Oklahoma counselor: There's no need for state to obtain mental health data
As a Licensed Professional Counselor with over 20 years in private practice, I am deeply troubled by the requirement to release mental health information into the statewide health information exchange (HIE). Senate Bill 1369 was passed in 2022. It requires all health care information, including mental health, be entered into a statewide database by July 2023. Oklahoma mental health providers were blindsided by this news, many not hearing about it until a public forum was held on March 7. On March 22, the proposed changes are scheduled to become permanent rules by the Oklahoma Healthcare Authority (OHCA) board of directors.
Recently, the authority approved emergency revisions to this bill that expanded the mandate to ALL Oklahomans, regardless of using private insurance or if one pays out of pocket for mental health services. Authority literature continues to evolve on its website, but based on information on March 13, providers will be required to enter, at minimum, a name, diagnosis, dates of service and procedure codes. This means a client will now interface with their health care providers wearing their mental health treatment and particular struggle on their forehead, leading to possible bias and stigma.
As a primarily self-pay provider, my clients have unique and varied reasons why they are willing to pay out of pocket to preserve their privacy. Having mental health information in a statewide database puts individuals at risk of discrimination, job loss, personal safety issues, loss of status, marital and divorce conflict, database leaks and even gossip.
Here are some examples of populations that might notpursue much needed counseling due to the aforementioned risks: any individual embarrassed of their diagnosis; individuals interfacing professionally with the public; individuals holding a public office; someone married, divorcing, or in a domestic abuse situation with a health care provider or their office staff; attorneys; health care professionals in fear of their peers knowing; first responders, veterans or anyone who does not want it known they are in counseling, let alone their diagnosis.
In a state already overwhelmed with mental health needs, limited providers and long waitlists, I am forced to choose between continuing as a counselor and breaking my confidentiality commitment to clients or seeking alternatives such as leaving the state to practice or turning in my hard-earned professional license.
The authority will tell you, you can opt-out of the HIE, however, the form says it will not make your information “viewable.” Providers still have to upload client information, and the authority has “emergency” provisions for allowing information to be shared. “Emergency” is not clearly defined. You also have to opt-out with every provider you see, not a global opt-out. Also, your information is in the system, therefore, vulnerable to breaches like what happened to the health information of lawmakers in Washington, D.C.
The authority says it needs the information to provide seamless care. Counseling clients always have had an option to sign releases to coordinate care with other health care professionals, but it’s at their request not the government's. In addition, if a state of emergency arises such as harm to self or others, we already have a duty to report the information. There is no need for mental health records to be in the HIE.
You can help by following the Oklahoma Providers for Privacy Facebook page and Twitter feed, and contacting your legislators and the Oklahoma Healthcare Authority. Ask for mental health records to be excluded from the HIE at the March 22 Oklahoma Healthcare Authority meeting, and ask for legislators to pass a bill to permanently exclude mental health records.
Leah Danley, MS, MEd, LPC, is a licensed counselor based in Oklahoma City and Edmond.
This article originally appeared on Oklahoman: Oklahoma counselor: No need for state to obtain mental health data
