930.4 Access to Case Records

Case records are the property of DHS. The CAO will monitor access to case records by persons outside DHS and by individuals.   

55 Pa. Code § 105.1.(f)

 

930.41 Use of Records by Persons outside the Department

A person may not have direct access to DHS records unless the records are essential to conducting their duties and:       

55 Pa. Code § 105.1.(f)

NOTE:  An auditor from the Department of the Auditor General or Department of the Treasury will have access to records during an auditing process.

A person has the right to access, inspect and obtain a copy of PHI for as long as the information is kept in the records. The request for access, inspection or copies of information must be in writing. See Appendix A for a copy of form PA 1805, Request to Access, Inspect or Obtain a Copy of Protected Health Information.

The CAO will allow an individual or his/her authorized representative to examine the individual's case record with a staff member present if the individual makes the request:       

55 Pa. Code § 105.5.(a)

NOTE:  These criteria do not apply to legal actions to access an individual's records such as a subpoena or an attorney’s preparation for a hearing.

An individual's access to his or her case record applies whether the case is open or closed. The CAO may not require an individual to name a representative in writing. However, the CAO may contact the individual for verification if it has reason to doubt that the person is the individual's authorized representative or personal representative.

The CAO will remove this information from the case record before giving the individual access to the record:      

55 Pa. Code § 105.5.(b)

NOTE:  The CAO may give a summary of a complaint to the individual only if the summary does not reveal the complainant’s name. The CAO will not give the complainant’s name under any circumstances.

When the CAO receives a request to access information it will:

Act on the request no later than 30 days after receiving the request.

Based on the individual's request, the CAO will provide photo copies of up to ten (10) pages from the record. If the individual asks for more than ten (10) pages, the CAO charges the individual using this schedule:       

55 Pa. Code § 105.5.(c)

Number of pages

1 copy

2 or more copies

1 through 10

no fee

$ .50 each page

11 and above

$.25 each page

$ .50 each page

Example: 10 pages

no fee

$ 5.00 each copy

12 pages

$ .50

$ 6.00 each copy

20 pages

$ 2.50

$10.00 each copy

60 pages

$12.50

$30.00 each copy

Exception: The CAO will not charge for:

55 Pa. Code § 275.4(a)(3)(v)(E)(II)

Payment must be by check or money order payable to "PA Department of Human Services.” The CAO will forward the check to:

Office of Income Maintenance
Bureau of Program Support
Room 442 Health and Human Services Building
P.O. Box 2675
Harrisburg, PA 17105

The CAO will include a memo with the check with:       

55 Pa. Code § 105.5.(c)

The Bureau of Program Support will forward the checks to the Comptroller’s Office with a request to deposit the check as a credit to the CAO account code.

 

930.42 Request for Amendment

The individual may request that the CAO correct or delete any part of the record the individual believes is wrong, irrelevant, or incomplete. The individual must make the request in writing. See Appendix A for PA 1804, Request for Amendment of Health Information. The CAO will help the individual make the request if necessary. The CAO will:      

55 Pa. Code § 105.5.(d)

The Department will allow the person to submit a written statement disagreeing with the denial of all or part of a requested amendment and the reason he or she disagrees. The Department may prepare a written rebuttal to the person’s statement of disagreement and must provide the person a copy of the rebuttal.

For future disclosures, the Department will identify the PHI in the record that is the subject of the disputed amendment and attach or link:

 

 

Revised October 24, 2023, replacing September 27, 2012