Public Health and Confidentiality

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Public Health and Confidentiality

• Denise Smith
• Dianna Ryan

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Objectives

• Review state codes and HIPPA on public health and
  Confidentiality.
• Learn the dos and donts of confidentiality
  during the investigation/interview process.
• Discuss examples during a group exercise.

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Public Health

• 16-6-1 Purpose
• The state recognizes its responsibility to
  assist in the provision of Essential Public
  Health services to provide Basic Public Health
  services that encourage healthy people in healthy
  communities.

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State Code on Confidentiality

• State Code __ 27-3-1 Definition of confidential
  information disclosure.
• (a) Communication and information obtained in the
  course of treatment or evaluation of any client
  shall be deemed to be confidential information.

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HIPAA

• What is HIPAA
• Health Insurance Portability and Accountability
  Act is a federal law that mandates standards that
  must be followed when healthcare information is
  used, disclosed, or transmitted for treatment,
  payment or healthcare operation purposes.
• The rules of HIPAA affect ALL persons who have
  access to Protected Health Information (PHI).

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HIPAA States

• Confidentiality The property that information
  is not made available or disclosed to
  unauthorized individuals, entities, or process

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Confidentiality

• What is Protected Health Information(PHI)
• Any information that can be used to individually
  identify a patient.
• Examples name, address, city ,state, zip code,
  birth date, admission date, discharge, date,
  treatment date, date of death, etc.

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Confidentiality

• Patient authorization is not required for
• Public Health purposes
• Emergency/disaster situations
• Information may be released to a public health
  authority legally authorized to collect or
  receive the information for the purpose of
  preventing or controlling disease, injury or
  disability .

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State Codes on Breach of Confidentiality

• State Code_ 9-9-20 confidentiality, fines and
  penalties.
• Any person who knowingly and willfully releases
  or causes to be released the confidential records
  and information described in the sectionshall be
  fined not more that 500 or confined in the
  county or regional jail for not more than 6
  months or both.

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HIIPA Penalties for Breach of Confidentiality

• HIPAA confidentiality, fines and penalties
• Misuse of PHI - 100/each violation
• 25,000/per person/per year
• Improperly obtaining/disclosing PHI
• Up to 50,000 and up to 1 year in federal prison

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Confidentiality and the Interview

• Learn Dos and Donts of confidentiality for
  Interviews/ Investigations
• CDC Guidelines based on federal review
• The Privacy Act of 1974
• Freedom of Information Act

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Dont of Confidentiality(When in doubt, dont
give it out)

• Tell the client this is a Confidential interview.
• Check understanding
• Do not name original patient to others during an
  investigation.
• Immediate family will know
• Others may know-do not confirm or deny !!!
• May name if written authorization is obtained

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Dont (cont.)

• Do not give out information on your
  investigations except to immediate supervisor or
  designee.
• Do not report information to any federal, State,
  or local agencies except as designated by Law
• Do not disclose any information to the media

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Dos of Confidentiality

• Do report to appropriate agency and only if you
  witness (as designated by law)
• child abuse
• geriatric abuse
• murder
• Licensed RNs and LPNs will report as designated
  by your governing body.

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Dos (cont.)

• Do request information based on previous
  knowledge without identifying original patient
• Ask open-ended questions during the interview
• Example of questions
• Tell me who you saw on this date?
• Where did you spend the 15th of March?
• Who did you see on April 2nd?

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Dos (cont.)

• Useful items
• Bring a Calendar
• Show clients dates to jog memory
• Ask to see
• Their Planner or date book
• Can pinpoint where client was each day
• Address/Telephone book
• Easy access to needed information on other
  contacts

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Dos (cont.)

• Refer all media, law enforcement and others
  requesting information
• Immediate supervisor or designee
• State epidemiologist (Loretta Haddy)
• State Health Officer (Cathy Slemp)

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Concerns/Question?

• Can you live with these confidentiality rules?
• Punishable by law if you breach them.
• If not, see Harlan Amandus
• Other concerns?

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PRACTICE