New York Law Review

Albany Law School v. NYS Office of Mental Retardation, 19 N.Y.3d 106 (2012): Access to Clinical Records for Disability Advocates

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Albany Law School v. New York State Office of Mental Retardation and Developmental Disabilities, 19 N.Y.3d 106 (2012)

Mental Hygiene Law §§ 45.09(b) and 33.13(c)(4) grant protection and advocacy organizations access to clinical records of developmentally disabled individuals consistent with the federal Developmental Disabilities Assistance and Bill of Rights Act (DD Act), balancing privacy rights with advocacy needs, and actively-involved family members can be considered legal representatives under certain circumstances.

Summary

Albany Law School and Disability Advocates, Inc., sought unrestricted access to clinical records of residents at two OPWDD facilities, arguing that Mental Hygiene Law §§ 45.09(b) and 33.13(c)(4) granted them this right. OPWDD countered that these state laws incorporated the access provisions of the federal DD Act, which balances resident privacy with advocacy needs. The New York Court of Appeals held that the state statutes must be read in accordance with federal law and that actively-involved family members can be considered legal representatives if they have sufficient decision-making authority and their designation is appropriately reviewed. The court remitted the case to determine the adequacy of OPWDD’s process for designating and reviewing family members as legal representatives.

Facts

Albany Law School and Disability Advocates, Inc. (petitioners), contracted with the New York State Commission on Quality of Care and Advocacy for Persons with Disabilities to provide protection and advocacy services to individuals with developmental disabilities. After receiving a complaint about discharge practices at an OPWDD facility and noting concerns about timely transfers to less restrictive settings, the petitioners requested access to the clinical records of all residents at two OPWDD facilities. OPWDD denied unrestricted access, citing the DD Act’s requirements for authorization from the individual or their legal representative.

Procedural History

Petitioners filed an Article 78 proceeding and a § 1983 action to compel OPWDD to grant access to the records. Supreme Court sided with OPWDD, holding that the Mental Hygiene Law incorporated the DD Act’s access procedures and that legal representatives could include actively-involved family members. The Appellate Division modified, finding that § 45.09(b) authorized access upon receipt of a complaint but disagreed that actively-involved family members could be legal representatives. Both OPWDD and petitioners were granted leave to appeal to the Court of Appeals.

Issue(s)

1. Whether Mental Hygiene Law § 45.09(b) and § 33.13(c)(4) provide P&A organizations with unqualified access to clinical records or incorporate the federal access provisions of the DD Act?

2. Whether actively-involved family members can be deemed legal representatives for purposes of the federal and state access provisions?

Holding

1. No, because Mental Hygiene Law § 45.09(b) and § 33.13(c)(4) must be read in accord with federal law, which balances privacy with advocacy needs.

2. Yes, because actively-involved family members can possess sufficient decision-making authority to qualify as legal representatives, pending an assessment of OPWDD’s appointment and review process.

Court’s Reasoning

The Court of Appeals reasoned that the primary consideration in statutory interpretation is legislative intent, as gleaned from the text, context, and legislative history. Although Mental Hygiene Law § 45.09(a) grants the Commission on Quality of Care broad access, § 45.09(b) and § 33.13(c)(4) tie the access rights of P&A organizations to the Commission’s administration of the P&A system “as provided for by federal law.” The court found the legislative history indicated that the amendments were intended to ensure New York’s compliance with the DD Act to maintain federal funding.

Regarding family members as legal representatives, the court noted that New York law grants actively-involved family members significant powers, such as consenting to major medical procedures and making end-of-life decisions. The court cited 45 CFR 1386.19, which defines a legal representative as “an individual appointed and regularly reviewed by a State court or agency…and having authority to make all decisions on behalf of individuals with developmental disabilities.” While actively-involved family members hold significant decision-making authority, the court remitted the case for further proceedings to examine the nature and adequacy of OPWDD’s process for selecting and reviewing these family members.

The court emphasized the need to balance the privacy rights of developmentally disabled individuals with the crucial advocacy role of P&A organizations, concluding that New York law parallels federal law in this regard.

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