(8-17-16) INOVA Fairfax Hospital needs to stop hiding behind federal privacy laws and explain why it had security guards escort a 29 year-old man, who police said was in the throes of a mental health crisis, to a bus stop rather than helping him.
That still unidentified man was fatally shot on the hospital grounds Monday night after he began swinging a metal signpost over his head and charged at a sheriff’s deputy.
The deputy involved was immediately put on administrative leave pending an investigation. The local police chief immediately disclosed the shooting at a news conference and promised to make public a video from a hospital security camera that possibly recorded footage of the shooting.
Everyone promised transparency – except for one critical player: INOVA Fairfax Hospital.
What brought this man to the hospital? More importantly, why was he released, especially if he was considered dangerous enough that the hospital had security guards escort him to a bus stop?
A spokesperson for INOVA Fairfax Hospital told The Washington Post that medical privacy laws prevented the hospital from disclosing any information.
I’m not certain Congress had this in mind when it passed the federal Health Insurance Portability and Accountability Act of 1996. The primary goal of the law was to make it easier for people to keep health insurance, protect the confidentiality and security of healthcare information, and help the healthcare industry control administrative costs.
Since passage, different interpretations and confusion about the law – as well as fear of lawsuits — have resulted in many hospitals and medical personnel adopting a position of ‘when in doubt, don’t disclose.’
All too often HIPAA has become an excuse to not reveal information that might turn out to be embarrassing or reveal misconduct.
Although I am not a HIPAA expert, I don’t understand why the hospital couldn’t have issued a statement that spelled out some fundamental facts without identifying the man. “A patient was admitted and…..blah, blah, blah….”
This is not the first time the INOVA hospital system has been involved in a situation where an individual with mental illness has been released — with tragic results.
Last year, Natasha McKenna, a 37 year-old woman with schizophrenia, passed through a revolving door at INOVA owned hospitals. At one point, officials sent her home in a taxi only to have her return again and again. Finally, hospital workers called the police who took her to jail where she eventually was shot four times with a Taser and later died.
There might be a legitimate and justifiable reason why hospital officials sent the patient to a bus stop. He might have refused treatment, which would have been his right. But because INOVA Fairfax is citing HIPAA, the public is left bewildered and prone to think the worst.
An immediate concern: hospital “streeting” – also called “patient dumping” and “bus therapy.”
In Virginia, ‘streeting” was first disclosed by G. Douglas Bevelacqua, when he was an inspector general with oversight of the state’s mental health care system. Bevelacqua reported that 200 individuals who needed emergency mental health care were refused help during a ninety day period in Virginia at hospitals because there were no beds available. The state got a further black eye when state Sen. Creigh Deeds sought help for his son, Gus, and was turned away because of a lack of a local bed. Gus later attacked his father with a knife and then ended his own life.
Rep. Tim Murphy (R.-Pa.) initially inserted language in his Helping Families In Mental Health Crisis Act that would have loosened HIPAA restrictions when it came to mental health admissions. His language was strongly opposed by privacy groups.
Now rewritten, his bill would require the federal Health and Human Services Agency to study its current HIPAA regulations and rules with an eye to toward making disclosures easier in some instances. What those situations might be still have to be defined.
If Murphy’s bill eventually becomes law, HHS would be smart to take a look at incidents such as the shooting in Fairfax and draft language that would not keep a hospital from being forthcoming about its actions leading up to a fatal shooting.
The public deserves to know why a man, who appears to have been mentally unstable, was escorted by hospital security guards to a bus stop with tragic results.
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