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LAFD chief halts public information flow about incidents, citing HIPAA. Mayor overrules chief, for now.

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Firegeezer’s opinion on latest LAFD controversy

A fire service leader in providing news to the public about its daily activities suddenly shut down the information flow on Sunday only to be told to turn the spigot on again. The news media started learning this week that the Los Angeles Fire Department, on orders of Chief Brian Cummings, was no longer providing key basic information about incidents, including the location of the response. This comes in the wake of an ongoing controversy about the department’s release of response time data that was not accurate. By late Wednesday, after complaints about the new policy, Mayor Antonio Villaraigosa had overruled the chief, for now.

LAFD’s Media and Public Relations Office has long been at the forefront of providing information about ongoing incidents and the inner workings of the department through many platforms, including the Internet and social media. The LAFD News & Information site, as of late Wednesday night, still has the original order from Chief Cummings that was posted on Tuesday:

The following has been issued from the Office of the Fire Chief, Brian L. Cummings:

The City Council has designated the City of Los Angelesas a “hybrid entity” under the Federal Health Insurance Portability and Accountability Act (HIPAA) of 1996 due to the Department’s status as a health care provider. As a hybrid entity, the Department must comply with HIPAA and is only permitted to release Protected Health Information (PHI) for the purposes of treatment, billing and operations under the HIPAA Privacy Rule, without the patient’s permission. In 2009, the President approved additional Federal legislation that increased civil and criminal penalties for the unauthorized disclosure of PHI.

The Department is currently seeking written advice from the City Attorney relative to the release of incident specific PHI to a variety of internal and external sources including elected officials, commissions, the media and associated stakeholders.

The City Attorney has preliminarily opined that the Department should immediately cease the practice of releasing PHI to any source not specifically authorized under the Privacy Rule’s treatment, billing and operations exemption. I realize that this practice will significantly impact the manner in which the Department provides updates and notifications to a wide variety of stakeholders. As the Department receives additional written advice from the City Attorney regarding specific issues, I will ensure that this information and the Department’s procedures will be forwarded for your information.

BRIAN L. CUMMINGS

Fire Chief
Earlier this week the LAFD Breaking News widget had details about fires but provided no address information. After Mayor Villagairosa stepped in locations of incidents are again being transmitted.
Below is news coverage of this controversy with excerpts of article both before and after Mayor Villaraigosa stepped in.
AP:

Los Angeles Mayor Antonio Villaraigosa has ordered the fire department to stop a new policy of withholding key information on emergencies.

A letter Wednesday from Villaraigosa tells Fire Chief Brian Cummings to wait for the city attorney’s opinion before implementing the policy.

City News Service says the LAFD announced Tuesday that they had already begun limiting the release of information like locations of incidents and injury information in order to conform to federal medical privacy laws.

Villaraigosa said in response that the department needs “more transparency, not less,” and it is “our duty to provide information to the media and the public.”

City and fire officials had already been butting heads in recent days over the department’s new methods of counting fast responses to emergency calls.

DailyNews.com:

“At a time when the Los Angeles Fire Department needs more transparency, not less, I am directing you to immediately resume releasing information that provides LAFD incident specifics without violating federal law,” Villaraigosa said in a letter sent to Fire Chief Brian Cummings this afternoon.

The department began limiting the information — such as incident locations and injury information — over the weekend to conform with the federal Health Insurance Portability and Accountability Act, or HIPAA, a medical privacy law.

The policy change caused a strong backlash by City Council members and news organizations, who argued the information was necessary for public safety reasons.

Los Angeles Times:

The mayor’s unusually blunt order came after a day in which council members criticized the department for halting its years-long practice of providing the public with basic rescue response details, including times, locations and the nature of emergencies, as well as the age and gender of victims.

The sudden change in disclosure was announced earlier this week, even as the department struggled to reassure the public and city lawmakers about response time reports that made it appear that rescuers were getting to people in crisis faster than they actually were. A malfunctioning dispatching system that has delayed help for some victims in recent weeks has added to the department’s woes.

The mayor’s directive marks the first time since the controversy began that Villaraigosa has publicly broken ranks with Fire Chief Brian Cummings and his policies.

City News Service via KFIAM640.com before new order from Mayor Villaraigosa:

Citing a federal medical privacy law, the Los Angeles Fire Department announced today it would no longer provide the public with basic information about fires, medical calls, traffic accidents or other emergencies it responds to.

LAFD public information officers contacted by City News Service today about various fire calls — including a vehicle shearing a fire hydrant in North Hills and a collision between a food truck and a car in downtown Los Angeles that sent two people to hospitals — said they were not permitted to provide any information, including the locations of the crashes. In the case of the downtown collision, a spokesman refused to even confirm a wreck had occurred, even though footage of the crash had already been shown on at least one television news station.

The policy apparently took effect Sunday, when the LAFD began omitting the addresses from media alerts it circulates about fires or other incidents to which crews are dispatched.

KNBC-TV before new order from Mayor Villaraigosa:

For example, a media alert issued Saturday by the LAFD specified that fire crews had responded to a fire at 936 W. 49th St.

By Sunday, the department’s media alert about a reported fire in a three-story apartment complex included no address or general location of the blaze.

Cummings said the department is subject to the Federal Health Insurance Portability and Accountability Act, commonly known as HIPAA, “and is only permitted to release Protected Health Information for the purposes of treatment, billing and operations under the HIPAA Privacy Rule, without the patient’s permission.”

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Comments - Add Yours

  • http://twitter.com/#!/USNGFlorida USNG08

    “Map 634, D6″ as per the widget display sure appears to be a “bingo” grid. Bingo grids need to be phased out; they are not interoperable. The lessons are long ago learned, the after action reports long ago written. A fully interoperable, designed for land-based operations coordinate system exists: US National Grid. Over time, change response maps accordingly.
    http://fema.ideascale.com/a/dtd/U.S.-National-Grid-as-the-Response-Language-of-Location/320144-14692

    • http://emtmedicalstudent.wordpress.com/ Joe Paczkowski

      It sounds like a Thomas Guide reference. Thomas Guides are a popular commercially available street guide in Southern California commonly used both by emergency departments and civilians alike, which makes it much less of a problem than a proprietary map system.

  • Pingback: Morning Lineup – March 22 | Firegeezer

  • DC Firefighter

    Sounds reminiscent of what LRB did here in DC when he wanted to get rid of Pete Piringer as DCFD’s PIO, and then he replaced him with his racist friend L.Walls. What mushroom factory do they grow these worthless chiefs in? It’s becoming like a cancer in the fire service. We live in an age where information flows at a real time pace from sources to the public, how is keeping the public informed of fire department incidents a bad thing? I just don’t see it that way. But then again I tend to look at things objectively with an open mind, I guess that’s why I’ll never be a Chief Officer.

  • Former Chief

    I am by no means a HIPAA expert, but it would appear the Chief was attempting to protect the City based on a verbal opinion of the City Attorney, which is probably prudent. Until, of course, the Mayor started to take heat from the media and overruled him. I’m sure the Mayor would have chastised the Chief as well if the City was found in violation of HIPAA. Hopefully there’s a solution so that LAFD can continue to set an example of how to provide public information. And, what a surprise, additional federal legislation appears to have spurred the entire problem. Who would have thought?! Dave, I’m sure you’re much more familiar with the intricacies of this. Any thoughts?

    • dave statter

      I can’t tell you how many different interpretations of HIPAA I received from hospitals and public safety during my years as a reporter. Some who cite it are genuinely misinformed others have used it to keep basic information from the public, or even to limit access in a public place.

      As to who has the correct reading on what is or isn’t allowed, I do not know (other than my hunch is there has generally been an over reaction since HIPAA was implemented). Maybe Curt Varone at FireLawBlog.com can set us straight.

      What I can tell you is that suddenly going from a department that has a history of putting out key information in real time to a situation where you have to play a guessing game to find out where an incident occurred was bound to cause more controversy for a department that is currently mired in it. It does not appear that it was well thought out or planned and the terse missive from the Mayor makes that pretty clear.

  • Former Chief

    I agree, even though I think the Chief was doing what he thought was the right thing, that it probably could have been thought out and handled better. But, we’re also basing our opinions on the information we have read. Who knows what’s really going on behind the scenes here or how adamant the City Attorney was that HIPAA regulations may have been violated. I too, have heard numerous interpretations of HIPAA over the years, sometimes I believe, being used as an excuse for not releasing information.

  • Ted

    HIPPA applies to “entities that charge for healthcare services.” LAFD does charge and does provide emergency healthcare services and “medical transporation.”

    LAFD IS “a holder of medical records,” so the guy from the LA Press Association is very misinformed there.

    So, LAFD does have to exercise SOME caution, not a total blackout though.

    Example:

    Wrong: “Joe Smith who resides at 123 Ventura Blvd was treated by LAFD paramedics tonight for a gunshot wound that he sustained at 12345 San Pedro Blvd, he was transported to UCLA Medical Center in critical condition.”

    Right: “LAFD paramedics provided ALS care and transportation to an adult male today who was involved in a shooting on San Pedro Blvd in the City. He was transported to a local trauma center.”

    Interestingly, HIPPA does not apply to an entity that does not charge for services. So a Fire Dept. that provides free medical fisrt response could release a bit more. The PD do not charge either, so clearly they can release much more. Of course state privacy laws apply.

    Ted

    • http://emtmedicalstudent.wordpress.com/ Joe Paczkowski

      Slight correction: HIPAA doesn’t apply to health care providers who submit transactions electronically for which a standard has been adapted. In theory, a health care provider can do their billing completely by paper and not have to follow HIPAA. I say “in theory” because my understanding is that Medicare only accepts electronic billing now.

    • http://tooldtowork.com Too Old To Work

      Your treatise on HIPAA would be a whole lot convincing if you spelled it correctly.

  • north chief

    HIPPA is one of the most mis-understood rules, good intent, bad interpretations. I have heard scanner traffic where the patient info such as name,address,complaint,sometimes phone number, age etc are given over the air, and I have been told that HIPPA does not apply to dispatch centers, they can say whatever they want. Someone needs to address this so all responders and the public recieve the correct information. It does sound like LAFD is hiding behind this law to cover thier butts.

    • http://emtmedicalstudent.wordpress.com/ Joe Paczkowski

      I would argue that an independent dispatch center (like consolidated county dispatch services or when a police department processes 911 calls) does not have to follow HIPAA because they are neither a covered entity, health plan, or an information clearing house . However, an in-house dispatch center (like LAFD) would be a part of a covered entity, and thus have to follow HIPAA.

  • HIPPASUCKS

    Any release such as address is not a violation it is an incidental release such as providing the info to responding units who may be heard via a scanner. Patient information only regards the name of the patient it does not apply to the persons physical address, Physical description etcc or giving info to the media such as a 35 year old male patient who was involved in the accident was taken to x hospital.

    Yes we do have to protect private information but the patient still has the right to release that info as they see fit such as if someone calls and requests info as long as they are approved. Since its inception HIPPA has done nothing but cause controversy and confusion and should be fixed or something else put in its place.

    One thing that especially annoys me is firefighters emt’s paramedics whatever saying that the public cant take pictures of the patient because they are breaching HIPPA hmmm the public is not covered under HIPPA so how are they breaching it? Also when someone dies HIPPA no longer applies to that person. When will all the confusion and stupidity stop?

    HIPPA killed a great discovery show remember Paramedics? Great show was killed by people misinterpreting HIPPA. Yet there are still shows in the ER that were and are still filmed after HIPPA so why kill paramedics and not the other ones? Oh I know a solution let the patient decide if they want to be part of it if not no filming if so here is a release form…But what if the person dies? Let the family decide if they want it to be released so I say to discovery learn the real facts and bring back a great show!!! or at-least release them on DVD.

  • Tree

    Information is power. Controlling information is a method of wielding power.

  • Rudedawg

    HIPPA ONLY applies to those entities that bill Medicare or Medicaid for their services. Dispatch centers are NOT covered by this law. Fire Departments that DO NOT BILL Medicare or Medicaid DO NOT have to follow this law. Police Departments can release ANY information they choose to because they DON’T bill Medicare or Medicaid. Anybody get the point? The L.A.F.D. Dispatch Center can release any information it chooses to without being in violation of HIPPA because it DOESN’T BILL MEDICARE OR MEDICAID !

  • http://tooldtowork.com Too Old To Work

    Chief Cummings is hiding behind HIPAA to avoid being accountable for lying about response times to the LA City Council.

    He should and might be fired for that. A sharp public rebuke by the Mayor is not a career enhancing move.

    It’s not the crime, it’s the cover up.

    http://tooldtowork.com/2012/03/its-not-the-crime-its-the-cover-up/