§ 7140.5. Collection of Information.

(a) The case record shall contain only information which is relevant and necessary to carry out the programs of the Department.

(b) A Client Information Booklet which describes the kinds of information that may be requested from the applicant/client shall be provided and explained to all applicants at the initial interview and shall be annually reviewed with the client or his/her representative thereafter. The applicant's signature on the Application for Services (DR 222 dated January, 1991) acknowledges receipt of the booklet. The Client Information Booklet shall contain:

(1) The title, address, and telephone number of the Department employee who maintains the case record.

(2) The name of the Division or individual within the Department who is requesting the information.

(3) A statement as to whether the provision of each item of information requested is mandatory or voluntary.

(4) An explanation of the consequences of not providing all or part of the requested information.

(5) An explanation of the purpose or purposes for which the information is to be used.

(6) The legal authority which authorizes the maintenance of the information.

(7) A statement as to the applicant's or client's right to review the case record.

(8) Any known or foreseeable interagency or intergovernmental transfer of the information which may be made.

(c) To the greatest extent practicable, information shall be collected directly from the applicant or client who is the subject of the information rather than from another source.

(d) A completed form DR 264 (dated 1/90) Consent for Release of Personal/Confidential Information, and form DR 264A (dated July, 1993) Consent to Release Medical Information, which are incorporated by reference herein, shall as appropriate be required for each request to a third party to obtain the following personal information about an applicant/client:

(1) Employment reports from former employers.

(2) School transcripts.

(3) Drug and alcohol abuse information of record.

(4) Public assistance information.

(5) Criminal justice cumulative summaries.

(6) Psychological resting information of record.

(7) Veteran's Administration information.

(8) Medical information of record.

(e) During the initial interview and whenever necessary, the Counselor shall complete form DR 264 (dated 1/90) or form DR 264A (dated July, 1993) to obtain applicant/client consent to contact each source of information about the applicant/client. Each release form shall:

(1) Specifically state the information requested and to whom the request for information is directed.

(2) Be signed and dated by the applicant/client authorizing each release. The signed release is used to verify that consent was obtained from the applicant/client or his/her authorized representative.

(3) Be prepared in triplicate. The original of each signed release shall be attached to the appropriate request for information, a copy shall be given to the applicant/client, and a copy shall be filed in the case record with relevant correspondence.

(4) Expire thirty (30) days from the date signed by the applicant/client unless the release specifies another expiration date.

(f) In addition to the above, the DR 264A (dated July, 1993) Consent to Release Medical Information must include a specific authorization from the applicant/client to the provider of health care (see Civil Code section 56.05(d) for definition) to allow the release of the information to the Department. The consent for the Department to obtain medical information shall specifically state:

“I authorize the above listed physician/facility to furnish to the Department of Rehabilitation my records containing medical history, treatment, and diagnosed mental and physical condition, including disabilities such as drug, alcohol, and psychiatric, or the result of any HIV test performed.

This information will be included in my case record and used to assist in the determination of eligibility and, if eligible, subsequent vocational rehabilitation services. The Department of Rehabilitation may not disclose the information received without my signed consent for each disclosure unless the disclosure is specifically required or permitted by law. “

“This consent, shall remain valid for 30 days unless otherwise specified.

(Applicant/client's signature and date)”

The applicant/client's signature must immediately follow the statement. The applicant/client shall be provided a copy of the authorization for each request.

(g) Medical, psychological, and work evaluation examinations and information created by the provider at the request and expense of the Department do not require a consent signed by the applicant/client to release such information to the Department except medical information that would disclose the results of any HIV test performed.

(h) The source of any information shall be identified in the case record unless the source is the applicant or client. If the source is an entity such as a governmental agency, a corporation, an association, or an individual, this requirement can be met by maintaining the name of the entity so long as the smallest responsible unit of that entity is reasonably identified.

(i) Except as provided in section 7141.5, information in the case file shall remain in the file until the case is destroyed. No information in the case record shall be removed, destroyed, or altered for purposes of avoiding compliance with these regulations. The following information may be purged from the case record and destroyed:

(1) Information in the case file that is irrelevant and unnecessary for carrying out the Rehabilitation program.

(2) Handwritten Notes when the Notes have been transcribed into the case record.

(3) Duplicative information.

HISTORY

1. Renumbering of section 7281 to section 7140.5 filed 6-21-90; operative 7-21-90 (Register 90, No. 35).

2. Amendment of subsection (b), new subsections (d), (e), (f) and (g) and relettering of former subsections (d) and (e) to subsections (h) and (i) filed 5-2-91; operative 6-1-91 (Register 91, No. 25).

3. Change without regulatory effect amending subsections (b), (d), (e) and (f) filed 3-28-94 pursuant to title 1, section 100, California Code of Regulations (Register 94, No. 13).

Note

Note: Authority cited: Sections 19006 and 19016, Welfare and Institutions Code; and Section 1798.30, Civil Code. Reference: Sections 56.10, 56.11, 56.13, 56.15 and 1798.14-1798.23, Civil Code; and 34 CFR Section 361.49.