Even when the
case plan “is something other than” reunification, the court still must determine
whether DHS “has made reasonable efforts to place the ward in a timely manner
in accordance with the plan.” ORS 419B.476(2)(b).
     5
       Under 45 CFR section 164.512(e)(1)(i) “[a] covered entity may disclose pro-
tected health information in the course of any judicial * * * proceeding * * * [i]n
response to an order of a court.” Likewise, ORS 179.505(2) provides that an indi-
vidual’s otherwise protected health information, including medical, dental, or
psychiatric treatment written accounts maintained in or by facilities of DOC, can
be disclosed when “required by state or federal law or by order of the court.” ORS
192.558(2)(a) and (b), similarly, provide that DOC “[m]ay * * * disclose protected
health information of an individual without obtaining an authorization from the
individual * * * [a]s otherwise permitted or required by state or federal law or by
order of the court.”
28                      Dept. of Human Services v. M. A. H.

to do case planning” and explained that, because the cur-
rent plan was reunification, DHS was required to “make
reasonable efforts toward[ ] reunification.” It maintained
that it needed the records to determine what services had
already been offered to father or what services were needed
to continue a plan of reunification. The court inquired if
“relevance” was the proper legal standard for deciding the
motion, and DHS responded that neither federal nor Oregon
law specifies a standard for such disclosures and suggested
that the court apply the relevance standard. Father did not
offer an alternative.
         DHS permanency case worker Arlen Craig testi-
fied to the following: (a) that father first agreed to a release
of information but later rescinded it; (b) that in addition to
learning that father was placed in a “specialized behavioral
unit,” Craig heard other concerning things from DOC staff,
including that father was “not allowed to be around other
people,” which raised concerns for Craig; (c) that DHS had
“refused to allow” father to have visitation with C because
C was listed as either a victim or a witness to a prior crime
committed by father; (d) that DHS sought but was unable to
obtain any information about father’s participation in ser-
vices while at DOC beyond the fact that he had a counselor;
(e) that DHS needed the information to understand father’s
circumstances, decide what services could be offered to “help
mitigate” safety concerns and coordinate services, as part of
assessing what plans could be made for reunification; and
(f) that obtaining father’s mental health information would
also help DHS decide whether to work to facilitate in-person
visits with C.
        Father stated that he was “more than willing” to
let DHS know about his participation in classes “and every-
thing like that” but was not willing to release the mental
health records because, according to him, “there [wa]s no
reason” for DHS to have “any” of those records.
         The juvenile court granted DHS’s motion, issuing a
qualified protective order which concluded that the requested
disclosure was proper and that the records requested were
“the minimum necessary to assist the court in planning for
[C] and making the necessary findings at the permanency
Cite as 332 Or App 25 (2024)                                                  29

hearing(s).” The order required, among other things, that
DOC and the other institutions identified in DHS’s motion
disclose to DHS all records regarding father’s mental health
diagnoses, treatment, and assessment.6
         On appeal, father renews his challenge to DHS’s
claimed need for his mental health records. He argues that
DHS failed to establish that his records, protected under
HIPAA and Oregon law, were “necessary or relevant” to the
purpose identified in its motion. DHS acknowledges that
father preserved his HIPAA argument but contends that he
failed to preserve his argument that Oregon law prevented
disclosure of the records. DHS argues that, in any event,
on the merits, both HIPAA and Oregon law authorized the
disclosure, that Oregon law did not prohibit it, and that the
juvenile court did not abuse its discretion in ordering the
disclosure.
         We begin with preservation and conclude that father
preserved his argument regarding Oregon law. Appellate
courts generally will not review a claim of error that was not
preserved in the lower court. ORAP 5.45(1). Nevertheless, “a
short-hand reference, such as a single word or phrase, * * *
used in a way and context in which the other parties and
the court would understand that the word or phrase refers
to a particular legal or factual argument, and also would
understand from that single reference the essential con-
tours of the full argument” is sufficient to preserve a claim
for appeal. See State v. Haynes, 352 Or 321, 335, 284 P3d 473
(2012).
        Here, as DHS pointed out, father did not expressly
mention the Oregon statutes during his arguments below.
However, during the motion hearing, father’s argument
that DHS had “set forth [no] basis upon which to disclose
these specifically protected records” was made in response

    6
      The court’s order prohibited the use of the disclosed information “for any
purpose other than [the respective] juvenile dependency proceeding.” Further-
more, the order required that “[c]opies of any of the records furnished to another
person for purposes of representation of a party must be returned to the party
that provided the record at the conclusion of the matter,” except for disclosures
required by law to satisfy legal disclosures under the Rules of Professional
Conduct and to satisfy the Professional Liability Fund and DHS’s right under
the public record retention requirement.
30                               Dept. of Human Services v. M. A. H.

to DHS’s claim of court authority in its motion and accom-
panying memorandum, which included ORS 179.505 and
ORS 192.558. Within that context, father’s reference to the
“basis” of DHS’s argument was sufficient to give DHS and
the juvenile court notice that father was challenging the
legal bases of DHS’s full argument. That reference was suf-
ficient to preserve father’s challenge on appeal.
         We turn to the merits of father’s argument, which
includes three main points. He first contends that DHS did
not demonstrate why the information whose disclosure he
offered to authorize, regarding only the fact of his partic-
ipation in and completion of services, would not be suffi-
cient to allow DHS to make decisions regarding visitation
and case planning, particularly given that he would not be
imminently functioning as C’s caregiver due to his long-
term incarceration. Second, father argues that DHS did not
demonstrate how his mental health records would impact
visitation, given that those visits would be “supervised by
necessity” due to his incarceration status. Third, father dis-
putes that providers would need his mental health informa-
tion in order to work with him. We are not persuaded.
         As father concedes, both federal and Oregon law
allow for disclosure of protected records in response to a
court order. See 45 CFR § 164.512(e)(1)(i) (“A covered entity
may disclose protected health information in the course of
any judicial or administrative proceeding * * * [i]n response
to an order of a court[.]”); see also ORS 192.558(2)(b) (provid-
ing the same exception); ORS 179.505(2) (same). We recog-
nize that none of those laws provide an evidentiary standard
for the court to use in making such an order.7 And, although
    7
      Under 45 CFR section 164.502(b), a “minimum necessary” standard applies
to covered entities, such as DOC, for the use or disclosure of protected health
information. That standard, however, does not apply to covered entities making
a disclosure pursuant to court orders, such as the order at issue. See 45 CFR
§ 164.502(b)(2)(v) (providing that the “minimum necessary” standard does not
apply to “disclosures that are required by law, as described by § 164.512(a)”);
see also 45 CFR § 164.512(a) (covering disclosures “required by law”); 45 CFR
§ 164.103 (the term “[r]equired by law includes, but is not limited to, court orders”).
The absence of a standard that applies to court orders makes sense because the
federal and Oregon laws are directed at the entities holding the protected infor-
mation and inform those entities when they may make a disclosure, such as in
response to a court order. Those laws do not directly apply to the authority of a
court to make an order.
Cite as 332 Or App 25 (2024)                                                  31

those laws simply do not prohibit such orders rather than
affording authority to order disclosure, we nevertheless con-
clude that court authority is not at issue here. To the con-
trary, we agree with the court’s apparent assumption that it
could order DOC to disclose father’s protected health infor-
mation as part of the juvenile proceeding in the absence of
a source of law limiting or prohibiting it from doing so. See
ORS 419B.893 - 419B.902 (allowing subpoena for documents
to nonparties).8 Father does not present us with an argu-
ment on which we could reverse the court’s order based on
the court lacking statutory authority to issue the order.
         Despite the apparent absence of statutory authority
that directly limits a juvenile court order to disclose pro-
tected information or that sets the standard to which the
court is bound, there is an administrative rule that appears
to place limits on DHS in seeking such protected informa-
tion. DHS concedes in its brief that it is bound by OAR 407-
014-0040(5), which provides:
       “When requesting protected information about an indi-
    vidual from another entity, [DHS] shall limit requests to
    those that are reasonably necessary to accomplish the
    purposes for which the request is made. [DHS] shall not
    request a person’s entire medical record unless [DHS] can
    specifically justify the need for the entire medical record.”
         To resolve whether DHS complied with that appar-
ent limitation here, we need to first resolve the standard of
review we must apply to the court’s decision to order DOC
to disclose father’s protected health information, given our
conclusion that father has not identified a basis for us to con-
clude that it lacked statutory authority to issue the order.
We recognize that we have stated that we review for legal
error whether a juvenile court “ha[d] authority to make a
particular order” and, where the court has such authority,
    8
      We note that, in the ordinary course, a party seeking documents from a
third party would issue a subpoena to the third party to disclose those docu-
ments. See ORS 419B.896; ORS 419B.899; ORS 419B.902. The third party then
would have the opportunity to object to the disclosure, which could include an
argument that federal or state law prohibit the disclosure. At that point, the
parties may seek juvenile court resolution of the dispute by court order. However,
no one has raised a challenge to the procedure used here in which DHS moved
directly for a court order without first issuing a subpoena for the records and
receiving an objection. As a result, we express no opinion on that procedure.
32                      Dept. of Human Services v. M. A. H.

“we review the juvenile court’s dispositional order for an
abuse of discretion.” Dept. of Human Services v. T. B., 326
Or App 192, 194, 531 P3d 718, rev den, 371 Or 476 (2023).
However, in T. B., we cited Dept. of Human Services v. T. C. A.,
251 Or App 407, 414-15, 283 P3d 956, rev den, 352 Or 665
(2012), for the abuse of discretion standard. In turn, T. C. A.
stated only that an abuse of discretion standard applies to a
juvenile court’s best interest of the child finding under ORS
419B.476(5)(f). The order at issue in T. B. also included a
juvenile court’s best interest finding in a different context.
T. B., 326 Or App at 198. Thus, we do not read either T. C. A.
or T. B. to stand for a general proposition that we will review
any order for an abuse of discretion as long as the juvenile
court had statutory authority to issue the order.
         Here, although we do not understand statutory
authority to be at issue, whether DHS complied with the
standard in OAR 407-014-0040(5), and thus was entitled to
an order requiring DOC to disclose father’s records, involves
a question of law because it states a legal standard that binds
DHS, but it is a question that arises in highly fact-specific
circumstances. As a result, we apply our usual standard of
review for dependency proceedings. Because father has not
requested de novo review, and we conclude that this is not an
exceptional case warranting such review, ORS 19.415(3)(b);
ORAP 5.40(8)(c), we view “the evidence, as supplemented and
buttressed by permissible derivative inferences, in the light
most favorable to the [juvenile] court’s disposition and assess
whether, when so viewed, the record was legally sufficient
to permit that outcome.” Dept. of Human Services v. N. P.,
257 Or App 633, 639, 307 P3d 444 (2013).
         Based on those standards, we turn to father’s sub-
stantive arguments, which raise issues about whether DHS
was entitled to his records under the factual circumstances
of this case, and we conclude that, on this record, DHS’s
request complied with OAR 407-014-0040(5), which binds
DHS to limiting its requests “to those that are reasonably
necessary to accomplish the purposes for which the request
is made.” More specifically, we agree that father’s mental
health records were “reasonably necessary” for the purposes
identified by DHS in its motion—“for use in the permanency
Cite as 332 Or App 25 (2024)                               33

hearing[ ],” to allow DHS to meet its burden to show that it
complied with the requirements of ORS 419B.476 and the
court to make the necessary determinations under that same
statute. Under ORS 419B.476, at each permanency hearing,
where the case plan is reunification with the ward’s family,
DHS must demonstrate that it had made reasonable efforts
“to make it possible for the ward to safely return home.” ORS
419B.476(2)(a). That statute further requires that in assess-
ing DHS’s burden, the court “shall” make the respective “rea-
sonable efforts” determination and “shall” also determine
“whether the parent has made sufficient progress to make
it possible for the ward to safely return home.” Id. Moreover,
“[i]n making its determination, the court shall consider the
ward’s health and safety the paramount concerns.” Id.; see
also Dept. of Human Services v. S. W., 267 Or App 277, 286,
340 P3d 675 (2014) (“the mere fact of a parent’s incarceration
does not excuse DHS from making the reasonable efforts
required by [ORS 419B.476(2)(a)]”).
         Here, as the court concluded, father’s mental health
records were “important information for DHS to have” and
“the minimum necessary” under ORS 419B.476(2)(a) to
assist the court in planning for C’s safe return to father’s
care after father’s release from incarceration. First, DHS
showed that such information was “important” for DHS to
have. DHS provided evidence that to meet its reasonable-
efforts burden, DHS would need father’s mental health
records to assess what services could help father to amelio-
rate the bases of jurisdiction, which was incarceration for
child sex abuse. See Dept. of Human Services v. D. M. R.,
301 Or App 436, 444, 455 P3d 599 (2019) (to meet its
reasonable-efforts burden, DHS shall “focus on ameliorat-
ing the adjudicated bases for jurisdiction”). DHS’s evidence
showed that C may have been a witness to father’s crimes
and that DOC had placed father in a “behavioral unit”
and did not allow father “to be around other people,” and
that DHS was unaware of the underlying reasons for DOC
doing so. Under those circumstances, it was reasonably nec-
essary for DHS to seek more detailed information about
father’s mental health beyond information about what ser-
vices DOC provided to him. That information would allow
DHS to assess which services DHS could offer to best help
34                     Dept. of Human Services v. M. A. H.

father with mitigating the consequences of his convictions
and incarceration and to ensure that it was safe for C to
be around father. See Dept. of Human Services v. K. G. T.,
306 Or App 368, 375, 473 P3d 131 (2020) (DHS’s “reasonable
efforts [burden] should be evaluated in view of the nature
of the parent’s problems”); see also ORS 419B.476(2)(a) (“the
ward’s health and safety [is] the paramount concerns” of the
reasonable-effort’s determination).
          Contrary to father’s arguments that his mental
health information was not necessary to meet DHS’s bur-
den given his incarceration status, DHS’s reasonable-efforts
burden is not diminished based on father’s incarceration
and DHS would still need the disputed information to meet
its reasonable-efforts burden. See K. G. T., 306 Or App at
375-76 (DHS’s reasonable-efforts burden applies “over the
life of the case,” regardless of a parent’s incarceration).
         Second, father’s mental health records were like-
wise reasonably necessary to assist the court in making the
ORS 419B.476(2)(a) reasonable-efforts and sufficient-progress
findings for the permanency hearing. In making that
assessment, the court would need to determine whether
DHS was able to help father “ameliorat[e] [the] adjudicated
bases for jurisdiction.” See Dept. of Human Services v. H. K.,
321 Or App 733, 746, 517 P3d 1044 (2022). That assessment
would further require the court to determine whether DHS
gave father a “reasonable opportunity to demonstrate [his]
ability to adjust [his] conduct and become [a] minimally
adequate parent[ ],” including helping father to mitigate any
issues related to his conviction that could impact the safety
of C, who was a witness to father’s underlying crimes. Id.
Consequently, the court would need to know what problems
father was going through to assess whether DHS addressed
any concerns that would affect the jurisdictional bases, thus
justifying its order.
         Moreover, because father’s mental health could pos-
sibly affect whether C could be safe around him, his men-
tal health information was reasonably necessary to allow
the court to prioritize C’s “health and welfare” in assessing
DHS’s reasonable efforts. Dept. of Human Services v. M. G. J.,
326 Or App 426, 434, 532 P3d 905, rev den, 371 Or 476
Cite as 332 Or App 25 (2024)                                                     35

(2023) (at a permanency hearing in a juvenile dependency
proceeding, the juvenile court “gives the highest priority to
[C]’s health and welfare”). In the context of father’s circum-
stances, the court would need father’s information to make
C’s welfare assessment. In doing that, the court would need
to assess not only whether DHS provided adequate services
but also the extent to which father benefited from any ser-
vices. See K. G. T., 306 Or App at 381 (requiring the court to
“engage in a cost-benefit-like analysis * * * tied to the goal of
providing the parent, over the life of the case, with a reason-
able opportunity to demonstrate improvement, if not amelio-
rate the jurisdictional bases”). Accordingly, the court would
need the disputed information to assess whether father had
problems that required intervention for the court to assess
whether DHS provided or failed to provide adequate ser-
vices to father and to assess benefits of any services.
          In sum, father has not presented us with an argu-
ment on which we can conclude that the juvenile court erred
in ordering DOC to disclose father’s mental health records
for the limited purpose of using those records to satisfy ORS
419B.476 requirements at the permanency hearing.9
           Affirmed.

    9
      Our decision in the present case should not be understood to indicate that
protections to an individual’s mental health records do not apply to DHS. We
emphasize that a court and DHS must not ignore the procedural steps provided
by federal and state law for DOC’s and other entities’ disclosure of protected infor-
mation regarding an adult in custody, including but not limited to, any applicable
provisions under 45 CFR section 164.512 and ORS 419B.893 to 419B.902.