Frieden in NYC

[Guest guest]

This is admittedly just my back yard...but a surprising place for this kind

of invasive behavior to begin?

Probably not. Bush et al. can be as secretive as they want, stonewalling

all information and FOIAs etc., with an INJustice Dept. full of liars,

thieves and torturers doing their level best to cover their crimes up while

snooping into the private lives of Quakers.

So....why not elsewhere in the world? An article from Housing Works.

M.

**

http://www.hwadvocacy.com/update/archives/2006/03/beyond_extreme.html

March 21, 2006

BEYOND EXTREME

Frieden bill demands near-total DOH access to patient records, ignores

patient consent for HIV testing

FRIEDEN'S BILL: Some language is worse than he ever suggested

A bill that NYC health commissioner Dr. Tom Frieden is putting before

Albany lawmakers to change state HIV-testing and medical privacy laws is

far broader in its call for DOH access to patient histories than the health

commissioner has ever indicated.

The bill, which Housing Works obtained this afternoon, appears to demand

that virtually any provider of healthcare or other services for people with

HIV/AIDS turn over any information on a patient that is requested by the

health department. It also requires Medicaid and the AIDS Drug Assistance

Program (ADAP) to share with the health department any patient's current or

former HIV-medication history.

In addition, the bill suggests that providers don't need to obtain explicit

consent from patients before giving an HIV test­but merely inform patients

they will be given a test.

Click here for the bill and here for its memo of support.

" It's sad and infuriating to learn that this bill embodies some of the very

worst and most extreme provisions that the comissioner has been saying all

along he wouldn't endorse, " said Housing Works president King this

afternoon.

" I feel vindicated in my distrust of the health department under Frieden, "

King continued. " And I hope that community groups that have been unsure

about his proposals will now join us in opposition when they read the

extreme measures here that Frieden is trying to write into law. "

The bill calls for alarming changes in three areas:

ACCESS TO PRIVATE PATIENT FILES:

For months, written and oral presentations from the DOH have asserted that

the department wanted merely the authority to contact HIV-care providers

(and, in some cases, patients) based on a limited amount of treatment

information it already obtains from the state, including individual patient

CD4-counts, viral loads and resistance profiles.

But the actual bill reads that " The commissioner...may require a health

facility or health-care provider...to provide additional information

[italics ours] concerning a[n HIV] case. " The bill then extends that

requirement to HIV COBRA case-management programs; other PWHA-serving

case-management programs; HIV special-needs plans (SNPs); and the AIDS Drug

Assistance Program (ADAP).

The language is alarming, because the broadness of " additional information "

could encompass anything from further medical details to particulars of the

person's sexual or drug-using history. Further, the number of agencies

beholden to the law encompass nearly the entire array of programs relied

upon by low-income New Yorkers living with HIV/AIDS. Requiring such

information from COBRA case-management programs, in particular, puts dozens

of nonprofit community-based programs that have spent years building up

trust with their clients in the position of having to open client files to

government watchdogs.

In addition, the bill makes no mention of appropriating new funding to help

groups provide such information for the health department.

ACCESS TO PATIENT MEDICATION HISTORIES:

Page 2 of the bill states: " A medical assistance program...shall disclose

to the commissioner...upon request...information concerning pharmaceutical

claims made by or on behalf of individuals [in such a program]...Such

information shall be limited to antiretroviral drugs... "

Moreover, the bill makes no mention of appropriating funding to help

Medicaid or ADAP, which is cash starved, provide such records.

DEFINITION OF INFORMED CONSENT FOR HIV-TESTING:

The bill strongly suggests that a provider giving an HIV-test doesn't need

explicit permission from the patient­even an oral one­to give the test. The

bill reads: " In order for there to be informed consent, the person ordering

the test shall at a minimum advise the protected individual that an

HIV-related test is being performed. "

This is very similar to a provider-education publication on HIV-testing the

DOH put out recently that suggests providers tell patients they will be

given an HIV test and then ask, " Do you have any questions? " ­rather than

explicitly asking, " Is that OK with you? " or " Do you consent to that? "

" That publication read like they were trying to ram HIV tests down people's

throats without their permission, " said King. " And now it's clear from the

bill that they're trying to write that violation of people's rights into

the actual law. "

Housing Works will provide further analysis of and community reaction to

the bill later in the week. Meanwhile, HW hopes that making the bill

available here will give people time to brief themselves on it before

tomorrow (Wednesday) night's first of several open community meetings with

the DOH. The forum takes place 6-8pm in the Repertory Theater at Hostos

Community College in the Bronx (click the link for directions).