CLEE Confidentiality and Privilege 2 — Questions and Answers
Question 1: Under HIPAA, what is the minimum necessary standard for disclosing protected health information?
- Disclose all records whenever requested
- Disclose only the minimum amount of information needed to accomplish the purpose (Correct answer)
- Disclose whatever the patient requests regardless of purpose
- Disclose full records to any licensed health provider
Correct answer: Disclose only the minimum amount of information needed to accomplish the purpose
HIPAA's minimum necessary standard requires that only the minimum PHI needed to accomplish the intended purpose be disclosed.
Question 2: A California therapist receives a subpoena for a patient's records. The correct first step is to:
- Immediately release the records to comply with the subpoena
- Notify the patient and obtain their consent or wait for a court order (Correct answer)
- Destroy the records to protect the patient
- Contact the opposing attorney directly
Correct answer: Notify the patient and obtain their consent or wait for a court order
A subpoena alone does not override privilege; the therapist must notify the patient so they can seek to quash the subpoena, unless a court order compels release.
Question 3: Which exception allows a therapist to disclose confidential information to prevent a patient from self-harm?
- The Tarasoff exception
- The duty-to-warn exception for third parties only
- The imminent danger to self exception under Civil Code §43.92 (Correct answer)
- There is no exception; self-harm is fully protected
Correct answer: The imminent danger to self exception under Civil Code §43.92
California Civil Code §43.92 and the duty-to-warn statutes permit disclosure to prevent serious and imminent harm to the patient themselves.
Question 4: When treating a minor, which party generally holds the psychotherapist-patient privilege?
- The minor patient exclusively
- The minor's parent or guardian
- Both the minor and the parent (Correct answer)
- The therapist on behalf of the minor
Correct answer: Both the minor and the parent
For minor patients, the privilege is held by the minor's parent or guardian, with limited exceptions such as when the minor independently consented to treatment.
Question 5: A therapist receives a written authorization from a patient to release records to their attorney. The therapist should:
- Release records only if a court orders it regardless of the authorization
- Release the records as specified in the valid written authorization (Correct answer)
- Refuse because attorney communications are unrelated to treatment
- Release only a summary, not the actual session notes
Correct answer: Release the records as specified in the valid written authorization
A valid written authorization from the patient allows the therapist to release records to the specified recipient as described in the authorization.
Question 6: The 'dangerous patient' exception in California allows a therapist to warn a threatened third party when:
- The patient expresses general anger toward people
- The patient presents a serious and credible threat of violence against an identifiable victim (Correct answer)
- The patient has a criminal history
- The patient refuses to take prescribed medication
Correct answer: The patient presents a serious and credible threat of violence against an identifiable victim
California Civil Code §43.92 requires a serious, credible, and imminent threat against a specifically identifiable victim before the duty to warn is triggered.
CLEE Confidentiality and Privilege 2
Under HIPAA, what is the minimum necessary standard for disclosing protected health information?