PA-RPM 8 - Access to Case Records*
Service recipients or designated legal representatives can access their case records, consistent with legal requirements.
Update: Revised Second Note, Added Second NA - 03/01/11; Update: Added Second Note, Deleted NA, Added NA - 12/01/10
PA-RPM 8 Original Second Note:
PA-RPM 8 does not apply to Community Change Initiatives (PA-CCI), Early Childhood Education (PA-ECE), Out-of-School Time (PA-OST), and/or Youth Development (PA-YD) programs. However, if agencies provide both those and other services, the standards will apply to the agency and should be implemented in all programs/services other than PA-CCI, PA-ECE, PA-OST, and PA-YD. Agencies that provide other types of non-clinical group or crisis intervention services should contact their Accreditation Coordinator if they have questions about the applicability of these standards.
PA-RPM 8 Original First NA - 12/01/10:
The agency provides non-clinical group or crisis intervention services.
Interpretation: Agencies are expected to have policies and procedures that address access to case records by service recipients.
Interpretation: For networks, PA-RPM 8 applies to case records and case information that is maintained by the network management entity, as well as records maintained by member agencies or subcontracted providers.
Note: See PA-DV 17 for further guidance about the information to be included in case records for Domestic Violence Services (PA-DV).
Note: If the agency operates a program that qualifies for an NA but also provides other types of services, the standards should be implemented in all programs aside from those that qualify for the NA.
NA The agency provides only Community Change Initiatives (PA-CCI), Early Childhood Education (PA-ECE), Out-of-School Time (PA-OST), and/or Youth Development (PA-YD) Services.
NA The agency provides only non-clinical group, crisis intervention, and/or information and referral services.
Access to confidential case records meets legal requirements, and is limited to:
Interpretation: Case records should not be left in public areas such as on carts in hallways, on desks, or in non-secured areas. When not being used by authorized staff, files should be returned to a secure area.
Reviews of case records by service recipients are:
If the agency determines that it would be harmful for a service recipient to review his/her case record, and applicable law provides no guidance on case record access, then:
Interpretation: An individual's right to review his or her care or treatment may be denied, or otherwise limited, only in the most extreme circumstances where serious harm is likely to ensue. In such cases, objective criteria must guide decisions to deny access. In all cases, the agency must operate in accord with applicable law.
Contracts with subcontracted provider agencies and independent practitioners ensure that the network management entity has access to the case records of persons and families receiving network services.
Interpretation: Network management entities require access to case information in order to conduct utilization management activities, verify billing, provide care coordination, and other network management activities.
NA The agency is not a network management entity.