19-000 D. CLIENT REQUEST FOR INFORMATION

  

Table of Contents

The Client Request for Information section includes the following information.  Refer confidentiality questions or requests for release of information not specifically addressed in this chapter to the site

 

Topic

Client Request

Information Provided by Third Party

IEVS Information

Other Requests

Inspection of Case Record in CalWIN

Information that Can Only be Released to the Subject

Information Which Cannot be Released to the Client

 

Client Request

 

 

Information relating to program or service eligibility that has been provided solely by the client or authorized by the client and is contained in applications, imaged in the Document Retrieval System (DoReS) or other documents made or kept by HHSA may be released to the client or the client’s authorized representative. 

 

Examples include but are not limited to:

 

·        Bank verification requests,

·        Medical releases,

·        Cash surrender verification requests, etc.

 

Staff may photocopy specific items imaged in DoReS in the case record, for the client and/or his/her authorized representative.

 

Note: Photocopies in response to general requests (such as the complete case file, all QR7s, etc.) will be referred to Regional Support (formerly Regional Operations) for an appointment.  Also, copies of most Case Comments will not be provided however, the client may make notes on what they see.

 

Information Provided by Third Party

Information provided confidentially to the Agency by a third party and not provided solely by a client will not be disclosed to the client or his/her authorized representative. 

 

Examples include but are not limited to:

 

·        Public Assistance Fraud Division (PAFD) Reports,

·        Whereabouts of an absent parent (provided by a child support

agency),

·        Child Welfare Services (CWS/CPS) findings,

·        Department of Health Care Services (DHCS) Investigations,

·        Foster Care or Adoptions Information,

·        Juvenile Court Detention Records & Minutes,

·        Information protected by attorney-client privilege,

·        Informant identity, and

·        Other privileged communication.

 

IEVS Information

Case information obtained through the Income Eligibility Verification System (IEVS) requires special handling to protect the confidentiality of IEVS information, which may have been mismatched to the client.

           

·        If the IEVS reports verify information previously reported by the client, the reports will be treated as verifications authorized by the client and may be released to the client.

 

·        If the IEVS reports do not appear to pertain to the client or if they contain previously unreported information, they will be treated as information provided confidentially by a third party and they may not be released until the discrepancy has been clarified and the accuracy confirmed.

 

·        Sufficient information from the reports may be provided to the client to allow the client to obtain additional verification and/or clarification.

 

EXAMPLE:    EDD reports a match of the SSN to a UIB recipient.  The name does not match and the client claims no UIB income.  The EDD Field Office number from the report may be provided to the client to aid EDD in clarifying the discrepancy.  The name of the UIB recipient may not be released.

 

Other Requests

Refer confidentiality questions or requests for release of information not specifically addressed in this chapter to the site manager for review.  Unauthorized disclosure of confidential information may render the County and/or staff liable for criminal and civil suits.

 

Inspection of Case Record in CalWIN

 

 

 

Authorized persons requesting an entire case review, as well as those authorized to actually complete the inspection will be referred to Regional Support and will be subject to the review procedures listed below.  This does not include those persons requesting review in preparation for a State Hearing.  Reviews requested in preparation for a State Hearing should be referred to the Appeals section to schedule an appointment.

 

Item

Review Procedure Requirement

1.

The complete case record, except for privileged communication as noted below, and information not provided solely by or authorized by the client will be made available for inspection in CalWIN by appointment with Regional Support.  Case Comments are to be shared, if requested, unless they contain privileged information or information provided by third parties.

 

Note: Personal opinions should not be entered in Case Comments.

2.

Case inspection will be permitted only during normal business hours.  The reviewer must make an appointment with a Regional Support Program Specialist to review non-privileged information in CalWIN and DoReS. 

3.

The Regional Support Program Specialist (PS) will make a private area available for record review where reviewers may discuss case contents in the presence of the PS or appropriate County staff.

 

Note: Reviewers shall not have access to a County computer or entry into CalWIN.  The viewing of a case will be made available only when the Program Specialist or other appropriate staff is present in the room and conducting the review during the entire period of examination.

4.

The reviewers will not be permitted any access to a computer, entry into CalWIN or to remove, alter, photocopy or photograph anything in the case record.  Reviewers will be permitted to make notes on what they see in the case record.

 

Upon request, specific items in the case record may be photocopied by county staff for the reviewer.  Photocopies in response to general requests (the case file, all QR7s, etc) shall not be provided.  Program Guides for other regulations will be available online during the case review.  Photocopies of applicable regulations may be made; however, entire chapters are not to be photocopied.

5.

Requests to review a closed case should be directed to the ACCESS call center.  

6

The HSS will record in the Case Comments all requests for inspection of case records.

 

Information that Can Only be Released to the Subject

Certain information can only be released to the subject of the document or their AR and not to other members of the Assistance Unit (AU) or household.  These include but are not limited to information regarding domestic abuse, medical history, criminal background, mental health and substance abuse treatment, learning disabilities, and case records of minors who have received services under Minor Consent Medi-Cal.  Such information may ONLY be released to the person who is the subject of the document.

 

Information Which Cannot be Released to the Client

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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There are communications contained in case records that are not subject to review by the client or his/her authorized representative.  Additionally, there are communications that are not subject to review by a client’s authorized representative without specific written consent of the client.

 

Some of these privileged communications are briefly summarized

 below:

 

·       Physician/Patient (Medical Personnel/Patient)

Confidential communication from a physician cannot be disclosed to the authorized representative without specific written consent of the patient.  Some physicians may request a report not to be released to the patient.  In such cases the physician’s consent to release the report must be obtained.

 

·        Public Assistance Fraud Division (PAFD) and Department of Health Care Services (DHCS) Reports

All reports, summaries and other confidential communication or information obtained by PAFD and DHCS in the process of investigation of an alleged fraud will be removed from the case record prior to its inspection by a client or authorized representative.

 

·       Identity of Informer

HSS’s will not disclose the identity of an informer to the client or his/her authorized representative.

 

·       Child Abuse Reports and Child Abuse Hotline Reports   

All Child Abuse reports and other confidential communication/ information obtained as a result of a Child Abuse Hotline Complaint will not be allowed to be viewed in the case record by the client or authorized representative during inspection. 

 

·       Lawyer/Client

Matters of confidential communication between a lawyer and client cannot be disclosed without specific written consent of the client.

 

·       Husband/Wife

Confidential communication between husband and wife during their marital relationship cannot be disclosed unless both agree to its disclosure, even if the marriage has terminated.