HIPAA and the Undocumented

nurseactivist · Sep 17, 2015

"The driver's license featured Borrego's picture and address, but the number belonged to a man, the card was the wrong color, and the hologram was missing, according to Jeff McShan, a spokesman for Harris County district attorney's office."

If I were this man, I don't think I would be too concerned.

JustBeachyNurse, LPN · Sep 17, 2015

I have been asked what I would have done. I am a public health nurse. I think I would have said the ID is not acceptable and referred her to a free clinic.
I would not have pretended we were going to see her, notifiy authorities (I believe knowing that she would be arrested/deported). I am not a police officer. In the same way, if a patient revealed to me that they had unpaid parking tickets. I would not take it upon myself to notify Parking and Control.
The reason I mentioned HIPAA and the question for me is, does revealing a patient's mere presence in a clinic violate medical privacy? Well, if it were a fertility clinic, I believe it does.

She's not being deported. She's been arrested and charged with presentation of and possession of fraudulent government documents. No presence does not violate privacy. She could be in an OBGYN clinic for any number of reasons. Presence does not equate medical privacy

sailornurse · Sep 17, 2015

"The driver's license featured Borrego's picture and address, but the number belonged to a man, the card was the wrong color, and the hologram was missing, according to Jeff McShan, a spokesman for Harris County district attorney's office."
If I were this man, I don't think I would be too concerned.

Illegal, but Not Undocumented | Center for Immigration Studies

Notice where it says: Lack of Respect for the Laws of Our Nation.

You are completely missing the point of Identity Theft.

Watch the video for an explanation.

She had both a fake driver's license & a social security card.

What do you suppose she was going to use the SS card for?

So on top of being here illegally, she commits two other illegal acts by obtaining fake documents.

If it was your SS number & your driver's license, it can affect ability to get credit, jobs, and can complicate things when someone else files income taxes using your social security number.

"Thus, when illegal aliens use SSNs or other documents belonging to American citizens and legal residents, the damage can be substantial. The true owners risk being saddled with the illegal aliens' credit, arrest, and medical records. Victims may be denied jobs, unemployment insurance, Social Security payments, and Medicaid benefits. It costs victims hundreds of hours and thousands of dollars to undo the damage and recover their names and lives."

I have a friend from NP school. Her husbands SS# was used to file income taxes 3 years ago, it is still not resolved. Ironic is that she is a legal immigrant, having fled the khmer rouge from Cambodia.

Those "immigrant rights" activists are on the wrong track organizing protests.

Illegal is illegal.

Why hasn't the 22 y/o applied for legal status? She is what is called a "Dreamer", waiting to get citizenship without going thru the proper steps.

MunoRN, RN · Sep 17, 2015

I think there's some confusion about the story; there was no potential identity theft since both the license and the SS card listed her real name. Randomly making up a license number and a SSN but having your real name attached to it is of no use in identity theft, anybody can randomly make up 8 and 9 digit numbers, that's not identity theft. She did not "obtain insurance using false identification", she was legitimately covered under her husbands plan.

Doctors have an ethical code that prevents them from turning patients into authorities for things that pose no imminent threats to others, regardless of whether or not protected health information would be revealed, receptionists do not (and apparently neither do many nurses). The methods used were certainly deserving of scrutiny.

hawaiicarl, BSN, RN · Sep 17, 2015

How many undocumented folks will avoid getting care after reading about this? What is the risk?

The risk is ... our tax rate may drop if we stop supporting illegal immigrants. That'd be a nice break. I am sure they have medical care in her country of origination. As an FYI, I am a LEGAL immigrant, it took 5 years, and thousands of dollars, for all the red tape to transition from my LEGAL green card to citizenship. Everyone chooses their path, and the consequences that result from those choices.

Cheers

MunoRN, RN · Sep 17, 2015

The risk is ... our tax rate may drop if we stop supporting illegal immigrants. That'd be a nice break. I am sure they have medical care in her country of origination. As an FYI, I am a LEGAL immigrant, it took 5 years, and thousands of dollars, for all the red tape to transition from my LEGAL green card to citizenship. Everyone chooses their path, and the consequences that result from those choices.
Cheers

I don't really have much sympathy for people who expect things without having to follow the rules, but the effect of undocumented workers/illegal immigrants on the economy (and our taxes) is what makes the situation tricky. If all the undocumented/non citizen workers were to disappear today our taxes would most likely go up.

Undocumented workers pay about $10 billion a year in federal and state taxes, yet don't qualify for most of what that money goes for, which reduces everyone else's costs since they essentially represent a revenue source without much of any potential economic liability to those same programs. Then there's the loss in GDP which would also increase everyone's taxes, and add to that the increase in the cost of goods and services and you begin to understand why even hard-core conservatives are somewhat measured in their rhetoric on this topic.

canigraduate · Sep 17, 2015

OP, I think you're being deliberately obtuse.

She had a fake ID. We arrest 18 year old citizens for this. Why wouldn't we arrest her?

Why would the clinic not fulfill their civic duty and report it?

Do you advocate for telling lawbreakers that it's OK to break the law as long as they are seeking healthcare? Because that's what you're saying.

I think you have an agenda and you picked the wrong article to support it.

Hoosier_RN, MSN · Sep 17, 2015

This is an issue that the mother must consider when deciding to live illegally in a country.

Or using fake ID

Mulan · Sep 18, 2015

I think there's some confusion about the story; there was no potential identity theft since both the license and the SS card listed her real name. Randomly making up a license number and a SSN but having your real name attached to it is of no use in identity theft, anybody can randomly make up 8 and 9 digit numbers, that's not identity theft. She did not "obtain insurance using false identification", she was legitimately covered under her husbands plan.
Doctors have an ethical code that prevents them from turning patients into authorities for things that pose no imminent threats to others, regardless of whether or not protected health information would be revealed, receptionists do not (and apparently neither do many nurses). The methods used were certainly deserving of scrutiny.

So what if those randomly made up 9 numbers just happened to match your SSN?

MunoRN, RN · Sep 18, 2015

So what if those randomly made up 9 numbers just happened to match your SSN?

I wouldn't care since that by itself cannot be used for anything. Just being able to randomly list 9 digits doesn't really have anything to do with identity theft. If I throw together the numbers 504-94-8745, which is most likely someone's SSN, have I just committed identity theft? Putting that number on a card with my own name is even further from identity theft since it ensures that I would fail in trying to use that person's identity since the number and the name don't match.

MunoRN, RN · Sep 18, 2015

OP, I think you're being deliberately obtuse.
She had a fake ID. We arrest 18 year old citizens for this. Why wouldn't we arrest her?
Why would the clinic not fulfill their civic duty and report it?
Do you advocate for telling lawbreakers that it's OK to break the law as long as they are seeking healthcare? Because that's what you're saying.
I think you have an agenda and you picked the wrong article to support it.

I'm not sure it's really a clinics primary responsibility to investigate and report fake ID's. They certainly have the right to ensure they will get paid, although this patient has been going to this group for some time and it doesn't sound like there's been any payment issues.

I've never told a patient it's "OK to break the law", but I also don't report them for things I discover while they are in the process of obtaining care if it poses no imminent threat to others as a matter of healthcare ethics. If you get a new admit in the hospital and they smell of marijuana, do you call the cops on them?

Mulan · Sep 18, 2015

I wouldn't care since that by itself cannot be used for anything. Just being able to randomly list 9 digits doesn't really have anything to do with identity theft. If I throw together the numbers 504-94-8745, which is most likely someone's SSN, have I just committed identity theft? Putting that number on a card with my own name is even further from identity theft since it ensures that I would fail in trying to use that person's identity since the number and the name don't match.

It can't? Oh, really?

Illegal, but Not Undocumented | Center for Immigration Studies

"Most (98 percent) Social Security number (SSN) thieves use their own names with stolen numbers. The federal E-Verify program, now mandated in only 14 states, can detect this fraud. Universal, mandatory use of E-Verify would curb this and stop virtually 100 percent of child identity theft."