0201c;when and to the extent necessary to facilitate the delivery of professional services to the client” (D.C. Code § 7-1203.01). Some states permit disclosure of mental health information for treatment without consent only in an emergency. Iowa law provides that “mental health information may be transferred at any time to another facility, physician, or mental health professional in cases of a medical emergency or if the individual or the individual's legal representative requests the transfer in writing for the purposes of receipt of medical or mental health professional services” (see Iowa Code § 228.2(3)). The Kansas statute allows for disclosure of mental health records in an emergency, as well as for “communication and information between or among treatment facilities regarding a proposed patient, patient or former patient for purposes of promoting continuity of care between the state psychiatric hospitals and the community mental health centers” (Kan. Stat. Ann. § 65-5603(5) and (13)). Nebraska law provides for disclosure of mental health records to “the department, * * * and any public or private agency under contract to provide facilities, programs, and patient services” (Neb. Rev. Stat. § 83-109(1)). Ohio permits disclosure for treatment only of limited mental health information and then only to a limited group of providers: Hospitals and other institutions and facilities within the department of mental health may exchange psychiatric records and other pertinent information with other hospitals, institutions, and facilities of the department, and with community mental health agencies and boards of alcohol, drug addiction, and mental health services with which the department has a current agreement for patient care or services. Records and information that may be released pursuant to this division shall be limited to medication history, physical health status and histor In most instances, the information regarding state laws found in this database was confirmed and updated through state-specific Westlaw searches. Like the Health Privacy Project database, this study is limited to state statutes and does not include information on state administrative regulations, attorney general opinions, licensure board opinions, or court decisions, all of which might contain further information on medical records privacy. This report should not be seen, therefore, as a comprehensive legal analysis of all the issues raised by the law of each state. § 164.501 define treatment to mean: … the provision, coordination, or management of health care and related services by one or more health care providers, including the coordination or management of health care by a health care provider with a third party; consultation between health care providers relating to a patient; or the referral of a patient for health care from one health care provider to another. One exception to this general rule of permitting the sharing of treatment information without consent is that “psychotherapy notes” may only be disclosed with authorization (45 C.F.R. STATE LAWS GOVERNING MENTAL HEALTH RECORDS It is more common for a state to have several specific statutes governing different types of medical records and information. Every state has some form of legislation governing mental health records. These generally take four forms. First, many states have laws governing the records of patients in state mental hospitals or mental health programs. These are in some instances part of general statutes governing state health records (See Idaho Code § 9-340C(8) and (13)) and are sometimes specific to mental hospitals (see N.Y. Mental Hygiene Law 33.13; N.C. Gen. Stat. § 122C-55). Second, a number of states have laws governing the records of specific mental health practitioners, most commonly psychologists, social workers, and counselors. Colo. Rev. Stat. Ann. § 12-43-218, for example, requires patient consent for any disclosure by a psychologist or psychotherapist, with no treatment exception. Massachusetts law (Mass. Gen. Laws. ch. 112 § 129A) provides that the records of psychologists are confidential, and makes no exception for sharing of information for treatment. Missouri law (Mo. Rev. Stat. § 337.636) contains similar provisions governing psychologists, social workers, and professional counselors, as does Wyoming (Wyo. Stat. Ann. The obligations imposed by these laws may pose the most substantial threat to the broad sharing of treatment information contemplated by HIPAA. Third, a number of states have specific statutes governing the records of patients who are involuntarily committed to mental institutions (see Idaho Code § 66-348; Neb. Rev. Stat. § 71-961; Wash. Rev. Code Ann. § 71.05.390). These statutes recognize, presumably, that patients who are involuntarily committed to institutions might have a special claim to privacy, though these laws also usually make provision for the use of records in the commitment process. § 172:8-a) provides confidentiality for substance abuse records, but also says they may be used for a rehabilitation or medical purpose without consent. These provisions would presumably be preempted as to facilities governed by the federal statute. Some state substance abuse Ohio permits disclosure for treatment only of limited mental health information and then only to a limited group of providers: Hospitals and other institutions and facilities within the department of mental health may exchange psychiatric records and other pertinent information with other hospitals, institutions, and facilities of the department, and with community mental health agencies and boards of alcohol, drug addiction, and mental health services with which the department has a current agreement for patient care or services.