In re Commonwealth for Order Approving Release of Patient Records from Drug and Alcohol Treatment Facility

208 A.3d 1090

In the MATTER OF the Application of the COMMONWEALTH of Pennsylvania FOR an ORDER APPROVING the RELEASE OF PATIENT RECORDS FROM a DRUG AND ALCOHOL TREATMENT FACILITY

Appeal of: Commonwealth of Pennsylvania

No. 734 EDA 2018

Superior Court of Pennsylvania.

Argued January 8, 2019

Filed April 24, 2019

Sarah A. Wilson, Assistant District Attorney, Milford, for Commonwealth, appellant.

Christian E. Weed, Public Defender, Hawley, for appellee.

BEFORE: OTT, STABILE, and McLAUGHLIN, JJ.

OPINION BY STABILE, J.:

Appellant, the Commonwealth of Pennsylvania, appeals from the February 20, 2018 order denying its application for a warrant for patient records from a drug and alcohol treatment facility. We affirm in part, reverse in part, and remand.

The Commonwealth is seeking records from a rehabilitation clinic ("the Clinic") in Pike County documenting distribution of methadone from January 1, 2017 to February 12, 2017. Specifically, the Commonwealth is seeking records pertaining to a person¹ ("Defendant") facing a pending charge of drug delivery resulting in death ( 18 Pa.C.S.A. § 2506 ). A supporting affidavit from a Pennsylvania State Police Trooper ("the Trooper") states that a victim ("Victim") was found dead in February of 2017. Affidavit, 1/24/18, at ¶ 2. Victim had a history of abusing crack cocaine, heroin, and marijuana. Id. at 17. A post-mortem toxicology report revealed methadone in Victim's system. Id. at ¶ 11. Defendant was on the scene when the Trooper arrived to investigate. Id. Also on the scene was Victim's brother ("Brother") who stated that Victim and Defendant had been discussing the use of methadone earlier in the day. Id. at ¶ 5. Defendant's cell phone and cell phone records revealed that Defendant and Victim texted back and forth about the use of methadone on the day of Victim's death, and that the two agreed that Defendant would bring some methadone to Victim's apartment. Id. at ¶¶ 9, 16. The cell phone records also confirmed Defendant's presence at the apartment on the day of Victim's death. Id. at ¶ 20. According to the Commonwealth's application for disclosure of records, Defendant received methadone from the Clinic as part of his treatment for opiate abuse. Application, 1/24/18, at ¶ 3. Thus, the Commonwealth asserts that the Clinic's records will confirm that Defendant had access to methadone. Id. at ¶ 6.

The Commonwealth filed its application pursuant to 42 U.S.C.A. § 290dd-2 and 42 C.F.R. § 2.65 (Id. at opening paragraph), but has since abandoned any reliance on federal law.² At the hearing, and on appeal, the Commonwealth has relied on a provision of the Controlled Substance, Drug, Device and Cosmetic Act ("CSA"), 35 P.S. § 780-112(b), Act of 1972, April 14, Pa. Laws 233, No. 64, § 12. Counsel for defendant argues that the trial court correctly denied the Commonwealth's application pursuant to a provision of the Pennsylvania Drug and Alcohol Abuse Control Act ("DAA"), 71 P.S. § 1690.108, Act of 1972, April 14, Pa. Laws 221, No. 63, § 8.³ We will confine our analysis accordingly.

Our standard of review for questions of statutory interpretation is de novo and our scope of review is plenary. Matter of Private Sale of Prop. by Millcreek Twp. Sch. Dist. , 185 A.3d 282, 290 (Pa. 2018). The CSA sets forth schedules of controlled substances, governs registration by manufacturers, distributers, and retailers of controlled substances; governs prescription, administration, and dispensing of controlled substances, and so forth. Section 780-112 of the CSA, titled "Records of distribution of controlled substances," provides in relevant part:

(b) Every practitioner licensed by law to administer, dispense or distribute controlled substances shall keep a record of all such substances administered, dispensed or distributed by him, showing the amount administered, dispensed or distributed, the date, the name and address of the patient, and in the case of a veterinarian, the name and address of the owners of the animal to whom such substances are dispensed or distributed. Such record shall be kept for two years from the date of administering, dispensing or distributing such substance and shall be open for inspection by the proper authorities.

35 P.S. § 780-112(b) (emphasis added).

The definition of "practitioner" includes:

[A] pharmacy, hospital, clinic or other institution licensed, registered, or otherwise permitted to distribute, dispense, conduct research with respect to or to administer a controlled substance, other drug or device in the course of professional practice or research in the Commonwealth of Pennsylvania.

35 P.S. § 780-102. Methadone is a controlled substance. 35 P.S. § 780-104(2)(ii)(11). The Commonwealth asserts, and Defendant does not dispute, that the Clinic is a practitioner within the meaning of § 780-102. As a practitioner, the Commonwealth argues, the Clinic must maintain records as required by the CSA and make them open for inspection by proper authorities, in this case the State Police and prosecuting authorities in Pike County.

The DAA, enacted on the same day as the CSA, incorporates the CSA's definitions. 71 P.S. § 1690.102. The DAA also establishes the Pennsylvania Advisory Council on Drug and Alcohol Abuse to advise the Department of Health on drug and alcohol programs. Id. at § 1690.103. The DAA has several provisions governing admissions and commitments to treatment facilities. Id. at § 1690.105, 1690.112a. It also governs drug and alcohol abuse services in correctional institutions, juvenile detention centers, and for persons on probation and parole. Id. at § 1690.106. Section 1690.108 of the DAA (titled "Confidentiality of records") provides:

(a) A complete medical, social, occupational, and family history shall be obtained as part of the diagnosis, classification and treatment of a patient pursuant to this act. Copies of all pertinent records from other agencies, practitioners, institutions, and medical facilities shall be obtained in order to develop a complete and permanent confidential personal history for purposes of the patient's treatment.

(b) All patient records (including all records relating to any commitment proceeding) prepared or obtained pursuant to this act , and all information contained therein, shall remain confidential, and may be disclosed only with the patient's consent and only (i) to medical personnel exclusively for purposes of diagnosis and treatment of the patient or (ii) to government or other officials exclusively for the purpose of obtaining benefits due the patient as a result of his drug or alcohol abuse or drug or alcohol dependence except that in emergency medical situations where the patient's life is in immediate jeopardy, patient records may be released without the patient's consent to proper medical authorities solely for the purpose of providing medical treatment to the patient. Disclosure may be made for purposes unrelated to such treatment or benefits only upon an order of a court of common pleas after application showing good cause therefor. In determining whether there is good cause for disclosure, the court shall weigh the need for the information sought to be disclosed against the possible harm of disclosure to the person to whom such information pertains, the physician-patient relationship, and to the treatment services, and may condition disclosure of the information upon any appropriate safeguards. No such records or information may be used to initiate or substantiate criminal charges against a patient under any circumstances.

71 P.S. § 1690.108(a), (b) (emphasis added).⁴

The bolded portions highlight the parties' competing interpretations of § 1690.108. The Commonwealth does not dispute that Defendant was a patient of the Clinic, or that the Clinic was providing Defendant with methadone as treatment for his opiate addiction. The Commonwealth argues, however, that it narrowly tailored its warrant application to seek records prepared pursuant to the CSA and not records prepared or obtained pursuant to the DAA . Defendant argues, and the trial court found, that the Commonwealth is seeking the records of a drug rehabilitation patient in order to substantiate criminal charges against that patient, in direct violation of the last sentence of § 1690.108(b).

Lacking any governing precedent on this precise issue, we turn to the rules of statutory construction. "The object of all interpretation and construction of statutes is to ascertain and effectuate the intention of the General Assembly. Every statute shall be construed, if possible, to give effect to all its provisions." 1 Pa.C.S.A. § 1921(a). "When the words of a statute are clear and free from all ambiguity, the letter of it is not to be disregarded under the pretext of pursuing its spirit." 1 Pa.C.S.A. § 1921(b). "Generally speaking, the best indication of legislative intent is the plain language of a statute." Gallo v. Conemaugh Health Sys., Inc. , 114 A.3d 855, 863 (Pa. Super. 2015).

We perceive no pertinent ambiguity in the statutory language presently at issue. The CSA provides that a practitioner licensed to administer, dispense or distribute controlled substances must maintain records thereof, and that the records must be open for inspection by proper authorities. Defendant does not dispute that the Clinic is a practitioner, nor does he dispute that the Clinic distributed the controlled substance methadone to him. Pursuant to § 780-112(b) of the CSA, the record of that "distribution" must be open for inspection by proper authorities. Defendant does not dispute that the Pennsylvania State Police and the Pike County District Attorney's office are proper authorities.

The DAA on the other hand, protects the records of patients undergoing treatment for drug or alcohol abuse. The DAA forbids disclosure of patient records for purposes of initiating or substantiating criminal charges against a patient. 71 P.S. § 1690.108(b). In In re Search Warrant Application No. 125-4, 852 A.2d 408 ...