MENTAL HEALTH RECORDS REQUIRE SPECIAL HANDLING

HIPAA rules give special protections to psychotherapy records. Among the protections is that a therapist can refuse to release a psychotherapy file, without giving you a reason, unless a valid court order compels a release of the record. To address a few common concerns you or your therapist might have, please know that:

  • The FAA advisory, stated above, specifically says that the psychiatrist must review treatment notes (not summaries) from your counseling provider.
  • A summary of treatment, whether by a letter or phone call, most of the time fails to meet the “sufficient detail” standard as described in the FAA’s specification sheet.
  • A therapist’s summary letter, which by definition as a summary of a record, highlights some content and excludes other information, unwittingly places the therapist as a decision maker in a public safety assessment.
  • By contrast, releasing the file without restrictions keeps the responsibility for aeromedical safety assessments focused on the aviation psychiatrist.
  • The records have the same HIPAA psychotherapy protections when held in this office as when kept by the originator. The file can be released only with your written consent or a court order. If your therapist asks that I not release the file to you, in order to preserve the therapeutic alliance between you and your therapist, I have an ethical obligation to honor that request and would not release the file to you without a court order.
  • I also have an ethical obligation to de-identify my report so that the assessment does not reveal protected health information (PHI) of others. For example, I am not allowed to quote something from the psychotherapy record that inadvertently identifies any other person, such as a spouse, child, or companion.
You can download a copy of the advisory formatted as a letter by scrolling to the bottom of the page.

You should request the complete record of care, which includes ALL notes of these types:

  • Individual counseling notes, including psychotherapy notes
  • Psychological test results and reports, if any
  • Notes that include any and all information about the use of drugs or alcohol
  • Intake assessment notes

You should request the complete record of care, which includes ALL notes of these types:

  • Individual counseling notes, including psychotherapy notes
  • Psychiatric medication management notes
  • Complete prescribing record
  • Psychological test results and reports, if any
  • Notes that include any and all information about the use of drugs or alcohol
  • Intake assessment notes

Rehab center charts include multiple categories of records to select. This is what counts as a full record:

  • Physician discharge summary
  • Admission history and physical
  • Psychosocial assessment/summary
  • All counselors notes
  • All physician notes and orders
  • All laboratory testing data
  • All nursing notes
  • Emergency Department report, if any
  • Psychological report, if any
  • Counselor’s discharge summary, if any
  • Substance use/abuse assessment, if any

This is what counts as a full group therapy record:

  • Counselor’s intake summary
  • Psychosocial assessment
  • All individual counseling notes
  • Any physician notes and orders
  • De-identified group therapy notes
  • All laboratory testing data, including sobriety testing
  • Psychological reports, if any
  • Counselor’s discharge summary, if any
  • Substance use/abuse assessment, if any

Treatment Records Should Come Directly To Me From The Provider, Not Through The Pilot

Safety assessments consider the validity of records through a chain of custody procedure. If the file comes through an non-medical intermediary, the file hypothetically could be altered and this limits its usefulness.

Some medical records systems allow the client to print medical records at home. Not only would this break the chain of custody, most systems do not allow a client to access mental health records without approval from the clinic.

Legal records can come directly from the pilot.

Where Does The Clinic Send Records?

I receive all mail, even for Las Vegas clients, in Denver at:

Aviation Psychiatry, LLC
Gregory L. Kirk, MD
2036 East 17th Avenue
Denver, Colorado, 80206

Emailed records should be to sent to

gregkirk@avipsy-secure.org

I cannot receive records by fax

You Should Request The Entire File, Not A Type- Or Date-limited Subset

Requesting the entire records ensures that no critical component of the safety assessment has been overlooked or ignored.

Most clinics prefer that you use their own release forms. You may be able to download a form from the clinic website, if they have one, or you can call your clinic’s office and ask about the records release procedure.

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