Improving Hospital Safety & Security. Release of Information to Law Enforcement. 20 th April, 2018, River Valley HIM Association

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1 Improving Hospital Safety & Security Release of Information to Law Enforcement 20 th April, 2018, River Valley HIM Association

2 Why partner with Law Enforcement? From IAHSS Guidelines on Collaborating with Law Enforcement: Statement: Healthcare Facilities (HCFs) should develop collaborative relationships with Law Enforcement Agencies (LEA) that support or interact with the HCF.

3 Why partner with Law Enforcement? Interactions with Law Enforcement Agencies cover a variety of situations: 1. Support with behavioral and prisoner patients 2. Disruptive patients, visitors or staff 3. Crimes in progress 4. Investigations and intelligence sharing 5. Educational and training programs 6. Large scale events and disasters including drills and exercises. 7. Dignitary and VIP visits 8. Proactive crime prevention efforts 9. Request for release of HCF-defined sensitive information.

4 Compliance with HIPAA? Who must comply with the HIPAA Privacy Rule? health plans, health care clearinghouses, and those health care providers that conduct certain health care transactions electronically (e.g., billing a health plan) Covered Entities (CE) Who is not required to comply with the HIPAA Privacy Rule? employers, most state and local police or other law enforcement agencies many state agencies like child protective services most schools and school districts *FERPA

5 Health care information vs. Protected Health Information HCI is defined very broadly includes any information that relates to an individual s past, present or future medical information or care. PHI is any health care information that is individually identifiable information that can be directly tied to a specific individual.

6 Covered Entities are expected to: What? develop policies and procedures Why? to limit the amount of information exchanged to the minimum necessary to achieve the purpose

7 A HIPAA-covered entity may disclose PHI: with the individual s signed authorization

8 A HIPAA-covered entity may disclose PHI: if it reasonably prevents/lessens a serious or imminent threat to the safety of the individual or the public

9 A HIPAA-covered entity may disclose PHI: if the health care provider (in good faith) reasonably believes it is evidence of a crime that occurred on the premises of the covered entity

10 A HIPAA-covered entity may disclose PHI: if it is alerting law enforcement of death of the individual and there is reason to believe the death occurred from criminal conduct

11 A HIPAA-covered entity may disclose PHI: when responding to an off-site medical emergency, as necessary to alert law enforcement to criminal activity

12 A HIPAA-covered entity may disclose PHI: when required by law to do so

13 A HIPAA-covered entity may disclose PHI: to comply with a court-ordered warrant or subpoena State/Federal laws/most hospital policies prohibit LEO s from drawing fluids (blood/urine/etc) without a warrant or patient consent.

14 A HIPAA-covered entity may disclose PHI: to respond for the purposes of locating a suspect must be limited to basic demographic and health information Not required

15 A HIPAA-covered entity may disclose PHI: when the victim of a crime requests their information be shared with law enforcement But if they disagree

16 A HIPAA-covered entity may disclose PHI: if the victim is a child and the health care provider suspects child abuse

17 Exceptions (uh-oh!): Disclosure that is required by state law continues to be allowed under HIPAA, if that disclosure is mandatory. If the state only permits disclosure, allowing discretion, that disclosure is not permitted under HIPAA. *45 C.F.R et seq.

18 FYI Kentucky is a minority state: Kentucky does not require medical providers to report to law enforcement injuries connected to firearms or other deadly weapons, such as gunshot wounds or cuts associated with knives.

19 Kentucky types that are mandatory include: Psychiatric hospitals are required to notify law enforcement if an involuntarily committed patient escapes or is released, if that patient has been charged with or convicted of a violent crime. (KRS 202A.410) Medical and other professionals who suspect insurance fraud (KRS )

20 Kentucky types that are mandatory include: Medical professionals (and in fact, anyone) who has knowledge concerning child (KRS ) or adult abuse (KRS , 194A.709). Reporting of a suspicious death to the coroner (KRS )

21 Kentucky types that are mandatory include: Public health issues HIV-AIDS

22 Kentucky types that are mandatory include: Animal bites Pharmaceuticals Must allow inspection of records Does not require reporting of abusers or doctor shoppers

23 Use caution: An officer present at an injury call and overhears medical or other information while assisting EMS that is considered an incidental disclosure.

24 The End!!! Roy Williams III, CHPA

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