Illegal Drugs & HIPAA

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I work in a very busy ED, my husband works in another hospital in our area that is also a very busy ED. While we were talking something he said caught me off guard. His hospital searches their patients pockets if they are a psych/trauma/intoxicated patient. If they find any illegal contraband they call the police and give patient information to them. Is this actually allowed?

For our hospital we scan patient belongings in a psych/trauma/intoxicated patient and give the items to security. We don't ever call the police for contraband. We service a very poor/high crime rate/high drug rate population. However this community trusts us and knows we don't turn them over to the police. When a shooting happens or something of the like we always bag our items for evidence and obviously police are involved. However we do not call if we find marijuana products on a person. Actually because of our relationship with the community members we have had a decrease in "drive by shootings" (you know where they push the victim out of the car and speed away so they aren't involved). We also release information if there's a bad batch of heroine going around and notify the police of that.

My question is, where can I find the exact fine line on this on the HIPAA guidelines website? It seems like it's a gray area and there is no definite answer. However I definitely feel it violates patient rights to have their pockets gone through simply because they are a "trauma" patient (coumadin + fall = trauma).

Thank you for your guidance on this matter.

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Specializes in Critical Care.

When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials?

http://www.acutecare.com/wp-content/uploads/2014/01/HIPAA-Executive-Summary.pdf

I've never worked anywhere that the police are notified just because we become aware the patient has been doing something illegal (ie drugs) and there are big ethical problems with doing that. Everyplace I've worked we actually give them all of their belongings back at discharge, no matter what's in them.

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Specializes in Leadership, Psych, HomeCare, Amb. Care.

Any contraband will be confiscated and locked up.

illegal contraband: weapons, drugs, whatever, will not be returned.

What at if a 3rd party was injured or killed by the returned contraband?

Probably illegal to transmit a drug or illegal weapon to the patient anyways.

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Specializes in Hospice.

It would seem to me that, in addition to HIPAA concerns, there would be issues over illegal search and seizure. If the OP's partner's hospital turns over "contraband" to the police and that, in turn, is used as grounds for an arrest. Wouldn't the hospital then have to observe the same legal guidelines as law enforcement?

It's a bucket of particularly stinky worms, for sure.

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When does the Privacy Rule allow covered entities to disclose protected health information to law enforcement officials?

http://www.acutecare.com/wp-content/uploads/2014/01/HIPAA-Executive-Summary.pdf

I've never worked anywhere that the police are notified just because we become aware the patient has been doing something illegal (ie drugs) and there are big ethical problems with doing that. Everyplace I've worked we actually give them all of their belongings back at discharge, no matter what's in them.

Thank you for this. We also give back all belongings at discharge regardless of whats in them. The links were helpful - thank you for the detailed information.

Heron, it really is a "bucket of stinky worms". I know if I were a patient in the hospital and I were alert, awake, and oriented x 3 and saw someone digging through my belongings I would be giving them an earful. I don't carry anything illegal or participate in any activity that is such, however as a patient I have rights and I don't feel like being treated like a criminal just because I've been involved in a "trauma". Definitely a bad situation all around.

Thank you all for the replies and links - much appreciated!

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Specializes in Critical Care.
Any contraband will be confiscated and locked up.

illegal contraband: weapons, drugs, whatever, will not be returned.

What at if a 3rd party was injured or killed by the returned contraband?

Probably illegal to transmit a drug or illegal weapon to the patient anyways.

The legal view of every facility I've worked at has been the opposite: what legal authority does staff have to take someone's possessions? Without any authority that's usually considered theft. Your not "transmitting" drugs or weapons to the patient since it is never legally in your possession, and if it is legally in your possession that why couldn't you be arrested for possessing drugs or illegal weapons?

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The legal view of every facility I've worked at has been the opposite: what legal authority does staff have to take someone's possessions? Without any authority that's usually considered theft. Your not "transmitting" drugs or weapons to the patient since it is never legally in your possession, and if it is legally in your possession that why couldn't you be arrested for possessing drugs or illegal weapons?

Bingo.

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Specializes in Emergency Room.

We can only search the belongings of anyone who is pink slipped. We just inventory their belongings in the chart so we know what they came in with. Behavioral health/intoxicated patients visitors have all belongings placed in a locker and the keys are kept with the sitter and escorted by security. If we find weapons or drugs - we call police to take the items and depending on the situation - we may disclose names.

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Specializes in Psych, Addictions, SOL (Student of Life).

If you read the HIPPA law there is specific language regarding situations that pose a threat to public safety. One of those would be specific illegal contraband such as guns, brass knuckles (which are illegal in all 50 states). The language states you have a duty to report illegal activity that poses a danger to the public and you cannot be prosecuted for this disclosure under HIPPA.

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Specializes in Nurse Leader specializing in Labor & Delivery.

HIPAA

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Specializes in Critical Care.
If you read the HIPPA law there is specific language regarding situations that pose a threat to public safety. One of those would be specific illegal contraband such as guns, brass knuckles (which are illegal in all 50 states). The language states you have a duty to report illegal activity that poses a danger to the public and you cannot be prosecuted for this disclosure under HIPPA.

HIPAA doesn't actually allow a disclosure because someone is found to possess guns or brass knuckles. HIPAA is very specific that an exemption is only allowed for threats that are specific and imminent, simply possessing something illegal doesn't count.

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An adolescent who has drugs come back in their system and has a parol officer will get the information...we say toodles.

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