HIPAA and Correctional Officers

[Neats, BSN]

We all know that there are times in corrections where HIPAA although is being followed, our officers can hear sensitive information, this is when they fall under the same HIPAA rules as we do.

Our Lt (not warden) wanted names of all inmates who are taking a paticular medication so "his team could watch those people and find out who is not taking their mental health medication". I as the DON did not provide that information, my staff refused to disclose that information. The Lt did have some great points of HIPAA and corrections relating security/safety to the needed information so they could keep the facility safe. I still did not budge.

All this communication was because 2 inmates found a pill (37.5mg Effexor) on the floor in a common class room area they brought it to the correctional officer who then informed the LT. Now the LT now feels this is a emergency safety issue.

If this was a life threatening situation I would provide the information to the Warden(s), or staff Sgt or LT with no problem. For this issue I stood my ground.

Thank you for the replies. We do watch inmates take their medication, and sometimes there is an officer, sometimes not. I am wanting feedback on how the LT should be assisted or would anyone give the information of names to the LT to protect security/safety.

My question is: What would you all do to assist the LT?

[itsnowornever, BSN, RN]

Do you watch the inmates swallow their pills? Because of HIPPA that's probably the best you can do...watch them swallow and then check their mouths to make sure it went down. Not that I have experience, just giving an idea and learning what it is that you do.

[Orca, ADN, ASN, RN]

I am also a DON, and I would not have disclosed the information you were asked to disclose for the same reasons. You were right to stand your ground on it. The discovery of a diverted pill does not constitute a safety hazard requiring the disclosure of large amounts of health information. Besides, Effexor is well down the list on the danger scale.

I am all for safety and security, and I support the efforts of our administration and custody officers to ensure it. However, we still have laws and regulations we have to operate under, and there are limits as to what I can legally do for them.

Our lieutenants are a good group. They generally don't panic over small stuff, and they consult with me all the time over verious issues involving health care. I have cultivated a strong cooperative working relationship with them, and as a result we don't get unreasonable demands from custody.

[deyo321]

Mouth checks are safety and securities concern. The LT should post at med pass and check each inmate. If I have an at risk inmate refusing their anti-pyschotic meds I will give the pod Officer a heads up. In segregation med refusals are logged in the pods briefing.

[Neats, BSN]

Ok OK everyone.

I work in a Minimum security prison. We in medical do mouth checks and sometimes we have an officer in the HS pill pass.

The LT;s whole reason was to monitor those on Effexor, I do not want my staff getting cought up in the investigations/or other security issues.

We are NCCHC accrediated and we have to be proactive up to a point for our patients. In this instance the pill was found in a common area, for all I know it could belong to a staff member. I think we have more issues with tobacco. I agree with the above refusal though I would not say what med, just that the patient is refusing meds that help them maintain normal ADL's.

[angelkay]

I work in prisons now and the correctional staff dont have a right to know what imates are taking, that is HIPPAA, at least in CA, we dont discuss mediactions, illness, or anything when we are asked. We tell them straight, that we are not obligated to give them that info. Now will we do it if its something contagious?? We wont divulge, but we make sure the officers wear whatever protective equipment they need to wear, such as masks, gloves etc... As for mouth checks, we do it and the officers do it if we think there is a problem but those inmates, are going to "cheek" meds if they are going to do it. I have seen inmates get busted with crushed T-3's, handfuls of it.... and they are made to show us empty cups and all but he still managed to get a handful. Inmates will swallow and bring it back up.

[Pranqster]

believe it or not, the law allows for certain disclosures :

I. Permitted Disclosures

A hospital providing prison health care may disclose PHI to a “correctional institution” or a

law enforcement official having lawful custody of an inmate if the correctional institution or law

enforcement official represents that such protected health information is necessary for:

A) the provision of health care to such individuals;

B) the health and safety of such individual or other inmates;

C) the health and safety of officers or employees or others at the correctional institution;

courts give prisons quite a bit of leway, for example, if an inmate becomes psychotic when of his meds, or is on "heat" meds, it is covered under "B) health and safety of such individuals or other inmates." Also, inmates are in the "custody" of the government, like children (big children). It is understandable why we may be hesitant to release info these days, but if you can justify the release of information under the law, you are covered. Just make sure you document thouroughly.