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ALASKA

CALIFORNIA NORTHWEST

FLORIDA

MID-PACIFIC

NORTHEAST

NORTHERN ROCKIES

ROCKY MOUNTAIN

WASHINGTON, DC

INTERNATIONAL

May2012 ImplicationsofAct13forHealthProfessionals ReceivingSecretInformationaboutChemicalsUsedinHydraulicFracturing 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 addressesmedicalemergencies,seeid.3222.1(b)(11).Inbothsituations,thehealthprofessional mustexecuteaconfidentialityagreementasaconditionofreceivingtheSecretInformation. PrincipalConclusions UnderAct13: SecretInformationmaybeobtainedonlyforchemicalinformationrelatedtohydraulic fracturingofunconventionalwells.Act13doesnotmandatereleaseofanyinformation aboutchemicalsusedinanyotherprocess(suchasdrilling)orforanyprocessusedto developconventionalwells.Therealsoisnorighttoobtaininformationaboutwellsthat werefracturedbeforeApril14(theeffectivedateofthelaw). SecretInformationmaybeobtainedbyahealthprofessionalonlyfordiagnosisand treatmentofanindividual. SecretInformationmaynotbeobtainedforpreventivemedicalpurposes,eventoprotect apatientsfamilyorcommunitymembers,whomaybeatrisk. SecretInformationmaynotbeobtainedformedicalresearchorotherscientificstudy. ItisunclearwhatSecretInformation,ifany,healthprofessionalsmaydisclosetoothers andunderwhattermsitmaybedisclosed.Theregulationsthataresupposedtodefine thetermsofrequiredconfidentialityagreementshavenotyetbeenproposed. HealthprofessionalswhoareauthorizedtodiscloseSecretInformationduringthe courseofdiagnosisortreatmentmusttakeaffirmativestepstoensurethattherecipients maintaintheconfidentialityoftheinformation.

TherelevantprovisionsofAct13andtheirimplicationsareexplainedbelow.

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Analysis RoutineHealthCare.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 thehealthprofessionalmaintainstheconfidentialityoftheinformation.Healthprofessionals alsohavenostatutoryauthoritytoobtainSecretInformationforthepurposeofconducting scientificresearchonthehealthimpactsofthechemicals. MedicalEmergencies.Whenthereisamedicalemergency,ahealthprofessionalmay obtainSecretInformationthatisnecessaryforemergencytreatment,byacknowledgingorally thattheinformationmaynotbeusedforpurposesotherthanthehealthneedsassertedand thattheprofessionalwillmaintaintheinformationasconfidential.Id.3222.1(b)(11). Thereafter,uponrequest,thehealthprofessionalmustprovidebothawrittenstatementofneed andaconfidentialityagreement,inconformancewithregulationspromulgatedunderthis chapter.Id.Again,disclosureisrequiredonlyforemergencytreatment,notforpurposesof preventivecare,improvingpublichealth,oradvancingscientificunderstanding. ConfidentialityAgreements.Act13doesnotdefinethepermittedtermsofthe confidentialityagreementsthathealthprofessionalsmustsigntoobtainSecretInformation.The statutesuggeststhattheparameterswillbedefinedinregulationsyettobeadopted.Until thoseregulationsareineffect,however,itwouldappearthathealthprofessionalssubmitting 2
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writtenrequestsforSecretInformationareatthemercyoftheindustry,whichcanrefuseto producetheinformationuntilaconfidentialityagreementissigned.Toavoidsigninganoverly broadagreementinsisteduponbytheindustryforexample,anagreementnotonlytokeep theSecretInformationconfidentialbutalsotorefrainfromdiscussinginpublicthehealth problemsoriginallypromptingtherequestahealthprofessionalwouldhavetogopublicwith objectionsandfightformorereasonableterms. Giventhevaguenessofthestatutewithrespecttoconfidentialityrequirements,health professionalsinPennsylvaniaimmediatelyexpressedconcernthatAct13wouldinterferewith theirabilitytofulfilltheirethicalresponsibilitiestotheirpatients.Legislativeleadersand CorbettAdministrationofficialsreactedswiftly.InalettertothePennsylvaniaMedicalSociety, SecretaryofthePennsylvaniaDepartmentofHealthEliAvilastated: Inherentin[physicians]righttoreceivethis[proprietary]informationisthe abilitytosharetheinformationwiththepatient,withotherphysicians,and providersincludingspecialistsassistingandinvolvedwiththecareofthe patient.Further,reportingandinformationsharingwithpublichealthand regulatoryagenciessuchastheDepartmentofHealthisnecessaryand 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 assurancesfromtheDepartmentofHealth,SpeakerSmithandHouseMajorityleaderMike Turzaithattheirintentindraftingthelawwasforphysicianstobeabletospeakfreelywith theirpatients,otherhealthcareprovidersinvolvedinthecareoftheirpatients,andappropriate publichealthofficials.Id. Asapreliminarymatter,thereisnoguaranteethattheinterpretationofAct13offered bythosepublicofficialswouldbeupheldincourt,ifahealthprofessionalweresuedforsharing SecretInformation.NothingintheexpresslanguageofAct13allowsforthedisclosures describedbySecretaryAvila.Moreover,postenactmentrepresentationsofgovernmental officialsabouttheirpersonalintentindraftingorpassingalawtypicallycarrylittleweight whenacourtisadjudicatingthemeaningofastatute.SeeInreDennisThomasik,LicenseNo.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)). 3
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Evenifcourtswouldallowhealthprofessionalstorelyonrepresentationsoflegislative leadershipandtheDepartmentofHealth,healthprofessionalsmustrecognizethelimitationsof thosestrongpublicassurances.SecretaryAvilasletterassureshealthprofessionalsthatthey mayutilizeSecretInformationinwhatevermannerisnecessarytorespondtothemedical needsassertedbythehealthcareprofessional.Asisexplainedabove,themedicalneeds assertedunderthetermsofAct13areonlythediagnosisandtreatmentofanindividual. HealthprofessionalsthusshouldnotconcludethatSecretInformationdisclosedpursuantto Act13maybeusedforanylegitimatepublichealthpurpose.Infact,theletterhasbeen carefullycraftedtoconfirmthatinformationmaybesharedonlywithpublicagenciesor personsdirectlyinvolvedwiththecareofthepatient.Theinformationmaynotbedisclosed anyoneelsetopreventhealthproblemsinthefutureortoadvancescientificresearch. Finally,healthprofessionalswhoareauthorizedtoshareSecretInformationarelikelyto beresponsibleforensuringthatallpersonsreceivingtheinformationunderstandthatitmay notbecommunicatedtoanyone(except,perhaps,regulatoryofficials)notinvolvedinthe patientsdiagnosisandtreatment.Inamedicalemergency,thehealthprofessionalthusmust ensurethatapatientreceivinglifesavingSecretInformationunderstandsthattheinformation maynotbedisclosedtootherswhomaybeatrisk,includingfamilymembers.IftheSecret Informationisreleasedbypersonswholearneditfromahealthprofessional,andthehealth professionalcannotprovethatheorsheexercisedreasonablecaretopreventthosepersons fromdivulgingtheinformation,theprofessionalcouldbeliablefordamagesresultingfromthe disclosure. Conclusion Act13isastepintherightdirectiontotheextentthatitguaranteesaccesstoSecret Informationthatotherwisewouldnotbeavailabletohealthprofessionals.TheSecret Informationmaybeobtainedforverylimitedpurposes,however,anditmustbekeptsecret pursuanttoasyetundefinedtermsofstatutorilymandatedconfidentialityagreements.Health professionalsactattheirownriskiftheydiscloseanyoftheSecretInformationtoothers,even thosedirectlyinvolvedinthediagnosisandtreatmentofapatient.Act13doesnotauthorize healthprofessionalstoobtainSecretInformationforanyotherpurposeincludingprotectinga patientsfamilymembers,providingpreventivecare,promotingpublichealth,oradvancing scientificresearch.Thus,thepublicwillremainlargelyinthedarkaboutthepotentialhealth impactsofproprietarychemicalsusedinhydraulicfracturingofunconventionalwells(andall chemicalsusedinotherprocessesorfordevelopingconventionalwells),untillegislaturesor courtsdecidethatthepublicinterestinprotectingcommunityhealthoutweighstheprivate interestinprofitingfromsecrecy. DeborahGoldberg ManagingAttorney

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ExhibitA Act13RequiredDisclosurestoHealthProfessionals 3222.1.Hydraulicfracturingchemicaldisclosurerequirements ... (b) Requireddisclosures. ... (10) Avendor,servicecompanyoroperatorshallidentifythespecificidentity andamountofanychemicalsclaimedtobeatradesecretorconfidential proprietaryinformationtoanyhealthprofessionalwhorequeststhe informationinwritingifthehealthprofessionalexecutesaconfidentiality agreementandprovidesawrittenstatementofneedfortheinformation indicatingallofthefollowing: (i) Theinformationisneededforthepurposeofdiagnosisor treatmentofanindividual. (ii) Theindividualbeingdiagnosedortreatedmayhavebeen exposedtoahazardouschemical. (iii) Knowledgeofinformationwillassistinthediagnosisortreatment ofanindividual. (11) Ifahealthprofessionaldeterminesthatamedicalemergencyexistsand thespecificidentityandamountofanychemicalsclaimedtobeatrade secretorconfidentialproprietaryinformationarenecessaryfor emergencytreatment,thevendor,serviceprovideroroperatorshall immediatelydisclosetheinformationtothehealthprofessionalupona verbalacknowledgmentbythehealthprofessionalthattheinformation maynotbeusedforpurposesotherthanthehealthneedsassertedand thatthehealthprofessionalshallmaintaintheinformationasconfidential. Thevendor,serviceprovideroroperatormayrequest,andthehealth professionalshallprovideuponrequest,awrittenstatementofneedand aconfidentialityagreementfromthehealthprofessionalassoonas circumstancespermit,inconformancewithregulationspromulgated underthischapter.

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