by Robert Avsec
How aware are you and the members of your department of the special needs population in your community? Before I go any further, let’s take a quick look at some of the special needs situations you are likely to encounter as you provide services in your community. You likely have people like this in your community:
• Those who do not speak English;
• Those who have mental or physical disabilities that affects their mobility;
• Those who are non-ambulatory and receiving home health care or hospice services;
• Those who are recovering from physical injuries, e.g., traumatic brain injuries, at home following rehabilitation; or
• Those who have stored oxygen and/or oxygen generating equipment in their home.
Now you likely know about situations like these, and others, in your service area. How? Well, you or other members may have already responded to an emergency at their home or they may be a friend or family member of one of your members. In the interest of ensuring that others in your department were aware of such a situation, you may have shared your experienced encounter with your co-workers or fellow members. No harm in that, right?
As a matter of fact, no! The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was enacted by the United States Congress and signed by President Bill Clinton in 1996. HIPAA gives the right to privacy to individuals from age 12 through 18. Any provider of health care services, including firefighters and EMS personnel, must have a signed disclosure from the affected party before giving out any information on provided health care to anyone, including parents.
A key provision of HIPAA that directly affect first responders is the Privacy Rule. The Privacy Rule protects all "individually identifiable health information" held or transmitted by a covered entity or its business associate, in any form or media, whether electronic, paper, or oral. The Privacy Rule calls this information "protected health information (PHI)." PHI is information, including demographic data, that relates to:
• The individual’s past, present or future physical or mental health or condition;
• The provision of health care to the individual; or
• The past, present, or future payment for the provision of health care to the individual; and
• That identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual. Individually identifiable health information includes many common identifiers (e.g., name, address, birth date, Social Security Number).
See Related: Summary of the HIPAA Privacy Rule
The challenge for any public safety agency is how to provide the best service possible to their citizens and comply with HIPAA requirements. One agency, the Emergency Communications 911 Center (ECC) in Chesterfield County, Virginia, has been using a process for many years now that helps the county’s public safety agencies to legally meet those challenges.
When public safety personnel become aware of a citizen with a special need or condition that information can be entered into the ECC’s Computer-Aided Dispatch System in the Premises Information Section as a Location Alert. When resources are dispatched to an emergency at an address with a Location Alert, the information from the Premises Information Section appears on the dispatch console display in the ECC and on the mobile data computers (MDC) of all units assigned to the call.
For special medical needs information to be entered into CADS, the citizen, or their legal guardian, must be the party that sends that information to the ECC for entry into CADS. Field providers give the non-emergency telephone number for the ECC to the citizen, or responsible party, and counsel them to contact the ECC directly about their need to have a Location Alert added for their address.
According to Ms. Pamela Cimburke, Programs Manager at Chesterfield 911, “The citizen provides the information that they want the field providers to know. Our CADS is protected from outside sources, so only public safety personnel have access to the information when we write the information to their call record.”
“We ask them [the requesting party] to send us a letter specifying the information that they want on file,” said Cimburke, “Once we have that letter in hand, we immediately enter the information into the Premises Information Section of CADS.”
Cimburke added, “Unless we hear otherwise from the requesting party, we keep that information in CADS for one year. Our Automation Analyst has the primary responsibility for reviewing, updating and/or purging premises information. When a location alert expires, we send a letter to the citizen asking them to update the need for the alert or to verify that we can purge it.”
As you can see, in the case of Chesterfield County’s ECC, it is possible to provide information on an address where a person with special needs resides AND still comply with the requirements of HIPAA. Here are some good ideas to improve upon a good idea:
• Put a link on your department’s website that people in your community can go to and learn about getting their address “put into your system” as an address where a person with special needs lives, and what those needs are, e.g., a person receiving home medical care with oxygen in the home.
• Place a link on your department’s Facebook Page that directs them to that page of information on your website. (You’ve got a Facebook Page, right?)
• If you’ve got a Facebook Page for your department, but not a website, add the information to your Facebook Page as a downloadable PDF file.
• Include a link on your website and Facebook Page where the public can download and/or print a form letter that lists all the information that they need to submit to your agency to get their address identified:
• Name of Person with the special need.
• Address and telephone number where that person resides.
• What is the special need that first responders should be aware of, e.g., a child with a chronic medical condition that requires specialized medical equipment in the home 24/7?
• Signature of that person or their legal guardian
• Mailing instructions, including address, for the person or their legal guardian to safely get the letter to your agency.
See Related Video: How to Set Up a Facebook Page for Your Organization
So what’s the procedure in your community? Now is the time to find out.