The Health Insurance Portability and Accountability Act of 1996, which took effect last year, has left many wondering about the limits of patient privacy and its effect on pastoral care.
C. Margaret “Meg” McClaskey, a consultant on clinical medical ethics, spoke about the regulations at the Wisconsin Council of Rabbis’ meeting on Monday, March 15 at the Milwaukee Jewish Federation.
The program, entitled, “The Truths about HIPAA,” was sponsored by the WCR in conjunction with the federation’s Jewish Chaplaincy Program. McClaskey addressed a group of some 15 rabbis, cantors, chaplains and health care administrators.
She answered the following questions regarding the regulations:
Q. If my loved one is hospitalized, will my rabbi be able to find out that information from the hospital? What about other rabbis who may know my family?
A. Your rabbi and rabbis who may know your family fall in very much the same category. If someone knows that your loved one is in the hospital and knows the name under which they are registered, then they can be told your loved one’s room number.
Other information will not be given to your rabbi or anyone other than your family without the patient’s expressed permission (or that of the designated decision-maker).
Whether or not your rabbi will be contacted by the hospital regarding your loved one’s stay depends upon the facility. Some hospitals have undertaken the extra work of having patients sign documents during admission that identify worship communities and give permission to make contact. Most have not.
It is very important that if your loved one wants your rabbi (or rabbis who know your family) to know he or she is in the hospital that the rabbi be notified directly. Do not expect the hospital to make those calls.
If you want your rabbi to know information, beyond the fact of hospitalization, the patient or you will need to inform them yourselves or be sure that the hospital and doctor have written permission to share medical information.
Q. I could imagine having a very private kind of illness that I didn’t want my rabbi and synagogue to know about. How can I make sure no one knows?
A. Under the HIPAA regulations, hospitals and physicians will protect the nature of your illness and keep it private unless you give them specific permission to release that information.
To be perfectly honest there is no way for you to be completely sure that no one will tell your rabbi or synagogue, since the regulations only apply to health care entities and their employees. Someone who knows you and your condition could report that fact to your rabbi or synagogue.
Q. Will my family or friends be permitted to contact me in the hospital without knowing my room number under all circumstances?
A. Yes, your family and friends will be able to contact you in the hospital without knowing your room number. (They do need to know the name under which you are registered at the hospital.)
Of course other things may determine whether or not you are contactable, such as the presence of a phone in your room, your ability to reach use the phone, isolation precautions, etc.
Q. It seems to me that all the paperwork I fill out in my doctors’ offices recently may have something to do with this law. Is that correct, if so what — why do I need to do the same thing every time I go?
A. Yes, some of the paper work you are filling out at the doctor’s office has to do with this law, but only some of it. You will probably be asked to sign documentation that you have been informed of the HIPAA regulations at your doctor’s and dentist’s offices, as well as your pharmacy, but each of these sites should only be asking you once. You will probably be asked to sign such a document with each admission to the hospital.
Q. If I want my synagogue to do a Mi she-Berakh (prayer for health) for me on the Shabbat morning when the Torah is read, are they permitted to do so under this law?
A. Privacy and confidentially are important in all settings, but the HIPAA regulations do not regulate health care information outside health care settings. Most synagogues have some rules about what is said during a Mi she-Berakh; that the reason for the Mi she-Berakh is not mentioned, let alone where someone is hospitalized.
Because many synagogues use only Hebrew names, there is some privacy. If you want the rabbi to let others in the congregation know about your illness or hospitalization, such as the Bikor Holim Committee, it is important for you to notify the rabbi. It is just as it is important for you to let the rabbi know when you do not want information shared with others.
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