Public Health and Confidentiality Denise Smith Dianna Ryan

Objectives n n n Review state codes and HIPPA on public health and Confidentiality. Learn the do’s and don’ts’ of confidentiality during the investigation/interview process. Discuss examples during a group exercise.

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.

State Code on Confidentiality n n 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”.

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). n

HIPAA States n Confidentiality – The property that information is not made available or disclosed to unauthorized individuals, entities, or process

Confidentiality n 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.

Confidentiality n Patient authorization is not required for: n n 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.

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 section…shall be fined not more that $500 or confined in the county or regional jail for not more than 6 months or both.

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

Confidentiality and the Interview n n Learn Dos’ and Don’ts’ of confidentiality for Interviews/ Investigations CDC Guidelines based on federal review n n The Privacy Act of 1974 Freedom of Information Act

Don’t of Confidentiality (When in doubt, don’t give it out) n Tell the client this is a Confidential interview. n n Check understanding Do not name original patient to others during an investigation. n n n Immediate family will know Others may know-do not confirm or deny !!! May name if written authorization is obtained

Don’t (cont. ) n n n 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

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

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

Do’s (cont. ) n n Useful items: Bring a Calendar n n Show clients dates to jog memory Ask to see n Their Planner or date book n n Can pinpoint where client was each day Address/Telephone book n Easy access to needed information on other contacts

Do’s (cont. ) n Refer all media, law enforcement and others requesting information: n n n Immediate supervisor or designee State epidemiologist (Loretta Haddy) State Health Officer (Cathy Slemp)

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

PRACTICE