HIPPA vs law enforcement

[Dustdevil]

"What if" does not constitute probable cause.

Exactly. He "felt" the ambulance was stolen? Ha! Good luck getting a warrant on that testimony.

And cops wonder why people want to kill them.

I wouldn't be too sure about my employer backing me up on any of this. EMS employers are notorious for throwing their minimum wage employees under the bus to suck up to the cops, firemonkeys, doctors, nurses, city councilmen, or anyone else who complains. It doesn't matter that you were in the right.

[Lone Star]

First off, since no one has said anything I guess I'll say it....It’s HIPAA , not 'HIPPA'

Secondly, even though disobeying a lawful order from law enforcement is a misdemeanor criminal offense, they CANNOT order you to break a law.

Since HIPAA is federally mandated, law enforcement CANNOT order you to break that law.

Exactly. He "felt" the ambulance was stolen? Ha! Good luck getting a warrant on that testimony.

When you consider that a simple license plate check (and possibly checking the VIN) would determine if the vehicle in question is stolen or not, I think the probability of getting a warrant or subpoena based on that ‘evidence’ would be slim to none.

Anyone remember that cop versus EMT video from some months back?

1) LEOs have firearms, most EMS crews do not.

2) Even if found guilty in good ol' boy Judge Bubba's court, YOU are the one going to have a record, and the expense of trying to have the record expunged.

2-A) If you are in a state/provence where, when renewing your certification/license, you must declare any arrest record, until the expungement, you're going to have trouble.

3) Any interaction between LEO, FD, and EMS agencies, other than sanctioned things like boxing matches or hockey games for charity, always has the potential of starting a "battle of the badges". As I have observed over many years, these "battles" end up embarrassing the direct participants, their respective agencies, and generate negative goodwill for long periods to follow.

1. Doesn’t matter if they carry bazookas, unless they have a REASON to draw said weapon and then use it, they could be dragging a 105mm Howitzer every where they go….they have to have a justifiable reason to ‘clear leather’ and start blasting. Anything less would constitute aggravated assault with intent to do great bodily harm or worse yet, attempted murder/murder.

2. There is nothing to find you ‘guilty’ of! You’re only following a FEDERAL LAW that they cannot force you to violate.

2-A) Since they cannot find you ‘guilty’ of anything, there should be no reason that this encounter should prevent you from renewing your license. Even if you ARE arrested, by the time you step into court and the judge finds that you’ve only adhered to federal law, getting your arrest record expunged is a matter of a court order. Additionally, ‘wrongful arrest’ and ‘wrongful imprisonment’ are highly frowned upon. This could also open up civil litigation against the officer and his department/municipality.

3. Since the officer was wrong in the first place, how can it really be a ‘negative effect’ on the EMS agency, or the EMT in question? Sure, it’s going to make the officer look like an overbearing buffoon, but in this case; it appears that the perception IS reality.

[island emt]

Lone : if you go back to post #2 in this thread you will see i Corrected HIPAA

This all boils down to are you willing to take on a redneck cop who has a hair across his ass that morning in an attempt to "protect" your patients rights.

The PT wasn't aware of what was going on and couldn't give consent is all a smoke screen.

I'm not saying it's right for the cop to do what was done:

Or saying it was wrong.

The question boils down to are you willing to take the consequences and pay the price of a confrontation ?

[usalsfyre]

The question boils down to are you willing to take the consequences and pay the price of a confrontation ?

Yep, I am. Maybe it's the fact I like to tilt at windmills, I don't know. Understand there may be consequences from taking the easy way out too. Remember, integrity is doing what's right when no one is looking.

Edited March 31, 2011 by usalsfyre

[Lone Star]

Lone : if you go back to post #2 in this thread you will see i Corrected HIPAA

I guess I missed that, I stand corrected.

The question boils down to are you willing to take the consequences and pay the price of a confrontation ?

Yes, I AM willing to take that chance, simply because I'm not going to allow fear or intimidation jeopardize what I've worked so hard to achieve, especially when I have the backing of the federal law on my side.

[MedicCraig]

I thought this topic might stir up some interesting points. All are valid points, too. Just for the record the officer involved was a Texas DPS officer. Thats a state trooper or hiway patrol officer in other states. My crew said that he told them he was unable to get a response when running the plates on the ambulance. That's not our problem, though. The ambulance is correctly licensed, driven and attended by a licensed crew on a legal, authorized non-emergent run. They were doing nothing wrong to be treated in this manner. They were guilty until proven innocent of an unknown crime.Maybe this should be a wake up call that we need to suggest that LEO needs to be trained or inserviced on HIPPA. I'll bet most of them don't know what it is. Any officers care to comment?

[usalsfyre]

I'm not an officer but as a resident of and taxpayer in the state of Texas I would very much appreciate it if you followed up on this issue.

[Lone Star]

I thought this topic might stir up some interesting points. All are valid points, too. Just for the record the officer involved was a Texas DPS officer. Thats a state trooper or hiway patrol officer in other states. My crew said that he told them he was unable to get a response when running the plates on the ambulance. That's not our problem, though. The ambulance is correctly licensed, driven and attended by a licensed crew on a legal, authorized non-emergent run. They were doing nothing wrong to be treated in this manner. They were guilty until proven innocent of an unknown crime.Maybe this should be a wake up call that we need to suggest that LEO needs to be trained or inserviced on HIPPA. I'll bet most of them don't know what it is. Any officers care to comment?

You're right about 'not getting a response' when running the plate being the crew's problem. Ultimately, if it WAS stolen, he would have gotten some type of 'response' to the querry about the license plate, vehicle number (from the company) and then would have had 'probable cause' to start looking deeper into the situation.

I highly doubt that the common criminal would know enough about HIPAA to even cite it to prevent a vehicle search, and simply peeking into the windows of the back doors would confirm that there was indeed, a patient on board; without having to see the PCR to confirm the existance of a patient.

[HERBIE1]

Something does not add up here. Why did the officer feel the need to run the plates? Based on the information given, as was suggested, I would suspect they were indeed looking for smugglers- illegals or drugs. They probably had an alert, had some intel that said ambulances could be used in such a manner. Is it a HIPAA violation? I'm no lawyer, but I disagree that the officers are not entitled to see PHI- given the appropriate circumstances.

Example-

If you have someone in critical condition, they may be a victim of or responsible for a violent crime. The officer may need to know mechanism of injury, type of injury(ie is it GSW or blunt force trauma) Is the patient expected to live? Any possible evidence you may need to preserve if possible? Can the patient give a quick description of their attacker or any witnesses? Why or why not? These things and more determine how they may need to proceed with their investigation. Do they need to call out detectives, a supervisor, evidence technicians, major accident investigators, more officers to canvass the area for witnesses, conduct a search, secure an area for a possible dangerous person, etc? You may indeed need to tell an officer that the patient is too critical to respond to questions, and in my experience, I have never had an officer challenge me on that.

I'm all about protecting the rights of patients, but we also do not operate in a vacuum. Other agencies may depend on not only our cooperation, but our discretion, to effectively do their jobs. Law enforcement is not the general public, and unless a cop is trying to satisfy some morbid/inappropriate curiosity about a patient, what possible harm could come from agreeing to verify you are indeed transporting a legitimate patient? Is the officer taking notes on the patient's medical condition? Are they asking you or the patient(I know, in this case the patient was incompetent) inappropriate questions?

I would also hazard a guess that laws concerning these things can vary from location to location.

I'd love to hear from any LEO's or lawyers about this to get a definitive answer.

Rules are fine, but you also need to temper adherence to those rules with common sense. To me, this is no different than some of the creative solutions we must come up with to best serve our patients, and not every one of them may follow the letter of the law or be in strict compliance with our policies, procedures, or standing orders.

[Lone Star]

Something does not add up here. Why did the officer feel the need to run the plates?

In the original post, the ambulance was pulled over in a routine traffic stop for allegedly following too close to the vehicle in front of it (even though there was no vehicle in front of the rig). This truck was also being used in a long distance transfer, so it was not from that particular area. (This is a more plausible reason for pulling the rig over in the first place).

Example-

If you have someone in critical condition, they may be a victim of or responsible for a violent crime. The officer may need to know mechanism of injury, type of injury(i.e. is it GSW or blunt force trauma) Is the patient expected to live? Any possible evidence you may need to preserve if possible? Can the patient give a quick description of their attacker or any witnesses? Why or why not? These things and more determine how they may need to proceed with their investigation. Do they need to call out detectives, a supervisor, evidence technicians, major accident investigators, more officers to canvass the area for witnesses, conduct a search, secure an area for a possible dangerous person, etc? You may indeed need to tell an officer that the patient is too critical to respond to questions, and in my experience, I have never had an officer challenge me on that.

Even in your example (victim of a violent crime/GSW) the officer isn't entitled to read the information in the PCR, simply because it has no direct bearing in the investigation of the crime. All he would need is the patient's name and the fact that they're a victim of a crime.

The PCR contains other information, such as past medical history and medications, which the responding officer is NOT entitled to know.

Furthermore since the officer is not directly involved in the continuity of care, there is no need to violate the patient's confidentiality by associating an individual with a specific illness or disease. How is knowing that shooting victim, Joe Schmoe, also is HIV positive or has HTN going to help nab the guy that shot him?

I'm all about protecting the rights of patients, but we also do not operate in a vacuum. Other agencies may depend on not only our cooperation, but our discretion, to effectively do their jobs. Law enforcement is not the general public, and unless a cop is trying to satisfy some morbid/inappropriate curiosity about a patient, what possible harm could come from agreeing to verify you are indeed transporting a legitimate patient? Is the officer taking notes on the patient's medical condition? Are they asking you or the patient (I know, in this case the patient was incompetent) inappropriate questions?

Since the call was a long distance transfer, what possible reason could the officer have for saying ANYTHING to the patient on board? HIPAA isn’t just about releasing information to the general public, it’s about keeping the patient’s privacy intact from ANYONE and EVERYONE not directly involved in the continuity of patient care. Unless the responding officer is a doctor, and is directly involved in the continuum of care, there is NO reason under the sun that he would need ANY information from the PCR.

Nothing was said about the patient’s competency level, it was said that they could not give consent, which is the ONLY way short of a subpoena that the officer could obtain ANY information from the PCR. It doesn’t matter if the officer is going to as appropriate or inappropriate questions; they have no business questioning the patient in the first place, since they were not involved in any crime, (victim or perpetrator).

What it sounds like to me, was that the officer spotted an ambulance that was from another state, and thought that they could increase revenues for their department and for the state by trying to find some reason to pull them over and issue a citation (notice that both the driver and attendant verified that there was no vehicle in front of them, and thereby couldn’t be ‘following too closely’).

We can 'what if' this all day long, but based on the information presented by the OP, clearly the officer was wrong to attempt to gain ANY information from the PCR, and to simply acquiesce and voluntarily give the information to the officer IS a violation of HIPAA and a breech of patient confidentiality.

*edited to add last paragraph*

Edited March 31, 2011 by Lone Star