FILED: December 15, 1999
In the Matter of Chelsea West,
a Minor Child.
STATE ex rel JUVENILE DEPARTMENT
OF MULTNOMAH COUNTY,
Respondent,
v.
DION WEST,
Appellant.
Appeal from Circuit Court, Multnomah County.
Paula Kurshner, Judge.
Argued and submitted May 10, 1999.
Daniel A. Cross argued the cause for appellant. With him on the brief was Bertoni & Todd.
Michael C. Livingston, Assistant Attorney General, argued the cause for respondent. With him on the brief were Hardy Myers, Attorney General, and Michael D. Reynolds, Solicitor General.
Before Landau, Presiding Judge, and Linder and Brewer, Judges.
LINDER, J.
Affirmed.
LINDER, J.
Father appeals a juvenile court order, made in the course of a child
dependency proceeding, authorizing disclosure of his drug evaluation and treatment
records from two medical facilities. ORS 419A.200. The issue presented is whether the
state's need for the records satisfies the "good cause" standard for their release under 42
USC section 290dd-2 (1994). Our resolution of that issue turns on the meaning and scope
of the federal statute and how it applies to this particular case. We review, therefore, for
legal correctness.(1) We conclude that the state's reasons for seeking disclosure of the
records fall within the scope of what a court properly may consider as "good cause" and,
further, that the records were not purely cumulative. We therefore affirm.
The material facts are undisputed. Police found father, who was
behaving in a delusional manner, walking around the streets of Portland with his three-year-old daughter. The officers took father to Providence Medical Center because they
suspected that he might have mental health or substance abuse problems. Staff at the
triage center examined him and concluded that he was actively psychotic, possibly due to
drugs. The staff notified the State Office for Services to Children and Families (SOSCF)
of child's circumstances, and the agency placed child in protective custody.
Within days, following a series of shelter hearings and the filing of a
jurisdictional petition, the juvenile court found probable jurisdiction over child and
committed child to SOSCF for shelter care placement. Meanwhile, father had been
transferred to Emanuel Hospital for further evaluation and treatment. Subsequently, he
was released. About one month after the incident that precipitated taking child into
protective custody, the state subpoenaed father's treatment records from Providence and
Emanuel. Father, through his attorney, objected to disclosure of the records on the
ground that they contained confidential information and were protected by federal law.
At one of the initial pretrial conferences, the parties argued their respective positions, but
the juvenile court declined to resolve the issue at that time.
At a pretrial proceeding held about three months after child was first
taken into custody, father admitted that he has "mental health issues" and "substance
abuse problems" that interfere with his ability to care for and parent child, as alleged in
the petition. Based on those admissions, the juvenile court referee found jurisdiction,
committed child to SOSCF's legal custody, and ordered father to complete drug and
alcohol evaluation and treatment and to undergo a psychological evaluation. The state
asked the court to resolve its request for an order directing disclosure of father's medical
records so that it could pursue its subpoena.(2) Father again objected. The referee ordered
release of the records but stayed their release pending rehearing before a juvenile court
judge.
At rehearing, father argued that there was no "good cause" for disclosure
of the records because he had admitted jurisdiction and the state therefore had no
"evidentiary need" for the records. Father also argued that the records would be merely
cumulative, because the court had ordered father to undergo substance abuse and
psychological evaluations, which would be available to the state and would provide
information about father's mental state and substance abuse problems.
(3) In response, the
state contended that the independent observations of treatment providers at the time of the
precipitating crisis would be uniquely valuable in understanding the exact nature of
father's problems so that the agency could ensure appropriate treatment and planning for
the possible return of child to father's custody. The juvenile court agreed with the state
and therefore affirmed the referee's decision ordering disclosure. In deciding that the
state's need for the records outweighed father's interests in keeping them confidential, the
juvenile court specifically relied on the fact that the requested records were made
contemporaneously with "the crisis that instituted this petition being filed in the first
place" and that the state was not seeking "the entire psychiatric record of this man or
[records from throughout] his whole life." On appeal, the parties renew the arguments
they made below.
We begin by examining 42 USC section 290dd-2 (1994) and its
restriction on the disclosure of certain drug treatment records. Congress enacted
protection for those records in recognition that fear of public disclosure of drug abuse
problems could serve as a disincentive for people to seek and obtain needed treatment.(4)
To that end, the federal statute provides for a general rule of confidentiality that attaches
to records pertaining to substance abuse treatment, programs, and research. 42 USC §
290dd-2(a) (1994).(5) The statute also provides, however, for disclosure of the records in
limited circumstances. See 42 USC § 290dd-2(b) (1994). Relevant here is the
authorization for release of such records upon a judicial determination that there is "good
cause" for disclosure. Specifically, the federal statute provides for disclosure,
notwithstanding a patient's lack of consent:
"If authorized by an appropriate order of a court of competent
jurisdiction granted after application showing good cause therefor,
including the need to avert a substantial risk of death or serious bodily
harm. In assessing good cause the court shall weigh the public
interest and the need for disclosure against the injury to the patient, to
the physician-patient relationship, and to the treatment services. Upon
the granting of such order, the court, in determining the extent to
which any disclosure of all or any part of any record is necessary, shall
impose appropriate safeguards against unauthorized disclosure."
42 USC § 290dd-2(b)(2)(C) (1994).
The statute outlines essentially three aspects to the court's good cause
inquiry. First, by its reference to good cause "including the need to avert a substantial
risk of death or serious bodily harm," the statute requires that a need relating to the
prevention of personal harm be of considerable gravity. Second, once such a need is
identified, the court must weigh the interests favoring disclosure against those favoring
confidentiality and must determine, on balance, which are greater. Finally, if the court
orders disclosure, the court must impose safeguards, as appropriate, to ensure that
disclosure does not occur beyond what the court has authorized.(6)
Father's first contention is that, in determining if there is "good cause"
for disclosure under the federal statute, a court may consider only a party's need for the
records as evidence in the proceeding pending before the court. Father therefore
maintains that because he admitted the allegations of the jurisdictional petition, the state
no longer needed the records "as evidence" to ensure protective custody of the child, and,
consequently, disclosure was not authorized. Father asserts that the state's need for the
records, insofar as it relates to providing services to child and to father, is legally
insufficient under the federal statute.
Father points to nothing in the statute's text that expresses such a
limitation. Nor is there any such limitation. To the contrary, the statute is worded
broadly and generally. It provides for disclosure of an otherwise protected record when
disclosure will help avert risk of serious personal harm. It does so without qualification
or limitation and without any suggestion that the records must be sought to provide
evidence in a case in which a party seeking disclosure seeks to
avert serious harm.(7)
Protecting a child from neglect and endangerment readily meets the level
of gravity that the statute suggests is necessary to provide "good cause." Nevertheless,
father's point may also be that disclosure in this particular case would not serve a
protective purpose because that purpose has been accomplished by establishing
jurisdiction over the child. If that is father's point, we disagree. The jurisdictional phase
of a dependency proceeding marks the beginning, not the end, of the court's and SOSCF's
protective role. As the state correctly points out, once jurisdiction is established, the
juvenile court is charged with determining whether to order father to participate in
treatment "to correct the circumstances that brought the child within the jurisdiction of the
court." ORS 419B.387. Periodically, SOSCF and the court must review the case and
determine whether child should be returned to father's care. ORS 419B.476(2)(a). As
needed, the court also is authorized to inquire into "the adequacy of and compliance with
the case plan and case progress report." ORS 419B.476(5). Father's admission of the
bare allegations of the jurisdictional petition--namely, his admission that he has "mental
health issues" and "substance abuse problems"--hardly suffices to permit the juvenile
court and SOSCF to carry out their protective role in a meaningful way. Actual
assessments of father's problems by medical and mental health professionals are critical to
their ability to do so.
Father also raises a related, but different, argument. He asserts that the
information contained in the records would be purely cumulative given that father has
admitted substance abuse and mental illness problems and has agreed to undergo
evaluations for those problems. That argument does not bear on what can qualify as good
cause under the federal statute but instead goes to the weight of the state's interest in
disclosure as balanced against father's interests in keeping the records confidential. See
Com'r of Social Ser., Etc. v. David R.S., 55 NY2d 588, 436 NE2d 451, 455, 451 NYS2d 1
(1982) (finding that little weight attached to the "need for disclosure" when the evidence
was cumulative because other proof on the disputed issue was available); Matter of
Stephen F., 118 Misc 2d 655, 460 NYS2d 856, 859 (Fam Ct 1982) ("good cause" was
defeated where records were only cumulative of the mother's drug use before the child's
birth).(8)
The juvenile court rejected father's argument because it concluded that
the records are not cumulative. We agree. To be sure, as father emphasizes, he has
admitted the allegations of the jurisdictional petition, and he thus has admitted that he has
substance abuse and mental illness problems that endanger his child's welfare. Also,
father is correct that the juvenile court's order requires him to undergo future
psychological assessments and drug and alcohol evaluations. But father's argument
overlooks that the records in question concern medical assessments of father's condition
at and near a critical time--namely, when he had become delusional and child had to be
placed in protective custody because of the danger father posed to child's welfare.
Father's admissions of substance abuse and mental illness problems, in and of themselves,
provide no particular information about his condition or conditions and no basis to plan
prospectively for child's welfare and return to father. Likewise, although later evaluations
undoubtedly will aid in assessing father's problems and needs, they cannot duplicate the
particular insights into the history, severity, or etiology of father's "problems" that records
made contemporaneously with his delusional crisis may provide. The records in question
are uniquely valuable in that regard, as the juvenile court concluded.(9)
In sum, we hold that the federal statute's "good cause" requirement is not
limited in this setting to use of the records as evidence to establish protective custody over
child. Rather, "good cause" legally can consist of the state's need to assess father's
substance abuse and mental illness problems for purposes of providing appropriate
services to father and returning child to his custody under circumstances that do not
seriously endanger child's health and well-being. We also conclude that, in this case, the
particular records sought were uniquely valuable to the state for understanding father's
problems and that they were not merely cumulative of what future court-ordered
evaluations might show.
Affirmed.
1. Father takes the position that our review is de novo because this is a
juvenile proceeding. De novo review, however, describes our standard of review for
factual issues. See generally Trabosh v. Washington County, 140 Or App 159, 163 n 6,
915 P2d 1011 (1995) (explaining appropriate meaning and use of the term "de novo"
review). A legal issue is a legal issue, to be reviewed as such, even if it arises in the
context of a case in which our factual review is de novo. Here, the issue turns on the
meaning of a federal statute. We therefore decide the statute's meaning without
deference to how the trial court determined that legal question, notwithstanding that
review of factual issues in juvenile cases is de novo.
Return to previous location.
2. The process for disclosure of medical records under the federal statute
involves two steps. As the implementing regulations observe, a court order of disclosure
pursuant to the statute "is a unique kind of court order. Its only purpose is to authorize a
disclosure or use of patient information * * *. Such an order does not compel disclosure.
A subpoena or a similar legal mandate must be issued" for that purpose. 42 CFR § 2.61
(1998).
Return to previous location.
3. Father also asserted that the records were subject to the physician-patient
privilege under state law. The state, however, argued that ORS 419B.040 abrogates the
physician-patient privilege in this circumstance. On appeal, father has abandoned his
reliance on state law.
Return to previous location.
4. See generally HR Conf Rep No 92-920, 92nd Cong, 2d Sess, reprinted in
1972 US Code Cong & Ad New, 2072 (discussing purpose behind former version of
statute).
Return to previous location.
5. 42 USC section 290dd-2(a) (1994) provides:
"Records of the identity, diagnosis, prognosis, or treatment of any
patient which are maintained in connection with the performance of any
program or activity relating to substance abuse education, prevention,
training, treatment, rehabilitation, or research, which is conducted,
regulated, or directly or indirectly assisted by any department or agency of
the United States shall, except as provided in subsection (e) of this section,
be confidential and be disclosed only for the purposes and under the
circumstances expressly authorized under subsection (b) of this section."
Return to previous location.
6. Regulations also address the effects, procedures, criteria, and contents of
judicial disclosure orders. See generally 42 CFR §§ 2.61-2.67 (1998). None of those
regulations is pertinent to the issue in this case.
Return to previous location.
7. Worth noting in that regard is that the federal regulations implementing the
"good cause" exception specifically contemplate that otherwise protected records might
be sought in circumstances that do not necessarily involve pending litigation, such as a
need for records to pursue an investigation. See generally 42 CFR § 2.63 et seq. (1998).
Return to previous location.
8. We find little guidance, either in the statute itself or in cases from other jurisdictions, as to the appropriate standard of review in assessing whether the court properly weighed the interests involved and properly determined which interests prevail. In this particular case, however, the specific argument that father makes invites a legal inquiry--i.e., whether any weight can be given to an asserted need for records when the same information is available through other records or sources. Apart from making that argument, father does not urge that the juvenile court erroneously assessed the overall balance of the interests involved, an issue that at least arguably might implicate review for abuse of discretion only.
Return to previous location.
9. Neither party requested an in camera review of the records by the juvenile court, apparently because the parties were in agreement about the general nature of their contents as revealed by the timing of when the records were created. We note, however, that our resolution of this appeal does not foreclose further consideration by the juvenile court of the precise contents of the records and appropriate restrictions on disclosure given those precise contents. Pursuant to 42 USC section 290dd-2(b)(2)(C) (1994), a court ordering disclosure may impose appropriate safeguards to ensure that the circumstances and extent of disclosure are tailored to the interests at stake. Thus, the juvenile court remains in a position in this case to tailor its order as the circumstances may require.
Return to previous location.
![]() |
|

![]() |
Updated: 12/15/99 Web authoring by Publishing & Distribution |