House OKs change to behavioral health records to better provide patients with continued care


STATE HOUSE – The House of Representatives today approved legislation sponsored by Rep. Rebecca Kislak to better provide a continuum of care to behavioral health patients by ensuring their health care providers can access the records they need to help them.

Under current law, although a doctor providing care to a patient can access that patient’s medical records for the purposes of treatment without having to obtain specific written consent, those privileges do not extend to behavioral health care records.

According to the Department of Behavioral Health, Developmental Disabilities and Hospitals, which sought the legislation, and health care providers who testified in favor of it, the situation harms some of the most vulnerable patients at a time when they are least able to advocate for themselves: after they have been discharged from a hospitalization for a behavioral health issue.

Because of the prohibition, a patient’s primary care provider does not receive notification of the hospitalization, nor would the provider be allowed to access any information about the hospitalization — the issue, diagnosis, treatment or medication provided, or recommended follow-up care — unless the patient provided that information themselves, or came in to the doctor’s office on their own and signed a release form.

“This legislation clarifies that behavioral health hospitalizations and medical hospitalizations will be treated similarly for the benefit of patients and follow-up health care. It is important for primary care providers to have hospital discharge information to ensure smooth transition from hospital- to community-based care, whatever the reason for the hospitalization,” 

said Representative Kislak (D-Dist. 4, Providence).

The legislation (2023-H 5687) passed by the House today amends the existing law regarding disclosure of confidential mental health care records to allow such records to be shared among medical and mental health professionals for the purposes of diagnosis, treatment and transitions of care, without having to obtain prior written consent from the patient. Psychotherapy notes are an exception for which written consent would still be required.

The legislation also enables the records to be shared electronically, and creates requirements for properly documenting any electronic transmission of such records. Under current law, such records are still shared by fax after patients sign the release form.

In addition to helping patients access care, sharing this information could also save time and health care dollars, because it could prevent escalation of untreated issues as well as redundant treatments, prescription interactions and other problems, Representative Kislak said.

Dr. Andrew Saal, chief medical officer of Providence Community Health Centers, who has been a strong advocate for the bill, testified to the House Health and Human Services Committee during its hearing that the current law is an example of the type of fragmentation of the health care system that often fails patients. A person who has been discharged from a behavioral health hospitalization might not even have a phone with which to call their provider, let alone the ability to swiftly make an appointment and communicate their needs.

“When electronic health information systems don’t notify primary care teams, care coordination doesn’t happen and patients all too easily fall between the cracks in the system,” said Dr. Saal. “Our Integrated Behavioral Health team, led by Dr. Nelly Burdette, knows all too well that lack of communication between health systems can leave providers trying to put together the pieces for the person in their care. H5687 creates a mechanism to share critical patient information with a patient’s primary care team while protecting essential privacy issues.”

The legislation now goes to the Senate, where Sen. Mark P. McKenney (D-Dist. 30, Warwick) is sponsoring companion legislation (2023-S 0719).