When HIPPA was passed by the Senate and House of Representatives and signed into law by the President, there was one aim and that was to protect the privacy of patients’ information that might be transmitted over the internet or faxed.  The law clearly states that any patient information transmitted or transferred through an electrical process (fax or internet) is protected by federal law. 

In our litigious society, all health care professionals panicked.  An extremely restrictive interpretation of the HIPPA law was taken.  As a natural consequence, the hyper-protective process was set into place regarding any health information because no one wanted to be the first person or agency or hospital to be sued.  The courts had not yet interpreted this law; and therefore the medical and health care profession wanted to be sure that they were covered.

Sometimes people ask us why The Special Gathering does advocacy.  We are a ministry within the mentally challenged community.  We do classic ministry, evangelism and discipleship.  Why do we extend ourselves in this direction?  It is because much of the lives of our members is involved with the State.   After a state or federal law is passed then it must be interpreted by the courts.  There are many unintended consequences to each law. 

Even after a law is set into motion, the state agencies must write rules which will implement this law.  Again, an array of unintended consequences.  The state and federal politicians, many of whom are lawyers, have a hard time remembering and understanding what a simple law may become.  How is it possible for a family member or a person who is developmentally delayed to understand and to remember the myriad of rules and regulation which control her lives.

This information was passed on to me through our blogsite from the APD State office.  It contains the rules that will be used by APD to help keep costs down for people who are living in their own apartments.  After almost an hour of trying to cut and paste this document onto the blogsite, I give up.  Here is the address that you can use to access it. 

http://apd.myflorida.com/customers/living/docs/apd-17-001.pdf

Whether you are a parent or professional, I believe this is an important document for you to read and keep.

We’ve all seen the ways that HIPPA has changed our lives.  What are some of the unintended consequences to actions taken in your life?  What about your members?  What actions changed your members’ lives and made them better people?

The Local Advocacy Council and the Statewide Advocacy Council consists of gubernatorial appointees who function as “guardians of the public trust to safeguard the health, safety, welfare and rights of the clients of those programs and services provided by the State of Florida health and human services delivery system from conditions or individuals that constitute a threat to our clients’ civil and human rights” (www.floridasac.org).  

With the advent of HIPPA, the State of Florida took the stand that LAC/SAC could no longer have access to the records of clients of Children and Family Services even though LAC/SAC functions under  Section 402.164 – 167, Florida Statutes. 

For more than four years, DCF and SAC/LAC have worked to hammer out an agreement to allow SAC/LAC access to client records.  FINALLY, an agreement has been reached.  Below is the Inter-Agency Agreement.  Here are the interesting observations of a former LAC chairperson regarding the content of this agreement. 

E-mail from former LAC chairperson:

The first paragraph talks A LOT about what I read as easy terms to terminate the agreement. Contrast this to before (HIPPA) when access was a matter of Florida statue.  Some thoughts:

  • “Contract must be reviewed annually by all parties.” Wonder what that will be like after a year of REAL investigations where LAC makes someone really angry on the state side of things through a thorny investigation?  Still, could be fun for a year for those on the LAC!
  • (I’m paraphrasing because the doc was a picture and not a text file, so bear with me.) “Neither party shall unilaterally terminate the agreement over an access issue…without first trying to reconcile.” Now that sounds interesting.  MAYBE READ:  “Make them shut up (over an investigation) or we tear this agreement up, NOW.”
  • Most of the Designated Points of Contact causes me no difficulties personally.  “The (LAC) designated point of contact shall notify the SAC designated contact regarding any record access or monitoring issues.” If this means you have to go to the SAC rep, which we know is at this point in history a DCF stooge, it could be…problematic.
  • It’s not access if you have to go to the LAC designee who has to relay your records’ request to the SAC designee who has to relay your request to the DCF designee for records access.  Or even if you cut out the SAC designee,  this is not spontaneious access that prevents “cooking the books.” And that is how I read the 4th paragraph down under “Designated Point of Cotnact.”
  • “SAC/LAC will in a timely fashion notify DCF of dates/times of all meetings. ”  Why?  Will DCF try to attend closed session?
  • Nothing else is really worrisome and reads as a fair agreement, if you can get past the above bullets.

 

INTER-AGENCY AGREEMENT

STATEWIDE ADVOCACY COUNCIL (SAC) AND LOCAL ADVOCACY COUNCIL (LAC)

WITH DEPARTMENT OF CHILDREN AND FAMILY SERVICES (DCF)

This agreement has been entered into for purposes of implementing the provisions of sections 402.164 through 402.167, Florida Statutes, 2007, and to permit disclosure of authorized client record by the Department of Children and Families (DCF) to whereby the SAC/LAC may monitor services and investigate claims in in order to safeguard the health, safety and welfare of consumers of services provided by DCF.

This Agreement shall be effective upon the date of execution by the parties, and is subject to renewal annually by formal execution of the parties, unless otherwise terminated by the parties prior to that date. Neither party shall unilaterally terminate this agreement due to an issue over access to records without first attempting to resolve the issue through the dispute resolution process contained in this agreement.

By entering into this agreement, DCF and SAC/LAC agree to the following:

DESIGNATED POINTS OF CONTACT PRESENCE AT LAC MEETINGS

The SAC executive Director, or his/her designee, shall serve as the administrative point of contact for any issues involving this Agreement.

Within 30 days of the effective date of this agreement, SAC/LAC shall designate staff within the various LAC Service Areas that will serve as point of contact for record access or monitoring issues that arise within those services areas during the course of their investigations.  The designated points of contact will notify the SAC Executive Director, or designee, regarding any record access or monitoring issues.

Within 30 days of the effective date of this agreement, DCF shall designate employees within the various DCF Circuits that will serve as points of contact for record access or monitoring issues that arise within those circuits during the course of SAC/LAC investigations.  The designated point of contact will notify the DCF administrative point(s) of contact regarding any record access or monitoring issues.

SAC/LAC will immediately inform DCF through the designated points of contact of any changes in council membership.

SAC/LAC will timely notify the designate DCF points of contact regarding the times and pace of all LAC meetings.  SAC/LAC, through the DCF designated points of contact may request DCF attendance and participation at any SAC/LAC meeting.

ACCESS TO RECORDS

The parties mutually agree that DCF shall retain all ownership rights to records and data referred to in this Agreement, and that disclosure or release of such date to the SAC/LAC for purposes of complying with this Agreement shall not diminish or change such ownership rights.

The Department shall disclose and the SAC/LAC shall have access to Medicaid, personal health information, or other confidential information as is necessary for the SAC/LAC to undertake the responsibilities as set forth in Florida Statutes 402.164-402.167.

And request by SCA/LAC for records or date involving individuals who are or have been receiving services from DCF will comply with SAC/LAC procedures and will adhere to applicable state and federal laws and regulations.  When laws and regulations require the SAC/LAC to obtain a written release for access to confidential client information, DCF will assist SAC/LAC in obtaining the necessary release to the degree allowed by applicable state and federal laws and regulations.

When requesting record from DCF, SAC/LAC shall inform the Department of the following:

A.     The Nature of the complaint.

B.     The source of the complaint upon which access is based (LAC Hotline, Governor’s complaint, or SAC/LAC Committee).

NOTIFICATION OF REPORTS OF ABUSE

SAC/LAC will receive notification of child and adult institutional abuse reports received by DCF, SAC/LAC will receive notification when DCF initially receives reports of abuse and neglect as well as timely notification of the final determinations (findings) once the investigation into the alleged abuse or neglect has been completed.

When providing the notifications to the SAC/LAC, DCF employees will use specified forms developed jointly by SAC/LAC and DCF (Attached).  In order to give sufficient information for SAC/LAC to determine whether or not to open an investigation, ALL information requested in the forms must be provided.

In order to ensure SAC/LAC continues to receive notifications of child and adult institutional abuse reports in the most timely and efficient manner, representative of SAC/LAC, as designated by the SAC Executive Director, and DCF, as designated by the Secretary of DCF, will meet both 4 months and 8 months from the effective date of this agreement, or as soon as possible thereafter, to explore possible options for improving the notification process.  Possible options to explore include, but are nto limited to, SAC/LAC receiving automatic notification from DCF’s existing child protection computer system (FSFN), as well as the possibility that specified SAC/LAC employees be given direct access to DCF’s system.

TRAINING

SAC/LAC shall ensure that members and staff are trained prior to nay investigation or monitoring activity.  Aspects of the training will include the following:

A.  state and federal confidentiality requirements;

B. the rights and responsibilities of DCF consumers and providers monitored by the various LAC councils;

C.  The requirements of this inter-agency agreement.

SAC/LAC shall ensure that member and staff sign the state confidentiality agreement once initial training on state and federal confidentiality requirements has been completed.

DCF shall ensure that DCF employees and providers are informed of the following:

A.   the existence of and role played by the SAC/LAC in protecting the rights of DCF consumers;

B.  the requirements of this inter-agency agreement.

At any time after the effective date of this agreement, the parties may work together on the training requirements included in this agreement.  In addition, both 4 months and 8 months from the effective date of this agreement, representatives of SAC/LAC, as designated by the SAC Executive Director, and DCF, as designated by the Secretary of DCF, shall jointly review all aspects of training required by this agreement in order to create and provide updated training for SAC/LAC members and DCF employees.  The updated training will include any new developments in confidentiality requirements, any possible improvements in the abuse and neglect notification process, and any other existing issues regarding the effective operation of this Inter-agency Agreement.

SAC/LAC INVESTIGATIONS AND NOTIFICATION OF FINDINGS/RECOMMENDATIONS

SAC/LAC shall notify the Agency of findings and recommendations within 30 days of the closing of any investigation or monitoring activity.

DISPUTE RESOLUTION PROCESS

SAC/LAC and DCF agree to attempt to resolve any disputes concerning this agreement, its terms and provisions at the DCF circuit level.  Disputes regarding this agreement shall initially be referred to the DCF circuit point of contact, and the LAC Service Area point of contact where the dispute arises.  If the issue remains unresolved at this level, the issue will be referred to the SAC Executive Director, or his/her designee, and the designated administrative point of contact at DCF Headquarters, for discussion and attempted resolution.  If the matter remains unresolved, it shall be referred to the Health and human Services Coordinator for the Governor’s Office of Policy and Budget for resolution.

SAC/LAC and DCF agree that petitioning of a court to resolve over access to information shall only be as of last resort and only after all other possible means of resolving the dispute have been attempted.  SAC/LAC and DCF agree that any petition of the courts by SAC/LAC regarding access to information held by DCF shall require notification and an opportunity for DCF to be heard by the court.  SAC/LAC agree to copy nay petition to the courts on the DCF administrative point of contact as well as the DCF circuit point of contact where the dispute arises.  SAC/LAC and CF agree that the Circuit Court of the Second Judicial District in and for Leon County, Florida, will have exclusive jurisdiction for any litigation arising out of or relating to this agreement.