7/31/2019 Act13-DisclosuretoHealthProfessionals.5-23-12

1/5

ALASKA CAL IFORNIA FLORIDA MID -PAC IF IC NORTHEAST NORTHERN ROCKIES

NORTHWEST ROCKY MOUNTA IN WASHINGTON, DC INTERNAT IONAL

1 5 6 W I L L I A M S T R E E T S U I T E 8 0 0 N E W Y O R K , N Y 1 0 0 3 8

T : 2 1 2 . 7 9 1 . 1 8 8 1 F : 2 1 2 . 9 1 8 . 1 5 5 6 E : n e o f f i c e @ e a r t h j u s t i c e . o r g W : w w w . e a r t h j u s t i c e . o r g

May2012

ImplicationsofAct13forHealthProfessionalsReceivingSecretInformationaboutChemicalsUsedinHydraulicFracturing

PennsylvaniarecentlyenactedlegislationcommonlyknownasAct13whichrequires

disclosureofcertainchemicalinformationrelatedtohydraulicfracturingofunconventional

wells. SeeActofFeb.14,2012,P.L.87,No.13(Act13),3222.1. TwoprovisionsofAct13

(annexedasExhibitAtothismemorandum)setforththeconditionsunderwhichhealth

professionalsmayobtainthespecificidentityoramountofchemicalsclaimedtobeatrade

secretorconfidentialproprietaryinformation(collectively,SecretInformation). Thefirst

provisionaddressesroutinehealthcaresituationsforwhichthehealthprofessionalhastimeto

submitawrittenrequestfortheSecretInformation,seeid.3222.1(b)(10),andthesecond

addresses

medical

emergencies,

see

id.

3222.1(b)(11).

In

both

situations,

the

health

professional

mustexecuteaconfidentialityagreementasaconditionofreceivingtheSecretInformation.

PrincipalConclusionsUnderAct13:

SecretInformationmaybeobtainedonlyforchemicalinformationrelatedtohydraulicfracturingofunconventionalwells. Act13doesnotmandatereleaseofanyinformation

aboutchemicalsusedinanyotherprocess(suchasdrilling)orforanyprocessusedto

developconventionalwells. Therealsoisnorighttoobtaininformationaboutwellsthat

were

fractured

before

April

14

(the

effective

date

of

the

law).

SecretInformationmaybeobtainedbyahealthprofessionalonlyfordiagnosisandtreatmentofanindividual.

SecretInformationmaynotbeobtainedforpreventivemedicalpurposes,eventoprotectapatientsfamilyorcommunitymembers,whomaybeatrisk.

SecretInformationmaynotbeobtainedformedicalresearchorotherscientificstudy. ItisunclearwhatSecretInformation,ifany,healthprofessionalsmaydisclosetoothers

and

under

what

terms

it

may

be

disclosed.

The

regulations

that

are

supposed

to

define

thetermsofrequiredconfidentialityagreementshavenotyetbeenproposed.

HealthprofessionalswhoareauthorizedtodiscloseSecretInformationduringthecourseofdiagnosisortreatmentmusttakeaffirmativestepstoensurethattherecipients

maintaintheconfidentialityoftheinformation.

TherelevantprovisionsofAct13andtheirimplicationsareexplainedbelow.

7/31/2019 Act13-DisclosuretoHealthProfessionals.5-23-12

2/5

2

1 5 6 W I L L I A M S T R E E T S U I T E 8 0 0 N E W Y O R K , N Y 1 0 0 3 8

T : 2 1 2 . 7 9 1 . 1 8 8 1 F : 2 1 2 . 9 1 8 . 1 5 5 6 E : n e o f f i c e @ e a r t h j u s t i c e . o r g W : w w w . e a r t h j u s t i c e . o r g

AnalysisRoutineHealthCare. Whenthereisnomedicalemergency,ahealthprofessionalmust

submitarequestinwritingtoobtainthespecificidentityoramountofchemicalsclaimedtobe

SecretInformation. Thewrittenrequestmustprovideastatementofneedthatindicatesallof

thefollowing:

(i) Theinformationisneededforthepurposeofdiagnosisortreatmentofan

individual.

(ii) Theindividualbeingdiagnosedortreatedmayhavebeenexposedtoa

hazardouschemical.

(iii) Knowledgeofinformationwillassistinthediagnosisortreatmentofan

individual.

id.3222.1(b)(10)(i)(iii). Thehealthprofessionalalsomustexecuteaconfidentialityagreement.Seeid.3222.1(b)(10).

ThisprovisionplainlystatesthatSecretInformationrequestedinwritingmaybe

obtainedforthepurposeofdiagnosisortreatmentofanindividual.Unlessthereisaspecific

individualrequiringdiagnosisortreatment,nothinginthestatuterequiresdisclosureofthe

informationtoahealthprofessional. Forexample,publichealthprofessionalsincommunities

expectinggasdevelopmentinthenearfuturearenotentitledtoobtainSecretInformationto

educatethemselvesorthepublicaboutsymptomsthatmaydevelopfromexposureto

chemicalsusedinhydraulicfracturingormeasuresthatmaybetakentopreventinjuryevenif

thehealth

professional

maintains

the

confidentiality

of

the

information.

Health

professionals

alsohavenostatutoryauthoritytoobtainSecretInformationforthepurposeofconducting

scientificresearchonthehealthimpactsofthechemicals.

MedicalEmergencies. Whenthereisamedicalemergency,ahealthprofessionalmay

obtainSecretInformationthatisnecessaryforemergencytreatment,byacknowledgingorally

thattheinformationmaynotbeusedforpurposesotherthanthehealthneedsassertedand

thattheprofessionalwillmaintaintheinformationasconfidential. Id.3222.1(b)(11).

Thereafter,uponrequest,thehealthprofessionalmustprovidebothawrittenstatementofneed

andaconfidentialityagreement,inconformancewithregulationspromulgatedunderthis

chapter.

Id.

Again,

disclosure

is

required

only

for

emergency

treatment,

not

for

purposes

of

preventivecare,improvingpublichealth,oradvancingscientificunderstanding.

ConfidentialityAgreements. Act13doesnotdefinethepermittedtermsofthe

confidentialityagreementsthathealthprofessionalsmustsigntoobtainSecretInformation. The

statutesuggeststhattheparameterswillbedefinedinregulationsyettobeadopted. Until

thoseregulationsareineffect,however,itwouldappearthathealthprofessionalssubmitting

7/31/2019 Act13-DisclosuretoHealthProfessionals.5-23-12

3/5

3

1 5 6 W I L L I A M S T R E E T S U I T E 8 0 0 N E W Y O R K , N Y 1 0 0 3 8

T : 2 1 2 . 7 9 1 . 1 8 8 1 F : 2 1 2 . 9 1 8 . 1 5 5 6 E : n e o f f i c e @ e a r t h j u s t i c e . o r g W : w w w . e a r t h j u s t i c e . o r g

writtenrequestsforSecretInformationareatthemercyoftheindustry,whichcanrefuseto

producetheinformationuntilaconfidentialityagreementissigned. Toavoidsigninganoverly

broadagreementinsisteduponbytheindustryforexample,anagreementnotonlytokeep

theSecretInformationconfidentialbutalsotorefrainfromdiscussinginpublicthehealth

problemsoriginallypromptingtherequestahealthprofessionalwouldhavetogopublicwith

objectionsand

fight

for

more

reasonable

terms.

Giventhevaguenessofthestatutewithrespecttoconfidentialityrequirements,health

professionalsinPennsylvaniaimmediatelyexpressedconcernthatAct13wouldinterferewith

theirabilitytofulfilltheirethicalresponsibilitiestotheirpatients. Legislativeleadersand

CorbettAdministrationofficialsreactedswiftly. InalettertothePennsylvaniaMedicalSociety,

SecretaryofthePennsylvaniaDepartmentofHealthEliAvilastated:

Inherentin[physicians]righttoreceivethis[proprietary]informationisthe

abilitytosharetheinformationwiththepatient,withotherphysicians,and

providersincludingspecialistsassistingandinvolvedwiththecareofthe

patient.Further,reportingandinformationsharingwithpublichealthandregulatoryagenciessuchastheDepartmentofHealthisnecessaryand

permitted.Inshort,theinformationcanbeutilizedinwhatevermanneris

necessarytorespondtothemedicalneedsassertedbythehealthcare

professional.

ScottDetrow,PennsylvaniaHealthSecretary:Act13WontMuzzleDoctors,StateImpact(Apr.19,

2012),http://stateimpact.npr.org/pennsylvania/2012/04/19/pennsylvaniahealthsecretaryact13

wontmuzzledoctors/. Inresponsetothatletter,PennsylvaniaMedicalSocietyPresident

MarilynHeinereleasedastatement,providinginpart:Wearegratifiedbythestrongpublic

assurancesfrom

the

Department

of

Health,

Speaker

Smith

and

House

Majority

leader

Mike

Turzaithattheirintentindraftingthelawwasforphysicianstobeabletospeakfreelywith

theirpatients,otherhealthcareprovidersinvolvedinthecareoftheirpatients,andappropriate

publichealthofficials. Id.

Asapreliminarymatter,thereisnoguaranteethattheinterpretationofAct13offered

bythosepublicofficialswouldbeupheldincourt,ifahealthprofessionalweresuedforsharing

SecretInformation. NothingintheexpresslanguageofAct13allowsforthedisclosures

describedbySecretaryAvila. Moreover,postenactmentrepresentationsofgovernmental

officialsabouttheirpersonalintentindraftingorpassingalawtypicallycarrylittleweight

when

a

court

is

adjudicating

the

meaning

of

a

statute.

SeeIn

re

Dennis

Thomasik,

License

No.

E

5173,5Pa.D.&C.4th474,479(Pa.Com.Pl.1989)(citingHoffmanv.PennsylvaniaCrimeVictims

CompensationBoard,46Pa.Commw.54,57n.2,405A.2d1110,1112n.2(1979)(remarksor

understandingofindividualrepresentativenotbindingwhenendeavoringtoascertain

legislativeintent)).

7/31/2019 Act13-DisclosuretoHealthProfessionals.5-23-12

4/5

4

1 5 6 W I L L I A M S T R E E T S U I T E 8 0 0 N E W Y O R K , N Y 1 0 0 3 8

T : 2 1 2 . 7 9 1 . 1 8 8 1 F : 2 1 2 . 9 1 8 . 1 5 5 6 E : n e o f f i c e @ e a r t h j u s t i c e . o r g W : w w w . e a r t h j u s t i c e . o r g

Evenifcourtswouldallowhealthprofessionalstorelyonrepresentationsoflegislative

leadershipandtheDepartmentofHealth,healthprofessionalsmustrecognizethelimitationsof

thosestrongpublicassurances. SecretaryAvilasletterassureshealthprofessionalsthatthey

mayutilizeSecretInformationinwhatevermannerisnecessarytorespondtothemedical

needsassertedbythehealthcareprofessional. Asisexplainedabove,themedicalneeds

assertedunder

the

terms

of

Act

13

are

only

the

diagnosis

and

treatment

of

an

individual.

HealthprofessionalsthusshouldnotconcludethatSecretInformationdisclosedpursuantto

Act13maybeusedforanylegitimatepublichealthpurpose. Infact,theletterhasbeen

carefullycraftedtoconfirmthatinformationmaybesharedonlywithpublicagenciesor

personsdirectlyinvolvedwiththecareofthepatient. Theinformationmaynotbedisclosed

anyoneelsetopreventhealthproblemsinthefutureortoadvancescientificresearch.

Finally,healthprofessionalswhoareauthorizedtoshareSecretInformationarelikelyto

beresponsibleforensuringthatallpersonsreceivingtheinformationunderstandthatitmay

notbecommunicatedtoanyone(except,perhaps,regulatoryofficials)notinvolvedinthe

patientsdiagnosis

and

treatment.

In

amedical

emergency,

the

health

professional

thus

must

ensurethatapatientreceivinglifesavingSecretInformationunderstandsthattheinformation

maynotbedisclosedtootherswhomaybeatrisk,includingfamilymembers. IftheSecret

Informationisreleasedbypersonswholearneditfromahealthprofessional,andthehealth

professionalcannotprovethatheorsheexercisedreasonablecaretopreventthosepersons

fromdivulgingtheinformation,theprofessionalcouldbeliablefordamagesresultingfromthe

disclosure.

Conclusion

Act13isastepintherightdirectiontotheextentthatitguaranteesaccesstoSecret

Informationthat

otherwise

would

not

be

available

to

health

professionals.

The

Secret

Informationmaybeobtainedforverylimitedpurposes,however,anditmustbekeptsecret

pursuanttoasyetundefinedtermsofstatutorilymandatedconfidentialityagreements. Health

professionalsactattheirownriskiftheydiscloseanyoftheSecretInformationtoothers,even

thosedirectlyinvolvedinthediagnosisandtreatmentofapatient. Act13doesnotauthorize

healthprofessionalstoobtainSecretInformationforanyotherpurposeincludingprotectinga

patientsfamilymembers,providingpreventivecare,promotingpublichealth,oradvancing

scientificresearch. Thus,thepublicwillremainlargelyinthedarkaboutthepotentialhealth

impactsofproprietarychemicalsusedinhydraulicfracturingofunconventionalwells(andall

chemicalsusedinotherprocessesorfordevelopingconventionalwells),untillegislaturesor

courtsdecide

that

the

public

interest

in

protecting

community

health

outweighs

the

private

interestinprofitingfromsecrecy.

DeborahGoldberg

ManagingAttorney

7/31/2019 Act13-DisclosuretoHealthProfessionals.5-23-12

5/5

5

1 5 6 W I L L I A M S T R E E T S U I T E 8 0 0 N E W Y O R K , N Y 1 0 0 3 8

T : 2 1 2 . 7 9 1 . 1 8 8 1 F : 2 1 2 . 9 1 8 . 1 5 5 6 E : n e o f f i c e @ e a r t h j u s t i c e . o r g W : w w w . e a r t h j u s t i c e . o r g

ExhibitAAct13RequiredDisclosurestoHealthProfessionals

3222.1.Hydraulicfracturingchemicaldisclosurerequirements

...

(b) Requireddisclosures.

...

(10) Avendor,servicecompanyoroperatorshallidentifythespecificidentity

andamountofanychemicalsclaimedtobeatradesecretorconfidential

proprietaryinformationtoanyhealthprofessionalwhorequeststhe

informationin

writing

if

the

health

professional

executes

aconfidentiality

agreementandprovidesawrittenstatementofneedfortheinformation

indicatingallofthefollowing:

(i) Theinformationisneededforthepurposeofdiagnosisor

treatmentofanindividual.

(ii) Theindividualbeingdiagnosedortreatedmayhavebeen

exposedtoahazardouschemical.

(iii) Knowledgeofinformationwillassistinthediagnosisortreatment

ofanindividual.

(11) Ifahealthprofessionaldeterminesthatamedicalemergencyexistsand

thespecificidentityandamountofanychemicalsclaimedtobeatrade

secretorconfidentialproprietaryinformationarenecessaryfor

emergencytreatment,thevendor,serviceprovideroroperatorshall

immediatelydisclosetheinformationtothehealthprofessionalupona

verbalacknowledgmentbythehealthprofessionalthattheinformation

maynotbeusedforpurposesotherthanthehealthneedsassertedand

thatthehealthprofessionalshallmaintaintheinformationasconfidential.

Thevendor,

service

provider

or

operator

may

request,

and

the

health

professionalshallprovideuponrequest,awrittenstatementofneedand

aconfidentialityagreementfromthehealthprofessionalassoonas

circumstancespermit,inconformancewithregulationspromulgated

underthischapter.