Wednesday, August 10, 2016

[Imperial County] Grand jury report says county BHS lacks flexibility regarding records

The Imperial County grand jury conducted an annual investigation as part of common procedure to learn more about the activities from various county agencies and identify what they are doing successfully and what they can improve on.
Among the departments that were under review on this occasion was Imperial County Behavioral Health Services. The civil grand jury in its report states that law enforcement agencies have complained about getting information from ICBHS.
“Many complaints have been heard regarding the lack of cooperation from ICBHS when attempting to evaluate individuals for placement,” the report states. “...Refusal to share records limits their ability to assign the individual to the proper placement.”
ICBHS Director Michael Horn said he finds the complaints unfounded. Horn and the report say that the Health Insurance Portability and Accountability Act is very specific and does not allow the department to share any medical records without a signed waiver from the patient.
Horn said the civil grand jury did not provide any specific information on which agencies had expressed concern, dates for which records requests were submitted or any other details regarding requests from law enforcement agencies.
In order to access a patient’s records, the department needs a waiver signed by the patient or the person that has legal ownership of the records or a court order. Horn said that even acknowledging that an individual is a patient is a violation of HIPAA.
“We get audited by the state on this and there are substantial penalties for not complying with the law,” Horn said. “If we shared that information without going through the proper procedures, then no one would come to get treated.”
The CGJ met with staff from ICBHS on Jan. 20. In the report the grand jury states that it asked to see a waiver form signed by a patient who committed suicide and their request was refused.
“The law is very specific. If we show them the form, we’ve acknowledged someone is a patient and we would’ve already broken their confidentiality,” Horn said.
He added that probation officers and social workers who work a lot with the department are very good at going through the process of filing the necessary paperwork and getting the proper signatures to get access to the records. He said even in those instances the requests have to be specific as to what exactly is needed from a patient’s medical record history.
Another issue the CGJ pointed out in its report was that there appears to be a lack of understanding about the role and services ICBHS provides.
Horn said the department does meet regularly with the agencies that they work closely with including law enforcement, social services and school districts so that they are aware of the processes and procedures the department has in place which the department highlighted in their response to the CGJ findings.
Although it is not mentioned in the report, Horn said that they have previously been requested to provide services for individuals in jail, something that the department isn’t required to do and the funds the department receives from Medi-Cal precludes them to work with those patients. He said that individuals can’t be treated by ICBHS while they are in jail.
“We are not designed, required or funded to work with patients at the jail,” Horn said.
The third finding that the CGJ has in its report was that people who tried to reach the ICBHS 24-hour hotline were unable to contact anyone at various hours.
“That’s not true, the Civil Grand Jury never called that number or else we would have a record of that call,” Horn said. “That is something they were told, but we monitor that hotline to make sure it is getting answered.”
He said that staff periodically call the hotline at various hours to ensure that calls are being answered and added that the state also does the same and said that again they were not given details of when the calls that went unanswered were made and by whom they were made.
A written response within 90 days of the release of the report is required. Horn said that the department has already given that response highlighting what the department does in terms of outreach and clarifies some information that could’ve been misunderstood.
July 31, 2016
Imperial Valley Press
By Edwin Delgado

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