Oberdorfer Law Firm

You might think that physician-patient privilege means your nurse won’t tell the police your hospital blood draw results. You could even think that HIPAA (the Health Insurance Portability and Accountability Act of 1996) protects your privacy as a patient.

HIPAA and Oregon law require hospital staff to notify police when they develop evidence a crime may have been committed. If you’re brought to the hospital after driving, and your hospital blood draw is above .08% BAC, expect a police officer to arrive in the emergency room to charge you with a crime.

ORS 676.260(1) imposes a mandatory reporting duty on health care facilities under certain circumstances. A health care facility “shall notify” a law enforcement officer present at the facility investigating a motor vehicle accident if, immediately after the accident, the facility treats “a person reasonably believed to be the operator of a motor vehicle involved in the accident” and, in the course of treatment, tests the person’s blood and discovers that the person’s blood alcohol level exceeds.08 percent or that the blood contains a controlled substance.

The Oregon Court of Appeals addressed this issue in State v. Miller, 303 Or App 165, vac’d 362 Or. 300 (2017), State v. Fincher, 303 Or App 165 (2020), rev’d on other grounds 368 Or 560 (2021), and State v. Hoffman, 321 Or App 330 (2022). In each of those cases, the court held that Oregonians do not enjoy a reasonable expectation of privacy in their hospital records related to BAC.

The law is in a state of flux, and there remain arguments about whether police get to use your hospital blood evidence against you at trial. Because ORS 676.260 and HIPAA require disclosure to police, the hospital blood draw appears to be a constitutionally significant search. See State v. Tucker, 330 Or 85, 90 (2000) (“[I]f a state officer requests a private person to search a particular place or thing, and if that private person acts because of and within the scope of the state officer’s request, then Article I, section 9, will govern the search.”); see also Skinner v. Railway Labor Executives Ass’n, 489 US 602, 614 (1989) (the Fourth “Amendment protects against such intrusions if the private party acted as an instrument or agent of the Government”).

In Riley v. California, 573 US 373, 397 (2014), the US Supreme Court explained that even though cell phone data is often stored on remote servers instead of on individual users’ devices, this fact “generally makes little difference.” Since Carpenter v. United States, 138 S Ct 2206 (2018), courts have included health records within the scope of materials that can be held by a third party without destroying the subject’s privacy interest. See, e.g., State v. Eads, 154 NE3d 538, 547 (Ohio Ct App 2020). In short, the law about admissibility of hospital blood evidence appears to be capable of change.

The court in Hoffman narrowed it down to a question of whether Oregon’s law permitting nurses to tell police your BAC reflects “the legislature’s assumption that there was no privacy interest in that information.” It is a difficult piece of logic: we are attacking the statute for permitting a constitutional privacy violation, pointing out that a statute cannot overwhelm our constitutional rights to privacy, but the statute itself is being used to suggest such privacy does not exist.

When hospital draws are admitted, this can be confusing as a matter of forensic science, as hospitals are not testing blood for use in court. They are testing blood to get a ballpark idea of what substances are on-board, so they can make good palliative and treatment decisions. The hospital lab will generally test serum or plasma, rather than whole blood. BAC will thus always be about 20% higher than a true forensic blood draw.

Finally, the state must prove chain-of-custody for your blood sample. Forensic blood draws are often scrupulously documented, since they are created to be used in court. Hospital blood draws are not. Sometimes hospital draws even specify, “[s]pecimen analysis was performed without chain of custody.” See State v. Martin, 307 Or App 396, 404 (2020) (state failed to lay chain-of-custody for hospital blood sample); State v. Hoffman, 321 Or App 330 (2022) (same).

If you find yourself arrested or cited at the hospital after a car wreck, be sure to get a DUII attorney quickly. Important time limitations apply, and your attorney can help you fight any proposed Implied Consent license suspension related to chemical tests.

If convicted of DUII, or if you enter DUII Diversion, you have a right to attend a DUII treatment program “of [your] choice and [to] be free from undue influence or coercion when choosing a provider,” and it’s not unusual for people to start alcohol treatment voluntarily before meeting with ADES / ADSS. It’s admirable to do so, it serves public safety goals, and it demonstrates early recognition of an alcohol problem (a consideration for the court in whether to allow DUII Diversion, ORS 813.220(2)).

You can generally find an out-patient alcohol treatment center by using internet search terms “alcohol treatment [town].” Sometimes searching in a maps program helps you find a provider nearby. When you call, let the treatment provider know you’ve been arrested for DUII, and you’d like to voluntarily start outpatient treatment early. If the provider says you must wait for court or “ADES,” hang up and call another provider — they’re letting you know they consider the court the client, not you.

ADES / ADSS in almost all circumstances should agree to the provider you’ve selected — in order to honor your rights listed below.

415-054-0481
Individual Rights

(1) In addition to all applicable statutory and constitutional rights, every individual receiving services has the right to:

(a) Choose from available services and supports that are culturally competent, provided in the most integrated setting in the community and under conditions that are least restrictive to the individual’s liberty, that are least intrusive to the individual, and that provide for the greatest degree of independence;

(b) Be referred to a Division approved DUII services provider of the individual’s choice and be free from undue influence or coercion when choosing a provider.

(c) Have the role of the court, DUII services provider, and ADSS monitoring process explained where the DUII system is concerned;

(d) Be treated with dignity and respect;

(e) Confidentiality and the right to consent to disclosure in accordance with ORS 107.154, 179.505, 179.507, 192.515, 192.507, 42 CFR Part 2 and 45 CFR Part 205.50;

(f) Inspect their service record in accordance with ORS 179.505;

(g) Refuse participation in experimentation;

(h) Receive prior notice of transfer, unless the circumstances necessitating transfer pose a threat to health and safety;

(i) Be free from abuse or neglect and to report any incident of abuse or neglect without being subject to retaliation;

(j) Have religious freedom;

(k) Be free from seclusion and restraint;

(L) Be informed at the start of services of the rights guaranteed by this rule;

(m) Be informed of the policies and procedures, service agreements and fees applicable to the services provided and to have a custodial parent, guardian, or representative assist with understanding any information presented;

(n) Have family and guardian involvement in service planning and delivery;

(o) File grievances, including appealing decisions resulting from the grievance;

(p) Exercise all rights set forth in ORS 109.610 through 109.697 if the individual is a child, as defined by these rules;

(q) Exercise all rights set forth in ORS 426.385 if the individual is committed to the Authority; and

(r) Exercise all rights described in this rule without any form of reprisal or punishment.

(2) The ADSS must give to the individual and, if appropriate, the guardian a document that describes the applicable individual’s rights as follows:

(a) Information given to the individual must be in written form or, upon request, in an alternative format or language appropriate to the individual’s need;

(b) The rights and how to exercise them must be explained to the individual and if applicable the guardian; and

Statutory/Other Authority: 413.042 & 430.256
Statutes/Other Implemented: 430.256, 430.205-430.210, 430.254-430.640, 430.850-430.955, 461.549 & 743A.168
History:
ADS 4-2017, adopt filed 12/28/2017, effective 01/01/2018

415-054-0490
Referrals

(1) After completion of a screening interview, the ADSS shall initiate a referral to the Division approved DUII services provider of the individual’s choice using forms and procedures designated by the Division.

(2) The ADSS shall provide the individual with a list of all Division approved DUII services providers:

(a) Within the geographic area preferred by the individual; and

(b) In any other geographic area capable of responding to a specific need including but not limited to:

(A) Ability to pay or seek reimbursement through insurance;

(B) Primary language;

(C) Culturally-specific services; or

(D) Hours of operation.

(3) The individual record shall include documentation of which Division approved DUII services providers were offered for referral that has been signed and dated by the individual.

(4) The ADSS may not deny a referral to any Division approved DUII services provider except in cases where the referral would constitute an imminent health or safety risk to the individual. Denials shall be clearly documented in the individual record and include the reason for the denial including the specific health or safety risk posed.

(5) Within three calendar days of a denial being made, the ADSS shall report to the Division using Division approved forms and procedures.

(6) Within five calendar days of the screening, the ADSS shall forward a copy of the Division approved referral form and completed screening instrument to:

(a) The selected DUII services provider; and

(b) The individual.

(7) When the individual is a resident of a state other than Oregon, the ADSS may refer the individual to a program licensed by and located in the individual’s state of residency.

(8) Referrals to out-of-state substance use disorder service providers shall also include a copy of applicable Oregon Administrative Rules for issuance of a DUII Treatment Completion Certificate.

Statutory/Other Authority: ORS 430.256 & 413.042
Statutes/Other Implemented: ORS 430.256
History:
ADS 4-2017, amend filed 12/28/2017, effective 01/01/2018
ADS 2-2011, f. 3-8-11, cert. ef. 3-9-11
ADS 4-2010(Temp), f. & cert. ef. 9-20-10 thru 3-9-11

415-054-0485
Screening

(1) The ADSS shall perform a screening interview using documents and procedures designated by the Division for individuals under a DUII Diversion Agreement or convicted of a DUII within the preceding 15 years to determine whether to recommend an individual to a DUII education program or a DUII rehabilitation program.

(2) The ADSS must utilize a screening procedure that at a minimum shall ensure the provision and documentation of the following:

(a) Individuals must be considered for entry without regard to race, ethnicity, gender, gender identity, gender expression, sexual orientation, religion, creed, national origin, age (except when program eligibility is restricted to children, adults, or older adults), familial status, marital status, source of income, and disability;

(b) Individuals must receive services in the most timely manner feasible consistent with the presenting circumstances;

(c) Development and maintenance of adequate records and other documentation for each individual served that demonstrates the specific services for which payment has been requested, including documentation of a suicide risk assessment and appropriate referral;

(d) An authorization for the release of information obtained for any confidential information concerning the individual being considered for or receiving services in accordance with ORS 179.505, Federal Confidentiality Regulations (42 CFR, Part 2), and HIPAA; and

(e) Reasonable effort is made to attain appropriate collateral information including but not limited to the individual’s DUII arrest record.

(3) At the time of screening, the program must offer to the individual and guardian, if applicable, written program orientation information. The information must be written or, upon request, in an alternative format or language appropriate to the individual’s need and must include:

(a) A description of individual rights;

(b) Policy concerning grievances and appeals consistent with these rules to include an example grievance form; and

(4) Screening interviews shall be conducted in a face-to-face interview unless:

(a) The individual provides documentation from a health care professional indicating that a face-to-face interview would jeopardize their health or safety;

(b) The individual is a resident of another state or county and lives more than 75 miles from the ADSS service site;

(d) Approved by the Division in writing prior to the screening interview.

(5) The ADSS shall clearly document the reason for the absence of a face-to-face interview in the individual record.

(6) Individuals who exhibit risk factors for a substance use disorder as indicated in the Division approved screening tool shall be referred to DUII Rehabilitation Services.

(7) Individuals who do not exhibit risk factors for a substance use disorder as indicated in the Division approved screening tool shall be referred to DUII Education Services.

Statutory/Other Authority: 413.042 & 430.256
Statutes/Other Implemented: 430.256
History:
ADS 4-2017, adopt filed 12/28/2017, effective 01/01/2018

415-054-0500
Transfers

(1) An individual may request a transfer to a different Division approved DUII services provider by submitting a request in writing to the ADSS.

(2) The ADSS shall initiate a referral to the requested Division approved DUII services provider as described in OAR 415-054-0490(3) within five calendar days from the receipt of the individual’s written request.

(3) The ADSS may not deny a transfer request to any Division approved DUII services provider except in cases where the referral would constitute an imminent health or safety risk to the individual. Denials shall be clearly documented in the individual record and include the reason for the denial including the specific health or safety risk posed.

(4) Within three calendar days of a denial being made, the ADSS shall report to the Division using Division approved forms and procedures.

Call for Consultation: 503-221-1792

Monthly Archives: December 2017

Is BAC in hospital records private?

Should I Start Alcohol Treatment Early?