AMENDED OPINION 1
¶ 1 The State brings this interlocutory appeal from the trial court’s order granting Defendant’s motion for in camera inspection of the alleged victim’s (B.W.) mental health records. The State asserts that the trial court erred by granting Defendant’s motion because (1) the trial court failed to determine whether Defendant’s request fell within an exception to the physician-patient privilege under rule 506(b) of the Utah Rules of Evidence,
see
Utah R. Evid. 506(b), (d); (2) the sought-after records do not relate to an element or claim of Defendant’s defense, as required by rule 506(d)(1) of the Utah Rules of Evidence,
see id.
R. 506(d)(1); and (3) Defendant did not establish, with reasonable certainty, that the records contain exculpatory, material evidence. The State also contends, and Defendant agrees, that it was
¶ 2 We agree that the trial judge should personally review the records, but otherwise affirm the trial court’s order.
BACKGROUND
¶ 3 On or about July 8, 2005, Defendant and his wife’s adopted child, B.W., attempted suicide and was subsequently admitted to the University of Utah Neuropsychiatric Institute (UNI). During a mental health evaluation, B.W. explained that she had “a lot of family strife recently ... [and was] getting in frequent fights with her mother.” She also reported prior abuse by her biological grandparents, but denied any other abuse. Defendant states that prior to the suicide attempt, B.W. had a heated argument with her mother.
¶ 4 During her nineteen-day stay at UNI, B.W. participated in individual, group, and family therapy. Afterward, B.W. participated in outpatient counseling on at least twelve occasions. During that time period, B.W. wrote about her family in a journal, and some of the entries describe B.W.’s angry feelings toward her mother. For example, in one entry B.W. stated:
My mom has pissed me off for the last time.... I feel as if I want to go out the door to [my friend’s] and stay there forever.... Next time my mom gets me as pissed off as I am now, I will kill her, and that’s a promise, I don’t care what happens to me I just want her to die in her bed all alone in her own pain and blood.
¶ 5 A few weeks after this journal entry, B.W. disclosed to her therapist that Defendant had sexually abused her. B.W.’s therapist reported the alleged abuse to the police, who charged Defendant with ten counts of aggravated sexual abuse of a child. See Utah Code Ann. § 76-5-404.1(3) (2003). At Defendant’s preliminary hearing, B.W. testified, inter alia, that Defendant had made her clean the house without her clothes on, made her lie on him, and touched her on her breasts and her genitals. She also recounted numerous other incidents of abuse spanning several years.
¶ 6 On cross-examination, defense counsel identified various inconsistencies in the allegations B.W. reported to law enforcement and mental health workers. Defense counsel also asked B.W. about her journal entries. In response to the prosecution’s objection, defense counsel stated that the entries went to motive and were admissible for impeachment purposes. Defense counsel also detailed his defense theory, including that B.W. had previously been abused, had multiple opportunities to report Defendant’s abuse but did not, had never written about the alleged abuse in her journal, hated her parents, and ultimately fabricated the allegations in order to be removed from her parents’ home.
¶ 7 Defendant was bound over for trial. He then filed a motion to subpoena B.W.’s medical records from July, when B.W. was admitted to UNI, through October, when she first made the abuse allegations. The trial court granted Defendant’s motion for the sole purpose of determining whether evidence existed that would illuminate B.W.’s feelings toward her parents. In an effort to protect B.W.’s privacy, the judge ordered his law clerk to review the records and highlight the relevant information before presenting the records to the judge for in camera review.
¶ 8 The State appeals from the trial court’s order, arguing that it was granted in error because the trial court neglected to first determine whether the sought-after records came within the ambit of a rule 506(b) exception for privileged communications, see Utah R. Evid. 506(b), (d); the records do not contain evidence that goes to a claim or element of Defendant’s defense, as required by rule 506(d)(1), see id. R. 506(d)(1); and Defendant did not establish, with reasonable certainty, that the sought-after records contain exculpatory, material evidence.
ISSUE AND STANDARD OF REVIEW
¶ 9 The State contends that the trial court erred by granting Defendant’s request for in camera review of B.W.’s medical rec
ANALYSIS
¶ 10 Rule 506(b) of the Utah Rules of Evidence protects, as privileged, communications between a health care provider and a patient if the communications are offered “in confidence and for the purpose of diagnosing or treating the patient.” Utah R. Evid. 506(b). Under this privilege, the patient may prevent disclosure of any such communications. See id However, the privilege is not absolute. There are three exceptions, see
id.
R. 506(d), only one of which is applicable here. Rule 506(d)(1) states that the “privilege does not exist” if the patient’s “physical, mental, or emotional condition” is relevant “in any proceeding in which any party relies upon the condition as an element of [a] claim or defense.”
Id.
R. 506(d)(1). Examining the extent of this exception, the Utah Supreme Court explained that it is not unlimited. In order to access otherwise privileged communications between a patient and a therapist, the inquirer “must show,
with reasonable certainty,
that the sought-after records actually contain ‘exculpatory evidence ... which would be favorable to his [or her] defense.’ ”
Blake,
¶ 11 The State argues that Defendant is not entitled to in camera inspection 2 of B.W.’s medical records because Defendant did not establish that the sought-after records fall within an exception to the rule 506(b) privilege; Defendant seeks impeachment evidence, which does not constitutes evidence regarding a claim or defense; and the sought-after records are not reasonably certain to contain material, exculpatory information. Defendant responds that the trial court did in fact determine that the records fall within an exception to the rule 506(b) privilege; Defendant was seeking more than impeachment evidence; and the trial court correctly determined that Defendant passed the reasonable certainty test. Based on the specific facts presented, we agree with Defendant.
I. Exception to the Rule 506(b) Privilege
¶ 12 The State’s first contention is that the trial court erred because it did not initially conduct an analysis to determine if the records at issue came within an exception to the rule 506(b) privilege. Put another way, the State argues that the trial court should have first addressed “whether [B.W.’s] records fell within a recognized exception to rule 506” instead of basing “its entire decision on whether defendant had shown a ‘reasonable certainty’ that the records contained exculpatory material evidence.” In support of its argument, the State relies on
State v. Cardall,
¶ 13 In this case, the trial court essentially followed the same analytical roadmap as the Cardall court. For example, in granting Defendant’s motion, the trial court first stated that the records Defendant sought are generally privileged under rule 506(b) of the Utah Rules of Evidence. It then noted that “rule [506(b) ] is subject to certain exceptions, one of which is Rule of Evidence Rule 506(d)(1).” The trial court then explained that the exception only applies if a defendant can “show, with reasonable certainty, that the sought-after records actually contain exculpatory evidence which would be favorable to his defense.” And finally, the trial court concluded that Defendant had, in fact, satisfied the requirements of the reasonable certainty test. Because this parallels the Utah Supreme Court’s reasoning in Cardall, see id. ¶¶ 29-34, we conclude that the trial court sufficiently addressed whether Defendant’s request fell within an exception to rule 506(b) before addressing the reasonable certainty test.
II. Elements of a Claim or Defense
¶ 14 The State next argues that the trial court erred by granting Defendant’s request because “motive to fabricate is not an element of a claim or defense” sufficient to bring Defendant’s request within the rule 506(d)(1) exception. More specifically, the State argues that the sought-after evidence is merely impeachment evidence and therefore does not constitute evidence that would support an “element of [a] claim or defense.”
3
Utah R. Evid. 506(d)(1). Rule 506(d)(1) suspends the rule 506(b) privilege for “a communication relevant to an issue of the physical, mental, or emotional condition of the patient in any proceeding in which
that condition is an element of any claim or
defense.” Although the Utah Supreme Court has applied this exception in various cases,
see, e.g., State v. Gonzales,
¶ 15 We reject the State’s first argument that because motive is not an element of an offense, it cannot be an element of a defense. We believe that the elements of a criminal
offense
do not necessarily correlate with the elements of a criminal
defense.
In addition, the notion of elements of a criminal defense produces tension with the State’s burden of proof in a criminal prosecution. In
State v. Spillers,
[A] defendant in a criminal case bears no burden of persuasion. The ultimate burden of proving the defendant’s guilt beyond a reasonable doubt remains on the state, whether defendant offers any evidence in an effort to prove affirmative defenses or not. It is sufficient ... that the evidence or lack thereof creates a reasonable doubt as to any element of the crime.
Id. ¶ 19 (citations and internal quotation marks omitted). Thus, a criminal defendant is, subject to relevancy and other evidentiary requirements, entitled to offer evidence that would cast doubt on any of the elements that the State is required to prove.
¶ 16 In this instance, roughly speaking, the State is required to prove that Defendant, occupying a position of special trust, sexually abused B.W. See Utah Code Ann. § 76-5-404.1(3) (2003). Defendant’s defense is that he did not commit the crime and he intends to show that by illustrating that B.W. hated her parents and that she therefore made up the allegations of abuse because she wanted to be placed in another home. Thus, although he may be seeking impeachment evidence, Defendant is also seeking evidence that would interject doubt into the State’s assertion that he committed the crime. Therefore, the sought-after records support an element of Defendant’s defense.
¶ 17 In reaching this conclusion, we also reject the State’s assertion that the Utah Supreme Court has twice, “sub silentio,” overruled
Cardall
and held that impeachment evidence cannot constitute an element of a defense under any circumstances. In the first case on which the State relies,
State v. Blake,
[The defendant] seeks disclosure of the counseling records for use in impeaching the victim’s testimony. It is unlikely that impeachment evidence qualifies as an element of a claim or defense. However, we need not reach the question of whether an element of a claim or defense is implicated since [the defendant] has not shown with reasonable certainty that the records he seeks contain exculpatory evidence.
Id.
Because the court’s comments regarding impeachment evidence in
Blake
are dicta, they are not binding authority.
See Jones v. Barlow,
¶ 18 In
State v. Gonzales,
[The defendant] argues that [the victim’s] mental health was an element of a claim or defense in the lawsuit, and therefore his request for the records was proper.
[The defendant’s] argument is flawed in two ways. First, his defense is simply “I didn’t do it.” He wishes to use [the victim’s] mental health records to impeach her credibility as a witness-part of his defense strategy, but not actually an element of his defense. Second, regardless of whether [the victim’s] mental health is an “element” of [the] defense, it is the process by which the records were obtained, not the status of the records as privileged or unprivileged that prevents [the defendant] from reviewing them.
Id. ¶¶ 42-43. While we reiterate that the court’s holding in Gonzales was confined to the propriety of the subpoenaed medical records, we also believe that this case is distinguishable from Gonzales.
¶20 Our supreme court has not recently addressed the nature of evidence that would qualify as an element of a criminal defense capable of overcoming rule 506(b)’s privilege. The State suggested at oral argument that virtually no evidence would meet that test in sexual abuse cases because of the legitimate concerns about further victimization and non-reporting in such cases.
See Blake,
¶21 We also note that the cases both parties rely on,
Blake, Gonzales,
and
Cardall,
all spring from the United States Supreme Court decision,
Pennsylvania v. Ritchie,
¶22 Although the Court referenced the requirement of materiality,
see id.
at 58 & n. 15,
¶ 23 Our decision is further influenced by
Davis,
a case on which the
Ritchie
Court relied.
See id.
at 51-54,
“Certain principles have remained relatively immutable in our jurisprudence. One of these is that where governmental action seriously injures an individual, and the reasonableness of the action depends on fact findings, the evidence used to prove the Government’s case must be disclosed to the individual to show that it is untrue. While this is important in the case of documentary evidence, it is even more important where the evidence consists of the testimony of individuals whose memory might be faulty or who, in fact, might be perjurers or persons motivated by malice, vindictiveness, intolerance, prejudice, or jealousy. We have formalized these protections in the requirements of confrontation and cross-examination-”
Id.
(quoting
Greene v. McElroy,
III. Reasonable Certainty Test
A. Materiality
¶ 24 The State next argues that the trial court erred by granting Defendant’s
¶25 The State’s emphasis on Defendant’s burden to establish, at this juncture, that the evidence he seeks is material is mistaken. In
Blake,
the supreme court explained that in order for a court to grant a request for in camera inspection of otherwise privileged communications, the defendant “must show, with reasonable certainty, that the sought-after records actually contain ‘exculpatory evidence ... which would be favorable to his defense.’ ”
¶ 26 Further, the State’s assertion that the records are cumulative, and therefore immaterial, is premature.
See People v. District Court,
It may well be that the evidence contained in the psychiatric records will yield no information different from that available elsewhere. However, the probability is equally as great that the records contain independently probative information. It is also quite probable that the quality and probative value of the information in the reports may be better than anything that can be gleaned from other sources. Finally, the information might well serve as a confirmation of [the victim’s] reality problems ....
Id. at 724. More recently, the Wisconsin Supreme Court observed that even though similar evidence may already be available to the defendant, it is not necessarily cumulative:
[T]he preliminary showing for an in camera review requires a defendant to set forth, in good faith, a specific factual basis demonstrating a reasonable likelihood that the records contain relevant information necessary to a determination of guilt or innocence and is not merely cumulative to other evidence available to the defendant. ... This test essentially requires thecourt to look at the existing evidence in light of the request and determine, as the Shiffra court did, whether the records will likely contain evidence that is independently probative to the defense.
State v. Green,
B. Application of the Reasonable Certainty Test
¶27 The State commented at oral argument that the reasonable certainty test establishes such a high standard that a criminal defendant will most likely never meet its requirements in eases regarding sexual abuse. Although supreme court precedent sets a stringent standard, we believe Defendant has satisfied that standard in this case.
¶28 Under the reasonable certainty test, Defendant must establish first that “the counseling records exist” and second, “reasonable certainty[ ] that the sought-after records actually contain ‘exculpatory evidence ... which would be favorable to his defense.’ ”
Blake,
¶29 In applying the reasonable certainty test to this ease, our inquiry begins with identifying Defendant’s defense. As previously explained, Defendant’s theory of the case is that he did not commit the crime, and he intends to show that by presenting evidence that B.W. hated her parents and that she made up the allegations because she wanted to be placed in another home. In
Cardall,
the defendant advanced similar allegations about the victim, and the supreme court ruled that the defendant was entitled to in camera review of the records because the evidence may have supported the defendant’s assertion that the allegations were false.
See
¶ 30 Our next inquiry is whether the records exist and whether there is reasonable certainty that they will contain exculpatory evidence favorable to Defendant’s defense. In Blake, the Utah Supreme Court expounded on what constitutes a sufficiently detailed request for medical records:
Where a defendant’s requests for in camera review is accompanied by specific facts justifying the review, a court will be much more likely to find with reasonable certainty that exculpatory evidence exists which would be favorable to his defense. However, when the request is a general one, such as [a] request ... for any impeachment material that might happen to be found in the privileged records, a court ought not to grant in camera review. At a minimum, specific facts must be alleged. These might include references to records of only certain counseling sessions, tohich are alleged to be relevant, independent allegations made by others that a victim has recanted, or extrinsic evidence of some disorder that might lead to uncertainty regarding a victim’s trustworthiness.
State v. Blake,
CONCLUSION
¶ 31 We conclude that the trial court properly considered whether Defendant’s request for medical records came within the reach of an exception to the rule 506(b) privilege. We also hold that Defendant’s argument advanced in favor of in camera review was based on an element of a defense, and that the trial court was not required to rule on materiality before granting Defendant’s request. Finally, we agree with the parties’ assertion that the trial judge, not a law clerk, should review the records at issue because of their sensitive nature and the need to limit the number of people allowed to view B.W.’s confidential medical records. 7
¶ 32 WE CONCUR: RUSSELL W. BENCH, Judge, and JUDITH M. BILLINGS, Judge.
Notes
. This Amended Opinion replaces the Opinion in Case No. 20060757-CA issued on November 16, 2007.
. In the context of sexual abuse cases, in camera review is typically required in order to "serve [the defendant’s] interests without destroying the [State's] need to protect the confidentiality” and privacy of sexual abuse victims.
Pennsylvania v. Ritchie,
. The State does not address the term "claim" as included in rule 506(d)(1). See Utah R. Evid. 506(d)(1). Likewise, Utah courts have focused on what constitutes an element of a defense, not on what constitutes a claim of a defendant or whether that is a separate concept.
See generally State v. Gonzales,
. In
Pennsylvania v. Ritchie,
. Although the trial court will address materiality, Defendant is not precluded from arguing that the evidence he seeks is material.
See Cardall,
. Under rule 506(b) of the Utah Rules of Evidence, the presence of B.W.'s mother at therapy sessions does not necessarily waive the privilege. See Utah R. Evid. 506(b) (discussing that the privilege extends to communications between a health care provider and a parent or guardian "who [is] present to further the interest of the patient because [such parent or guardian is] reasonably necessary for the transmission of the communications, or participation in the diagnosis and treatment under the direction of the physician or mental health therapist”).
. Based on the fact that the parties agree, and because this is a sexual abuse case, in camera review by the trial judge himself is warranted.
