Instructor Instructions Preview PowerPoint before presenting it. If connected to the Internet, hyperlinks should be active. Hand out the quiz at the beginning.

Instructor InstructionsInstructor Instructions

Preview PowerPoint before presenting it. If connected to the Internet, hyperlinks should be active.Hand out the quiz at the beginning of the

presentation, so the participants can fill in the blanks as the information appears.

Have the attendees sign the training roster.All students sign HIPAA Confidentiality Statement.Return roster, quizzes, and forms to Station 6-5.Any suggestions – please forward to Shari Turner.

20152015 HIPAA Training HIPAA Training &&

Other Need-to-Know Other Need-to-Know InfoInfo

For DES RespondersFor DES Responders

Matanuska-Susitna Borough

Department of Emergency Services

Course Completion Course Completion RequirementsRequirements

Take the Quiz – Minimum Score 100%(Answer the questions as the information is presented.)

Make sure you have signed the training roster

AND Confidentiality Statement.

MSB DES Policy MSB DES Policy Confidentiality & HIPAAConfidentiality & HIPAA

The DES and ALL of its employees and volunteers

are committed to insuring the confidentiality of our patients.

This policy pertains to ALL information.

Oral Paper-based

Electronic Photographic

What is What is HIPAA?? HIPAA??

Health Insurance Portability and Accountability Act

Created by the U.S. Department of Health and Human Services (HHS)

(Yes, 2 A’s)

HIPAA should NEVER negatively impact the quality of patient care or impede the ability to provide care.

What is PHI?What is PHI?

The “appropriate” communication of PHI with other health care

providers, directly involved in providing patient care, does not constitute a violation

of HIPAA.

Privacy RulePrivacy Rule

Privacy RulePrivacy Rule

For example…In a busy emergency room, it

may be necessary for healthcare providers to speak loudly in order

to ensure appropriate treatment.

The Privacy Rule is not intended to prevent this appropriate behavior.

The Privacy Rule of HIPAAThe Privacy Rule of HIPAA

Provides basic rights regarding the use of “Protected Health Information” (PHI)

We must have in place appropriate administrative, technical, and physical safeguards to protect the privacy of PHI.

The Privacy Rule requires The Privacy Rule requires us to: us to:

Protect PHIDesignate a Compliance OfficerLook for “Leaks” in our PoliciesConduct Training for the Entire DepartmentDevelop an Authorization Form for Release of

PHIProvide Patients with an NPP Brochure

Notice of Privacy Practices Notice of Privacy Practices (NPP)(NPP)

EMS personnel must make a “good faith” attempt to provide an NPP

Brochure to each patient.

EMS responders must also make an “good faith” effort to get a signed Acknowledgement of Receipt.

MATANUSKA-SUSITNA BOROUGHDepartment of Emergency Services

Notice of Privacy Act IMPORTANT: THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Matanuska-Susitna Borough Department of Emergency Services is committed to protecting your personal health information. We are required by law to maintain the privacy of health information that could reasonably be used to identify you, known as “protected health information” or “PHI.” We are also required by law to provide you with the attached detailed Notice of Privacy Practices (“Notice”) explaining our legal duties and privacy practices with respect to your PHI. We respect your privacy, and treat all healthcare information about our patients with care under strict policies of confidentiality that our staff is committed to following at all times.

PLEASE READ THE ATTACHED DETAILED NOTICE. IF YOU HAVE ANY QUESTIONS ABOUT IT, PLEASE CONTACTOUR HIPAA COMPLIANCE OFFICER, AT (907) 861-8010 or [email protected]

Detailed Notice of Privacy Practices…

NNotice of otice of PPrivacy rivacy PPractices ractices ((NPPNPP))

2-Sided Brochure2-Sided Brochure(Sample - Beginning Portion of the NPP Brochure)

Back of Page 1 of PCR

Acknowledgement of Receipt:

“By signing below I acknowledge that

I have received MSB-EMS’s Notice of Privacy Practices.”

Notice of Privacy PracticesNotice of Privacy Practices

What if the patient cannot sign?

◦Document the Reason

◦Attempt to get signature of a legal guardian, power of attorney, family member, or facility representative

NPP also available on MSB website:

Protected Health Protected Health InformationInformation

PHI is any information about a person’s past, present, or future

healthcare that identifies the patient

or reasonably identifies the patient.

PHIPHI is considered to be… is considered to be…

ANY unique identifying number, characteristic, code, or combination that allows

identification of an individual.Such as…

Individuals’ Identifiable Individuals’ Identifiable Health InformationHealth Information

Names, including NicknamesAll Geographic Info Smaller than

a StateDOB and/or DODAdmission/Discharge DatesTelephone NumbersSocial Security NumberMedical Records Numbers (PCR

#s)More…

Individuals’ Identifiable Individuals’ Identifiable Health InformationHealth Information

Email Addresses & Web Addresses

Biometric Identifiers◦Finger and Voice Prints◦Photographic Images◦Tattoos and Piercings

Vehicle Identifiers◦License Plates◦VINs

Beware of Discussion of Beware of Discussion of PHIPHI

Such as…

Discussing a call anywhere other than an official audit/review

Talking about current or prior incident while re-stocking ambulance or writing report

Discussing “interesting” calls with non-involved responders

Chatting about famous patients or neighborsSharing co-workers or fellow responders PHIComplaining about frequently seen patients

Use of Cameras in Use of Cameras in FieldField

It may be appropriate to capture images of an accident scene to determine mechanism of injury.

Any image, video, or audio recording that could identify the patient is PHI and should be secured.

Only use devices owned & issued by MSB – no personal devicesStore images & clips securelyImages are property of MSB

Social Networking, Texting, Social Networking, Texting, and Photosand Photos

Posting of ANY patient or incident-related information,

in any manner, is NOT permitted.

Landmarks, vehicles, buildings, or clothing

may identify a patient.

Failure to Failure to Comply Comply

The U.S. Dept of HHS may impose civil penalties of $100 per failure to

comply with a Privacy Rule requirement.

A person who knowingly obtains or discloses individually identifiable health

information faces a fine of $50,000 and up to one year imprisonment.

More…

Failure to Comply Failure to Comply

Obtaining PHI under false pretenses may lead to 5 years imprisonment

or $100,000 fine, or both.

Using PHI for commercial advantage, personal gain, or

malicious harm may lead to 10 years imprisonment or $250,000

fine, or both.

HIPAA permits disclosure of PHI when

necessary for treatment purposes.

Nonetheless…

Safeguarding PHISafeguarding PHI

PCRs must be kept in a secure location.PCRs should go directly from each station to Medical Billing;

◦Station 6-5 is considered a secondary option.

NO deviations are permitted.

Requests for Individual Requests for Individual PCRsPCRs

All “CPR” PCRs shall be scanned/emailed directly to the EMS

QA Manager.

Do not Cc yourself or anyone else.

Requested PCRs may be hand-delivered via a chief or supervisor to

the EMS QA Manager.

PCRs may not be faxed.

Permitted DisclosuresPermitted Disclosures

Disclosure of PHI is acceptable in the following circumstances:

TreatmentLaw EnforcementVictims of AbusePaymentOperationsPublic Health

Regulations Judicial ProceedingsProtection of Public

SafetyBirths and DeathsApproved Research

Specifics…

OK to disclose OK to disclose limitedlimited PHIPHI to help police identify or to help police identify or

locate: locate: ◦Suspect◦Fugitive◦Material Witness

◦Missing Person

OK to Disclose OK to Disclose PHIPHI to to Law EnforcementLaw Enforcement

Document verbal permission

If patient is unconscious OK if in best interest of patient

and the Officer agrees that it will not be used against victim

OK to disclose when it appears victim died as a result of criminal activity

Law EnforcementLaw EnforcementWhen assisting the police on-scene in identifying or locating a suspect, missing person, or witness,

the responder may release:

Name and AddressDOBSS#Date/Time of TreatmentDistinguishing

Characteristics ◦Height & Weight◦Tattoos & Scars

Other

Need-to-KnowNeed-to-Know

IInfonfo for DES Respondersfor DES Responders

You MUST You MUST Report…Report…

Suspected Child Abuse

Belief of Vulnerable Adults

If you report it – Document it!

Child Abuse & NeglectChild Abuse & Neglect

Physical InjuryFailure to Care for a

ChildSexual AbuseSexual ExploitationMental InjuryMaltreatment

Office of Children’s Office of Children’s ServicesServices

(800) 478-4444

Reports should be made immediately

following the encounter.

AK Statutue 47.17.010 (g)AK Statutue 47.17.010 (g)A person required to report child abuse or neglect, who

makes the report to the person's job supervisor or to

another individual working for the entity that employs the

person, is not relieved of the obligationnot relieved of the obligation

to make the report to the department as required.

Vulnerable AdultsVulnerable AdultsAbandonmentExploitationAbuseNeglectSelf-neglectUndue

Influence

Alaska law requires that protective services

not interfere with the elderly or disabled adults who are capable of caring for

themselves.

Adult Protective ServicesAdult Protective Services

NEW CentralizedOnline Reporting

Reports must be made

no later than 24 hours after first having cause for

belief.

You Must Also You Must Also Report…Report…

2nd or 3rd Degree Burns to 5% or more of a patient's

body

Burns to a patient's upper respiratory tract or laryngeal edema due to the inhalation of

super-heated air

You Must Also Report …You Must Also Report …Bullet wounds, powder burns, or

other injuries apparently caused by the discharge of a firearm;

Injury apparently caused by a knife, axe, or other sharp or pointed instrument, unless the injury was clearly accidental; and

Injury that is likely to cause the death of the patient, unless the injury was clearly accidental.

Report to Whom??Report to Whom??Injuries that are caused by bullets or

knives, or non-accidental injuries that may lead to death, must be

reported to the relevant local law enforcement:

ASTPalmer PDWasilla PD

What About Dog What About Dog Bites?Bites?

Dispatch will notify the appropriate local law enforcement agency.

But it’s still a good idea to document that the authorities were contacted.

Document on the PCR all reports

made to the authorities.

Reporting Liability??Reporting Liability??Responders who make reports

in “good faith” are immune from liability and protected by law from

retaliation.

When in Doubt…When in Doubt…On Scene,

Contact Your Supervisor!

After the fact, you may refer any requests for information to:

Medical Billing SpecialistTiffanie Robinson 861-8564

or

HIPAA Compliance OfficerShari Turner 861-8010

Q&A TimeQ&A TimeWhat question do you have??

Let’s see…

Q:Q: What if I’m accidentally What if I’m accidentally overheard discussing a overheard discussing a

patient’s patient’s PHIPHI record? record?

A: A: It is not a violation, if you were taking reasonable precautions,

and discussing the Protected Health Information

for a legitimate purpose.

Q:Q: If the patient is unconscious, If the patient is unconscious,

to whom can we disclose the to whom can we disclose the PHIPHI? ?

A:A: Use the Minimum Necessary standard: disclose only information that is

directly relevant to the person's involvement with the patient's health care.

Q:Q: What should I do if a What should I do if a government government agencyagency, ,

law enforcement person, or fire law enforcement person, or fire code official, code official,

requests information about a requests information about a patient? patient?

A: A: If you are on the scene, you may assist a law enforcement officer, if the PHI is necessary to

identify or locate a suspect, missing person, or witness.

Otherwise, they must contact theMSB Medical Billing Department

861-8564

When in doubt… consult your supervisor.

Q: Q: What should I do if I get a phone What should I do if I get a phone call call from the patient from the patient looking for looking for information? information?

A: A: Ask them to please contact the

Medical Billing department: Tiffanie Robinson 861-8564

Q:Q: May I give information to May I give information to parents parents

or guardians of incompetent or guardians of incompetent patients? patients?

A: A: If someone other than the patient has the legal right to make health care

decisions for the patient, then that person has the right to access the

patient's PHI.

Q:Q: If I am speaking to a patient, If I am speaking to a patient, and friends or family are in the same and friends or family are in the same

room, room, do I assume the patient has given me do I assume the patient has given me

permission permission to discuss the PHI in front of them to discuss the PHI in front of them or do I need to ask them to leave? or do I need to ask them to leave?

A: A: It is proper to speak, unless the patient objects. If you are uncertain, ask the patient

if it’s okay to discuss their PHI in front of others.

Q:Q: May I give the patient’s family May I give the patient’s family and friends and friends

PProtected rotected HHealth ealth IInformation? nformation? A: A: If possible, ask the patient and

document the response in the PCR.

The patient’s general condition and location should be sufficient.

A: A: Yes – to locate a patient or enable the hospital to retrieve records.

Q: Q: Is it OK to use the patient’s name Is it OK to use the patient’s name

over the radio?over the radio?

A: A: This is considered an “incidental disclosure”

- not a HIPAA violation.It is the same as if a bystander

overhears PHI.

Q: Q: What if someone overhears a What if someone overhears a patient’s name on a scanner?patient’s name on a scanner?

A: A: HIPAA does not prevent multiple patients

from being transported in the same ambulance.

Q: Q: If it does not adversely affect If it does not adversely affect patient care, may we transport patient care, may we transport

multiple patients?multiple patients?

Unsure About Discussing an Unsure About Discussing an Incident??Incident??

Ask yourself…

Would a judge agree that the disclosure benefited patient care AND was performed with the utmost discretion?

If you were the patient, would you want an your personal illness or injury to be discussed?

Remember…Remember…

NEVER apply HIPAA in a way that delays,

impedes, or prevents patient care.

When in Doubt…When in Doubt…

Contact MSB DES HIPAA Compliance Officers

◦ Quality Assurance Manager Shari Turner 861-8010

◦ Medical Billing Specialist Tiffanie Robinson 861-8564

http://www.hhs.gov/ocr/privacy/index.h

tml

Thank You for Your Thank You for Your Participation!Participation!

Make sure you have signed the Training Roster AND Confidentiality Statement.