Client Advocacy: What to do When Your Clients HIV
Confidentiality or Testing Rights Have Been Violated 2013
Slide 3
2 Whos the Legal Action Center? Anti-Discrimination &
Privacy work: People with criminal records, alcohol/drug histories,
and/or HIV/AIDS Legal services & litigation Advice to providers
Trainings Policy advocacy & research
Slide 4
3 Free Legal Services Including HIV testing &
confidentiality Discrimination based on: HIV status Alcohol/drug
history Criminal record Rap sheet review and error correction
Certificates of Relief and Good Conduct Job & Housing
Discrimination
Slide 5
4 How to get help? Call the Legal Action Center 212-243-1313
800-223-4044 (toll-free) Clients: Ask for paralegal on call
Providers: Ask for attorney on call Monday Friday, 1 to 5 pm
Slide 6
5 This training has 3 parts: Part 1: Review of the Basics:
Fundamentals of New Yorks HIV Testing and Confidentiality Law
Assumes youve received overview before Part 2: Client Advocacy: HIV
Confidentiality or Testing Rights Violated by a Different Agency
Part 3: Client Advocacy: HIV Confidentiality or Testing Rights
Violated by Your Agency
Slide 7
6 Hand-outs PowerPoint Flow chart on NYS HIV confidentiality
law HIV/AIDS Testing, Confidentiality & Discrimination: What
You Need to Know About New York Law Two DOH Technical Assistance
bulletins on 2011 release forms DOH 2557 & 5032 DOH materials
about Art. 27F changes Sample Complaint narratives All are
available at
http://lac.org/index.php/lac/149#advocacyhttp://lac.org/index.php/lac/149#advocacy
More about Article 27-F amendments of 2010:
http://www.health.ny.gov/diseases/aids/testing
Slide 8
7 Part 1: Review of HIV Confidentiality & Testing
Basics
Slide 9
8 Review of the Basics HIV confidentiality
Slide 10
9 Relevant Laws Major Laws governing confidentiality of health
information and HIV related information: Federal Law: HIPAA (Health
Insurance Portability & Accountability Act) New York Law: NYS
Public Health Law, Article 27-F
Slide 11
10 HIPAA what is it? (cont.) Federal law that establishes
minimum safeguards to protect the privacy of medical records and
other personal health information (PHI). Applies to personal health
information no matter how it is shared: in electronic, written or
oral form.
Slide 12
11 HIPAA: Who is covered? Covered Entities Are: Health Plans
Health Care Clearinghouses Health Care Providers IF they transmit
personal health information electronically in order to process
payment or make eligibility determinations.
Slide 13
12 Article 27-F what is it? New York State law that governs:
HIV testing HIV confidentiality HIV reporting HIV partner
notification Also note related provisions about HIV case reporting
in Pub. Health Law 2130-2139
Slide 14
13 Article 27-F Who is covered? 1.ANY person or agency who
receives HIV-related information about a protected individual:
while providing a covered health or social service Examples: health
care professionals and health facilities, foster care agencies,
school nurses, OR
Slide 15
14 Article 27-F Who is covered (cont.)? 2. Anyone who receives
HIV information pursuant to a proper written release. This means if
you obtain a clients HIV information pursuant to his or her signed
HIV release form, you must follow Article 27-F. if you disclose a
clients HIV information pursuant to an HIV release form, the
person/agency receiving it must follow Article 27-F too. OR
Slide 16
15 Article 27-F Who is covered (cont.)? 3.ANY New York state or
local governmental agency that: provides, supervises or monitors
health or social services Examples: DOH, OASAS, OTDA, DOCCS, HRA,
DSS
Slide 17
16 Article 27-F Does NOT apply to: Protected individuals
themselves Friends, relatives Courts Insurers Pharmacies Federal
agencies (military, federal prisons) Schools (except medical staff)
Employers
Slide 18
17 Article 27-F Does NOT apply to (cont.) : BUT other laws may
protect confidentiality. Examples: U.S. Constitutional right to
privacy applies to government Americans with Disabilities Act
applies to employers Privacy Act applies to federal government
Slide 19
18 HIPAA & Article 27-F: Who must comply with both? Most
health care providers in New York State, assuming they transmit
health information electronically for purposes of billing or
reimbursement.
Slide 20
19 What happens if both HIPAA & Art. 27-F apply? HIPAA
pre-empts contrary state law except if state law is more stringent
than HIPAA provides greater privacy protection or gives individuals
more rights. Article 27-F is usually more protective (stringent),
so you must follow Article 27-F.
Slide 21
20 General Confidentiality Rule HIPAA & Art. 27-F generally
both prohibit the disclosure of health information about an
individual. HIPAA: covers nearly all personal health information
(which it calls protected health information) Article 27-F: covers
only HIV-related information.
Slide 22
21 Article 27-F: The general rule (cont.) NO DISCLOSURE: A
provider may not disclose any HIV-related information obtained
while providing health or social service or through a release.
Slide 23
22 Article 27-F: The general rule (cont.) HIV-related
information includes Had an HIV test (whether positive or negative)
Has HIV infection, HIV related illness or AIDS Has been treated/is
being treated for HIV Takes medication specific to HIV disease Is a
contact of someone with HIV (spouse, sexual or needle-sharing
partner)
Slide 24
23 Article 27-F: HIV Related Information i ncludes: Case
study/Poll: In the Waiting Room
Slide 25
Article 27-F: The general rule (cont.) Case Study waiting room
John & other patients sitting in clinic waiting room. Clinician
enters: John, please come for your HIV test results. Did clinician
disclose protected HIV- related information? 1.Yes 2.No 24
Slide 26
25 Article 27-F: HIV Related Information includes (cont):
Correct Answer: #1 Yes. HIV-related information includes: Had HIV
test even if results not disclosed.
Slide 27
Exceptions to the General Rule: When Disclosure is Permitted
Despite general non-disclosure rule: Both HIPAA & Article 27-F
have exceptions that permit sharing HIV information. Main Article
27-F exceptions are outlined in Article 27-F flow chart (see slide
below, and hand-out). 26
Slide 28
27
Slide 29
28 Main Article 27-F exceptions permitting disclosure
Exceptions covered by this presentation: Written Release
Disclosures to health care providers Note: Follow Article 27-F
rules governing these exceptions, since it is more stringent
provides greater protections than HIPAA.
Slide 30
Exception #1: Written Release Any and all confidential HIV
related information can be disclosed with (proper) written release.
Use DOH-approved release (complies with Article 27-F & HIPAA)
OR Form thats consistent with it. DOH forms are in hand-outs (more
on that later) In writing. No oral release! Voluntary. 29
Slide 31
Written release (cont.) Signature Do not ask client to sign
blank or partially completed form. Who signs form? Protected
individual if has capacity to consent: 1.Understand and appreciate
nature and consequences of proposed disclosure and 2.Make an
informed decision. 30
Slide 32
31 Approved Release Forms Authorization for Release of Health
Information and Confidential HIV Related Information DOH 2557 (in
handouts) & DOH 2775ES (Spanish on DOH website), revd 2/11
Authorization for Release of Health Information (Including
Alcohol/Drug Treatment and Mental Health Information) and
Confidential HIV/AIDS Related Information DOH 5032 (in handouts)
& 5032es (Spanish on DOH website), revd 4/11
Slide 33
32 Helpful DOH Guidances on Release Forms DOH wrote Technical
Assistance Bulletins with FAQs In Hand-outs Forms & bulletins
available at http://www.health.state.ny.us/diseases/aids/forms/
http://www.health.state.ny.us/diseases/aids/forms/
informedconsent.htm
Slide 34
33 Article 27-F No Redisclosure Remember: Person receiving HIV
related information pursuant to release may not redisclose Person
providing HIV related information pursuant to consent usually must
provide notice prohibiting redisclosure Sample Notice Prohibiting
Redisclosure is in hand-outs
Slide 35
34 Article 27-F No Redisclosure (cont.) For confidential
drug/alcohol patient- identifying information, a Notice Prohibiting
Redisclosure is also required Sample forms: OASAS website
www.oasas.state.ny.us/mis/forms
Slide 36
Article 27-F Written Release Case study/Poll: Release
requirements (3 questions) 35
Slide 37
Article 27-F Releases Case Study POLL (a) Sam works at case
management program. Helping client get HIV housing through a City
agency. Sam calls client: OK to disclose your HIV status to the
City agency today? You can sign a release when you come in next
week. Is Sam complying with Article 27-F? 36
Slide 38
Article 27-F Releases Case studies (cont.) Possible Answers:
1.Yes 2.No 37
Slide 39
Article 27-F Releases Case studies (cont.) Correct Answer: #2
No Oral authorization to release information never sufficient under
Art. 27-F. Specific HIV release form required before disclosure.
Back to poll: prior knowledge 38
Slide 40
Article 27-F Releases Case Study POLL (b) What if the client
said, the agency already knows my HIV status. It is fine to discuss
it with them. Does that allow Sam to discuss the clients HIV with
the agency? 1.Yes, as long as the agency mentions it first. 2.No, a
written release is still required. 39
Slide 41
Article 27-F Releases Case studies (cont.) Correct Answer: #2
No Even if the other party already knows a persons HIV status, a
reference to the persons HIV status counts as a disclosure.
Specific HIV release form still required before disclosure. Back to
poll: email / fax 40
Slide 42
Article 27-F Releases Case studies (cont.) Poll (c) Could Sam
have faxed or emailed client a form to sign and send back by fax or
email? 1.Yes, if agency policies permit it. 2.No never. 41
Slide 43
Article 27-F Releases Case studies (cont.) Correct Answer #1
Yes, if Legally, faxed or scanned copy of release form is
permitted. Agencies may set own policies. If permit emailing/faxing
HIV information, set protocols to avoid accidental breach of
confidentiality. 42
Slide 44
43 Exception #2: Disclosures to Health Care Providers Case
scenario/poll. Referral to medical specialist
Slide 45
Exception #2: Disclosures to Health Care Providers Case Study
Referral to Specialist Jan has seen primary care doctor since HIV
diagnosis three years ago. Primary care doctor now plans to refer
her to a specialist. Does doctors office need HIV release form to
disclose Jans HIV status to specialist? 44
Slide 46
45 Exception #2: Disclosures to Other Health Care Providers
Possible answers: 1.Yes 2.No
Slide 47
46 Exception #2: Disclosures to Other Health Care Providers
Correct answer: #2 No. May disclose HIV related information to a
health care provider when it is necessary to provide appropriate
care or treatment to: 1.The individual 2.His or her child OR 3.A
contact (spouse, sex or needle-sharing partner).
Slide 48
Disclosures to Health Care Providers (cont.) Answer (cont.).
Here Knowing Jans HIV status is necessary for specialist to give
her appropriate care. Some agency policies require written release
anyway consider it good practice. DOH advises CBOs to always seek
release for HIV disclosures to health care providers. Find out your
agencys policy. 47
Slide 49
48 Exception #2: Disclosures to Other Health Care Providers
(cont.) Document the disclosure. Do not need notice prohibiting
redisclosure.
Slide 50
Disclosures to Health Care Providers (cont.) Twist on the same
case study/poll: Post-diagnosis referral for follow-up care 49
Slide 51
Disclosures to Health Care Providers (cont.) Poll Jans primary
care doctor just made initial HIV diagnosis Arranging for follow-up
medical care with another health care provider, as required by Art.
27-F Needs written release for the referral? 1.Yes 2.No 50
Slide 52
Disclosures to Health Care Providers (cont.) Correct answer: #2
need oral consent No written release needed. BUT do need oral
consent. 51
Slide 53
52 Other Exceptions Other exceptions include: 1.Internal
Disclosures 2.Physicians Disclosures about Minors 3.Case reporting
4.Partner notification 5.Foster care & adoption 6.3 rd party
payers 7.People convicted/charged w/sex offenses
Slide 54
53 Review of the Basics: HIV testing
Slide 55
54 Article 27-F HIV Testing: Mandatory Offer DOH materials in
your hand- outs for Q&A and guidance on Art 27-F amendments of
2010 Also available at http://www.health.state.ny.us/diseases/aid
s/testing/hiv_testing_law.htm
http://www.health.state.ny.us/diseases/aid
s/testing/hiv_testing_law.htm HIV Testing, Confidentiality and
Discrimination in New York
Slide 56
55 Article 27-F HIV Testing: Mandatory Offer Mandatory HIV test
offer (since Sept. 2010) : Health care providers in many settings
must offer HIV test to patients aged 13-64 (or younger/older if
evidence of risk activity), including: Providers of health services
in inpatient or E.R. of hospital Primary care providers offering
primary care svc in hospital outpatient dept or a diagnostic &
treatment ctr, and
Slide 57
56 Article 27-F HIV Testing: Mandatory Offer Mandatory HIV test
offer (cont.) : Physicians, physician assts, nurse practitioners,
and midwives providing primary care in any setting. BUT not
required to offer test if patient: Treated for life threatening
emergency Previously been offered/subject of HIV test, unless
another test is indicated Lacks capacity to consent.
Slide 58
57 Article 27-F HIV Testing: Informed consent No HIV testing
without voluntary, informed, HIV-specific CONSENT By the person who
has capacity to consent to the HIV test.
Slide 59
58 Article 27-F HIV Testing: Informed consent (cont.) Consent
must be written, except oral consent OK for rapid HIV testing. But
do need written consent for rapid testing in correctional
facilities. Oral consent (rapid testing) must be documented in
medical record by person ordering test.
Slide 60
59 Article 27-F HIV Testing: Informed consent (cont.) When
written consent is required, it may be either: On a general consent
to medical care IF theres space by signature to opt out of HIV test
OR On HIV-specific consent to test form.
Slide 61
60 Art. 27-F - HIV testing Capacity to consent Similar to
capacity standard for disclosures: Regardless of age, 1. Able to
understand & appreciate the nature & consequences of HIV
test AND 2. Able to make an informed decision
Slide 62
61 Art. 27-F - HIV testing Capacity to consent (cont.) Case
study/poll: No capacity to consent to HIV test.
Slide 63
Art. 27-F - HIV testing Capacity to consent (cont.) Poll no
capacity to consent to HIV test Jon, age 25, is comatose in
hospital. Doctors think he has AIDS but Jon lacks capacity to
consent to HIV test. Doesnt have a health care proxy & court
hasnt appointed guardian. May Jons partner legally consent to an
HIV test for Jon? 1.Yes 2.No 62
Slide 64
63 Art. 27-F - HIV testing Capacity to consent (cont.) Correct
answer: #1 yes Generally, persons authorized by law to make health
care decisions could be any of: Parent of minor Court-appointed
guardian Health care proxy Surrogate under Family Health Care
Decisions Act
Slide 65
64 Art. 27-F - HIV testing Capacity to consent (cont.) If no
proxy or guardian, Family Health Care Decisions Act permits
surrogate decision maker to make health care decisions in
hospital/nursing home: Spouse/domestic partner, adult child,
parent, sibling, or close friend, or If none, the physician, in
consultation with other staff.
Slide 66
65 Art. 27-F - HIV testing Capacity to consent (cont.)
Surrogate has authority to make all health care decisions not just
HIV testing, but also treatment. So Johns spouse or domestic
partner can authorize the HIV test.
Slide 67
66 Art. 27-F - HIV testing Capacity to consent (cont.) More
helpful information in: Fact Sheet: Family Health Care Decisions
Act & HIV/AIDS
http://www.health.ny.gov/diseases/aids/regulations/fhcda/ai_fact_sheet.htm
Slide 68
67 Article 27-F e xceptions: HIV testing without consent HIV
testing without consent is allowed in limited circumstances,
mainly: Newborns People with sex offense convictions/charges, upon
victims request (court must order).
Slide 69
68 Part 2: CLIENT ADVOCACY HIV Confidentiality or Testing
Rights Violated by a Different agency
Slide 70
69 Part 2: CLIENT ADVOCACY Hand-outs: Sample Complaint
narratives
Slide 71
70 Client Advocacy Confidentiality Breach by Different Agency
Lets hear from you poll: Any of your clients or patients ever
complain that someone in a different agency breached their HIV
confidentiality or testing rights? 1.Yes 2.No
Slide 72
71 Client Advocacy Confidentiality Breach by Different Agency
Lets hear from you -- Poll: What did you do? 1.Referred the client
to Dept. of Health? 2.Referred the client to a lawyer? 3.Both 1 and
2? 4.Other/None of the above
Slide 73
72 Client Advocacy Confidentiality Breach by Different Agency
Case scenario: Michaels Pre-Employment Exam
Slide 74
73 Client Advocacy Confidentiality Breach by Different Agency
You are Michaels case worker. Michael got a new job. Michael is
very upset one day because his new boss said, I hope youre feeling
OK. I just saw your pre-employment medical report, and it said that
you have HIV. Michael did not sign a release for this disclosure
and even told doctor not to disclose. He asks you what he can do.
What should you do?
Slide 75
74 Client Advocacy Confidentiality Breach by Different Agency
(cont.) In general, most of you are not lawyers and shouldnt be the
ultimate judge of whether the disclosure was illegal. Dont tell
client: disclosure definitely did or did not violate the law. But
could say that you think the disclosure may have violated the
law.
Slide 76
75 Client Advocacy Confidentiality Breach by Different Agency
(cont.) First Did the doctor violate Michaels HIV confidentiality
rights? Yes. Disclosures to employers are never permitted without
HIV-specific, written release. Even true if HIV status relevant to
Michaels ability to do his job. Still need release.
Slide 77
76 Client Advocacy Confidentiality Breach by Different Agency
(cont.) So what do you do next? Options more on each, later:
1.Counsel client. 2.Do informal advocacy yourself, 3.Refer Michael
to attorneys. 4.Refer Michael to an oversight agency.
Slide 78
77 Client Advocacy Confidentiality Breach by Different Agency
(cont.) 1.Counsel your client. Do encourage your client to explore
options and rights. These include: Informal advocacy Referral to
attorney Complaints to oversight agencies.
Slide 79
78 Client Advocacy Confidentiality Breach by Different Agency
(cont.) 1.Counsel your client (cont.). Do not say definitely
whether disclosure violated the law. Do not give false hopes of
millions of dollars in lawsuit awards.
Slide 80
79 Client Advocacy Confidentiality Breach by Different Agency
(cont.) 2. Informal advocacy with alleged breacher: Help client
file complaint with the entity that breached his confidentiality
(supervisors, director, legal counsel) Ask for copies of all
release forms Michael signed. Demand a thorough investigation.
Slide 81
80 Client Advocacy Confidentiality Breach by Different Agency
(cont.) 3. Referrals to attorneys. Instead of or in addition to
doing informal advocacy yourself Attorneys will evaluate legality
of disclosure & counsel client about options. Referral: Legal
Action Center, and see www.lawhelp.org. www.lawhelp.org
Slide 82
81 Client Advocacy Confidentiality Breach by Different Agency
(cont.) 4.Refer client to an oversight agency Administrative remedy
Here are the options.
Slide 83
82 Administrative remedies: Article 27-F DOH Process File
complaint with DOH. If complaint is against a hospital, file with
the Centralized Hospital Intake Program Complaint form available at
http://www.health.ny.gov/forms/doh-4299.pdf
http://www.health.ny.gov/forms/doh-4299.pdf (800) 804-5447 If
complaint is against any other provider, file with AIDS Institute,
Special Investigation Unit (SIU) Complaint form available at:
http://www.health.state.ny.us/forms/doh-2865.pdf
http://www.health.state.ny.us/forms/doh-2865.pdf (800)
962-5065
Slide 84
83 Administrative remedies: Article 27-F DOH Process Testing:
First file complaint with entity that did test without consent (or
proper counseling). THEN File complaint: Johanne Morne NYS Dept of
Health, AIDS Institute Corning Tower, Room 485 Albany, NY 12237
(518) 473-2907
Slide 85
84 Administrative remedies: Article 27-F DOH Process (cont.)
What will DOH do with it? Confidentiality breach: Might refer it to
agency overseeing or employing breacher eg, HRA, DOH Home Care
Bureaus, DOCCS. HIV testing complaint: Might also refer it to DOH
agency overseeing medical professionals/health care facilities, or
Office of Professions overseeing other licensed professionals
(e.g., nurses).
Slide 86
85 Administrative remedies: Article 27-F DOH Process (cont.)
$5,000 civil fine criminal penalty if willful Usual remedy =
statement of deficiencies requiring corrective action
Slide 87
86 Administrative remedies: Article 27-F DOH Process (cont.)
May ask attorney, legal service provider like Legal Action Center
to represent client in this proceeding But dont need a lawyer
Slide 88
87 Administrative remedies: Article 27-F DOH Process (cont.)
Advocating for your client at the DOH Help write the complaint
Include details about what happened Support your conclusion; e.g.,
dont assume that because someone learned your clients status, the
breacher had to be X Sample Complaint Narratives HIV
confidentiality; HIV testing (in hand-outs)
Slide 89
88 Administrative remedies: Article 27-F DOH Process (cont.)
Monitor progress of complaint If dont get resolution, keep calling!
Speed and thoroughness of investigations may vary by agency No
pre-set timeframes
Slide 90
89 Administrative remedies: Article 27-F DOH Process (cont.)
Appeal: May appeal within 60 days of mailing of the finding But
client likely will not be advised of right to appeal
Slide 91
90 Administrative remedies: Article 27-F DOH Process (cont.)
Value of the DOH process: Client may feel vindicated; got justice;
voice was heard Corrective action may prevent further breaches or
HIV testing violations Do not need a lawyer Usually much faster
than a lawsuit
Slide 92
91 Administrative remedies: Article 27-F DOH Process (cont.)
Downside to DOH process: Depending on which agency reviews case:
may take a long time may not do thorough investigation corrective
action may not satisfy your client Process & correspondence may
be unclear No money for client Fines & criminal penalties
virtually never imposed
Slide 93
92 Administrative remedies: HIPAA violations Individuals may
file complaint with HHS/Office of Civil Rights (OCR) within 180
days Sample complaint form is http://www.hhs.gov/ocr/privacy/hipaa/
complaints/index.html http://www.hhs.gov/ocr/privacy/hipaa/ OCR
(toll-free): 800-368-1019
Slide 94
Administrative remedies: HIPAA violations Penalties: Civil
& criminal fines Often impose corrective action 93
Slide 95
94 Administrative Remedies: Professional Licensing Rules
Article 27-F and HIPAA violations also might violate State
laws/rules governing the professions
Slide 96
95 Administrative Remedies: Professional Licensing Rules
Physicians Complaints may be filed with Office of Professional
Medical Conduct complaint form: call or download 800-663-6114 or
[email protected][email protected]
Slide 97
96 Administrative Remedies: Professional Licensing Rules Other
licensed professionals For example, social workers, nurses,
pharmacists Complaints may be filed with the NYS Education Dept.,
Office of the Professions 800-442-8106 OR
http://www.op.nysed.gov/opd/complain.htm
Slide 98
97 Lawsuits May sue in court for violations of Article 27-F
confidentiality & HIV testing provisions Generally need a
lawyer May not sue for HIPAA violations.
Slide 99
98 Lawsuits (cont.) Damages include: Emotional harm Did the
word spread to others? Ostracism? Depression? Isolation? Anger?
Lost sleep or appetite? Employment consequences; Lost wages
Slide 100
99 Lawsuits (cont.) Damages also include: Physical harm:
Affected ability/willingness to stay in health care? Stress-related
complications? Other out-of-pocket losses Punitive damages
(sometimes)
Slide 101
100 Lawsuits (cont.) Dont give client unrealistic expectation
of easy money Downside to lawsuits: Can take many years Hard to
find free legal counsel Have to relive the trauma through testimony
and continuous contact with attorney
Slide 102
101 Lawsuits (cont.) Downside to lawsuits (contd): Adversarial
model can make clients even angrier, as wrongdoer may defend
position Clients emotional life & personal behavior & HIV
status will be on display and subject to probing
Slide 103
102 Lawsuits (cont.) Advantages of lawsuits: Might win or get
good settlement Victory/good settlement might feel like justice
Publicity/legal precedent may help educate others about issues and
individuals rights and legal protections
Slide 104
103 Part 3: CLIENT ADVOCACY HIV Confidentiality or Testing
Rights Violated by Your Agency
Slide 105
104 CLIENT ADVOCACY Case scenario/poll: Ritas home health aide
Youre a supervisor in a home care agency. Rita calls to complain:
neighbor said he learned Ritas HIV status from her home health
aide. Rita wants a different aide and demands that her old aide be
fired. What should you do?
Slide 106
105 CLIENT ADVOCACY Case scenario/poll: Ritas home health aide
1.Tell Rita she shouldnt have disclosed her HIV status to her home
health aide if she didnt want her neighbors to learn it. 2.Fire the
home health aide immediately. 3.Follow your agencys grievance
procedures.
Slide 107
106 CLIENT ADVOCACY Correct answer: #3 Follow your agencys
grievance procedure. Make sure your agencys grievance procedure
complies with HIPAA.
Slide 108
107 HIPAA requires covered entities to: 1.Provide patient
complaint process. concerning HIPAA policies and procedures.
2.Establish sanctions for violations of privacy policies.
3.Designate a staff member to receive complaints. (Can be privacy
official.) 4.Document all complaints & their disposition.
Responding to Complaints Your Agency
Slide 109
108 Responding to Complaints Your Agency (contd) Suggestion:
Acknowledge importance of confidentiality Dont belittle clients
complaint Inform client complaint procedure Dont give client the
run around
Slide 110
109 Responding to Complaints Your Agency (contd) Conduct
thorough investigation Talk to witnesses Look at documentation Get
clients feedback
Slide 111
110 Responding to Complaints Your Agency (contd) After
investigation & conclusion: Retrain staff/remind them of
policies even if no violation occurred Deliver conclusion to client
respectfully
Slide 112
111 Responding to Complaints Your Agency (contd) If violation
is verified: Apologize Take disciplinary action against individual
who violated the law Update agency policies, if necessary, to
prevent further violations Train staff about policies Inform client
corrective actions taken
Slide 113
112 Responding to Complaints Your Agency (contd) Good practice
to understand the harm: May believe everyone knows status; life
will never be the same Severe emotional harm depression, anxiety,
paranoia Anger Ostracism and even physical harm Reliving trauma of
diagnosis
Slide 114
113 Responding to Complaints Your Agency (contd) Understand
what client might want: vindication; acknowledgment that someone
hurt them policy change & training: this shouldnt happen to
anyone else money
Slide 115
114 Call on us for help! Legal services for people affected by
HIV/AIDS statewide! Training on HIV-related legal issues for HIV
service providers statewide! Hot-line and technical assistance on
HIV-related legal issues statewide! Legal Action Center:
212-243-1313 or 800-223-4044
Slide 116
Thank you! Thank you. And thanks to the AIDS Institute, New
York State Department of Health. 115