Small towns struggle with new medical privacy laws

Sunshine Week

For Release March 13, 2005

By JOE RUFF
Associated Press Writer

NELIGH, Neb. (AP) -- It used to be easy for Hope Weaver to comfort friends when they were in the hospital. If she didn't hear that someone needed a visit by word-of-mouth, she'd simply pick up the newspaper, tune in her radio or look at the patient list posted in the hospital's front lobby.

"You like to send people a card or keep in touch with them," the 79-year-old resident notes.

Now those practices, which helped neighbors stay connected in this community of 1,200 and others like it across the country, are largely gone -- partly because of the nation's new medical privacy laws under the Health Insurance and Portability and Accountability Act.

Designed to better protect a patient's right to privacy, the sweeping overhaul of federal health care laws went into effect in April 2003. That same month, Antelope Memorial Hospital in Neligh shut off general access to its patients' names.

The federal regulations "closed the openness that small communities have," said Shirley Clinton, a hospital privacy officer for Antelope. Now, printing and broadcasting names of patients makes a hospital liable under the law if someone's name is released without permission.

Clinton said HIPAA has helped in some ways. In the past, well-meaning people who didn't have loved ones in the hospital could bother patients who did not want to be disturbed, she said.

But the changes still don't sit well with some people in Neligh.

Gary Snodgrass, of nearby Clearwater, used to keep tabs on who was in the hospital as he listened to KBRX radio while driving his gravel truck for the Antelope County roads department. A list of people admitted and released was read, and hospitalized friends at least received a telephone call, Snodgrass said.

The new rules also upset Snodgrass' 88-year-old mother, Lois Snodgrass, and many of her friends, who once watched the newspaper carefully for people they might visit.

"Even people I didn't know too well, people from church, we'd send cards," she said.

Mrs. Snodgrass benefited from the old policy, too. Eight years ago. she was in the hospital for about a month with complications from gall bladder surgery and other health problems.

"At that time, people could come and visit," she said. "It helped make my stay a lot more pleasant."

Now, word of mouth or announcements at church have to suffice if the wider community wants to know who is hospitalized.

The HIPAA regulations, which carry civil and even criminal penalties if violated, require doctors, hospitals, pharmacies and insurers to notify patients about the privacy rules, describe how their medical information may be used and explain patients' rights under the new guidelines.

Unless patients insist on strict privacy, hospitals still can tell people who ask for patients by name what their general condition is, and hospitals can issue names of patients to clergy who want to visit ailing parishioners.

If patients don't want their names or other information released, health officials cannot even acknowledge that those individuals are in the hospital.

Antelope Memorial is far from alone in stepping up patient privacy.

Robert Dockter, chief executive of a hospital and assisted living center in Eureka, S.D., said his facility stopped broadcasting patient names about three years ago, as patients in the town of 1,100 began opting out of being identified and HIPAA regulations loomed.

Rosemary Blackmon, a spokeswoman for the Alabama Hospital Association, said the practice of publishing names in that state began fading away even before HIPAA, largely because people became more protective of their privacy.

"Years ago, that was the practice," Blackmon said. "Everybody in the world wanted to know who was in the hospital."

Joan Wright, owner, editor and publisher of the weekly Neligh News & Leader, said the newspaper received a number of telephone calls after it ran a notice explaining that names of hospitalized residents no longer would be printed.

Townspeople complained, "'My neighbor was in the hospital and I didn't even know it,'" Wright said.
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On the Net:
Health and Human Service's HIPAA page: http://www.hhs.gov/ocr/hipaa/