Privileged and Confidential Information

[EAS 19-006]

Certain portions of the case record are considered to be privileged and/or confidential information and cannot be released to the client or Authorized Representative (AR). Privileged or confidential information includes but is not limited to:

Attorney-client communications between SSA and its attorneys.
Confidential information about another adult or head of household in or out of the home. (e.g. they are a victim of abuse, criminal records, substance abuse information, mental health information, medical information or juvenile case records).
Identity of a reporting party or informant.
Mental Health information in which the health care provider has indicated in writing that disclosure would cause significant harm to the client or another’s safety if seen by the client.
Whereabouts of an absent parent received from a Child Support Agency.
Minor Consent Medi-Cal case records when the Minor is not the client.
Child Protective Services or Adult Protective Services information including the status or whereabouts of children, an elder or dependent adult not living with the client.

When allowing clients or ARs to review a case, staff must ensure that this information is protected and they are not allowed to review it. Staff may protect privileged information in the case record by either:

Removing or redacting the information from a physical case folder, or
Navigating through the IDM system for the client or AR to ensure confidential information is not displayed.

If privileged or confidential information is mixed in with information that the client or AR should have access to, redact only the privileged or confidential information and allow the client or AR access to the remainder of the file and or screen.

Responsibility for Case Review

When a fair hearing is filed, request for case reviews will be conducted by Appeals Officers (AO). Escalations will be first to their supervisor and if necessary, to the ASB Coordinator. Any other requests will be handled by the assigned Eligibility Workers (EW) at the district office. Escalation for these cases will be managed by the DEBS Ombudsman.

Removal of Privileged/Confidential Information

When an Appeals Officer (AO) or Eligibility Worker (EW) is preparing the case for a client/third party review and determines that the case contains privileged/confidential information that cannot be reviewed, the following process must occur:

Who

Action

Appeals Officer (AO)/ Eligibility Worker (EW)

Reviews the case for a client/third party review. Determines if the case contains privileged/confidential information.
Informs ASB Coordinator or DEBS Ombudsman of the documents determined containing privileged/confidential information.
Completes a “Response to Request to Inspect Case Record” (CW 2213) indicating what information is being withheld, if any.
Provides the CW 2213 to the client/third party at the time of the case review.

Client/Third Party

Receives the CW 2213 indicating which information is being withheld.

If the client/third party...	Then the EW...
Agrees with the removal of the information,	Takes no further action.
Disputes the information being withheld, if any,	Explains to the client/third party that the information will be escalated to the ASB Coordinator or DEBS Ombudsman. Explains the escalation process and that it may take a few days but no longer than one week for a decision to be made. Informs ASB Coordinator or DEBS Ombudsman.

ASB Coordinator/ DEBS Ombudsman

Receives the CW 2213.
Reviews the reasons for withholding information.

If the ASB Coordinator/ DEBS Ombudsman...	Then...
Disagrees with the EW’s determination,	Discusses the issue with the designated DEBS staff. Explains that he/she must allow the client/third party to review the information.
Agrees with the EW’s determination,	Consults with County Counsel regarding the determination. Provides a short summary of the specific issue to County Counsel (e.g. AR objects to redacting lines 3-6 of document XYZ which contains information about non-client adult head of household’s mental health.) Includes the PDF version of the document in question and any correspondence with the AR.

County Counsel

Receives the CW 2213.
Reviews the reasons for withholding information.

If County Counsel...	Then County Counsel...
Disagrees with the determination,	Discusses the issue with the ASB Coordinator/ DEBS Ombudsman. Explains that the client/third party must be allowed to review the information.
Agrees with the determination,	Informs ASB Coordinator/ DEBS Ombudsman that the determination is correct.

ASB Coordinator/ DEBS Ombudsman

Receives the decision from County Counsel.

If the decision was...	Then the EW...
Upheld,	Contacts the client/third party and explains the decision.
Overturned,	Contacts client/third party and allows him/her to review the information that was originally withheld.

CalWIN Screens

The following chart provides the most common types of privileged information which the client does NOT have the right to access and the CalWIN or case document where this information would be located:

Privileged Information	CalWIN Windows to Review	Documents to Look for in IDM/Paper Case
Community Complaint	Maintain Case Comments Note: Only the basis of the complaint can be disclosed.	“Community Inquiry or Report” (SCD 16) Note: Only the basis of the complaint can be disclosed.
Confidential Information on Another Adult In or Out of the Home that was provided by someone other than the client (See Examples #1 and #2 Below)	All CalWIN Windows	All documents in the paper case or in IDM must be reviewed to determine if it meets the criteria above to be considered privileged.
Confidential Referrals - Fraud or Child/Adult Protective Services	Maintain Case Comments Display Referrals	"Suspected Child Abuse Report" (SS8572) "Report of Suspected Dependent Adult/Elder Abuse" (SOC 341)
Minor Consent Information (When Minor is not the client)	Maintain Case Comments (Entire Minor Consent Medi-Cal Case is CONFIDENTIAL)	“Request for On-Line Action” (SCD 1296) "Statement of Need for Mental Health Services Medi-Cal Minor Consent" (SCD 558) "Request for Eligibility Limited Service" (MC 4026)
Whereabouts of the Absent Parent Received From Child Support Agency	Maintain Case Comments Collect Absent Parent Information - Child Support Address Tab	"Absent Parent Referral" (CW 2.1)

Example 1

A mother and her 17 year old child receive CalWORKs. The mother’s 21 year old daughter and the daughter’s child live with them and also receive CalWORKs. All four of them receive CalFresh in the senior mother’s case. The senior mother cannot be granted access to information/verifications provided by her daughter.

Example 2