Keeping Oklahomans' Mental Health Records Confidential

Confidentiality is at the core of the therapist and client relationship. Only under certain situations must a counselor, by law, disclose client information. Those situations include:

• if a child or vulnerable adult is being physically, sexually, or emotionally abused,
• if a client is in immediate danger of harming themselves or others,
• if court ordered by a judge due to a legal preceeding. 

Even in the above scenerios, the counselor is ethically mandated to disclose as little information as is relevant and necessariy to other parties. 

However, the Oklahoma Health Information Exchange posed a threat to the core of the counselor/ client relationship.

Is it "Opt In" or "Opt Out"? It Makes ALL THE DIFFERENCE

When this issue first began to be noticed by mental health professionals in early March 2023, government officials stated that "all health care professionals" (including mental health therapists)  must utilize the new Health Information Exchange for all patients. In addition, if a patient did not which for their medical information to be part of the Health Information Exchange then they must "opt out" of the exchange by completing a form, have it signed by their provider (or notarized) and sent to the Health Information Exchange. 

For mental health clients, this act alone violates client confidentiality- a person's name and identifying information being put on a form and signed by a mental health professional stating that they do not want their health information part of the Health Information Exchange. 

This issue was at the core of mental health providers' conflict with the new law and rules:

1. That all mental health client's information must be transmitted to the Health Information Exchange without the client's consent.

2. In order for it not to be viewable, a client must "opt out" by giving their name and signing a form to be presented to the Health Information Exchange. Thereby, breaking his or her confidentiality. 

"We admit that we could have done a better job with our messaging"

During a press conference on March 21, 2023 government officials clarified that, despite their initial message, mental health clients would- by default- not have their mental health records transmitted to the Health Information Exchange unless they chose to "opt in" and give their written consent for their records to be transmitted to the exchange. The written consent would be kept in the counselor's office and not transmitted to the Health Information Exchange.

This same distinction was again expressed during the Oklahoma Health Care Authority meeting on March 22, 2023. The OHCA admitted that this was always the case with mental health records and that they could have done a better job communicating the distinction to mental health professionals and to the general public. 

Was It or Wasn't It? It Doesn't Really Matter...Unless You Hold Public Office

Did mental health providers "bring a fire truck when there was no fire" as expressed by Represenative Marcus McEntire during the press conference on March 21, 2023? Were mental health records safe all along and mental health providers just over reacted? Was Represenative McEntire right to be angry at mental health providers being too "emotional" about client confidentiality? Or, did government officials back peddle after the outcry from mental health professionals and the public? 

As long as the objective to protect mental health records is maintained, then it doesn't really matter- unless you hold public office. 

Join the Facebook group Oklahoma Providers for Privacy to stay informed! (open to health care providers and the general public)

In the News

Therapist Worried About Oklahoma Law Requiring Database for Patient's Mental Health Information

KOCO 5 News

Therapists Raise Privacy Concerns Over New Oklahoma Medical Records Law

By: News On 6

Oklahoma Representative Marcus McEntire Holds Press Conference to Explain the HIE

Rep Marcus McEntire held a press conference on March 21, 2023 to explain the Oklahoma Health Information Exchange. During the press conference he stressed that mental health records will be protected and that mental health clients will have the ability to choose to OPT IN to sharing their mental health data with the Health Information Exchange.

This is the first time, to our knowlege,  that it was stated that mental health clients will be able to choose to OPT IN (meaning that the default is that their mental health records will not be shared with the Health Information Exchange). Is this a change due to public backlash or poor education, from the begining, to the public about the rules from government officials?

Mr. McEntire also made it a point to discuss how unprofessional he felt that the mental health provider community was being in sharing their concerns and fears about client information with their clients and with government officials. He expressed his anger that mental health professionals were being "too emotional" while advocating for client confidentiality. 

Despite Distressed Constituents and Public Outrage, Representative McEntire Admits to Waiting Two Weeks Before Correcting "Misinformation"

During a recent post to his public Facebook page, Representative Marcus McEntire chastised the Oklahoma mental health provider community for spreading "misinformation" to the general public. In the same post, he admitted that a distressed constituent which was "suicidal" had been calling his office for two weeks. The public press conference on March 21, 2023 was the first public comment from Mr. McEntire on a new law he authored which "obviously" was not going to affect mental health records despite mental health professionals concerns. Mr. McEntire chose to not make a pubilc comment, appear on media, or post to his Facebook page until March 21st. Many are now wondering why Mr. McEntire did not speak out publically sooner to ease the concerns of his constituents, or was he, like mental health professionals, unsure how the new law would affect mental health records.

Many mental health providers and advocates believe this bill was poorly written and did not take into account the complexity of mental health records. 

The Oklahoma Providers for Privacy Issues a Press Release on Their Facebook Page After the March 22, 2023 OHCA Meeting