Y.C. v. Superior Court ( 2021 )


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  • Filed 11/8/21 (see concurring opn.; see concurring & dissenting opn.)
    CERTIFIED FOR PUBLICATION
    IN THE COURT OF APPEAL OF THE STATE OF CALIFORNIA
    FIRST APPELLATE DISTRICT
    DIVISION FOUR
    Y.C.,
    Petitioner,
    v.
    THE SUPERIOR COURT OF SAN                              A162063
    MATEO COUNTY,
    (San Mateo County
    Respondent;
    Super. Ct. No. 20JW0474)
    THE PEOPLE,
    Real Party in Interest.
    After being detained on assault and firearm charges, 17-year-old Y.C.
    agreed to participate in a mental health assessment conducted by a family
    therapist, pursuant to an established protocol of the Juvenile Services
    Division of the San Mateo County Probation Department. The therapist
    provided a summary of her interview to the probation department, which
    included the summary in a report provided to the juvenile court at Y.C.’s
    detention hearings. In this writ proceeding, Y.C. contends the disclosure of
    the assessment interview to the probation department and juvenile court,
    and its use at his detention hearings, violated his constitutional right against
    self-incrimination and his right to counsel, as well as various privacy rights
    and privileges.
    1
    Because, during the pendency of this writ proceeding, Y.C. entered a
    change of plea and was released from detention, we dismiss his petition as
    moot to the extent it seeks relief relating to the detention order or to evidence
    considered at the detention hearings. In all other respects, we deny the
    petition.
    BACKGROUND
    A.     The Charges
    On November 10, 2020, the juvenile court issued an arrest warrant for
    Y.C., then 17 years old. On the same day, the People filed a wardship petition
    charging Y.C. with three felonies: assault with a firearm (Pen. Code, § 245,
    subd. (a)(2)); carrying a loaded firearm (Pen. Code, § 25850, subd. (c)(4)); and
    possession of a firearm by a minor (Pen. Code, § 29610). The first count
    included a firearm-use enhancement (Pen. Code, § 12022.5, subd. (a)).
    According to the detention report, Y.C. was alleged to have shot a suspected
    rival gang member in the leg.
    Arrested on November 11, 2020, Y.C. was taken to the Juvenile
    Assessment Center (Assessment Center), where he met with a probation
    officer and invoked his rights under Miranda v. Arizona (1966) 
    384 U.S. 436
    .
    The probation officer spoke to Y.C.’s mother, who told the probation officer
    she had been concerned with Y.C.’s behavior. Y.C.’s mother reported that
    several months earlier, she had approached the Burlingame Police
    Department for assistance controlling Y.C.’s behavior. The mother indicated
    to police that she had noticed a “ ‘black flat thing, that is part of a gun’ ” in
    the family home, reprimanded Y.C., and told him to get it out of the house.
    B.     The Assessment Center Interview
    San Mateo County created its Assessment Center in response to the
    need for “comprehensive early intervention with at-risk first-time offenders.”
    2
    The Assessment Center is part of a collaborative effort of the San Mateo
    County Juvenile Justice Coordinating Council, which brings together the
    county’s probation department, Behavioral Health and Recovery Services
    (BHRS) agency, sheriff’s department, district attorney’s office, private
    defender’s office, and judges of the juvenile court.
    As part of the Assessment Center program, a multidisciplinary team
    consisting of a probation officer, nurse practitioner, and psychiatric social
    worker or therapist makes an intake assessment of a minor taken into
    custody to determine the minor’s risk to the community and whether he or
    she is in danger. Pursuant to this program, the probation officer referred Y.C.
    to Linda Johnson, a licensed marriage and family therapist with San Mateo
    County’s BHRS team. The purpose of the referral was for Johnson to assess
    Y.C.’s needs, formulate a recommendation for a further mental health or
    substance abuse evaluation, and potentially suggest future treatment.
    On November 12, Johnson contacted Y.C. by telephone. At the
    beginning of the call, Johnson informed Y.C. that he did not have to speak
    with her and that if he did, the interview would not be confidential and would
    be disclosed to the probation department and the court. Johnson also told
    Y.C. that if he chose not to participate, she would report that fact to the
    probation department and court. Y.C., without counsel, agreed to proceed
    with the interview.
    Johnson spoke with Y.C. for approximately two hours. They did not
    discuss the charges against Y.C., and no reference to the circumstances
    leading to his arrest appears in the report Johnson submitted to the
    probation department. Johnson’s report summarized the substance of the
    interview, discussing Y.C.’s physical and mental health history, including his
    history of substance abuse. The report described Y.C.’s educational and
    3
    employment history, and his relationship with his family and friends.
    Johnson recommended a psychological evaluation to “aid the Court in
    determining an appropriate disposition and treatment plan” for Y.C. The
    probation department included Johnson’s report in the detention report it
    submitted to the juvenile court.
    C.    The Detention Hearings
    Counsel for Y.C. first appeared in juvenile court on November 13, 2020,
    for Y.C.’s initial detention hearing. Counsel objected to the court’s
    consideration of Johnson’s report, but the court overruled the objection and
    ordered continued detention for Y.C., determining detention was reasonably
    necessary for the protection of the person or property of another and that
    placement in Y.C.’s home was contrary to his welfare. (Welf. & Inst. Code,
    § 636, subd. (a).) 1 The record does not reflect the factual underpinnings of the
    court’s findings.
    The court invited Y.C.’s attorney to file a formal motion to suppress and
    seal Johnson’s report, and scheduled a further hearing to reconsider
    detention. Counsel then filed a written motion, arguing that the statements
    Y.C. made to Johnson were obtained in violation of his constitutional rights
    to counsel and against self-incrimination, and that the inclusion of his
    statements in the detention report violated the federal Health Insurance
    Portability and Accuracy Act (HIPAA) and state “privacy rights.” Y.C.
    requested that the court “order the statements excluded from the detention
    report and that they not be used against [Y.C.] by the government.” He also
    requested that the court seal the detention report and direct the preparation
    1 All further undesignated statutory references are to the Welfare and
    Institutions Code.
    4
    of a new detention report without the inclusion of Johnson’s interview with
    Y.C.
    At the December 22, 2020 hearing on the motion, Y.C. called Johnson
    as witness. Johnson testified that her role with the BHRS team is to meet
    with minors upon their arrival at the Assessment Center “to gather a
    biopsychosocial history so that we can determine the needs for this youth and
    their families.” Johnson explained, “The things that I look for are treatment
    issues, resources that they need, history of abuse or neglect. My goal is to
    help youth who potentially would fall through the cracks otherwise.” Johnson
    said the probation department refers a minor to her for an assessment
    generally within 24 hours after the minor has first been detained. In most
    cases, the probation department informs Johnson of a minor’s name and date
    of birth but provides no other details, including the reason for the minor’s
    detention. For minors over 15 years old, Johnson did not contact counsel
    before conducting an assessment; nor did she inquire whether the probation
    department had contacted counsel. This was Assessment Center policy at the
    time of Y.C.’s detention although, as discussed below, that policy changed
    after an intervening change in state law.
    Johnson meets with a minor alone 2; the probation department does not
    participate. Johnson begins an assessment by introducing herself and
    informing the minor that she is to conduct an assessment in order to
    formulate a recommendation to the juvenile court regarding the need for a
    further mental health or substance abuse evaluation, and to make
    suggestions for future treatment. She reads a list of disclosures to the minor,
    Prior to March 2020, Johnson would meet with minors in person at
    2
    the Assessment Center. Beginning in March 2020, Johnson began contacting
    minors by telephone due to restrictions on in-person contact brought on by
    the COVID-19 pandemic.
    5
    including (1) that the information provided by the minor can and will be
    shared with the probation department and juvenile court, (2) that as a result
    of the assessment, the BHRS team “will formulate a recommendation to the
    Court regarding the need for further mental health or alcohol and other drug
    evaluation, and . . . may make suggestions for future treatment,” (3) that the
    minor may refuse to participate in the assessment, but any refusal must be
    made known to the probation department and juvenile court; and (4) that the
    minor may change his mind about participating at any time and refuse to
    answer specific questions. Johnson does not read a minor his Miranda rights
    and is not informed by the probation department whether the minor has
    previously invoked his Miranda rights.
    If a minor chooses to participate, Johnson’s interview covers a wide
    range of categories, including education, family, social history, mental health,
    physical health, abuse, neglect, trauma history, and alcohol and drug history.
    Johnson does not ask about the nature of the charged crimes and, if a minor
    attempts to speak about the charges, Johnson tells the minor to stop.
    After interviewing the minor, Johnson formulates a working clinical
    interpretation that can lead to a provisional diagnosis and additional
    treatment. She also prepares a written summary of her assessment and
    provides it to the probation department for inclusion in the detention report.
    The probation department has no input on the contents of Johnson’s
    summary. Johnson reviews her summary after it has been included in the
    detention report to ensure its accuracy.
    In Y.C.’s case, Johnson explained that she went through the standard
    disclosures with Y.C., and that he agreed to proceed with the assessment.
    Johnson testified that Y.C. was “surprisingly forthcoming and open” during
    the interview and had “good insight for a youth with his history.”
    6
    Following Johnson’s testimony and the parties’ arguments, the juvenile
    court denied Y.C.’s motion to seal and suppress. The court observed that the
    Welfare and Institutions Code “specifically requires that probation do an
    investigation and provide information to the court and that that investigation
    includes the circumstances of the minor and the facts surrounding his or her
    being taken into custody. Part of the way that is done is through the
    interview” by BHRS. The court explained that the interview with Johnson
    was “not an interrogation” because not “on an inculpatory basis,” and it
    concluded there was no Fifth Amendment or Miranda violation, no due
    process violation, and no “[S]ixth [A]mendment violation of the right to
    counsel.” Further, the court concluded that because the interview was
    “provided after an extensive discussion with the minor about how it was
    going to be used, who was going to see it, and what was going to be done for
    it,” there was no HIPAA violation.
    After denying the motion to seal or suppress, the court considered
    Y.C.’s motion to be released from the Assessment Center pending the
    disposition of his case. Y.C.’s mother and a family friend both testified on
    Y.C.’s behalf, explaining that each had a strong relationship with Y.C., that
    Y.C. was a loving person who had made some poor choices, and that they
    would work with him to provide necessary care if the court were to release
    him. The court nonetheless determined, in an order dated December 23,
    2020, that detention remained necessary for the protection of the person or
    property of another, and that placement in the home of Y.C.’s mother would
    be contrary to Y.C.’s welfare.
    D.    Court of Appeal proceedings
    On February 22, 2021, Y.C. filed a petition for writ of mandate in this
    court seeking to vacate the orders denying his motions to seal and suppress
    7
    and for immediate release. Y.C. also filed a separate motion to seal Johnson’s
    report pending our review of the writ petition. After receiving preliminary
    briefing, we issued an order to show cause. We denied the motion to seal
    pending our review of the petition, but observed that the report of Johnson’s
    interview remained confidential pursuant to section 827, which allows only
    specified persons and entities access to a juvenile case file.
    The County of San Mateo filed an application to appear as a real party
    in interest. We denied the county’s application but accepted its proposed
    opposition to Y.C.’s writ petition as an amicus curiae brief. 3
    On May 5, 2021, the Attorney General filed a motion to dismiss Y.C.’s
    writ petition as moot. The Attorney General reported that two days earlier
    Y.C. had pleaded no contest to possession of a firearm by a minor and battery
    with serious bodily injury, and he was awaiting a dispositional hearing on
    May 17. The Attorney General argued that Y.C.’s petition was moot because
    we could no longer grant relief from Y.C.’s pre-adjudication detention. Y.C.
    opposed the motion and we denied it.
    We have since been advised that Y.C. received a disposition of 240 days
    of confinement, which after application of predisposition credits resulted in
    further confinement of four days. Y.C. was then released home on juvenile
    probation subject to ankle monitoring.
    3 We overrule Y.C.’s objections to exhibits attached to the amicus brief.
    Although not considered by the juvenile court, the county resolution creating
    the BHRS team’s Assessment Center procedure, the documents issued by
    federal agencies regarding application of privacy rules in light of the COVID-
    19 pandemic, and an executive order from Governor Newsom addressing
    changes to privacy laws in light of the pandemic, though of limited relevance,
    are properly subject to judicial notice.
    8
    DISCUSSION
    I.    Mootness
    The disposition of Y.C.’s delinquency case does not moot the petition
    before us, but it does substantially narrow the issues we must decide. Y.C.
    has asked this court to vacate the juvenile court’s orders at his detention
    hearings that deny: (1) the sealing and suppression of statements he made to
    Johnson, and (2) his release from custody. We agree with the Attorney
    General that, with Y.C.’s plea of no contest and his release from custody, this
    court can no longer grant “effectual relief” from the detention order, and
    Y.C.’s challenge to the order detaining him is accordingly moot. (Sturgell v.
    Department of Fish & Wildlife (2019) 
    43 Cal.App.5th 35
    , 43.) Y.C.’s challenge
    to the sealing and suppression order is, for the same reason, partially moot.
    To the extent Y.C. argues the statements he made to Johnson should not
    have been used in deciding whether to detain him, that issue is moot now
    that he is no longer detained. But the juvenile court’s order addressed
    sealing, as well as suppression, and there the analysis is different.
    To the extent Y.C. asks that the report containing his statements to
    Johnson be sealed, returned, or destroyed to protect his privacy, that issue is
    not moot. As the United States Supreme Court held in Church of Scientology
    of California v. United States (1992) 
    506 U.S. 9
    , 13, when the Government
    has obtained materials unlawfully, a court can “effectuate relief by ordering
    the Government to return the records.” Although only “a partial remedy,” the
    possibility of an order requiring such relief prevents a case from being moot.
    (Ibid.)
    Courts sometimes have discretion to decide an issue even when it is
    moot, but we decline to do so in this case. A court has the power “to resolve an
    issue rendered moot by subsequent events if the question to be decided is of
    9
    continuing public importance and is a question capable of repetition, yet
    evading review.” (People v. Alsafar (2017) 
    8 Cal.App.5th 880
    , 883, 886.)
    Courts may review the legality of pretrial detention on this theory because
    “ ‘ “[p]retrial detention is by nature temporary, and it is most unlikely that
    any given individual could have his constitutional claim decided on appeal
    before he is either released or convicted.” ’ ” (Alfredo A. v. Superior Court
    (1994) 
    6 Cal.4th 1212
    , 1219.) But in this case we are skeptical that the moot
    issues regarding Y.C.’s pretrial detention are likely to recur because of recent
    changes to state law and to the policy of the San Mateo County probation
    department.
    When Y.C. was first detained in November 2020, section 625.6
    protected only minors who were younger than Y.C. The statute provided:
    “Prior to a custodial interrogation, and before the waiver of any Miranda
    rights, a youth 15 years of age or younger shall consult with legal counsel in
    person, by telephone, or by video conference. The consultation may not be
    waived.” (Former § 625.6, subd. (a).)
    Consistent with the former statute, the policy of the San Mateo County
    probation department was to contact counsel for youths before referring them
    to BHRS only if a minor was 15 years of age or younger. That changed on
    January 1, 2021 because the Legislature amended section 625.6 so that it
    applies to all minors. (§ 625.6, subd. (a).) Beginning on January 1, 2021, the
    probation department amended its policy so that it contacts counsel for all
    minors, including 16- and 17-year-olds, before referring them to BHRS. Given
    this change in the probation department’s policy, it is unlikely that other
    youths will raise similar challenges to the inclusion of BHRS interview
    summaries with their detention reports. We accordingly decline to address
    those aspects of Y.C.’s petition that are moot.
    10
    II.   Constitutional Claims
    Y.C. argues that use of his assessment center interview for any purpose
    other than health care services violates his Fifth Amendment right against
    self-incrimination and Sixth Amendment right to counsel. 4 To the extent Y.C.
    is using these arguments to challenge his detention order or to argue that
    Johnson’s report should not have been considered at the detention hearings,
    those issues are moot since Y.C. is no longer detained. And to the extent Y.C.
    is using these arguments to have the summary of his interview with Johnson
    sealed, returned, or destroyed to protect his privacy, that form of relief is not
    available for either alleged violation.
    The Fifth Amendment guarantees that no person “shall be compelled in
    any criminal case to be a witness against himself.” (U.S. Const., 5th Amend.)
    Compelled statements “of course may not be used against a defendant at
    trial, [citation], but it is not until their use in a criminal case that a violation
    of the Self–Incrimination Clause occurs.” (Chavez v. Martinez (2003) 
    538 U.S. 760
    , 767 (plur. opn. of Thomas, J.); see also 
    id., at pp. 777-779
     (conc. opn. of
    Souter, J.); New York v. Quarles (1984) 
    467 U.S. 649
    , 686 (Marshall, J.,
    dissenting).) Because the privilege is focused on the use of statements during
    a criminal case, the privilege “does not protect against the nonpenal adverse
    use of officially compelled answers.” (Speilbauer v. County of Santa Clara
    4  While the parties have focused their arguments on the Sixth
    Amendment’s right to counsel, the right to counsel in delinquency
    proceedings is derived from principles of due process rather than the Sixth
    Amendment. (In re Gault (1967) 
    387 U.S. 1
    , 41.) We will presume the right to
    counsel applies to minors in delinquency proceedings in the same manner as
    to adult defendants in criminal cases. (See In re Elijah C. (2016) 
    248 Cal.App.4th 958
    , 964, fn. 5; but see In re William F. (1974) 
    11 Cal.3d 249
    , 254
    [“[t]he right of counsel in juvenile proceedings” is “not necessarily as broad as
    the right to counsel in criminal proceedings”] disapproved on another point in
    People v. Bonin (1988) 
    46 Cal.3d 659
    , 695, fn. 4.)
    11
    (2009) 
    45 Cal.4th 704
    , 715.) Thus, in Spielbauer, the Supreme Court held
    that “a public employee may be compelled, by threat of job discipline, to
    answer questions about the employee’s job performance, so long as the
    employee is not required, on pain of dismissal, to waive the constitutional
    protection against criminal use of those answers.” (Id. at p. 710, italics
    omitted.) The Fifth Amendment does not prevent compelling an employee’s
    statements, the Court explained. “It simply forbids use of the compelled
    statements, or the fruits thereof, in a criminal prosecution against the
    employee.” (Id. at p. 727.)
    Similarly, in People v. Elizalde (2015) 
    61 Cal.4th 523
    , the Supreme
    Court held that an un-Mirandized statement from a defendant about his
    gang affiliation, elicited during jail booking, was not admissible in the
    prosecution’s case-in-chief, but also observed that it remains “permissible to
    ask arrestees” questions about gang affiliation during the booking process.
    (Id. at p. 541.) The Court recognized, “[j]ail officials have an important
    institutional interest in minimizing the potential for violence within the jail
    population,” and they “retain substantial discretion to devise reasonable
    solutions to the security problems they face. [Citation.] We simply hold that
    defendant’s answers to the unadmonished gang questions posed here were
    inadmissible in the prosecution’s case-in-chief.” (Ibid.)
    What these authorities make clear is that eliciting an unwarned, even
    an involuntary, statement from a person in custody is not itself a Fifth
    Amendment violation. It is the use in court proceedings of such a statement
    that offends the Fifth Amendment. Here, the simple fact of Johnson’s
    interview of Y.C. did not violate the Fifth Amendment, even if use of the
    interview report during the detention hearing would have (an issue we do not
    decide because it is moot). The Fifth Amendment is therefore unavailable as
    12
    a vehicle to order the sealing or destruction of any reference to Y.C.’s
    statements to Johnson in his case file.
    We reach the same result with respect to Y.C.’s right-to-counsel
    argument, albeit for slightly different reasons. Once Sixth Amendment rights
    attach, a violation of the right to counsel “occurs when the uncounseled
    interrogation is conducted.” (Kansas v. Ventris (2009) 
    556 U.S. 586
    , 592.) The
    right to counsel “renders inadmissible in the prosecution’s case in chief
    statements ‘deliberately elicited’ from a defendant without an express waiver
    of the right to counsel.” (Michigan v. Harvey (1990) 
    494 U.S. 344
    , 348.) But a
    statement that is inadmissible as part of the prosecution’s case-in-chief may
    be used for other purposes. For example, a statement obtained in violation of
    the right to counsel can be used to impeach the defendant’s testimony.
    (Ventris, at p. 594.) In addition, because the right to counsel is “offense
    specific,” a defendant’s statements “regarding offenses for which he had not
    been charged [are] admissible notwithstanding the attachment of his Sixth
    Amendment right to counsel on other charged offenses.” (Texas v. Cobb (2001)
    
    532 U.S. 162
    , 168.) An uncounseled statement may even be considered at a
    juvenile disposition hearing, as “there is no statutory or constitutional
    prohibition on the consideration of illegally obtained evidence at a juvenile
    delinquency disposition hearing,” as long as the evidence is reliable, not
    obtained as a result of gross or shocking misconduct, and not obtained for
    purposes of influencing the sentencing court. (In re Michael V. (1986) 
    178 Cal.App.3d 159
    , 172–173.)
    Because there are permissible uses of a statement taken in violation of
    the right to counsel, it would, once again, be inappropriate to seal or destroy
    records of such statements so that they could never be considered for any
    purpose. We do not here decide whether Y.C.’s statements to Johnson could
    13
    be used in any particular circumstance, as no other use of the statements is
    before the court. We simply conclude, now that the challenge to the juvenile
    court’s pretrial detention order is moot, that relief is no longer available for
    any alleged violation of Y.C.’s right to counsel. Since neither this claim nor
    Y.C.’s Fifth Amendment claim provides a vehicle for granting the sealing or
    destruction relief he seeks, we deny (to the extent not dismissed) Y.C.’s writ
    petition as to both federal constitutional claims.
    III.   Federal and State Privacy Laws
    Y.C. asserts that disclosure of his assessment interview violated
    (1) HIPAA and state regulations requiring compliance with HIPAA;
    (2) California’s Confidentiality of Medical Information Act (CMIA); (3) the
    state constitutional right to privacy; (4) the psychotherapist-patient privilege;
    and (5) state laws governing informed consent of medical decisions. He asks
    that we “ensure all documents relating to the Assessment Center interview,
    and copies thereof, are returned to respondent court without being further
    read or consulted.” He also requests that we order the juvenile court to “seal
    or destroy those documents.”
    A.    HIPAA and CMIA
    HIPAA “prohibits the unauthorized disclosure or sharing of a person’s
    medical information and imposes civil and criminal penalties on those who
    do.” (County of San Diego v. Mason (2012) 
    209 Cal.App.4th 376
    , 382.) When it
    enacted HIPAA, “Congress expressed its concern for protecting the integrity
    and confidentiality of personal medical records, and for preventing the
    unauthorized use or disclosure of such records. (42 U.S.C. § 1320d-2(d)(2).)”
    (Bugarin v. Chartone, Inc. (2006) 
    135 Cal.App.4th 1558
    , 1561–1562.)
    Similar to HIPAA, CMIA “is intended to protect the confidentiality of
    individually identifiable medical information obtained from a patient by a
    14
    health care provider, while at the same time setting forth limited
    circumstances in which the release of such information to specified entities or
    individuals is permissible.” (Loder v. City of Glendale (1997) 
    14 Cal.4th 846
    ,
    859.) “To provide such protection, the act specifies that ‘[n]o provider of
    health care shall disclose medical information regarding a patient of the
    provider without first obtaining an authorization . . .’ (Civ. Code, § 56.10,
    subd. (a)), and then sets forth, in some detail, the requirements of a valid
    authorization for the release of medical information ‘by a provider of health
    care’ (id., § 56.11) or by an employer (id., § 56.21).” (Loder, at pp. 859–860.)
    Y.C. argues that Johnson failed to follow the authorization and notice
    requirements in HIPAA and CMIA, rendering disclosure of the assessment in
    the detention report unlawful under both laws. Specifically, Y.C. argues that
    Johnson failed to obtain signed, written authorization, as required by both
    statutes (see 45 C.F.R. § 164.508(c)(1); Civ. Code, § 56.11), and that he was
    not provided with a “Notice of Privacy Practices” or the opportunity to object
    to disclosure of the assessment, as required by HIPAA’s regulations. (See 45
    C.F.R. §§ 164.510, 164.520.) As to CMIA, Y.C. claims that BHRS conditioned
    its services on his allowing disclosure of the information to the probation
    department and court, in contravention of Civil Code section 56.37.
    But Y.C. has not addressed key aspects of HIPAA and CMIA.
    Y.C. asserts that BHRS is “plainly a HIPAA covered entity” based on a
    BHRS policy memorandum describing BHRS’s procedure for complying with
    HIPAA. However, Y.C. overlooks and does not address the portion of the
    same memorandum stating that disclosure of protected health information by
    BHRS is mandatory “[t]o the courts, (e.g., to the Juvenile Judge), as
    necessary for the administration of justice, in accordance with federal and
    California law.” (BHRS memorandum, Confidentiality/Privacy of Protected
    15
    Health Information (PHI), Feb. 25, 2003, p. 4
     [as
    of Nov. 8, 2021].) More importantly, Y.C. does not address HIPAA’s definition
    of a “Covered entity” set out in title 45 of the Code of Federal Regulations,
    part 160.103: a covered entity is a “health plan,” a “health care
    clearinghouse,” and a “health care provider who transmits any health
    information in electronic form in connection with a transaction covered by
    [HIPAA’s regulations].” (45 C.F.R. § 160.103.) These terms each have their
    own definition under HIPAA, and Y.C. does not attempt to establish that any
    of them encompasses the San Mateo County probation department or BHRS.
    We see no way the probation department or BHRS could be considered a
    “health plan” or “health care clearinghouse.” 5 And assuming, without
    deciding, that the probation department or BHRS is a “health care provider,”
    we see no indication that either transmitted health information “in
    connection with a transaction” covered by HIPAA’s regulations. The
    5 “Health plan” is defined as “an individual or group plan that provides,
    or pays the cost of, medical care.” The definition provides a non-exclusive list
    of 17 types “health plans,” such as a group health plan, a health insurance
    issuer, an HMO, and a variety of government programs such as Medicare and
    Medicaid. A “Health care clearinghouse” is a “public or private entity,
    including a billing service, repricing company, community health
    management information system or community health information system,
    and ‘value-added’ networks and switches, that does either of the following
    functions: [¶] (1) Processes or facilitates the processing of health information
    received from another entity in a nonstandard format or containing
    nonstandard data content into standard data elements or a standard
    transaction[;] [¶] (2) Receives a standard transaction from another entity and
    processes or facilitates the processing of health information into nonstandard
    format or nonstandard data content for the receiving entity.” Nothing in the
    record before us suggests the probation department and BHRS satisfies these
    definitions. (45 C.F.R. § 160.103.)
    16
    regulations define “Transaction” as the “transmission of information between
    two parties to carry out financial or administrative activities related to
    health care” (45 C.F.R. § 160.103), which is not something Y.C. claims
    occurred in this case. We decline to wade further into the regulatory thicket
    in search of arguments Y.C. might have made to support his HIPAA claim. It
    is enough to observe that he fails to carry his burden of establishing that the
    trial court erred when it found no HIPAA violation. (See Denham v. Superior
    Court (1970) 
    2 Cal.3d 557
    , 564.)
    As for CMIA, it contains a number of exceptions that seem to permit
    disclosure of Y.C.’s assessment interview to the probation department,
    juvenile court, and other parties participating in Y.C.’s treatment and care.
    CMIA permits disclosure of medical information when “specifically
    authorized by law” (Civ. Code, § 56.10, subd. (c)(14)), a provision that
    “legitimizes a myriad of situations the Legislature may not have cared to
    spell out.” (Shaddox v. Bertani (2003) 
    110 Cal.App.4th 1406
    , 1414.)
    Disclosure of the assessment interview in this case appears authorized by the
    Welfare and Institutions Code provision requiring a probation officer to
    “investigate the circumstances of the minor” (§ 628, subd. (a)), and to provide
    a report to the juvenile court, which the court must consider with any other
    evidence (Cal. Rules of Court, rule 5.760(a)). Similarly, applicable regulations
    require the administrator of a juvenile facility to “develop and implement
    written policies and procedures for assessment and case planning,” that allow
    “for the multi-disciplinary sharing of health information,” and “for providing
    information to the court, child supervision staff and to probation.” (Cal. Code
    Regs., tit. 15, §§ 1355, 1407(a).) Separately, CMIA also authorizes a provider
    of health care to disclose medical information to a probation officer “or any
    other person who is legally authorized to have custody or care of a minor for
    17
    the purpose of coordinating health care services and medical treatment
    provided to the minor.” (Civ. Code, § 56.103, subd. (a).)
    Even if HIPAA or CMIA were violated in the manner asserted by Y.C.,
    the “Right to Truth-in-Evidence” provision found in article I, section 28 of our
    state Constitution prohibits the juvenile court from sealing or destroying the
    summary of Johnson’s interview with Y.C. This constitutional provision
    provides, in relevant part: “relevant evidence shall not be excluded . . . in any
    trial or hearing of a juvenile for a criminal offense, whether heard in juvenile
    or adult court.” (Cal. Const., art. I, § 28, subd. (f)(2).) Our Supreme Court has
    explained that this provision “was intended to permit [the] exclusion of
    relevant, but unlawfully obtained evidence, only if exclusion is required by
    the United States Constitution.” (In re Lance W. (1985) 
    37 Cal.3d 873
    , 890.)
    Neither HIPAA nor CMIA authorizes a court to exclude otherwise relevant
    evidence as part of a juvenile delinquency proceeding. (See Elder-Evins v.
    Casey (N.D.Cal., July 3, 2012, No. C 09-05775 SBA (LB)) 2012 U.S. Dist.
    Lexis 92467, p. *28 [
    2012 WL 2577589
    , p. *8] [“HIPAA’s general penalty
    provision, 42 U.S.C. § 1320d-5(a)(1), does not include a suppression remedy,”
    but rather “a civil penalty that can be assessed only against covered entities
    and their business associates”]; United States v. Streich (9th Cir. 2009) 
    560 F.3d 926
    , 935 (conc. opn. of Kleinfeld, J.) [“HIPAA does not provide any
    private right of action, much less a suppression remedy”]; cf. Civ. Code,
    § 56.35 [listing compensatory damages, punitive damages, and attorney fees
    as remedy for CMIA violation, in addition to any other remedies available at
    law].) Nor has Y.C. cited authority holding that the federal Constitution
    requires exclusion of information obtained in violation of HIPAA or CMIA.
    Because, as far as we are aware, Y.C. remains on juvenile probation and
    under the jurisdiction of the juvenile court, the Right to Truth-in-Evidence
    18
    provision counsels against the court sealing or destroying relevant evidence
    in his case file. Whether such evidence could be used in any future court
    proceeding should remain for decision another day.
    Finally, we note that section 827 restricts access to juvenile case files to
    specified persons and entities, balancing the Legislature’s belief “that
    juvenile court records, in general, should be confidential” with its intent “to
    provide for a limited exception to juvenile court record confidentiality to
    promote more effective communication among juvenile courts, family courts,
    law enforcement agencies, and schools to ensure the rehabilitation of juvenile
    criminal offenders.” (§ 827, subd. (b)(1); see also § 827, subd. (a)(1); In re Gina
    S. (2005) 
    133 Cal.App.4th 1074
    , 1081.) Tellingly, Y.C. has cited no authority
    stating that the protections of section 827 are insufficient to protect a youth’s
    privacy rights during or after juvenile court proceedings.
    B.    Right to privacy, psychotherapist-patient privilege, and
    informed consent
    Y.C. also argues that the disclosure of Johnson’s assessment to the
    probation department and juvenile court violated his state constitutional
    right to privacy, the psychotherapist-patient privilege, and state laws
    governing informed consent.
    We disagree that the disclosure violated Y.C.’s constitutional right to
    privacy. The California Constitution does recognize a right of privacy (Cal.
    Const., art. I, § 1), but the party asserting the right must establish “an
    objectively reasonable expectation of privacy in the given circumstances.”
    (Williams v. Superior Court (2017) 
    3 Cal.5th 531
    , 552.) Y.C. could not
    reasonably have expected that information he provided during the
    assessment interview would not be disclosed to the probation department or
    the juvenile court because Johnson explicitly advised Y.C. that any
    information he shared would be disclosed to the probation department and
    19
    juvenile court. Johnson also reminded Y.C. that he could stop participating at
    any time. We recognize that within a short span of time Y.C. was arrested by
    police, detained at the Assessment Center, brought before a probation officer,
    and then referred to Johnson for an assessment interview—all undoubtedly
    stressful for any youth. However, we cannot agree that any uncertainty Y.C.
    may have had concerning the consequences of participating in the assessment
    interview changes this basic fact: he had no objectively reasonable
    expectation that the interview would not be shared with the probation
    department and the juvenile court.
    For similar reasons, we disagree with Y.C. that his interview with
    Johnson was protected by the psychotherapist-patient privilege. The
    psychotherapist-patient privilege grants a patient the right to refuse to
    disclose, and to prevent others from disclosing, a confidential communication
    between himself and a psychotherapist. (Evid. Code, § 1014.) But Johnson’s
    interview with Y.C. cannot be considered a completely confidential
    communication. She informed Y.C., without qualification, that “[a]ny
    information disclosed by you during this Assessment can and will be shared
    with Probation and the Court.” She also informed him that she was a
    mandated reporter, so that if she “suspected that you pose a danger to
    yourself or others I am also required to report those concerns to the
    appropriate persons and/or agencies.” To the extent that Johnson told Y.C. in
    advance she would share his statements, those statements are not protected
    by the psychotherapist privilege. (Accord People v. Henderson (1977) 
    19 Cal.3d 86
    , 97–98 [defendant interview with jail psychotherapist not
    confidential when defendant advised of constitutional rights and informed
    interview was being conducted at request of district attorney], overruled on
    other grounds by People v. Flood (1998) 
    18 Cal.4th 470
    , 484.)
    20
    Last, we conclude that the doctrine of informed consent has no bearing
    on whether the contents of Johnson’s interview should be sealed or destroyed.
    The doctrine of informed consent “imposes a duty on the physician to provide
    material information about any proposed treatment, such as risks and
    alternative procedures.” (Conte v. Girard Orthopaedic Surgeons Medical
    Group, Inc. (2003) 
    107 Cal.App.4th 1260
    , 1267.) Y.C. claims Johnson failed to
    inform him about what use the probation department would make of the
    information he supplied, and failed to explain what rights he had to
    alternative mental health services or legal assistance. But even if Y.C. could
    establish that Johnson breached a duty to provide him material
    information—an issue we do not decide—that breach would not entitle Y.C.
    to the sealing order he seeks. Y.C. points to the black-letter principle that
    breach of a professional’s obligation to obtain informed consent renders any
    purported consent void. (Citing Sheppard, Mullin, Richter & Hampton, LLP
    v. J-M Manufacturing Co., Inc. (2018) 
    6 Cal.5th 59
    , 87.) But Y.C. fails to
    explain how this principle translates into a right to the relief he seeks.
    Nothing in our analysis presupposes that Y.C. provided informed consent to
    Johnson’s interview, so Y.C.’s effort to nullify such consent is beside the
    point. Although we have established that once Johnson advised Y.C. the
    contents of his interview would be disclosed to the probation department and
    juvenile court, it was not objectively reasonable for Y.C. to believe otherwise,
    that is a different matter.
    In sum, none of Y.C.’s statutory or state constitutional claims entitle
    him to the sealing or destruction order he sought from the juvenile court.
    DISPOSITION
    To the extent petitioner seeks relief from the juvenile court’s detention
    order or the court’s consideration of the challenged statements during the
    21
    detention hearings, the petition for writ of mandate is dismissed as moot. In
    all other respects, the petition for writ of mandate is denied.
    TUCHER, P.J. *
    I CONCUR:
    POLLAK, P.J.
    *Presiding Justice of the Court of Appeal, First Appellate District,
    Division Three, sitting by assignment pursuant to article VI, section 6 of the
    California Constitution.
    22
    POLLAK, P.J. — I concur but write separately to emphasize that although
    we do not decide the constitutional issues raised by Y.C. because they are
    moot as to him, we do not imply that we would agree with his contentions
    were we to decide them. To the contrary, the constitutional provisions cited
    by Y.C. are designed to prevent the forced or uninformed disclosure of
    incriminating information. (See, e.g., Rhode Island v. Innis (1980) 
    446 U.S. 291
    , 301, fn. 5; United States v. A.R. (3d Cir. 1994) 
    38 F.3d 699
    , 703–705;
    United States v. Mitchell H. (1999) 
    182 F.3d 1034
    , 1035.) Here, in my view,
    there is no indication that Y.C.’s participation in the interview with a
    therapist from the county’s Behavioral Health and Recovery Services was
    either compelled or lacking in informed consent, 1 and the interview was
    designed and implemented to avoid discussion of Y.C.’s alleged offenses or of
    any potentially incriminating information. The therapist’s interview was no
    more than an extension of the probation officer’s interview, designed “not to
    elicit evidence of guilt — the function of police questioning — but to assist the
    probation officer in deciding at the outset of the case whether the minor need
    be further detained pending a court hearing,” which our Supreme Court
    approved in In re Wayne H. (1979) 
    24 Cal.3d 595
    , 601. There the Supreme
    Court held that statements made during such an interview “are not
    admissible as substantive evidence, or for impeachment, in any subsequent
    1 The advisement that failure to participate would be reported to the
    court was hardly a threat. The therapist never stated or implied Y.C. would
    receive less favorable treatment from the court if he declined to participate,
    or suggested that he would receive more favorable treatment if he did
    participate. (See People v. Holloway (2004) 
    33 Cal.4th 96
    , 116.) Indeed, the
    therapist could be faulted only if she had failed to make that disclosure. In
    addition, the therapist interview with Y.C. has no resemblance to the coercive
    and threatening questioning that was present in other cases in which a
    minor’s statement was found involuntary. (See In re T.F. (2017) 
    16 Cal.App.5th 202
    , 221; In re Elias V. (2015) 
    237 Cal.App.4th 568
    , 583–584.)
    1
    proceeding to determine criminal guilt, whether juvenile or adult,” but “may,
    of course, be admitted and considered in hearings on the issues of detention
    and fitness for juvenile treatment.” (Id. at p. 602.)
    As to the asserted violation of the Health Insurance Portability and
    Accountability Act (HIPAA), which I agree does not apply, I would add one
    observation. Even were the statute applicable, neither the therapist nor the
    court ran “roughshod” over Y.C.’s rights under its provisions as Y.C.
    contends. The therapist’s failure to obtain a signed, written authorization
    from Y.C. was a consequence of restrictions on in-person contact at the
    Juvenile Assessment Center caused by the COVID-19 pandemic. Although
    the therapist interviewed Y.C. over the telephone, her admonishments
    covered HIPAA’s principal requirements for a valid authorization, including
    an advisement of the purpose of the interview and identification of the
    persons to whom disclosure of information would be made. (See 45 C.F.R.
    § 164.508(c)(1).) Under the circumstances, there was substantial compliance
    with the HIPAA safeguards.
    In short, and without belaboring the arguments, the approach adopted
    by the San Mateo County Probation Department is well designed to
    accomplish its legitimate purpose without compromising the minor’s rights or
    violating any statutory or constitutional restrictions. Prompt evaluation of
    the mental health of a minor taken into custody is to be desired. The
    therapist in this case breached no duty of loyalty or confidentiality, was fully
    cognizant of her obligation to avoid eliciting potentially incriminating
    information from Y.C., and complied with that obligation.
    POLLAK, P. J.
    2
    STREETER, J., Concurring and Dissenting.
    The collaborative, multidisciplinary approach San Mateo County took
    to establishing its Juvenile Assessment Center (the Assessment Center or the
    Center) appears to have been well intentioned. But no matter how well
    intentioned in concept, in practice the Assessment Center carries out two
    functions that are at war with each other. The Center offers detained youth
    mental health services while at the same time, through the required sharing
    of information among its constituent members—specifically in this case, the
    dissemination to a probation officer of a psychologist’s assessment of a 17-
    year-old youth held in custody, charged with felony offenses—it also supports
    the prosecutorial function carried out by the probation department and the
    district attorney. Whether Linda Johnson, the department of Behavioral
    Health and Recovery Services (BHRS) psychologist who conducted the
    assessment, understood this conflict is beside the point. Wittingly or not, the
    fact is that her professional duties of loyalty and confidentiality to her young
    patient were compromised.
    If the BHRS saw fit to accommodate some kind of protocol of the
    probation department by sharing Ms. Johnson’s clinical assessment, that
    does not excuse the resulting violations of law. Nor does the fact that the
    probation department is a constituent member of the Assessment Center
    transform the BHRS into an arm of the probation department. Indeed, in her
    testimony at the detention hearing, Ms. Johnson emphasized that she does
    not work for the probation department. She said she is “part of the BHRS
    forensic team.” By embedding a clinical psychologist in a collaborative body
    that also includes the probation department, San Mateo County cannot
    render inoperative the obligations of confidentiality that arise out of the
    1
    psychologist’s professional responsibility to her patient. Ms. Johnson had the
    obligation to recommend mental health treatment for Y.C., if warranted; the
    probation officer had the obligation to pursue his prosecution, if warranted.
    Because these professional roles are fundamentally incompatible with each
    other, it was up to Ms. Johnson to level with Y.C. about the potential
    jeopardy she was putting him in, or at least put him in a position to
    understand that disclosure of her assessment summary to the probation
    department might not be in his best interests. For a lawyer in comparable
    circumstances, we would never tolerate this kind of conflict absent full
    disclosure and knowing waiver, even for sophisticated clients.
    The issues raised in this case are not unique to San Mateo County, or
    to California. Commentators with expertise in this specialty area have
    surveyed the problems arising in psychological assessment interviews of
    minors at the intake stage of juvenile justice systems across the country. 1
    One of the unfortunate aspects of the way in which these issues have arisen
    1  Lore, Pretrial Self-Incrimination in Juvenile Court: Why a
    Comprehensive Pretrial Privilege Is Needed to Protect Children and Enhance
    the Goal of Rehabilitation (2009) 47 U. Louisville L.Rev. 439, 442–443,
    fn. omitted (“Often, children will make self-incriminating statements during
    the pre-adjudication stage of a juvenile court case while being evaluated or
    receiving rehabilitative or therapeutic services. . . . [¶] The issue of children
    making self-incriminating statements at the pre-adjudication stage has
    grown in importance recently because of the trend within the juvenile justice
    system to provide earlier screening and assessment . . . , often immediately
    after arrest, but prior to any official court or attorney involvement. At an
    initial screening, where children are often assessed for any immediate needs
    such as mental health or substance abuse problems, [they] are generally
    unrepresented. This lack of counsel increases the likelihood that they may
    make self-incriminating statements that could drastically impact their
    lives.”); see Rosado, Outside the Police Station: Dealing with the Potential for
    Self-Incrimination in Juvenile Court (2012) 38 Wash. U. J.L. & Pol’y 177,
    182–183.
    2
    here is that the objective of making sure psychological assessments are
    undertaken as an adjunct to the probation department’s reporting
    responsibility to the court—as the lead opinion puts it, to “ ‘aid the Court in
    determining an appropriate disposition and treatment plan’ ” (lead opn., ante,
    at p. 4)—could just as easily be carried out by the Assessment Center as a
    collaborative endeavor after the detention hearing, the point in time when
    Y.C. was guaranteed the assistance of counsel by statute. (Welf. & Inst.
    Code, 2 § 634.) 3 Ms. Johnson admitted in her testimony that any urgent need
    for mental health services prior to the detention hearing can be handled
    independently, without consulting a probation officer. She also testified that
    a court order is unnecessary for the provision of urgent services at that point.
    Thus, it is the timing of the collaboration between BHRS and the probation
    department that is most problematic here, not the fact of it.
    Because only a slight timing adjustment would have brought the
    Assessment Center into compliance with governing law at no cost to the
    prompt delivery of mental health services to juvenile arrestees, the issues
    that have arisen here could have been avoided quite easily. Why all the
    controversy surrounding this writ proceeding then? That seems plain to see. I
    would have thought that, by now, all these years after Miranda v. Arizona
    2All subsequent statutory references, as in the lead opinion, are to the
    Welfare and Institutions Code, unless otherwise noted.
    3 Indeed, for youths like Y.C., who the court finds are beyond effective
    parental control and thus for whom immediate return to their parents is not
    a viable option, that is exactly what the statutory scheme contemplates.
    (§ 636.1, subd. (a) [“When a minor is detained pursuant to Section 636
    following a finding by the court that continuance in the home is contrary to
    the minor’s welfare and the minor is at risk of entering foster care, the
    probation officer shall, within 60 calendar days of initial removal, or by the
    date of the disposition hearing, whichever occurs first, complete a case
    plan.”].)
    3
    (1966) 
    384 U.S. 436
     (Miranda) and In re Gault (1967) 
    387 U.S. 1
    , it would be
    beyond debate that a juvenile accused of a felony has the right to counsel
    during any custodial interrogation. But apparently not. Although counsel
    must be appointed for all juvenile arrestees at their detention hearings, for a
    brief period prior to that point these young arrestees sit in jail unrepresented.
    At stake here is whether the San Mateo County Probation Department,
    indirectly through BHRS psychologists, may be given access to uncounseled
    juvenile arrestees before a lawyer enters the picture. 4
    Which highlights another unfortunate aspect of the case: Because Y.C.
    has now been released pursuant to an agreed disposition, and because a
    recent amendment to section 625.6 gives all minors a mandatory, unwaivable
    right to consult with counsel before submitting to any type of interrogation
    while in custody, 5 any endorsement of the Center’s past practices appears to
    be pointless. I therefore join the lead opinion in concluding that the case is at
    least partially moot, and to the extent it is moot, in further concluding that
    we should decline to apply the recurring-but-evading-review exception to the
    mootness doctrine. I would go further, however. I think the entire case is
    4 The fact that Y.C. was an apparently fully capable 17 year old is of no
    moment. He was a minor. In 2011, the United States Supreme Court drew
    attention to how the psychological pressures of custodial interrogation that it
    warned against in Miranda can be especially powerful in breaking the will of
    a juvenile. (J.D.B. v. North Carolina (2011) 
    564 U.S. 261
    , 272.) The Court’s
    sensitivity to this issue is not new. (See Gallegos v. Colorado (1962) 
    370 U.S. 49
    , 53–55; Haley v. Ohio (1948) 
    332 U.S. 596
    , 599–601 (plur. opn. of Douglas,
    J.).)
    5 Section 625.6, subdivision (a) (“Prior to a custodial interrogation, and
    before the waiver of any Miranda rights, a youth 17 years of age or younger
    shall consult with legal counsel in person, by telephone, or by video
    conference. The consultation may not be waived.”). Until January 1, 2021,
    only youths 15 years of age or younger were covered by this statute.
    4
    moot and that we should say so, without more. I do not think Church of
    Scientology of California v. United States (1992) 
    506 U.S. 9
    , which addresses
    Article III mootness in the federal courts, compels a contrary conclusion. That
    case involved a taxpayer’s request for return of its own records. The high
    court observed that “[t]axpayers have an obvious possessory interest” in their
    records. (Church of Scientology of California, supra, at p. 13.) The document
    at issue here is a detention report prepared by the San Mateo County
    Probation Department. What gave rise to all of Y.C.’s objections, and
    ultimately to this writ proceeding, is that Ms. Johnson authored a section of
    the probation department’s detention report. I fail to see how that could
    possibly have given Y.C. a possessory interest in the detention report itself.
    He could complain about the probation department’s use of the detention
    report, which is what he did via his motion to suppress, but he could not
    demand it back or have it treated like it was his property, since it was never
    his.
    Because I see no possible basis for any return, sealing, or destruction of
    records, I do not think we should be issuing what amounts to an advisory
    opinion on the claims requesting those remedies, since we cannot award
    effective relief on them. I will say, though, that having concluded we still
    have a live controversy here to an extent, Presiding Justice Tucher has done
    an admirable job setting forth an analysis that deftly tacks back and forth
    from merits discussion to mootness discussion, while keeping our merits
    rulings relatively narrow. I appreciate that, though I am concerned about the
    clarity of what we say here, since, at least as to some of the claims, the
    analysis seems to suggest both that we are rejecting them on the merits and
    that we deem them moot. For an opinion that seeks to garner agreement from
    two colleagues with polar opposite views on this particular case, as our
    5
    separate opinions surely demonstrate, I suppose some opaqueness is to be
    expected.
    To the extent we are reaching the merits, explicitly or impliedly, I must
    dissent. I will comment briefly on only two sections of the lead opinion. First,
    I would find a violation of the Health Insurance Portability and
    Accountability Act of 1996 (HIPAA) (42 U.S.C. § 1320d et seq.) on this record.
    HIPAA prohibits a “covered entity” from using or disclosing protected health
    information. (45 C.F.R. § 164.502(a) (2020).) Covered entities include a
    “health plan,” a “health care clearinghouse,” and a “health care provider who
    transmits any health information in electronic form in connection with a
    transaction” under HIPAA. (45 C.F.R. § 164.104(a) (2020).) The disclosure of
    “psychotherapy notes” is specifically mentioned in the regulations as a
    disclosure for which authorization is required. (45 C.F.R. § 164.508 (2020).)
    In my view, BHRS—a public health agency that delivers mental health
    services to juveniles—is clearly a “covered entity” since it is a “health care
    provider.” It violated HIPAA because the information gathered by its
    employee, Ms. Johnson, was “health information” (42 U.S.C. § 1320d(4)), the
    disclosure of which was prohibited (42 U.S.C. § 1320d-6) absent patient
    consent (45 C.F.R. § 164.508 (2020). Patient consent is governed by strict
    regulatory standards. (See 45 CFR 160.102(a)(3) (2020) [applicability of
    regulatory standards to a “healthcare provider”].) Ms. Johnson failed to
    secure Y.C.’s consent in the form of a “valid authorization” written in “plain
    language” advising Y.C. of the purpose of the disclosure, describing in
    “specific and meaningful fashion” the information to be disclosed, telling Y.C.
    his right to treatment was not conditioned on consent to disclosure, and
    warning Y.C. of the prospect that any disclosed information could lose its
    protected status under HIPAA. (45 C.F.R. § 164.508(c)(1)(i), (iv), (vi) and
    6
    (c)(3) (2020).) Nor is there any basis for excusing the failure to obtain an
    effective consent. The exception for disclosures made in connection with
    judicial and administrative proceedings—which appears to be what the
    mandatory governmental disclosure proviso in BHRS’s policy memorandum
    is about—does not apply in the absence of a court order, subpoena or
    assurance that steps have been taken to secure a protective order. (45 C.F.R.
    § 164.512(e) (2020).) 6
    Second, under the due process principles enunciated in In re Gault,
    supra, 
    387 U.S. 1
    , I think Y.C.’s assessment interview violated Y.C.’s
    privilege against self-incrimination (Estelle v. Smith (1981) 
    451 U.S. 454
    ,
    468–469) and right to counsel (Massiah v. United States (1964) 
    377 U.S. 201
    ,
    205–206), which means it was error to admit into evidence and consider at
    the detention hearing the portion of the detention report that set forth Ms.
    Johnson’s summary of Y.C’s psychological assessment, just as it would have
    been error to consider it in the state’s affirmative case at a jurisdictional
    hearing or subsequent criminal proceedings on the same charges. In re Wayne
    H. (1979) 
    24 Cal.3d 595
    , a key case relied upon by the Attorney General, and
    cited by Presiding Justice Pollak as well, is not to the contrary. The appellant
    in Wayne H. received a Miranda warning and made a considered choice to
    6 Obviously, the BHRS cannot declare an exemption that is broader
    than the governing regulations allow. And to the extent the lead opinion
    suggests the BHRS is not covered at all by HIPAA—which is of course
    inconsistent with BHRS’s own policy memorandum concerning its HIPAA
    compliance practices—I read 45 Code of Federal Regulations part 160.103
    (2020) to be directed toward the handling of billing and other support
    functions carried out by entities that provide services to a “health care
    provider.” That regulation does not govern the core confidentiality standards
    applicable directly to a “health care provider.” Reading the regulations as a
    whole to apply only to “financial or administrative activities related to
    healthcare,” as the lead opinion apparently does (lead opn., ante, at p. 17),
    has the effect of gutting the statute.
    7
    participate in a section 628 interview after being advised of his right to
    counsel. Y.C. never had that opportunity. Under Miranda, supra, 
    384 U.S. 436
    , unwarned statements in a custodial interrogation are presumed to have
    been coerced.
    There is no question here that Ms. Johnson’s interview of Y.C. took
    place in a custodial setting. Nor can there be any genuine question about
    whether the interview qualifies as an “interrogation” for Fifth Amendment
    purposes. “Interrogation” simply means “questioning” (Miranda, 
    supra, 384
    U.S. at p. 461), and even without an expressly communicated inquiry, may
    include “any words or actions” the examiner should know “are reasonably
    likely to elicit an incriminating response from the suspect.” (Rhode Island v.
    Innis (1980) 
    446 U.S. 291
    , 301, fn. omitted.) The Fifth Amendment privilege
    “not only permits a person to refuse to testify against himself at a criminal
    trial in which he is a defendant, but also ‘privileges him not to answer official
    questions put to him in any other proceeding, civil or criminal, formal or
    informal, where the answers might incriminate him in future criminal
    proceedings.’ ” (Minnesota v. Murphy (1984) 
    465 U.S. 420
    , 426, italics added.)
    The Sixth Amendment guarantee of counsel is equally applicable. Once
    charges are filed accusing a person of a crime (People v. Bustamante (1981)
    
    30 Cal.3d 88
    , 106–107), there is a Sixth Amendment right to counsel at any
    “stage of the proceedings [that is] a critical one from [the] defendant’s
    standpoint.” (People v. Horton (1995) 
    11 Cal.4th 1068
    , 1136.) A “critical stage”
    includes any pretrial event “at which crucial decisions affecting [the
    defendant’s] defense [are] to be made, and where his counsel could [take]
    steps” toward “protect[ing] and further[ing] [his] substantial rights” (ibid.).
    8
    For Y.C.—from his standpoint—I believe Ms. Johnson’s interview was a
    “critical stage” of the proceedings against him. 7
    A significant thrust of the Attorney General’s argument in opposition to
    Y.C.’s Fifth Amendment and Sixth Amendment claims, echoed in Presiding
    Justice Pollak’s concurrence, is that Ms. Johnson’s assessment interview was
    part of the probation officer’s fact-gathering process under section 628, and
    that, as a result, Wayne H. not only bars the use of any statements in the
    interview to prove guilt at the jurisdictional hearing but expressly permits
    their use at the detention hearing. The detention hearing, the Attorney
    General argues, was a neutral proceeding that did not bear upon guilt. He
    cites by analogy United States v. A.R. (3d Cir. 1994) 
    38 F.3d 699
     and United
    States v. Mitchell H. (9th Cir. 1999) 
    182 F.3d 1034
    . These federal cases are
    problematic for a number of reasons (see Commonwealth v. Brown (2011)
    
    26 A.3d 485
    , 501–502), but the premise of this line of argument collapses if
    there is no Wayne H. use immunity. I say that because Wayne H. has no
    constitutional foundation. Because Wayne H. is based solely on an
    interpretation of section 628 and the statutory scheme of which that
    provision is part, I doubt its rule of use immunity survived the passage of
    article I, section 28, subdivision (f )(2) (formerly subdivision (d)) of the
    7 When Ms. Johnson visited Y.C., the stakes for him at the detention
    hearing turned out to be more consequential than he could possibly have
    known without the assistance of counsel. When finally released, still without
    a jurisdictional hearing, he had spent six months behind bars, far beyond the
    presumptive maximum period of 15 judicial days’ temporary detention
    contemplated by the statutory scheme. (§ 657, subd. (a)(2).) That is one of the
    most troubling aspects of this case. In the circumstances Y.C. faced—whether
    because of the alleged use of a gun, the alleged involvement of gangs, or some
    concern about his family ties to a foreign country—he was entitled to counsel
    to advise him of the potential that he might be deemed a flight risk and a
    danger to public safety, and kept behind bars for an extended period of time
    before his case came on for trial.
    9
    California Constitution, passed as Proposition 8 in 1982. (Cf. Ramona R. v.
    Superior Court (1985) 
    37 Cal.3d 802
    , 806–811 [use immunity for juvenile’s
    transfer hearing testimony and statements to probation officer in advance of
    that hearing is founded on article 1, section 15 of the California Constitution
    and is therefore valid under Proposition 8 by virtue of the savings clause for
    constitutionally based privileges in Evid. Code, § 940].)
    It is not the case that, because the questioning at Ms. Johnson’s
    assessment interview concerned only matters relating to Y.C.’s personal life
    and mental health, we may conclude that nothing Y.C. said in the interview
    was potentially incriminating. The felony assault and weapons charges in
    this case alleged that Y.C. shot a gang member. Without revealing any
    clinical diagnoses or recommendations for treatment set forth in
    Ms. Johnson’s assessment interview summary, suffice it to say that the
    interview covered a variety of topics concerning Y.C.’s personal background,
    including his family’s immigrant story and some information concerning the
    nature of his friendships. Together with independent evidence coming from
    his mother that Y.C. may have been involved with drugs and might have
    been in possession of a gun, it is not difficult to see how Y.C.’s statements to
    Ms. Johnson could have been used against him in a case alleging gang
    involvement.
    The issue here is whether there was an incriminatory hazard, not
    whether there was actual incrimination. “An ordinary witness need not
    actually prove the existence of an incriminatory hazard, as that would
    surrender the very protection which the privilege against self-incrimination
    was designed to guarantee. Instead, the privilege forbids compelled
    disclosures which could serve as a ‘link in a chain’ of evidence tending to
    establish guilt of a criminal offense; in ruling upon a claim of privilege, the
    10
    trial court must find that it clearly appears from a consideration of all the
    circumstances in the case that an answer to the challenged question[s]
    cannot possibly have a tendency to incriminate the witness.” (Prudhomme v.
    Superior Court (1970) 
    2 Cal.3d 320
    , 326, disapproved on other grounds in
    Izazaga v. Superior Court (1991) 
    54 Cal.3d 356
    , 371–372; see Hoffman v.
    United States (1951) 
    341 U.S. 479
    , 486–488.) I am not convinced we can say
    the assessment interview of Y.C. could not “possibly have a tendency to
    incriminate” him. That interpretation of the record accepts on faith
    Ms. Johnson’s professed desire only to help this young man, while ignoring
    the fact that the prosecutor might react to the information in her assessment
    summary in a wholly different way, and use it to build a case against him.
    The lead opinion relies on a line of cases holding there is no Fifth
    Amendment protection beyond the “core” privilege not to have incriminating
    statements used adversely in later criminal proceedings. (Spielbauer v.
    County of Santa Clara (2009) 
    45 Cal.4th 704
    , 714–715, 727; Chavez v.
    Martinez (2003) 
    538 U.S. 760
    , 767–773 (plur. opn. of Thomas, J.); see Chavez,
    at pp. 777–778 (conc. opn. of Souter, J.).) Even under this analysis, the
    central contention Y.C. makes in this case, that the assessment interview
    summary should have been excluded at the detention hearing—a contention
    we say is moot in light of Y.C.’s release, but not moot in light of his request
    for affirmative relief—qualifies as an attack on a later use of his statements
    that posed an incriminatory hazard at the detention hearing. At that hearing,
    Y.C. faced a significant threat to his physical liberty, and along with it the
    potential stigma of extended incarceration. Gault traches that those things
    are by no means neutral or rehabilitative. (In re Gault, supra, 387 U.S. at
    pp. 49–55.) The fact that there may be other, “permissible uses” (lead opn.,
    11
    ante, at pp. 13–14) of Y.C.’s statements to Ms. Johnson does not erase the
    underlying Fifth Amendment violation.
    Notably, moreover, Spielbauer and Chavez are civil cases in which the
    prospect of criminal exposure was not immediately in view. Gault definitively
    rejected the idea that juvenile delinquency proceedings are “civil” in nature
    and thus that there is no possibility of criminal exposure warranting
    application of the Fifth Amendment. (In re Gault, supra, 387 U.S. at pp. 49–
    55.) And in any event, to the extent the narrow Spielbauer and Chavez
    conception of the Fifth Amendment applies in a scenario where criminal
    charges are pending, our Supreme Court has invoked those cases only where
    a defendant who knowingly waived his Fifth Amendment privilege had yet to
    face any questions at all. (See Maldonado v. Superior Court (2012) 
    53 Cal.4th 1112
    , 1127–1128 [where represented criminal defendant made strategic
    choice to put his mental state in issue, protective order entered in advance of
    mental examination sought by prosecution not justified by the Fifth
    Amendment since scope of defendant’s waiver could only be determined at
    the examination].)
    There was no knowing waiver on this record. (See Miranda, 
    supra, 384
     U.S. at p. 475 [“this Court has always set high standards of proof for the
    waiver of constitutional rights”]; Johnson v. Zerbst (1938) 
    304 U.S. 458
    , 464–
    469 [“intelligent waiver” requires “intentional relinquishment or
    abandonment of known right or privilege”].) Where there is no waiver and
    there is clear criminal exposure—or its equivalent, a pending trial in
    delinquency proceedings—the prophylactic sweep of the Fifth Amendment
    under Miranda extends beyond simple prohibition on direct evidentiary use
    of compelled statements in the state’s case-in-chief on the issue of guilt at
    12
    trial. It also prohibits the use of such statements outside the courtroom to
    build a case for guilt. 8
    The lead opinion’s citation to People v. Elizalde (2015) 
    61 Cal.4th 523
    ,
    is no more illuminating than Spielbauer and Chavez. If anything, that case
    tends to support Y.C.’s claim of a Fifth Amendment violation here. Elizalde
    holds that, in a case involving gang allegations, the collection of information
    about gang affiliation, even if gathered for permissible purposes—there, the
    questions were asked at jail intake in order to ensure the safety of inmates
    and staff—does violate the Fifth Amendment. (Elizalde, at pp. 530–532.)
    “Any number of questions posed to arrestees, such as whether they are
    injured or under the influence of drugs or alcohol, and how they came to be
    so, may be both necessary and highly incriminating. In-custody defendants
    generally retain their Fifth Amendment protections even if the police have
    good reasons for asking un-Mirandized questions,” the court explained. (Id. at
    p. 536, italics added.) The remedy for this violation, the court held, was
    suppression of the defendant’s “unadmonished answers” at trial (id. at
    p. 540), though the failure to do so in that case was not prejudicial (id. at
    p. 542). My colleagues appear to confuse the issue of whether there was a
    violation of the Fifth Amendment with the issue of remedy. In this case, it is
    enough to say that Y.C. is not entitled to the remedy he seeks. Instead, we
    hold, incorrectly I believe, that there was no violation at all. (Lead opn., ante,
    8 This is why courts distinguish use immunity from derivative use
    immunity. See, e.g., People v. Jablonski (2006) 
    37 Cal.4th 774
    , 803 (holding
    that the rule of judicially declared immunity for statements made in a
    compelled mental competency examination fully protects a defendant against
    any nonevidentiary uses of statements obtained from the defendant during
    the competency hearing to the same extent he or she is protected by the
    privilege against self-incrimination).
    13
    at p. 12 [“the simple fact of Johnson’s interview of Y.C. did not violate the
    Fifth Amendment”].)
    If Y.C. had been ordered to participate in a psychological assessment
    interview (§ 711), he would have enjoyed full use and derivative immunity for
    any statements made to Ms. Johnson. (People v. Jablonski, 
    supra, 37
     Cal.4th
    at p. 803.) Y.C. may have chosen to participate in the interview—under
    duress, and without adequate warning that his statements could be used
    against him—but unless we recognize his participation as effectively
    compelled, he was not entitled to full immunity from the use of his
    statements, “either directly or as a lead to other evidence, to bolster the
    prosecution’s case against the defendant.” (Maldonado v. Superior Court,
    supra, 53 Cal.4th at p. 1125.) The Attorney General cannot have it both ways
    on this issue. If, as the Attorney General contends, Y.C.’s participation in the
    assessment interview was voluntary, he enjoyed at most a narrow, statutorily
    derived use immunity under Wayne H. prohibiting the prosecution from
    seeking later admission of any incriminating statements he made to
    Ms. Johnson as substantive evidence of guilt of a criminal offense. But
    Wayne H. does not shield him from indirect, nonevidentiary use of anything
    else that might have bolstered the prosecution’s case against him in a later
    proceeding. And, worse, if the pure use immunity conferred by Wayne H. is no
    longer valid, as I have suggested above is likely the case, then he had no
    protection at all—even in this juvenile proceeding. These may seem like
    subtleties, but ultimately they explain why Y.C. faced a significant risk of
    incrimination in answering questions that seemed both necessary and
    benign, as the defendant in Elizalde did, not just at the detention hearing,
    but at the jurisdictional hearing and beyond. Y.C. may not have confessed at
    the assessment interview, but he supplied information that the state was free
    14
    to use either in building a case for guilt or in arguing he was dangerous
    enough to justify an extended period behind bars. 9
    STREETER, J.
    9 In light of that risk, had there not been an agreed disposition in this
    case—which moots the issue—I would have favored granting some form of
    writ relief designed to give Y.C. use and derivative use immunity,
    affirmatively barring the prosecution from nonevidentiary use of
    Ms. Johnson’s assessment summary in any further investigation of whether
    he committed the offenses charged against him. The statutory confidentiality
    and sealing to which he is automatically entitled under section 827 and
    rule 5.552 of the California Rules of Court do not provide sufficiently broad
    protection to accomplish that. I mention this in closing because I suspect
    there is an 800-pound gorilla in the room here: an unstated concern on the
    part of the BHRS and the probation department that, if counsel for juvenile
    arrestees were involved, that would disrupt psychological assessment
    interviews of the kind at issue in this case. A similar concern has been
    recognized and taken into account by our Supreme Court in comparable
    circumstances. (People v. Pokovich (2006) 
    39 Cal.4th 1240
    , 1252.) Going
    forward here, I see no reason why full use and derivative use immunity could
    not be conferred by a negotiated protective order applicable to assessment
    interviews. If that level of protection were granted, the BHRS and the
    probation department may be surprised to find that defense counsel—who
    surely understand their paramount duty to protect the welfare of their young
    clients, as do all other professionals involved in juvenile delinquency
    proceedings—would not impede or stand in the way of these interviews.
    15
    Trial Court:                                                   Contra Costa County Superior Court
    Trial judge:                                                   Honorable Susan Jakubowski
    Counsel for petitioner:                                        Michelle May Peterson
    Lana M. Kreidie
    Counsel for amicus curiae on behalf                            Abigail Trillin, Executive Director
    of petitioner                                                  Legal Services for Children
    Jesse Hahnel, Executive Director
    National Center for Youth Law
    Meredith Desautels, Staff Attorney
    Youth Law Center
    Counsel for respondent:                                        No appearance
    Counsel for real party in interest:                            Rob Bonta
    Attorney General of California
    Matthew Rodriquez
    Acting Attorney General of
    California
    Lance E. Winters
    Chief Deputy Attorney General
    Jeffrey M. Laurence
    Senior Assistant Attorney General
    Seth K. Schalit
    Supervising Deputy Attorney
    General
    Eric D. Share
    Supervising Deputy Attorney
    General
    Y.C. v. Superior Court for the County of San Mateo (A162063)
    16