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HIPAA provides for the disclosure of the patient's name and PHI to CDC or

other appropriate public health agencies.

What they do with the information is governed by their policies and

procedures.

Gene

>

> So now that they released the name of the Atlanta Lawyer that

> potentially exposed passengers on two overseas flights it begs the

> question, do the potential exposures warrant releasing the name of the

> patient?

>

> Would it not suffice to say that if you were on plane X and Y contact

> the CDC or local health department for testing? Seems like unnecessary

> exposure including the point that his father-in-law works in TB for the

> CDC.

>

> Gene, want to jump in?

>

> Lt. Steve Lemming, AAS, LP

> EMS Administration Officer

> C-Shift

> Azle, Texas Fire Department

>

> This e-mail is confidential and intended solely for the use of the

> individual (s) to whom it is addressed. Any views or opinions presented

> are solely those of the author and do not necessarily represent those of

> The City of Azle or its policies. If you have received this e-mail

> message in error, please phone Steve Lemming (817)444-7108. Please also

> destroy and delete the message from your computer.

>

> For more information on The City of Azle, visit our web site at:

> <http://azle.http://azlhttp>

>

>

>

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Guest guest

I have a question about HIPAA. Ambulance is dispatched to an accident scene

and the patient refuses transport and the ambulance leaves. 30 minutes to

one hour later the troop that worked the accident has now placed the patient

under arrest and to book this patient into jail he needs a copy of the

refusal. I say I can not release this information unless I have a subpoena,

I am not real popular right now, but am I right?

If this person is under arrest, let us say in jail then the report can be

released to the jail, because they are the ones in charge of the well being

of this person. Is that correct?

Debbie

Re: HIPAA?

HIPAA provides for the disclosure of the patient's name and PHI to CDC or

other appropriate public health agencies.

What they do with the information is governed by their policies and

procedures.

Gene

>

> So now that they released the name of the Atlanta Lawyer that

> potentially exposed passengers on two overseas flights it begs the

> question, do the potential exposures warrant releasing the name of the

> patient?

>

> Would it not suffice to say that if you were on plane X and Y contact

> the CDC or local health department for testing? Seems like unnecessary

> exposure including the point that his father-in-law works in TB for the

> CDC.

>

> Gene, want to jump in?

>

> Lt. Steve Lemming, AAS, LP

> EMS Administration Officer

> C-Shift

> Azle, Texas Fire Department

>

> This e-mail is confidential and intended solely for the use of the

> individual (s) to whom it is addressed. Any views or opinions presented

> are solely those of the author and do not necessarily represent those of

> The City of Azle or its policies. If you have received this e-mail

> message in error, please phone Steve Lemming (817)444-7108. Please also

> destroy and delete the message from your computer.

>

> For more information on The City of Azle, visit our web site at:

> <http://azle.http://azlhttp>

>

>

>

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Guest guest

Whether you give it to the trooper or the jail, it's the same thing. They

already have the patient's personal information, they just need it to show the

called the ambulance to check out the patient. I do not believe you'd be

violating HIPAA.

Salvador Capuchino Jr

EMT-Paramedic

Re: HIPAA?

HIPAA provides for the disclosure of the patient's name and PHI to CDC or

other appropriate public health agencies.

What they do with the information is governed by their policies and

procedures.

Gene

>

> So now that they released the name of the Atlanta Lawyer that

> potentially exposed passengers on two overseas flights it begs the

> question, do the potential exposures warrant releasing the name of the

> patient?

>

> Would it not suffice to say that if you were on plane X and Y contact

> the CDC or local health department for testing? Seems like unnecessary

> exposure including the point that his father-in-law works in TB for the

> CDC.

>

> Gene, want to jump in?

>

> Lt. Steve Lemming, AAS, LP

> EMS Administration Officer

> C-Shift

> Azle, Texas Fire Department

>

> This e-mail is confidential and intended solely for the use of the

> individual (s) to whom it is addressed. Any views or opinions presented

> are solely those of the author and do not necessarily represent those of

> The City of Azle or its policies. If you have received this e-mail

> message in error, please phone Steve Lemming (817)444-7108. Please also

> destroy and delete the message from your computer.

>

> For more information on The City of Azle, visit our web site at:

> <http://azle.http://azlhttp>

>

>

>

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Guest guest

They already have all that information. They have his name address age the

fact that an ambulance was dispatched to the scene and that the patient

refused transport is on the radio log that is at the county dispatcher which

does the dispatching for the trooper, the sheriff's department (which would

be housing this patient) and the ambulance. So if they have all this

information why do they need a copy of our refusal?

Debbie

Re: HIPAA?

Whether you give it to the trooper or the jail, it's the same thing. They

already have the patient's personal information, they just need it to show

the called the ambulance to check out the patient. I do not believe you'd

be violating HIPAA.

Salvador Capuchino Jr

EMT-Paramedic

Re: HIPAA?

HIPAA provides for the disclosure of the patient's name and PHI to CDC or

other appropriate public health agencies.

What they do with the information is governed by their policies and

procedures.

Gene

>

> So now that they released the name of the Atlanta Lawyer that

> potentially exposed passengers on two overseas flights it begs the

> question, do the potential exposures warrant releasing the name of the

> patient?

>

> Would it not suffice to say that if you were on plane X and Y contact

> the CDC or local health department for testing? Seems like unnecessary

> exposure including the point that his father-in-law works in TB for the

> CDC.

>

> Gene, want to jump in?

>

> Lt. Steve Lemming, AAS, LP

> EMS Administration Officer

> C-Shift

> Azle, Texas Fire Department

>

> This e-mail is confidential and intended solely for the use of the

> individual (s) to whom it is addressed. Any views or opinions presented

> are solely those of the author and do not necessarily represent those of

> The City of Azle or its policies. If you have received this e-mail

> message in error, please phone Steve Lemming (817)444-7108. Please also

> destroy and delete the message from your computer.

>

> For more information on The City of Azle, visit our web site at:

> <http://azle.http://azlhttp>

>

>

>

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Guest guest

According to my HIPAA privacy policy:

You must request your PHI in writing.

I must keep a log of who I gave your PHI to and why.

I do not give a copy of PCR to anybody outside of the

continuance of care without a written request or a

subponea.

I have never had a police officer return with

information to the contrary no matter how upset they

were when I told then no you cannot have a copy of the

PCR. I even had one Highway Patrol lie to me and tell

me a neighboring service gives him a carbon copy. I

checked with that service and they did not know what I

was talikng about.

--- Debbie Fishbeck wrote:

> They already have all that information. They have

> his name address age the

> fact that an ambulance was dispatched to the scene

> and that the patient

> refused transport is on the radio log that is at the

> county dispatcher which

> does the dispatching for the trooper, the sheriff's

> department (which would

> be housing this patient) and the ambulance. So if

> they have all this

> information why do they need a copy of our refusal?

>

> Debbie

>

> Re: HIPAA?

>

> Whether you give it to the trooper or the jail, it's

> the same thing. They

> already have the patient's personal information,

> they just need it to show

> the called the ambulance to check out the patient.

> I do not believe you'd

> be violating HIPAA.

> Salvador Capuchino Jr

> EMT-Paramedic

>

> Re: HIPAA?

>

> HIPAA provides for the disclosure of the patient's

> name and PHI to CDC or

> other appropriate public health agencies.

>

> What they do with the information is governed by

> their policies and

> procedures.

>

> Gene

> In a message dated 5/31/07 4:32:50 PM,

> slemming@... writes:

>

>

> >

> > So now that they released the name of the Atlanta

> Lawyer that

> > potentially exposed passengers on two overseas

> flights it begs the

> > question, do the potential exposures warrant

> releasing the name of the

> > patient?

> >

> > Would it not suffice to say that if you were on

> plane X and Y contact

> > the CDC or local health department for testing?

> Seems like unnecessary

> > exposure including the point that his

> father-in-law works in TB for the

> > CDC.

> >

> > Gene, want to jump in?

> >

> > Lt. Steve Lemming, AAS, LP

> > EMS Administration Officer

> > C-Shift

> > Azle, Texas Fire Department

> >

> > This e-mail is confidential and intended solely

> for the use of the

> > individual (s) to whom it is addressed. Any views

> or opinions presented

> > are solely those of the author and do not

> necessarily represent those of

> > The City of Azle or its policies. If you have

> received this e-mail

> > message in error, please phone Steve Lemming

> (817)444-7108. Please also

> > destroy and delete the message from your computer.

> >

> > For more information on The City of Azle, visit

> our web site at:

> > <http://azle.http://azlhttp>

> >

> >

> > [Non-text portions of this message have been

> removed]

> >

> >

> >

>

>

>

>

> **************************************

> See what's free at http://www.aol.com.

>

>

> [Non-text portions of this message have been

> removed]

>

>

>

>

>

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Guest guest

Yes, you are right. The Trooper's request does not fall within any of the

exceptions that the HIPAA regulations make for disclosures to law enforcement.

There must be an urgent need for the information, and it must fall within 6

different, specifically delineated categories to be released. The Trooper's

request does not fall within any of them.

The report cannot be released to " the jail " unless it is released to medical

personnel there. If the report relates to care that is being rendered by

" health care providers " at the jail, then the information can be transmitted.

Otherwise, there is no provision in HIPAA for releasing such information. At

best the thread is tenuous between your information and what the jail says it

needs.

HIPAA has a " minimum necessary " rule. That says that only the minimum

necessary information should be released in any circumstance outside the chain

of

treatment, for payment, or healthcare operations.

Jail employees other than medical employees would not be in the " chain of

care " and thus would have no right to the information. The Trooper has no

immediate need for the information since he has two years in which to file his

charge, and there is ample time for him to obtain the information through the

legal process. There is no emergency. An emergency in a Trooper's mind is

not

an exception to the HIPAA rules and regulations.

Gene G.

>

> I have a question about HIPAA. Ambulance is dispatched to an accident scene

> and the patient refuses transport and the ambulance leaves. 30 minutes to

> one hour later the troop that worked the accident has now placed the patient

> under arrest and to book this patient into jail he needs a copy of the

> refusal. I say I can not release this information unless I have a subpoena,

> I am not real popular right now, but am I right?

>

> If this person is under arrest, let us say in jail then the report can be

> released to the jail, because they are the ones in charge of the well being

> of this person. Is that correct?

>

> Debbie

>

> Re: HIPAA?

>

> HIPAA provides for the disclosure of the patient's name and PHI to CDC or

> other appropriate public health agencies.

>

> What they do with the information is governed by their policies and

> procedures.

>

> Gene

> In a message dated 5/31/07 4:32:50 PM, slemming@...@c writes:

>

> >

> > So now that they released the name of the Atlanta Lawyer that

> > potentially exposed passengers on two overseas flights it begs the

> > question, do the potential exposures warrant releasing the name of the

> > patient?

> >

> > Would it not suffice to say that if you were on plane X and Y contact

> > the CDC or local health department for testing? Seems like unnecessary

> > exposure including the point that his father-in-law works in TB for the

> > CDC.

> >

> > Gene, want to jump in?

> >

> > Lt. Steve Lemming, AAS, LP

> > EMS Administration Officer

> > C-Shift

> > Azle, Texas Fire Department

> >

> > This e-mail is confidential and intended solely for the use of the

> > individual (s) to whom it is addressed. Any views or opinions presented

> > are solely those of the author and do not necessarily represent those of

> > The City of Azle or its policies. If you have received this e-mail

> > message in error, please phone Steve Lemming (817)444-7108. Please also

> > destroy and delete the message from your computer.

> >

> > For more information on The City of Azle, visit our web site at:

> > <http://azle.http://azle.<w>

> >

> >

> >

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Guest guest

To clarify my first post, one must differentiate between the patient's

personal information and protected health information. The Trooper already

knows

the patient's personal information. He also knows that the ambulance was

called. However, the results of the ambulance crew's assessment is PROTECTED

HEALTH INFORMATION and the Trooper had no immediate need for it either to make a

charging decision or for any other emergent reason. Therefore, it cannot be

released without subpoena. The Trooper can and must follow the rules and

obtain a subpoena for the information before it can be disclosed.

Gene G.

> Whether you give it to the trooper or the jail, it's the same thing. They

> already have the patient's personal information, they just need it to show

> the called the ambulance to check out the patient. I do not believe you'd be

> violating HIPAA.

> Salvador Capuchino Jr

> EMT-Paramedic

>

> Re: HIPAA?

>

> HIPAA provides for the disclosure of the patient's name and PHI to CDC or

> other appropriate public health agencies.

>

> What they do with the information is governed by their policies and

> procedures.

>

> Gene

>

>

>

> >

> > So now that they released the name of the Atlanta Lawyer that

> > potentially exposed passengers on two overseas flights it begs the

> > question, do the potential exposures warrant releasing the name of the

> > patient?

> >

> > Would it not suffice to say that if you were on plane X and Y contact

> > the CDC or local health department for testing? Seems like unnecessary

> > exposure including the point that his father-in-law works in TB for the

> > CDC.

> >

> > Gene, want to jump in?

> >

> > Lt. Steve Lemming, AAS, LP

> > EMS Administration Officer

> > C-Shift

> > Azle, Texas Fire Department

> >

> > This e-mail is confidential and intended solely for the use of the

> > individual (s) to whom it is addressed. Any views or opinions presented

> > are solely those of the author and do not necessarily represent those of

> > The City of Azle or its policies. If you have received this e-mail

> > message in error, please phone Steve Lemming (817)444-7108. Please also

> > destroy and delete the message from your computer.

> >

> > For more information on The City of Azle, visit our web site at:

> > <http://azle.http://azlhttp>

> >

> >

> >

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Guest guest

They do not need a copy of the refusal, and they are not entitled to a copy

of the refusal except under subpoena.

The decision to request the information through subpoena will have to come

from somebody above the level of Trooper.

Release of the refusal document without either a subpoena or the patient's

authorization in writing will constitute a HIPAA violation.

Gene G.

>

> They already have all that information. They have his name address age the

> fact that an ambulance was dispatched to the scene and that the patient

> refused transport is on the radio log that is at the county dispatcher which

> does the dispatching for the trooper, the sheriff's department (which would

> be housing this patient) and the ambulance. So if they have all this

> information why do they need a copy of our refusal?

>

> Debbie

>

> Re: HIPAA?

>

> Whether you give it to the trooper or the jail, it's the same thing. They

> already have the patient's personal information, they just need it to show

> the called the ambulance to check out the patient. I do not believe you'd

> be violating HIPAA.

> Salvador Capuchino Jr

> EMT-Paramedic

>

> Re: HIPAA?

>

> HIPAA provides for the disclosure of the patient's name and PHI to CDC or

> other appropriate public health agencies.

>

> What they do with the information is governed by their policies and

> procedures.

>

> Gene

> In a message dated 5/31/07 4:32:50 PM, slemming@...@c writes:

>

> >

> > So now that they released the name of the Atlanta Lawyer that

> > potentially exposed passengers on two overseas flights it begs the

> > question, do the potential exposures warrant releasing the name of the

> > patient?

> >

> > Would it not suffice to say that if you were on plane X and Y contact

> > the CDC or local health department for testing? Seems like unnecessary

> > exposure including the point that his father-in-law works in TB for the

> > CDC.

> >

> > Gene, want to jump in?

> >

> > Lt. Steve Lemming, AAS, LP

> > EMS Administration Officer

> > C-Shift

> > Azle, Texas Fire Department

> >

> > This e-mail is confidential and intended solely for the use of the

> > individual (s) to whom it is addressed. Any views or opinions presented

> > are solely those of the author and do not necessarily represent those of

> > The City of Azle or its policies. If you have received this e-mail

> > message in error, please phone Steve Lemming (817)444-7108. Please also

> > destroy and delete the message from your computer.

> >

> > For more information on The City of Azle, visit our web site at:

> > <http://azle.http://azle.<w>

> >

> >

> >

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Guest guest

Ahh and sometimes it is nice to watch a trooper squirm... opps did I say that!

No no I recant... we must have good relations with all agencies.

ez

EMT B / FF

wegandy1938@... wrote: They do not need a

copy of the refusal, and they are not entitled to a copy

of the refusal except under subpoena.

The decision to request the information through subpoena will have to come

from somebody above the level of Trooper.

Release of the refusal document without either a subpoena or the patient's

authorization in writing will constitute a HIPAA violation.

Gene G.

>

> They already have all that information. They have his name address age the

> fact that an ambulance was dispatched to the scene and that the patient

> refused transport is on the radio log that is at the county dispatcher which

> does the dispatching for the trooper, the sheriff's department (which would

> be housing this patient) and the ambulance. So if they have all this

> information why do they need a copy of our refusal?

>

> Debbie

>

> Re: HIPAA?

>

> Whether you give it to the trooper or the jail, it's the same thing. They

> already have the patient's personal information, they just need it to show

> the called the ambulance to check out the patient. I do not believe you'd

> be violating HIPAA.

> Salvador Capuchino Jr

> EMT-Paramedic

>

> Re: HIPAA?

>

> HIPAA provides for the disclosure of the patient's name and PHI to CDC or

> other appropriate public health agencies.

>

> What they do with the information is governed by their policies and

> procedures.

>

> Gene

> In a message dated 5/31/07 4:32:50 PM, slemming@...@c writes:

>

> >

> > So now that they released the name of the Atlanta Lawyer that

> > potentially exposed passengers on two overseas flights it begs the

> > question, do the potential exposures warrant releasing the name of the

> > patient?

> >

> > Would it not suffice to say that if you were on plane X and Y contact

> > the CDC or local health department for testing? Seems like unnecessary

> > exposure including the point that his father-in-law works in TB for the

> > CDC.

> >

> > Gene, want to jump in?

> >

> > Lt. Steve Lemming, AAS, LP

> > EMS Administration Officer

> > C-Shift

> > Azle, Texas Fire Department

> >

> > This e-mail is confidential and intended solely for the use of the

> > individual (s) to whom it is addressed. Any views or opinions presented

> > are solely those of the author and do not necessarily represent those of

> > The City of Azle or its policies. If you have received this e-mail

> > message in error, please phone Steve Lemming (817)444-7108. Please also

> > destroy and delete the message from your computer.

> >

> > For more information on The City of Azle, visit our web site at:

> > <http://azle.http://azle.<w>

> >

> >

> >

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Guest guest

Gene,

Does this also apply if the refusal document is seperate and not a part of the

patient care report? Our signature form, which includes a refusal section,

contains no patient assessment information.

We've encountered situations similar to the one described in the original

message. We've had DPS Troopers tell us that the jail won't accept the prisoner

unless they can show that he was seen by EMS and refused transport. We've

butted heads with Troopers in the past and will continue to do in the future if

necessary. We've also been told by local PD personnel that the county jail

won't accept prisoners who have any kind of medical complaint or injury unless

they can show that the prisoner has already been evaluated by medical (EMS)

personnel. Of course, this is a bit of a different situation when the prisoner

has a specific medical conplaint or condition and the information will be going

to medical personnel at the jail who will be responsible for following up on the

prisoner's condition or medical care.

We've encoutered this often enough that I've considered keeping some of our

HIPAA release forms on the ambulances or developing another form (like we don't

have enough paperwork already)specifically for these situations that says

something like " Officer abc of xyz agency has requested copies of EMS records

regarding service provided to me on ___date at ___location. I understand that

these records may contain information that is considered confidential and

protected under state and federal laws. I also understand that copies may be

given to Officer abc personally or may be faxed to such-and-such facility. " , and

which would have a place for the patient's signature and a witness signature

(other than the officer making the request).

Any thoughts?

Maxine Pate

hire-Pattison EMS

---- Original message ----

>Date: Sat, 2 Jun 2007 00:13:27 EDT

>From: wegandy1938@...

>Subject: Re: HIPAA?

>To: lcambulance@..., texasems-l

>

> They do not need a copy of the refusal, and they are

> not entitled to a copy

> of the refusal except under subpoena.

>

> The decision to request the information through

> subpoena will have to come

> from somebody above the level of Trooper.

>

> Release of the refusal document without either a

> subpoena or the patient's

> authorization in writing will constitute a HIPAA

> violation.

>

> Gene G.

> In a message dated 6/1/07 2:47:31 PM,

> lcambulance@... writes:

>

> >

> > They already have all that information. They have

> his name address age the

> > fact that an ambulance was dispatched to the scene

> and that the patient

> > refused transport is on the radio log that is at

> the county dispatcher which

> > does the dispatching for the trooper, the

> sheriff's department (which would

> > be housing this patient) and the ambulance. So if

> they have all this

> > information why do they need a copy of our

> refusal?

> >

> > Debbie

> >

> > Re: HIPAA?

> >

> > Whether you give it to the trooper or the jail,

> it's the same thing. They

> > already have the patient's personal information,

> they just need it to show

> > the called the ambulance to check out the patient.

> I do not believe you'd

> > be violating HIPAA.

> > Salvador Capuchino Jr

> > EMT-Paramedic

> >

> > Re: HIPAA?

> >

> > HIPAA provides for the disclosure of the patient's

> name and PHI to CDC or

> > other appropriate public health agencies.

> >

> > What they do with the information is governed by

> their policies and

> > procedures.

> >

> > Gene

> > In a message dated 5/31/07 4:32:50 PM,

> slemming@...@c writes:

> >

> > >

> > > So now that they released the name of the

> Atlanta Lawyer that

> > > potentially exposed passengers on two overseas

> flights it begs the

> > > question, do the potential exposures warrant

> releasing the name of the

> > > patient?

> > >

> > > Would it not suffice to say that if you were on

> plane X and Y contact

> > > the CDC or local health department for testing?

> Seems like unnecessary

> > > exposure including the point that his

> father-in-law works in TB for the

> > > CDC.

> > >

> > > Gene, want to jump in?

> > >

> > > Lt. Steve Lemming, AAS, LP

> > > EMS Administration Officer

> > > C-Shift

> > > Azle, Texas Fire Department

> > >

> > > This e-mail is confidential and intended solely

> for the use of the

> > > individual (s) to whom it is addressed. Any

> views or opinions presented

> > > are solely those of the author and do not

> necessarily represent those of

> > > The City of Azle or its policies. If you have

> received this e-mail

> > > message in error, please phone Steve Lemming

> (817)444-7108. Please also

> > > destroy and delete the message from your

> computer.

> > >

> > > For more information on The City of Azle, visit

> our web site at:

> > > <http://azle.http://azle.<w>

> > >

> > >

> > > [Non-text portions of this message have been

> removed]

> > >

> > >

> > >

> >

> > ************ ******** ******** *******

> > See what's free at http://www.aol.http

> >

> > [Non-text portions of this message have been

> removed]

> >

> >

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Guest guest

In a message dated 6/2/2007 4:38:26 P.M. Central Daylight Time,

west_tx_firefighter@... writes:

Ahh and sometimes it is nice to watch a trooper squirm... opps did I say

that!

No no I recant... we must have good relations with all agencies.

Ah but a long long long time ago in a land not much unlike Texas (more alike

then either land would like to admit) I learned from a wise old fire

Chief/Paramedic type (yea we had both too) that in the land of milk and honey

where

agencies get into arguments in the street the guy with the gun ALWAYS wins at

least the first round.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

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In a message dated 6/2/2007 6:34:58 P.M. Central Daylight Time,

west_tx_firefighter@... writes:

And this is why in texas EVERYONE carries a gun but only we carry the

bandaids ;)

I had forgotten that fact ;)

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with unless

I

specifically state that I am doing so. Further this E-mail is intended only for

its

stated recipient and may contain private and or confidential materials

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I dont think that your HIPAA release form idea will work. First the request

should go through your agencies privacy officer. Secondly why would someone

sign such a form knowing that it will get them into jail faster?

This really isnt a HIPAA issue its much bigger.

As far as the trooper having a problem getting the prisoner admitted to the

jail its a problem between DPS and the local jail - why get involved in

their fight. Weather or not the prisoner was seen by EMS is not an issue,

the jail should be making a decision on admitting the patient on their

assessment at booking weather or not they were seen by EMS.

AJL

Gene,

Does this also apply if the refusal document is seperate and not a part of

the patient care report? Our signature form, which includes a refusal

section, contains no patient assessment information.

We've encountered situations similar to the one described in the original

message. We've had DPS Troopers tell us that the jail won't accept the

prisoner unless they can show that he was seen by EMS and refused transport.

We've butted heads with Troopers in the past and will continue to do in the

future if necessary. We've also been told by local PD personnel that the

county jail won't accept prisoners who have any kind of medical complaint or

injury unless they can show that the prisoner has already been evaluated by

medical (EMS) personnel. Of course, this is a bit of a different situation

when the prisoner has a specific medical conplaint or condition and the

information will be going to medical personnel at the jail who will be

responsible for following up on the prisoner's condition or medical care.

We've encoutered this often enough that I've considered keeping some of our

HIPAA release forms on the ambulances or developing another form (like we

don't have enough paperwork already)specifically for these situations that

says something like " Officer abc of xyz agency has requested copies of EMS

records regarding service provided to me on ___date at ___location. I

understand that these records may contain information that is considered

confidential and protected under state and federal laws. I also understand

that copies may be given to Officer abc personally or may be faxed to

such-and-such facility. " , and which would have a place for the patient's

signature and a witness signature (other than the officer making the

request).

Any thoughts?

Maxine Pate

hire-Pattison EMS

>

>

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Ok as someone who has worked as a jailer and an emt...

On the jail side: the receiving jail personnel have the authority to not take in

an inmate until the incoming inmate has received medical treatment. It is the

responsibility of the arresting officer to take inmate to a medical facility and

have treatment rendered. It is no longer an option for the inmate to refuse

medical treatment due to his status as an in custody prisoner, ie prisoners lose

some right to self control and the right to refuse medical treatment. (this is

why you can have an officer arrest someone who a danger to themselves or an

attempted suicide for medical treatment). Texas has several laws pertaining to

this. If the prisoners condition is of an emergent nature then EMS can and will

be summoned to the jail facility and the prisoner has no right to refuse medical

service. If the prisoner is not emergent then it is the responsibility of the

officer to take the prisoner to a medical facility.The arresting agency is

responsible for the bill for the check up

and any treatment subsequent to an incustody check up. In either case a DOCTOR

must issue some type of document for the jail medical file on the prisoner as to

situation or injuries, diagnosis and medication if any exist. There is nothing

to say what this document may be, so it can be as simple as the note for a child

returning to school, a work excuse or a more formal document. This goes in the

prisoner medical file which the state says EVERY prisoner must have on intake to

a jail facility. It is to be made available and transported with the prisoner on

any facility transfer or be on premises with prisoner at the incarcerating

facility.Even so this file falls under HIPAA protocols.

Now as to what the officer does on scene prior to taking a person into

custody... well with what I just said about the officer needing a refusal... he

doesnt. Even if the person refused ems at the scene, when he gets to the jail he

maybe taken to a ED or ems called again. Either way the trooper or officer is

going to be sitting in a chair in the ED waiting. What the arresting officer is

doing in this type of senario is to cut down his time doing reports or waiting

on a prisoner.

As for a jail requiring a refusal... hog wash. It would only lengthen the paper

trail the intake facility has to put up with, and be useless because they will

decide who needs medical care on intake, refusal or not. Once that person gets

to the jail its a mute point.

Another thing to consider is the age old... " your going with me or them "

situation. For the officer its again more paperwork if the prisoner goes with

him when he gets to the jail... so having the extra work from putting up with a

trip to the ED and explain the extra cost to his agency for the trip... well you

get the picture. They try to bluff around it all.

Alan Lambert wrote: I dont

think that your HIPAA release form idea will work. First the request

should go through your agencies privacy officer. Secondly why would someone

sign such a form knowing that it will get them into jail faster?

This really isnt a HIPAA issue its much bigger.

As far as the trooper having a problem getting the prisoner admitted to the

jail its a problem between DPS and the local jail - why get involved in

their fight. Weather or not the prisoner was seen by EMS is not an issue,

the jail should be making a decision on admitting the patient on their

assessment at booking weather or not they were seen by EMS.

AJL

Gene,

Does this also apply if the refusal document is seperate and not a part of

the patient care report? Our signature form, which includes a refusal

section, contains no patient assessment information.

We've encountered situations similar to the one described in the original

message. We've had DPS Troopers tell us that the jail won't accept the

prisoner unless they can show that he was seen by EMS and refused transport.

We've butted heads with Troopers in the past and will continue to do in the

future if necessary. We've also been told by local PD personnel that the

county jail won't accept prisoners who have any kind of medical complaint or

injury unless they can show that the prisoner has already been evaluated by

medical (EMS) personnel. Of course, this is a bit of a different situation

when the prisoner has a specific medical conplaint or condition and the

information will be going to medical personnel at the jail who will be

responsible for following up on the prisoner's condition or medical care.

We've encoutered this often enough that I've considered keeping some of our

HIPAA release forms on the ambulances or developing another form (like we

don't have enough paperwork already)specifically for these situations that

says something like " Officer abc of xyz agency has requested copies of EMS

records regarding service provided to me on ___date at ___location. I

understand that these records may contain information that is considered

confidential and protected under state and federal laws. I also understand

that copies may be given to Officer abc personally or may be faxed to

such-and-such facility. " , and which would have a place for the patient's

signature and a witness signature (other than the officer making the

request).

Any thoughts?

Maxine Pate

hire-Pattison EMS

>

>

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Guest guest

And this is why in texas EVERYONE carries a gun but only we carry the bandaids

;)

lnmolino@... wrote:

In a message dated 6/2/2007 4:38:26 P.M. Central Daylight Time,

west_tx_firefighter@... writes:

Ahh and sometimes it is nice to watch a trooper squirm... opps did I say

that!

No no I recant... we must have good relations with all agencies.

Ah but a long long long time ago in a land not much unlike Texas (more alike

then either land would like to admit) I learned from a wise old fire

Chief/Paramedic type (yea we had both too) that in the land of milk and honey

where

agencies get into arguments in the street the guy with the gun ALWAYS wins at

least the first round.

Louis N. Molino, Sr., CET

FF/NREMT-B/FSI/EMSI

Freelance Consultant/Trainer/Author/Journalist/Fire Protection Consultant

LNMolino@...

(Cell Phone)

(IFW/TFW/FSS Office)

(IFW/TFW/FSS Fax)

" A Texan with a Jersey Attitude "

" Great minds discuss ideas; Average minds discuss events; Small minds

discuss people " Eleanor Roosevelt - US diplomat & reformer (1884 - 1962)

The comments contained in this E-mail are the opinions of the author and the

author alone. I in no way ever intend to speak for any person or

organization that I am in any way whatsoever involved or associated with

unless I

specifically state that I am doing so. Further this E-mail is intended only

for its

stated recipient and may contain private and or confidential materials

retransmission is strictly prohibited unless placed in the public domain by

the

original author.

************************************** See what's free at http://www.aol.com.

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Guest guest

>

> Gene,

>

> Does this also apply if the refusal document is seperate and not a part of

> the patient care report? Our signature form, which includes a refusal section,

> contains no patient assessment information.

>

> Yep. Patient care information is patient care information. The definition

is " individually identifiable health information. " So a refusal is a part

of the patient files and cannot be separated.

> We've encountered situations similar to the one described in the original

> message. We've had DPS Troopers tell us that the jail won't accept the

> prisoner unless they can show that he was seen by EMS and refused transport.

We've

> butted heads with Troopers in the past and will continue to do in the future

> if necessary. We've also been told by local PD personnel that the county jail

> won't accept prisoners who have any kind of medical complaint or injury

> unless they can show that the prisoner has already been evaluated by medical

(EMS)

> personnel. Of course, this is a bit of a different situation when the

> prisoner has a specific medical conplaint or condition and the information

will be

> going to medical personnel at the jail who will be responsible for following

> up on the prisoner's condition or medical care.

>

The Sheriff's criteria for accepting prisoners into the jail has nothing to

do with release of protected health information. The Sheriff can make any

kind of rules he wants to, but he doesn't control the information that is

released.

What the Troopers want and need is has nothing to do with what HPAA allows a

healthcare provider to do unless their need for information falls within the

narrow categories that define when PHI can be released to LE.

If the jail refuses to accept a prisoner without a refusal of care from EMS,

then it is the JAIL, not the Trooper, that should request the information, and

then it's " iffy " as to what can be released.

Protected Health Information (PHI) can only be released to persons involved

in continuing patient care, among other things not related to this question.

If the jail is not going to be a healthcare provider, then HIPAA prevents the

release of PHI to jail personnel.

Healthcare providers have no obligation to make life easier for either cops,

Troopers, or Jail people. HIPAA doesn't make those divisions.

HIPAA says that, as a covered healthcare provider, you cannot release PHI

without authorization in writing from the patient or his representative, unless

the situation is covered under one of the exceptions to the rule.

Jail admissions criteria do not, as far as I can see, fall within one of the

exceptions.

So you cannot disclose patient refusal forms unless the patient authorizes it

in writing. You cannot honor a requst from a DPS Trooper for protected

information unless he or she can show that the information is necessary for an

emergency situation. Booking into a jail is not an emergency situation.

GG

>

> We've encoutered this often enough that I've considered keeping some of our

> HIPAA release forms on the ambulances or developing another form (like we

> don't have enough paperwork already)specificall We've encoutered this often

> enough that I've considered keeping some of our HIPAA release forms on the

> ambulances or developing another form (like we don't have enough paperwork

> already)specificall<wbr>y for these situations that says something like

" Officer abc

> of xyz agency has requested copies of EMS records regarding service provided

> to me on ___date at ___location. I understand that these records may contain

> information that is considered confidential and protected under state and

> federal laws. I also understand that copies may be

>

> Any thoughts?

>

> Maxine Pate

> hire-Pattison EMS

>

> ---- Original message ----

> >Date: Sat, 2 Jun 2007 00:13:27 EDT

> >From: wegandy1938@wegandy

> >Subject: Re: HIPAA?

> >To: lcambulance@lcambulance, texasems-l@yahoogrotexasem

> >

> > They do not need a copy of the refusal, and they are

> > not entitled to a copy

> > of the refusal except under subpoena.

> >

> > The decision to request the information through

> > subpoena will have to come

> > from somebody above the level of Trooper.

> >

> > Release of the refusal document without either a

> > subpoena or the patient's

> > authorization in writing will constitute a HIPAA

> > violation.

> >

> > Gene G.

> > In a message dated 6/1/07 2:47:31 PM,

> > lcambulance@lcambulance writes:

> >

> > >

> > > They already have all that information. They have

> > his name address age the

> > > fact that an ambulance was dispatched to the scene

> > and that the patient

> > > refused transport is on the radio log that is at

> > the county dispatcher which

> > > does the dispatching for the trooper, the

> > sheriff's department (which would

> > > be housing this patient) and the ambulance. So if

> > they have all this

> > > information why do they need a copy of our

> > refusal?

> > >

> > > Debbie

> > >

> > > Re: HIPAA?

> > >

> > > Whether you give it to the trooper or the jail,

> > it's the same thing. They

> > > already have the patient's personal information,

> > they just need it to show

> > > the called the ambulance to check out the patient.

> > I do not believe you'd

> > > be violating HIPAA.

> > > Salvador Capuchino Jr

> > > EMT-Paramedic

> > >

> > > Re: HIPAA?

> > >

> > > HIPAA provides for the disclosure of the patient's

> > name and PHI to CDC or

> > > other appropriate public health agencies.

> > >

> > > What they do with the information is governed by

> > their policies and

> > > procedures.

> > >

> > > Gene

> > > In a message dated 5/31/07 4:32:50 PM,

> > slemming@...@c writes:

> > >

> > > >

> > > > So now that they released the name of the

> > Atlanta Lawyer that

> > > > potentially exposed passengers on two overseas

> > flights it begs the

> > > > question, do the potential exposures warrant

> > releasing the name of the

> > > > patient?

> > > >

> > > > Would it not suffice to say that if you were on

> > plane X and Y contact

> > > > the CDC or local health department for testing?

> > Seems like unnecessary

> > > > exposure including the point that his

> > father-in-law works in TB for the

> > > > CDC.

> > > >

> > > > Gene, want to jump in?

> > > >

> > > > Lt. Steve Lemming, AAS, LP

> > > > EMS Administration Officer

> > > > C-Shift

> > > > Azle, Texas Fire Department

> > > >

> > > > This e-mail is confidential and intended solely

> > for the use of the

> > > > individual (s) to whom it is addressed. Any

> > views or opinions presented

> > > > are solely those of the author and do not

> > necessarily represent those of

> > > > The City of Azle or its policies. If you have

> > received this e-mail

> > > > message in error, please phone Steve Lemming

> > (817)444-7108. Please also

> > > > destroy and delete the message from your

> > computer.

> > > >

> > > > For more information on The City of Azle, visit

> > our web site at:

> > > > <http://azle.http://azle.<w>

> > > >

> > > >

> > > > [Non-text portions of this message have been

> > removed]

> > > >

> > > >

> > > >

> > >

> > > ************ ******** ******** *******

> > > See what's free at http://www.aol.http

> > >

> > > [Non-text portions of this message have been

> > removed]

> > >

> > >

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Guest guest

Agree.

GG

>

> I dont think that your HIPAA release form idea will work. First the request

> should go through your agencies privacy officer. Secondly why would someone

> sign such a form knowing that it will get them into jail faster?

>

> This really isnt a HIPAA issue its much bigger.

>

> As far as the trooper having a problem getting the prisoner admitted to the

> jail its a problem between DPS and the local jail - why get involved in

> their fight. Weather or not the prisoner was seen by EMS is not an issue,

> the jail should be making a decision on admitting the patient on their

> assessment at booking weather or not they were seen by EMS.

>

> AJL

>

>

>

> Gene,

>

> Does this also apply if the refusal document is seperate and not a part of

> the patient care report? Our signature form, which includes a refusal

> section, contains no patient assessment information.

>

> We've encountered situations similar to the one described in the original

> message. We've had DPS Troopers tell us that the jail won't accept the

> prisoner unless they can show that he was seen by EMS and refused transport.

> We've butted heads with Troopers in the past and will continue to do in the

> future if necessary. We've also been told by local PD personnel that the

> county jail won't accept prisoners who have any kind of medical complaint or

> injury unless they can show that the prisoner has already been evaluated by

> medical (EMS) personnel. Of course, this is a bit of a different situation

> when the prisoner has a specific medical conplaint or condition and the

> information will be going to medical personnel at the jail who will be

> responsible for following up on the prisoner's condition or medical care.

>

> We've encoutered this often enough that I've considered keeping some of our

> HIPAA release forms on the ambulances or developing another form (like we

> don't have enough paperwork already)specificall don't have enough paperwor

> says something like " Officer abc of xyz agency has requested copies of EMS

> records regarding service provided to me on ___date at ___location. I

> understand that these records may contain information that is considered

> confidential and protected under state and federal laws. I also understand

> that copies may be given to Officer abc personally or may be faxed to

> such-and-such facility. " , and which would have a place for the patient's

> signature and a witness signature (other than the officer making the

> request).

>

> Any thoughts?

>

> Maxine Pate

> hire-Pattison EMS

>

> >

> >

>

>

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Guest guest

You say that a prisoner cannot refuse medical treatment. The Texas

Aministrative Code says that he can. Am I missing something? Can you refer us

to the laws that support your position?

Maxine Pate

Texas Administrative Code

TITLE 37 PUBLIC SAFETY AND CORRECTIONS

PART 9 TEXAS COMMISSION ON JAIL STANDARDS

CHAPTER 273 HEALTH SERVICES

RULE §273.2 Health Services Plan

Each facility shall have and implement a written plan, approved by the

Commission, for inmate medical, mental, and dental services. The plan shall:

(8) provide procedures for the rights of inmates to refuse health care in

accordance with informed consent standards for certain treatments and procedures

(in the case of minors, the informed consent of a parent, guardian, or legal

custodian, when required, shall be sufficient);

---- Original message ----

>Date: Sat, 2 Jun 2007 15:05:30 -0700 (PDT)

>

>Subject: Re: HIPAA?

>To: texasems-l

>

> Ok as someone who has worked as a jailer and an

> emt...

> It is no longer an option for the inmate

> to refuse medical treatment due to his status as an

> in custody prisoner, ie prisoners lose some right to

> self control and the right to refuse medical

> treatment.

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Guest guest

" An inmate may refuse treatment or certain procedures " but cannot refuse to be

evaluated for any injury or illness that may present a danger to himself or

others in a facility.

I should have stated that better. There is a distinction between a person in

custody and being placed in a jail and a regular inmate. At the time of arrest

and booking a person does not have the right to refuse an evaluation.

TITLE 37PUBLIC SAFETY AND CORRECTIONS PART 9TEXAS COMMISSION ON JAIL STANDARDS

CHAPTER 271CLASSIFICATION AND SEPARATION OF INMATES RULE §271.1Objective

Classification Plan

---------------------------------

(B) The following classification procedures shall be conducted utilizing the

approved classification instruments.

(1) Intake Screening. To be completed immediately on all inmates admitted for

purposes of identifying any medical, mental health or other special needs that

require placing inmates in special housing units;

(2) Initial Custody Assessment. To be completed on all newly admitted inmates

prior to housing assignments to determine custody levels.

TITLE 37PUBLIC SAFETY AND CORRECTIONS PART 9TEXAS COMMISSION ON JAIL STANDARDS

CHAPTER 265ADMISSION RULE §265.12Communicable Disease

---------------------------------

Inmates suspected of having a reportable communicable disease shall be

isolated and immediate arrangements made for the inmate's transfer to a facility

equipped to handle the suspected disease, unless the admitting facility can

safely and effectively segregate and maintain a medically prescribed course of

treatment.

After that initial point, an inmates right to refuse medical services are still

limited to what may constitute a danger to the regular population of the

facility ie he can refuse going to a dentist for a check up but not refuse

screening for TB.

There is the word " certain " that is left up to interpretation.

hire-Pattison EMS wrote:

You say that a prisoner cannot refuse medical treatment. The Texas

Aministrative Code says that he can. Am I missing something? Can you refer us

to the laws that support your position?

Maxine Pate

Texas Administrative Code

TITLE 37 PUBLIC SAFETY AND CORRECTIONS

PART 9 TEXAS COMMISSION ON JAIL STANDARDS

CHAPTER 273 HEALTH SERVICES

RULE §273.2 Health Services Plan

Each facility shall have and implement a written plan, approved by the

Commission, for inmate medical, mental, and dental services. The plan shall:

(8) provide procedures for the rights of inmates to refuse health care in

accordance with informed consent standards for certain treatments and procedures

(in the case of minors, the informed consent of a parent, guardian, or legal

custodian, when required, shall be sufficient);

---- Original message ----

>Date: Sat, 2 Jun 2007 15:05:30 -0700 (PDT)

>

>Subject: Re: HIPAA?

>To: texasems-l

>

> Ok as someone who has worked as a jailer and an

> emt...

> It is no longer an option for the inmate

> to refuse medical treatment due to his status as an

> in custody prisoner, ie prisoners lose some right to

> self control and the right to refuse medical

> treatment.

---------------------------------

Now that's room service! Choose from over 150,000 hotels

in 45,000 destinations on Yahoo! Travel to find your fit.

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Guest guest

Matters of consent and refusal and HPAA compliance are two different issues.

As far as HIPAA is concerned, If the patient is an inmate of a correctional

institution or under the custody of a law enforcement official, you may release

your PHI to the correctional institution or law enforcement official under

specific circumstances such as (1) for the institution to provide the inmate

with health care; (2) to protect the inmate's health and safety or the health

and

safety of others; or (3) for the safety and security of the correctional

institution.

Regarding an inmate's right to refuse medical care, it is not an unqualified

right. The Supreme Court has adopted a rule which balances the inmate's

rights against the necessities of the custodial institution, other prisoners,

and

the interests of the state in preserving the inmate's health.

For an excellent article on the subject see:

http://www.ncchc.org/pubs/CC/legal_refusal.html

Gene Gandy

Return to Top

> So, if I get called to the police department for a sick call in the jail

> section, can the patient refuse treatment even if he is in custody?   vice

> versa, if the patient wants to go to the hospital, can PD deny this because

> the patient is in their custody? and can PD request the copy of the PCR or

> does the patient have to release a waiver giving PD right to copy of the

> PCR.

>

> I read these codes but to my understanding a patient has the right in

> custody or not to request what hospital he wants to go to and when.  Correct

> me if Im wrong.

>

>

>

>

> >

> >Reply-To: texasems-l

> >To: texasems-l

> >Subject: Re: HIPAA?

> >Date: Sun, 3 Jun 2007 03:27:01 -0700 (PDT)

> >

> > " An inmate may refuse treatment or certain procedures " but cannot refuse to

> >be evaluated for any injury or illness that may present a danger to himself

> >or others in a facility.

> >

> >I should have stated that better. There is a distinction between a person

> >in custody and being placed in a jail and a regular inmate. At the time of

> >arrest and booking a person does not have the right to refuse an

> >evaluation.

> >

> >TITLE 37PUBLIC SAFETY AND CORRECTIONS   PART 9TEXAS COMMISSION ON JAIL

> >STANDARDS   CHAPTER 271CLASSIFICATION AND SEPARATION OF INMATES   RULE

> >§271.1Objective Classification Plan

> >---------------------------------

> >

> >

> >(B) The following classification procedures shall be conducted  utilizing

> >the approved classification instruments.

> >

> >

> >(1) Intake Screening. To be completed immediately on all inmates  admitted

> >for purposes of identifying any medical, mental health or other special 

> >needs that require placing inmates in special housing units;

> >

> >

> >  (2) Initial Custody Assessment. To be completed on all  newly admitted

> >inmates prior to housing assignments to determine custody levels.

> >

> >TITLE 37PUBLIC SAFETY AND CORRECTIONS   PART 9TEXAS COMMISSION ON JAIL

> >STANDARDS   CHAPTER 265ADMISSION   RULE §265.12Communicable Disease

> >---------------------------------

> >    Inmates suspected of having a reportable communicable disease shall be

> >isolated and immediate arrangements made for the inmate's transfer to a

> >facility equipped to handle the suspected disease, unless the admitting

> >facility can safely and effectively segregate and maintain a medically

> >prescribed course of treatment.

> >

> >

> >After that initial point, an inmates right to refuse medical services are

> >still limited to what may constitute a danger to the regular population of

> >the facility ie he can refuse going to a dentist for a check up but not

> >refuse screening  for TB.

> >

> >There is the word " certain " that is left up to interpretation.

> >

> >hire-Pattison EMS wrote:             

      

> >              You say that a prisoner cannot refuse medical

treatment.  The

> >Texas Aministrative Code says that he can.  Am I missing something?  Can

> >you refer us to the laws that support your position?

> >

> >  Maxine Pate

> >

> >

> >  Texas Administrative Code

> >

> >  TITLE 37 PUBLIC SAFETY AND CORRECTIONS

> >  PART 9 TEXAS COMMISSION ON JAIL STANDARDS

> >  CHAPTER 273 HEALTH SERVICES

> >  RULE §273.2 Health Services Plan

> >

> >  Each facility shall have and implement a written plan, approved by the

> >Commission, for inmate medical, mental, and dental services. The plan

> >shall:

> >

> >  (8) provide procedures for the rights of inmates to refuse health care in

> >accordance with informed consent standards for certain treatments and

> >procedures (in the case of minors, the informed consent of a parent,

> >guardian, or legal custodian, when required, shall be sufficient);

> >

> >  ---- Original message ----

> >  >Date: Sat, 2 Jun 2007 15:05:30 -0700 (PDT)

> >  >

> >  >Subject: Re: HIPAA?

> >  >To: texasems-l

> >  >

> >  >   Ok as someone who has worked as a jailer and an

> >  >   emt...

> >

> >  >   It is no longer an option for the inmate

> >  >   to refuse medical treatment due to his status as an

> >  >   in custody prisoner, ie prisoners lose some right to

> >  >   self control and the right to refuse medical

> >  >   treatment.

> >

> >

> >

> >

> >

> >---------------------------------

> >Now that's room service! Choose from over 150,000 hotels

> >in 45,000 destinations on Yahoo! Travel to find your fit.

> >

> >

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Guest guest

So, if I get called to the police department for a sick call in the jail

section, can the patient refuse treatment even if he is in custody? vice

versa, if the patient wants to go to the hospital, can PD deny this because

the patient is in their custody? and can PD request the copy of the PCR or

does the patient have to release a waiver giving PD right to copy of the

PCR.

I read these codes but to my understanding a patient has the right in

custody or not to request what hospital he wants to go to and when. Correct

me if Im wrong.

>

>Reply-To: texasems-l

>To: texasems-l

>Subject: Re: HIPAA?

>Date: Sun, 3 Jun 2007 03:27:01 -0700 (PDT)

>

> " An inmate may refuse treatment or certain procedures " but cannot refuse to

>be evaluated for any injury or illness that may present a danger to himself

>or others in a facility.

>

>I should have stated that better. There is a distinction between a person

>in custody and being placed in a jail and a regular inmate. At the time of

>arrest and booking a person does not have the right to refuse an

>evaluation.

>

>TITLE 37PUBLIC SAFETY AND CORRECTIONS PART 9TEXAS COMMISSION ON JAIL

>STANDARDS CHAPTER 271CLASSIFICATION AND SEPARATION OF INMATES RULE

>§271.1Objective Classification Plan

>---------------------------------

>

>

>(B) The following classification procedures shall be conducted utilizing

>the approved classification instruments.

>

>

>(1) Intake Screening. To be completed immediately on all inmates admitted

>for purposes of identifying any medical, mental health or other special

>needs that require placing inmates in special housing units;

>

>

> (2) Initial Custody Assessment. To be completed on all newly admitted

>inmates prior to housing assignments to determine custody levels.

>

>TITLE 37PUBLIC SAFETY AND CORRECTIONS PART 9TEXAS COMMISSION ON JAIL

>STANDARDS CHAPTER 265ADMISSION RULE §265.12Communicable Disease

>---------------------------------

> Inmates suspected of having a reportable communicable disease shall be

>isolated and immediate arrangements made for the inmate's transfer to a

>facility equipped to handle the suspected disease, unless the admitting

>facility can safely and effectively segregate and maintain a medically

>prescribed course of treatment.

>

>

>After that initial point, an inmates right to refuse medical services are

>still limited to what may constitute a danger to the regular population of

>the facility ie he can refuse going to a dentist for a check up but not

>refuse screening for TB.

>

>There is the word " certain " that is left up to interpretation.

>

>hire-Pattison EMS wrote:

> You say that a prisoner cannot refuse medical treatment. The

>Texas Aministrative Code says that he can. Am I missing something? Can

>you refer us to the laws that support your position?

>

> Maxine Pate

>

>

> Texas Administrative Code

>

> TITLE 37 PUBLIC SAFETY AND CORRECTIONS

> PART 9 TEXAS COMMISSION ON JAIL STANDARDS

> CHAPTER 273 HEALTH SERVICES

> RULE §273.2 Health Services Plan

>

> Each facility shall have and implement a written plan, approved by the

>Commission, for inmate medical, mental, and dental services. The plan

>shall:

>

> (8) provide procedures for the rights of inmates to refuse health care in

>accordance with informed consent standards for certain treatments and

>procedures (in the case of minors, the informed consent of a parent,

>guardian, or legal custodian, when required, shall be sufficient);

>

> ---- Original message ----

> >Date: Sat, 2 Jun 2007 15:05:30 -0700 (PDT)

> >

> >Subject: Re: HIPAA?

> >To: texasems-l

> >

> > Ok as someone who has worked as a jailer and an

> > emt...

>

> > It is no longer an option for the inmate

> > to refuse medical treatment due to his status as an

> > in custody prisoner, ie prisoners lose some right to

> > self control and the right to refuse medical

> > treatment.

>

>

>

>

>

>---------------------------------

>Now that's room service! Choose from over 150,000 hotels

>in 45,000 destinations on Yahoo! Travel to find your fit.

>

>

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Guest guest

An inmate (pretrial at the county jail - their are different standards for

convicted inmates in state prisons) can refuse any treatment at the jail

facility. However transportation to a hospital for a medical exam by a

physician is not treatment in itself and generally cannot be refused. This

includes medication that will improve the mental health of the inmate so

he/she can be fit to go to trial. A physican outside of the jail

facility can force treatment if the patient is not competent. However their

are ecceptions for mental health conditions.

There is currently a case in Federal court that may overturn this but

pretrial motions are still being appealed. This pretrial inmate is

knowingly refusing medication to make him compentent to stand trial and so

far the courts have ruled in his favor.

The PCR is like any paperwork that contains PHI, it needs to be treated like

any other document that is being requested. ***end of story period, just

because law enforcement is involved it dose not change anything*** The man

with the gun may intimidate you to get his way but it is still a violation

of the HIPAA privacy rule.

AJL

>

> So, if I get called to the police department for a sick call in the jail

> section, can the patient refuse treatment even if he is in custody? vice

> versa, if the patient wants to go to the hospital, can PD deny this

> because

> the patient is in their custody? and can PD request the copy of the PCR or

> does the patient have to release a waiver giving PD right to copy of the

> PCR.

>

> I read these codes but to my understanding a patient has the right in

> custody or not to request what hospital he wants to go to and

> when. Correct

> me if Im wrong.

>

>

>

>

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