C.F.R. » Title 42 » CHAPTER I—PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER D—GRANTS › PART 51—REQUIREMENTS APPLICABLE TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH MENTAL ILLNESS PROGRAM › Subpart D—Access to Records, Facilities and Individuals

42 C.F.R. § 51.41

Access to records

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(a) Access to records shall be extended promptly to all authorized agents of a P&A system.

(b) A P&A system shall have access to the records of any of the following individuals with mental illness:

(1) An individual who is a client of the P&A system if authorized by that individual or the legal guardian, conservator or other legal representative.

(2) An individual, including an individual who has died or whose whereabouts is unknown to whom all of the following conditions apply:

(i) The individual, due to his or her mental or physical condition, is unable to authorize the P&A system to have access.

(ii) The individual does not have a legal guardian, conservator or other legal representative, or the individual's guardian is the State or one of its political subdivisions; and

(iii) A complaint or report has been received and the P&A system has determined that there is probable cause to believe that the individual has been or may be subject to abuse or neglect.

(3) An individual who has a legal guardian, conservator, or other legal representative, with respect to whom a complaint or report has been received by the P&A system and with respect to whom the P&A system has determined that there is probable cause to believe that the health or safety of the individual is in serious and immediate jeopardy, whenever all of the following conditions exists:

(i) The P&A system has made a good faith effort to contact the representative upon prompt receipt of the representative's name and address;

(ii) The P&A system has made a good faith effort to offer assistance to the representative to resolve the situation; and

(iii) The representative has failed or refused to act on behalf of the individual.

(c) Information and individual records, whether written or in another medium, draft or final, including handwritten notes, electronic files, photographs or video or audio tape records, which shall be available to the P&A system under the Act shall include, but not be limited to:

(1) Information and individual records, obtained in the course of providing intake, assessment, evaluation, supportive and other services, including medical records, financial records, and reports prepared or received by a member of the staff of a facility or program rendering care or treatment. This includes records stored or maintained in locations other than the facility or program as long as the system has obtained appropriate consent consistent with section 105(a)(4) of the Act. The system shall request of facilities that in requesting records from service providers or other facilities on residents that they indicate in the release form the records may be subject to review by a system.

(2) Reports prepared by an agency charged with investigating abuse neglect, or injury occurring at a facility rendering care or treatment, or by or for the facility itself, that describe any or all of the following:

(i) Abuse, neglect, or injury occurring at the facility;

(ii) The steps taken to investigate the incidents;

(iii) Reports and records, including personnel records, prepared or maintained by the facility, in connection with such reports of incidents; or

(iv) Supporting information that was relied upon in creating a report, including all information and records used or reviewed in preparing reports of abuse, neglect or injury such as records which describe persons who were interviewed, physical and documentary evidence that was reviewed, and the related investigative findings.

(3) Discharge planning records.

(4) Reports prepared by individuals and entities performing certification or licensure reviews, or by professional accreditation organizations, as well as related assessments prepared for the facility by its staff, contractors or related entities, except that nothing in this section is intended to preempt State law protecting records produced by medical care evaluation or peer review committees.

(5) Professional, performance, building or other safety standards, demographic and statistical information relating to the facility.

(d) A P&A system shall have reasonable access and authority to interview and examine all relevant records of any facility service recipient (consistent with the provisions of section 105(a)(4) of the Act) or employee.

(e) A P&A system shall be permitted to inspect and copy records, subject to a reasonable charge to offset duplicating costs.

Notes of Decisions
Cited in 29 cases (6 in the last 5 years), 1999–2025 · leading case: Ctr. for Legal Advocacy v. Hammons, 323 F.3d 1262 (10th Cir. 2003).
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Ctr. for Legal Advocacy v. Hammons, 323 F.3d 1262 (10th Cir. 2003). · cites it 8× “*1267 42 C.F.R. § 51.41 (c)(4). Thus, this regulation arguably implemented the language contained in the Committee Reports, excluding from access under PAMII peer review or medical care evaluation materials which are privileged under state law.”
Indiana Prot. & Advocacy Servs. v. Indiana Fam. & Soc. Servs. Admin., 603 F.3d 365 (7th Cir. 2010). · cites it 2× “The regulations define the word “records” broadly, 42 C.F.R. §§ 51.41 (c)(l)-(4), but note “that nothing in this section is intended to preempt State law protecting records produced by medical care evaluation or peer review committees.”
Disability Rights New York v. Wise, 171 F. Supp. 3d 54 (N.D.N.Y. 2016). · cites it 4× “§ 15043 (a)(2)(J)(i) (requiring that requested records be provided not later than three business days after the P & A system makes a written request); 42 C.F.R. § 51.41 (a) (“Access to records shall be extended promptly to all authorized agents of a P & A system.”
Iowa Prot. & Advocacy Servs., Inc. v. Gerard Treatment Programs, L.L.C., 152 F. Supp. 2d 1150 (N.D. Iowa 2001). · cites it 3× “Thus, 42 C.F.R. § 51.41 further defines a P & A’s right of access to records, including further identification of what constitutes “records” within the scope of the PAMII Act, see 42 C.”
Prot. & Advocacy Sys., Inc. v. Freudenthal, 412 F. Supp. 2d 1211 (D. Wyo. 2006). · cites it 4× “” The PAIMI regulations at 42 C.F.R. § 51.41 (c)(d) and (e) also address records which may be accessed.”
Disability Rights Ohio v. Buckeye Ranch, Inc., 375 F. Supp. 3d 873 (S.D. Ohio 2019). · cites it 2× “See 42 C.F.R. § 51.41 (b)(iii) ("the P & A system has determined that there is probable cause to believe that the individual has been or may be subject to abuse or neglect"); 45 C.”
Iowa Prot. & Advocacy Servs., Inc. v. Rasmussen, 206 F.R.D. 630 (S.D. Iowa 2001). · cites it 2× “They point to 42 C.F.R. 51.41(c)(2)(i): (c) Information and individual records, whether written or in another medium .”
Ohio Legal Rights Serv. v. Buckeye Ranch, Inc., 365 F. Supp. 2d 877 (S.D. Ohio 2005). · cites it 2× “” 42 C.F.R. § 51.41 (b)(2)(ii). OLRS alleges that FCCS is a political subdivision of the State of Ohio.”
Virginia v. Reinhard, 568 F.3d 110 (4th Cir. 2009). “See 42 C.F.R. § 51.41 (c)(4); 45 C.F.R. § 1386.”
Arizona Ctr. for Disability Law v. Allen, 197 F.R.D. 689 (D. Ariz. 2000). · cites it 2× “); 42 C.F.R. § 51.41 (b)(2) (same); 45 C.F.R.”
Off. of Prot. & Advocacy for Persons With Disabilities v. Armstrong, 266 F. Supp. 2d 303 (D. Conn. 2003). “§ 10805 ; 42 C.F.R. § 51.41 (b)(2). Between approximately August 2000 and April 2001, Connecticut P & A became aware of the suicide deaths of five DOC inmates: K.”
Ind. Prot. & Adv. Servs. v. Ind. Fam. & Soc., 603 F.3d 365 (7th Cir. 2010). · cites it 2× “The regulations define the word "records" broadly, 42 C.F.R. §§ 51.41 (c)(1)-(4), but note "that nothing in this section is intended to preempt State law protecting records produced by medical care evaluation or peer review committees.”
Show all 29 citing cases →
— 42 C.F.R. § 51.41(c) — 1 case
Disability Rights Connecticut, Inc. v. Connecticut Dep't of Corr. (D. Conn. 2024).
— 42 C.F.R. § 51.41(c)(2)(i) — 3 cases
Iowa Prot. & Advocacy Servs., Inc. v. Rasmussen, 206 F.R.D. 630 (S.D. Iowa 2001). “They point to 42 C.F.R. 51.41(c)(2)(i): (c) Information and individual records, whether written or in another medium .”
Iowa Prot. & Advocacy Servs., Inc. v. Rasmussen, 521 F. Supp. 2d 895 (S.D. Iowa 2002).
Iowa Prot. & Advocacy Servs. v. Rasmussen, 521 F. Supp. 2d 895 (S.D. Iowa 2002).
— 42 C.F.R. § 51.41(c)(4) — 1 case
Ctr. for Legal Advocacy v. Hammons, 323 F.3d 1262 (10th Cir. 2003). “*1267 42 C.F.R. § 51.41 (c)(4). Thus, this regulation arguably implemented the language contained in the Committee Reports, excluding from access under PAMII peer review or medical care evaluation materials which are privileged under state law.”
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