Commissioner of Social Services of City of New York v. David R. S.
| Decision Date | 18 May 1982 |
| Citation | 55 N.Y.2d 588,436 N.E.2d 451,451 N.Y.S.2d 1 |
| Parties | , 436 N.E.2d 451 In the Matter of the COMMISSIONER OF SOCIAL SERVICES OF the CITY OF NEW YORK, as Assignee of Guiliana S., Petitioner, v. DAVID R. S., Respondent. The Door--A Center of Alternatives, Appellant. |
| Court | New York Court of Appeals Court of Appeals |
Patient records maintained by a drug abuse treatment center which is assisted by an agency of the United States are not to be denied the shelter of statutory confidentiality where the center made a diagnosis for drug abuse, notwithstanding that the patient first sought non-drug-related services from the center and that the records sought to be disclosed pertain to other than a drug-related condition.
Incident to his defense in a paternity proceeding pending in Family Court of Kings County, respondent, David S., sought to subpoena records of The Door (a drug and alcohol abuse prevention and treatment facility receiving direct and indirect assistance from the National Institute on Drug Abuse) concerning Guiliana S., the mother on whose behalf the allegation of paternity had been made. The Door has resisted disclosure on the ground that the records are protected by the Federal Drug Abuse Prevention, Treatment and Rehabilitation Act (U.S.Code, tit. 21, § 1101 et seq.). 1 Two questions are presented: whether the records demanded are within the coverage of the statute, and if so, whether the direction for their disclosure by the Family Court represents a proper exercise of the power conferred on courts of competent jurisdiction to make exceptions to the statutory proscription (U.S.Code, tit. 21, § 1175, subd. par. cl. ). We conclude that the records do come within the coverage of the statute and that their disclosure was not authorized.
The paternity proceeding in which this controversy arises was commenced by the New York City Commissioner of Social Services as assignee of Guiliana. When the alleged father, David, served a subpoena duces tecum on The Door for its production of the "record, pertaining to examinations, consultations, treatment, birth control, abortion, etc." of Guiliana, and The Door indicated its unwillingness to comply, David moved in Family Court for an order directing compliance. His purpose was to use the records to impeach Guiliana's credibility in the paternity proceeding by showing a prior pregnancy and abortion and sexual promiscuity which he expected those records would confirm.
The motion was initially denied but, after hearing the mother's testimony, Family Court reconsidered its decision and ordered The Door to produce the records for an in camera inspection the following day. After that inspection, Family Court held that the records came within the scope of the statute but, finding that good cause existed, directed that portions of the records be made available to David's counsel. On appeal taken by The Door, the Appellate Division unanimously affirmed (83 A.D.2d 636, 441 N.Y.S.2d 540). It concluded, however, that title 21 ( § 1175, subd. ) of the United States Code was inapplicable because a review of the portion of the records that had been ordered to be disclosed revealed that Guiliana had contacted and continued to deal with the center "for purposes wholly unrelated to drug abuse counselling". It had no occasion to consider whether, had the records come within the embrace of the statute, their disclosure should be authorized in the circumstances of this case.
We disagree with the Appellate Division's conclusion that the Federal statutory provision addressed to protection of confidentiality is not applicable because Guiliana first came to The Door for one of its services other than drug counseling. The center attempts to respond to a variety of needs to which young people are exposed and thereby to gain their confidence and, it is hoped, their acceptance of drug and alcohol abuse counseling and treatment where appropriate. In Guiliana's case, although her initial visit was for pregnancy evaluation and she continued to receive pregnancy counseling during the period to which the records ordered disclosed relate, the center thereafter expanded its assistance to her, providing diagnostic service with respect to drug abuse. 2 By reason of such diagnostic service, Guiliana was a "patient" within the meaning of subdivision (a) of section 1175 as that term is defined by regulations adopted pursuant to authorization provided by subdivision (g) 3 of the statute. Section 2.11 of the departmental regulations provides that "term 'patient' means any individual (whether referred to as a patient, client, or otherwise) who has applied for or been given diagnosis or treatment for drug abuse or alcohol abuse" (42 CFR 2.11). "Diagnosis" and "treatment" are defined broadly in subdivision (e) of the same regulation: "The terms 'diagnosis' and 'treatment' include interviewing, counselling, and any other services or activities carried on for the purpose of or as an incident to diagnosis, treatment, or rehabilitation with respect to drug abuse".
The alleged father asserts however that the protection of confidentiality afforded by the statute does not extend to records maintained by The Door with respect to any pregnancy or abortion of Guiliana but is limited only to those pertaining to drug abuse diagnosis or treatment.
Such a narrow interpretation of the statute is not mandated by its language, is at variance with the expectations of "the strictest adherence" to the confidentiality provision of the statute expressed in the Congressional Conference Report issued in connection with the Federal legislation, 4 and, in the case of centers like The Door which gain access to drug and alcohol abusers by offering a gamut of services, would be counterproductive to the accomplishment of drug and alcohol abuse diagnosis, treatment and rehabilitation. Records entitled to the protection of confidentiality under subdivision (a) of section 1175 are those which are "maintained in connection with the performance of any drug abuse prevention function conducted, regulated, or directly or indirectly assisted by any department or agency of the United States"; protection is not restricted to records of diagnosis and treatment for drug abuse. In the circumstances here presented we have no difficulty in concluding that the operation of The Door is a "drug abuse prevention function" within the language of the statute and that the records it kept with respect to this patient's diagnosis, prognosis and treatment, whether for a drug-related condition or otherwise, are records "maintained in connection with the performance of" its drug abuse prevention function. A narrower interpretation of the statutory confidentiality protection would deter not only those, like Guiliana, who initially come for other services (as to which they may also desire confidentiality) and thereafter become drug abuse patients, but also youths whose only interest is in obtaining assistance with drug problems but who, not perceiving the line between what is and is not protected, will forego any aid rather than risk exposure. Broad interpretation furthers the objectives of the Federal statute addressing drug and alcohol abuse prevention, treatment and rehabilitation by not chilling the willingness or discouraging the readiness of individuals to come to facilities operated under the statute. Moreover, a comprehensively inclusive interpretation of subdivision (a) of section 1175 is invited by the addition of subdivision (b) providing, inter alia, for court ordered exceptions where "good cause" is shown.
Concluding that the records sought by this putative father are within the protection of subdivision (a), we turn then to whether there is present in this case "good cause" sufficient to allow their disclosure to be directed by court order pursuant to subdivision (b) (par. cl. ). An examination not only of the statement of factors which the statute requires be considered in assessing good cause but also of the relevant departmental regulation satisfies us that there is no good cause in this instance.
In addition to repeating the statutory injunction that "the court shall weigh the public interest and the need for disclosure against the injury to the patient, to the physician-patient relationship, and to the treatment services" 5 the regulation includes a further guideline: "If there is evidence that disclosure would have an adverse effect upon successful treatment or rehabilitation of the patient or would impair the effectiveness of the program, or other programs similarly situated, in the treatment or rehabilitation of other patients, the application should be denied unless the court finds that the adverse effects are outweighed...
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