The Latest Column
Below are the questions from the latest Standards Q&A column, posted in March 2013.
We have a federal court security expert who has requested that detention medical staff provide data to security when they perform a presegregation assessment after inmate-on-inmate assaults and similar information when there is an exam following use of force by custody. Is this a violation of the NCCHC standard on forensic information (I-03)? Is there any information medical can provide under these circumstances? I think even asking the inmate to provide a release of information would be coercive.
First we must ask ourselves what is the purpose of conducting a presegregation assessment? What is the purpose of conducting an evaluation after the use of force? Such evaluations are generally performed for the benefit of the patient to ensure that he or she does not suffer from injuries as a result of the altercation. Hence, this medical information needs to be protected in the same manner as any other medical information. NCCHC holds to the same community standard of care when it comes to protecting confidential patient information.
The second question that has to be raised is what “data” is being requested? If it is information that breeches the patient–physician confidential bond, then it should not be released. However, if it is information that notifies security that there is or is not a contradictory reason to place the inmate in segregation, then yes, that is allowed. A patient release of information should be obtained if more information is required (photos, drawings, description of injuries or description of the event).
CONTINUITY OF CARE
A hospital in our area recently changed its policy regarding inmates. They are saying that if an inmate is sent to the hospital, the hospital staff cannot contact the jail once the inmate is to be released from the hospital and therefore another warrant has to be issued for their arrest before that person returns to jail. I’m trying to do research on where in the HIPAA law this is stated.
NCCHC is not aware of such practice. The standard on Continuity of Care (E-12) requires that when an inmate returns from an emergency room visit (or hospital stay), the physician sees the patient, reviews the discharge orders and issues follow-up orders as clinically indicated. You should consult with legal counsel to check for local statute or regulation that may impact on this issue.