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Confidentiality
    HIPAA


Carlos F. Martinez MHA, M.Ed.
http://carlosFmartinez.com
CONFIDENTIALITY




       Did you know that…?
In Jacksonville FL

 An  employee’s teenage girl was
 left unattended in a hospital and
 she looked up patient’s phone
 numbers and phoned them to
 tell them they had tested
 positive for HIV. One of them
 attempted suicide.
In Rapid City SID

   A medical student “stole” the
    records of a mental health patient to
    do a research paper. He then threw
    them away in the dumpster of a fast
    food restaurant. A person found
    them and gave them to a newspaper
    reporter
In Miami FL

 Hundreds   of JMH employees
 browsed through the records
 when Italian designer Gianni
 Versace was transferred to this
 facility, even though few of them
 were actually involved in the
 case.
What is HIPAA?

 H…health
 I…insurance
 P…portability
 A…accountability
 A…Act
HIPAA…Definition

   A US law designed to provide privacy
    standards to protect patients' medical
    records and other health information
    provided to health plans, doctors,
    hospitals and other health care
    providers.
(http://www.medterms.com/script/main/art.asp?
   articlekey=31785)
HIPAA

 The
  Health Insurance Portability and Accountability
   (HIPAA) was passed on August 21, 1996
 The final version of the HIPAA Privacy
  regulations were issued in December 2000,
  and went into effect on April 14, 2001

(http://www.hipaaps.com/main/background.html)
What is health insurance
  accountability?

A patient’s health information is to
 be kept private and secure. Only
 people who MUST have information
 about the client to provide care or to
 process client’s records should
 know his/her private health
 information
What information must you
    protect?
•   Information you create or receive in the course of
    providing treatment or obtaining payment for
    services or while engaged in teaching and research
    activities, including:
   Information related to the past, present or future
    physical and/or mental health or condition of an
    individual
   Information in ANY medium − whether spoken,
    written or electronically stored − including videos,
    photographs and x-rays
Protected Health Information (PHI)

   A person who passes a computer screen
    or a fax machine, the individual cleaning
    your hospital room or any other person
    talking in an elevator SHOULD NOT learn
    anything about a patient’s health
    information because it is private. It must
    be protected – and it is called Protected
    Health Information (PHI).
Protected Health Information (PHI)

HIPAA defines PHI as individually identifiable health information
   including:
   Name, geographic information (address,
    city, zip code, etc), birth date, admission
    date, discharge date, date of death,
    phone/fax/cell number, email address, SS #,
    account #, insurance #, license #, vehicle ID,
    URL, IP address, photograph, and/or any
    unique identifier.
"WRONGFUL DISCLOSURE OF
INDIVIDUALLY IDENTIFIABLE HEALTH
INFORMATION”

"SEC. 1177. (a) OFFENSE.--A person who
    knowingly and in violation of this part—
   uses or causes to be used a unique health
    identifier;
   obtains individually identifiable health
    information relating to an individual; or
   discloses individually identifiable health
    information to another person,
   shall be punished…
PENALTIES

   be fined not more than $50,000, imprisoned not
    more than 1 year, or both;
   if the offense is committed under false
    pretenses, be fined not more than $100,000,
    imprisoned not more than 5 years, or both; and
   if the offense is committed with intent to sell,
    transfer, or use individually identifiable health
    information for commercial advantage, personal
    gain, or malicious harm, be fined not more than
    $250,000, imprisoned not more than 10 years, or
    both
http://aspe.hhs.gov/admnsimp/pl104191.htm#1176
Definition

 falsepretense - (law) an offense
 involving intent to defraud and
 false representation and
 obtaining property as a result of
 that misrepresentation.
HIPAA Privacy Rule & Preemption

   If a state or federal law or regulation
    grants the client greater access to their
    PHI, then it will preempt HIPAA
   If a state or federal law or regulation gives
    the client health information greater
    protections from disclosure then it will
    preempt HIPAA
Ways to Protect Privacy

 Refrainfrom talking about
 your patients/clients in public
 places: cafeteria, elevator, by
 the water cooler, in lounges,
 waiting rooms or parking lot.
Ways to Protect Privacy
   Make sure no one can see your computer
    screen while you are working
   Never share your access code
   Log off when you leave your work
    area/computer
   Change your password and notify your
    supervisor if your password becomes
    known by anyone else
Ways to Protect Privacy

   Never leave information on voice-mail or
    emails…you don’t know who has access
    to those messages
   Leave only your name and number on
    your client’s answering machine when
    you ask him/her to call you back
   Make sure you are in a private area when
    you listen to or read your messages
Ways to Protect Privacy

 Make sure no one around you can overhear
  your conversation, especially in an office or
  waiting room
 Never leave documents unattended:

– Store, file, shred or destroy according to
  your agency/school policy
Ways to Protect Privacy

 Make sure fax numbers are correct and
  use a cover sheet with a confidentiality
  statement.
 Give your supervisor forms or materials
  with client information you find in places
  such as:
– a classroom or lounge, cafeteria, floor or
  wastebasket.
Ways to Protect Privacy

   If you happen to see a client in a public
    place, be careful when greeting him/her.
    They may not want others to know they
    have been a client
   If a client comes to your office with
    another person, s/he may not want that
    person to hear his/her private information,
    so ask the person to wait outside
Question

1. A staff person whom you supervise clinically
   finds you in the staff break room and starts
   describing a counseling session s/he had with a
   client today so that s/he can ask for your advice.
   How would you handle the situation?
 A. Let the staff person describe the details so
   that you can provide him/her with guidance.
 B. Politely remind him/her that you are in a
   public area and ask him/her to accompany you to
   your office so that you can discuss this in
   private
 C. Ask him/her to get authorization from the
   client before s/he discusses it further.
Question

 Areyou willing to risk being
 fined, losing your job, your
 license, or going to jail because
 you don’t follow the legal, the
 ethical, the RIGHT thing to do?
THANK YOU

        Questions?

carlos@carlosFmartinez.com

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HIPPA

  • 1. Confidentiality HIPAA Carlos F. Martinez MHA, M.Ed. http://carlosFmartinez.com
  • 2. CONFIDENTIALITY Did you know that…?
  • 3. In Jacksonville FL  An employee’s teenage girl was left unattended in a hospital and she looked up patient’s phone numbers and phoned them to tell them they had tested positive for HIV. One of them attempted suicide.
  • 4. In Rapid City SID  A medical student “stole” the records of a mental health patient to do a research paper. He then threw them away in the dumpster of a fast food restaurant. A person found them and gave them to a newspaper reporter
  • 5. In Miami FL  Hundreds of JMH employees browsed through the records when Italian designer Gianni Versace was transferred to this facility, even though few of them were actually involved in the case.
  • 6. What is HIPAA?  H…health  I…insurance  P…portability  A…accountability  A…Act
  • 7. HIPAA…Definition  A US law designed to provide privacy standards to protect patients' medical records and other health information provided to health plans, doctors, hospitals and other health care providers. (http://www.medterms.com/script/main/art.asp? articlekey=31785)
  • 8. HIPAA  The Health Insurance Portability and Accountability (HIPAA) was passed on August 21, 1996  The final version of the HIPAA Privacy regulations were issued in December 2000, and went into effect on April 14, 2001 (http://www.hipaaps.com/main/background.html)
  • 9. What is health insurance accountability? A patient’s health information is to be kept private and secure. Only people who MUST have information about the client to provide care or to process client’s records should know his/her private health information
  • 10. What information must you protect? • Information you create or receive in the course of providing treatment or obtaining payment for services or while engaged in teaching and research activities, including:  Information related to the past, present or future physical and/or mental health or condition of an individual  Information in ANY medium − whether spoken, written or electronically stored − including videos, photographs and x-rays
  • 11. Protected Health Information (PHI)  A person who passes a computer screen or a fax machine, the individual cleaning your hospital room or any other person talking in an elevator SHOULD NOT learn anything about a patient’s health information because it is private. It must be protected – and it is called Protected Health Information (PHI).
  • 12. Protected Health Information (PHI) HIPAA defines PHI as individually identifiable health information including:  Name, geographic information (address, city, zip code, etc), birth date, admission date, discharge date, date of death, phone/fax/cell number, email address, SS #, account #, insurance #, license #, vehicle ID, URL, IP address, photograph, and/or any unique identifier.
  • 13. "WRONGFUL DISCLOSURE OF INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION” "SEC. 1177. (a) OFFENSE.--A person who knowingly and in violation of this part—  uses or causes to be used a unique health identifier;  obtains individually identifiable health information relating to an individual; or  discloses individually identifiable health information to another person,  shall be punished…
  • 14. PENALTIES  be fined not more than $50,000, imprisoned not more than 1 year, or both;  if the offense is committed under false pretenses, be fined not more than $100,000, imprisoned not more than 5 years, or both; and  if the offense is committed with intent to sell, transfer, or use individually identifiable health information for commercial advantage, personal gain, or malicious harm, be fined not more than $250,000, imprisoned not more than 10 years, or both http://aspe.hhs.gov/admnsimp/pl104191.htm#1176
  • 15. Definition  falsepretense - (law) an offense involving intent to defraud and false representation and obtaining property as a result of that misrepresentation.
  • 16. HIPAA Privacy Rule & Preemption  If a state or federal law or regulation grants the client greater access to their PHI, then it will preempt HIPAA  If a state or federal law or regulation gives the client health information greater protections from disclosure then it will preempt HIPAA
  • 17. Ways to Protect Privacy  Refrainfrom talking about your patients/clients in public places: cafeteria, elevator, by the water cooler, in lounges, waiting rooms or parking lot.
  • 18. Ways to Protect Privacy  Make sure no one can see your computer screen while you are working  Never share your access code  Log off when you leave your work area/computer  Change your password and notify your supervisor if your password becomes known by anyone else
  • 19. Ways to Protect Privacy  Never leave information on voice-mail or emails…you don’t know who has access to those messages  Leave only your name and number on your client’s answering machine when you ask him/her to call you back  Make sure you are in a private area when you listen to or read your messages
  • 20. Ways to Protect Privacy  Make sure no one around you can overhear your conversation, especially in an office or waiting room  Never leave documents unattended: – Store, file, shred or destroy according to your agency/school policy
  • 21. Ways to Protect Privacy  Make sure fax numbers are correct and use a cover sheet with a confidentiality statement.  Give your supervisor forms or materials with client information you find in places such as: – a classroom or lounge, cafeteria, floor or wastebasket.
  • 22. Ways to Protect Privacy  If you happen to see a client in a public place, be careful when greeting him/her. They may not want others to know they have been a client  If a client comes to your office with another person, s/he may not want that person to hear his/her private information, so ask the person to wait outside
  • 23. Question 1. A staff person whom you supervise clinically finds you in the staff break room and starts describing a counseling session s/he had with a client today so that s/he can ask for your advice. How would you handle the situation?  A. Let the staff person describe the details so that you can provide him/her with guidance.  B. Politely remind him/her that you are in a public area and ask him/her to accompany you to your office so that you can discuss this in private  C. Ask him/her to get authorization from the client before s/he discusses it further.
  • 24. Question  Areyou willing to risk being fined, losing your job, your license, or going to jail because you don’t follow the legal, the ethical, the RIGHT thing to do?
  • 25. THANK YOU Questions? carlos@carlosFmartinez.com