LAFD Reviews Federal Health Insurance Portability and Accountability Act (HIPAA)

Tuesday, March 20, 2012 |

The following has been issued from the Office of the Fire Chief, Brian L. Cummings:


The City Council has designated the City of Los Angeles as a “hybrid entity” under the Federal Health Insurance Portability and Accountability Act (HIPAA) of 1996 due to the Department’s status as a health care provider.  As a hybrid entity, the Department must comply with HIPAA and is only permitted to release Protected Health Information (PHI) for the purposes of treatment, billing and operations under the HIPAA Privacy Rule, without the patient’s permission.  In 2009, the President approved additional Federal legislation that increased civil and criminal penalties for the unauthorized disclosure of PHI.

The Department is currently seeking written advice from the City Attorney relative to the release of incident specific PHI to a variety of internal and external sources including elected officials, commissions, the media and associated stakeholders. 

The City Attorney has preliminarily opined that the Department should immediately cease the practice of releasing PHI to any source not specifically authorized under the Privacy Rule’s treatment, billing and operations exemption.  I realize that this practice will significantly impact the manner in which the Department provides updates and notifications to a wide variety of stakeholders.  As the Department receives additional written advice from the City Attorney regarding specific issues, I will ensure that this information and the Department’s procedures will be forwarded for your information.

BRIAN L. CUMMINGS
Fire Chief


Submitted by Matt Spence
Spokesman, Los Angeles Fire Department

17 comments:

Anonymous said...

Brian,

HIPAA information is medical information related to the treatment of a medical patient. Notification of a traffic accident that does not name a person or provide any details regarding the specific victims/patients is not a violation of HIPAA. The Department needs to be practical. It is interesting that Chief Cummings has temporarily discontinued providing information about emergency incidents when he is fighting allegations of deception, fraud, dishonesty and skewed response time numbers. Is this HIPAA cover a mere coincidence?

Anonymous said...

Brian,
You may want to pass this along to the Fire Chief and the City Attorney. Although this opinion is from Wisconsin, since HIPAA is a Federal Law I am sure the ruling would be the same for us in California.

HIPAA Law Doesn't Mean Fire Departments Can Operate In Secret
United States (Wisconsin) - Fire departments in Wisconsin cannot use the federal HIPAA law as a reason to withhold basic public information about ambulance calls, such as names and addresses of those who required medical help, the attorney general said in an opinion issued Thursday. The opinion by Attorney General J.B. Van Hollen will have an effect around the state, where some fire departments routinely refuse to release information about those treated by emergency personnel.
Such was the case earlier this year in Waukesha, where the Fire Department cited HIPAA privacy provisions in refusing a Journal Sentinel request to release information resulting from its call to treat a suspected drunken mail carrier who crashed his government vehicle into a sign.

In blacking out virtually every word of its report on the incident, the department relied on advice from Waukesha City Attorney Curt Meitz's office about the use of the federal Health Insurance Portability and Accountability Act, known as HIPAA, a directive that his office later rescinded.

The initial refusal to release the information under the Wisconsin Public Records Law prompted a letter from Journal Sentinel Managing Editor George Stanley to the attorney general, requesting a legal opinion.

Van Hollen said he wrote the opinion because HIPAA was being misinterpreted statewide with regularity.

"Although the particular incident giving rise to your inquiry has now been resolved, I have concluded that your question merits a full answer because it continues to recur with regularity," Van Hollen said. "Consequently, record custodians and the public alike are in need of guidance."

Fire departments in West Bend and Cedarburg this year cited HIPAA to initially deny access to ambulance records. But both departments later released the information after being told of the state law pertaining to ambulance records.

Stanley praised Van Hollen's finding.

"Attorney General Van Hollen's well-researched legal opinion provides a valuable public service by clearing up confusion and explaining that federal HIPAA law does not enable local and state government officials to keep records secret if they should otherwise be open," Stanley said.

"In this case, a local fire department had refused to provide information about a public employee who crashed his truck into a sign and was arrested for drunk driving. The taxpayers who pay for his salary, for the truck he was driving and for the auto and liability insurance - as well as the people who live in the neighborhoods he was driving drunk through - deserve to know that information."
Written by Milwaukee Journal Sentinel

Red Cross Mike said...

what happened to freedom of information act?

Red Cross Mike said...

what happened to the freedom of information act

ColeslawPatriot said...

I smell cover up.

Anonymous said...

Timing is everything. And the cities timing on this couldn't be worse.

Anonymous said...

This is not going to be good. The alerts are going to be gone, I am not happy.

Colin said...

Does this mean that the Deptartment wont be posting any photos of emergency scenes with patients in them??

Anonymous said...

HIPPA regulations, do not, I repeat do not apply to public agencies. If there is a 3 car TC on the 118 at Balboa with 3 victims, as long as the LAFD is not saying "John Smith of 123 Any Street, Northridge, CA who has a history of cardiac disease, diabetes, and other aliments" was driving.....". HIPPA applies the the release of transmitted electronic information as in claims that are filed by physicians, hospitals and the like and also personal information, not non-discript information such as that when there is an emergency. If that is the case then every single newpaper in the city will not be able to print the name of anyone who is injured, killed or otherwise. Please, I have read that stupid 1,986 page bill and have been certified in HIPPA since 2003. Don't use this law for what it was NOT intended.

Anonymous said...

Brian

Why didnt you print the information I sent regarding HIPAA? Were you directed by the Fire Chief not to print it?

Anonymous said...

WOW.....now, looks like the Mayor is appointing a new Fire Commmissioner and a new civilian statistial analysist for an unknown undisclosed salary....to fix the LAFD. The LAFD seems can not be trusted?? Seems the mayor may be regretting the political appointee of his, Brian Cummmings?? I know they have some good people, great people, within the LAFD. Seems once you make it a political appointee, you loose integrity.
I'm just saying.....look at how the last Fire Chief bailed out once he got his year in, leaving the department to fend and fix his mess. And now, this guy seems to be struggling. What next?

Anonymous said...

Take this garbage off your blog...it's old news that embarrassed the LAFD.

Calibabe said...

HIPPA Title I- Health Insurance Reform-This applies to workers

HIPPA Title II- Applies to Administration Simplification-basically the transmission of electronic medical claims information from one entity to another.

HIPPA Title III- Tax Related Provisions-nothing that the LAFD does relates to this provision of HIPPA

HIPPA Title IV-Enforcement of Group Health Plan

HIPPA Title V-Revenue Offsets

So none of these titles of this 1,986 pages applies to anything that the LAFD does.

The projections were clearly wrong. The chief needs to fall on his own sword and say so. I would have a ton of respect for him if he stood up and said to the city council and the mayor who give him the numbers to work with, 'This is the money YOU gave us to work with" and unfortunately as YOU can see the "projections" were incorrect and were wrong.

Don't use HIPPA to hide behind. It has nothing to do with any of this and worse of all it is giving the LAFD a black eye and that is the worst part. I believe we have one of the best fire departments in the country. This however does not make them look good. All because of a bunch of politicians who kept gutting the department when the union was tell the truth all the time.

Anonymous said...

@Red Cross Mike, You are still free to file FOIA requests with the city, however such requests will probably not meet a timeframe that is useful to you or the public.

LAFD Media and Public Relations said...

Dear Friends,

Thanks for your notes. I apologize for the delay in posting your messages and a reply - which was caused solely by my vacation. Thanks for your patience. BH

@Anonymous 8:04,

Thanks for your note. We are still waiting for a detailed written directive from the City Attorney's Office to clarify their formal stance on a handful of such nuances and apparent incongruencies.

@Anonymous 8:13,

We saw mention of the Wisconsine ruling in the press, and thank you for sending the details. We remain confident that the Los Angeles City Attorney's Office will turn to a multitude of resources in researching their formal opinion. Again, thanks for writing.

@RedCross Mike

The Freedom of Information Act is a federal law with a particular focus on federal entities.

The more applicable statute for our agency and others in The Golden State is the California Public Records Act.

@ColeSlaw Patriot

If you have evidence or wish to further your concerns, we strongly encourage you to contact the Fraud, Waste and Abuse Hotline at the City Controller's Office by calling (866)428-1514.

@Anonymous 9:27

We agree that the timing of this issue could not have come at a more inopportune time.


Respectfully Yours in Safety and Service,

Brian Humphrey
Firefighter/Specialist
Public Service Officer
Los Angeles Fire Department

LAFD Media and Public Relations said...

Dear Friends (continued),

@Anonymous 10:30

We are *still* seeking clarification from the City Attorney's Office on nuances related to our LAFD_ALERTs. Harden not your heart.

@Colin

We are *still* seeking clarification from the City Attorney's Office on nuances related to the LAFD themed Flickr photo gallery, which almost exclusively features images taken by civilian photographers in public places.

@Anonymous 1:56,

We sense your passion, but are somewhat puzzled by your message. As you infer - yet contradict, the LAFD and other Fire Departments that provide Emergency Medical Services are often bound by medical privacy statutes, including HIPAA (two A's) - and as someone who as studied the law, you must realize that HIPAA does not apply to non-medical practitioners such as journalists or Police Officers.

That much said, we are eagerly awaiting detailed written clarification from the City Attorney's Office to identify how (if at all) our establshed practices may fail to be in compliance with the 1996 law.

@Anonymous 10:12,

As mentioned earlier, I took a (rare for me) "duty segment" off to enjoy time with my family during their Spring Break from school and to get things done around the house. I can assure you there is nothing nefarious in the delay, and I deeply appreciate your patience.

@Anonymous 11:01,

What comes next? We're as eager as you to find out!

@Anonymous 11:36,

The words in the blog post above (right, wrong or otherwise) came on official letterhead from the Office of the Fire Chief. While they may not meet your standards - or even the test of time, it would be wholly unethical for me to remove them (and I unabashedly cite my mentor, the legendary Jim Perry).

Please rest assured that the message is indeed "dated", and may become more so in the years ahead, but it is part and parcel of our proud if not always perfect history.

Should your anger remain, please give me a call and we can chat.

@Calibabe,

Thank you for sharing your opinion.

@Anonymous 6:41,

As mentioned to @RedCrossMike above, the Freedom of Information Act (FOIA) is a federal law with a focus on federal entities. The more applicable statute for the LAFD and government agencies in The Golden State is the California Public Records Act. I hope this helps.


Respectfully Yours in Safety and Service,

Brian Humphrey
Firefighter/Specialist
Public Service Officer
Los Angeles Fire Department

Anonymous said...

Nice to see social discourse on an important topic.

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