New Home

I am working on a new home for the blog, on my own hosted website, but it has proven to be more challenging, tech-wise, than I thought.  I announced the new website on my Facebook page, and now it’s not q u i t e  how I wanted it.  When I do get it up and running, I’ll link to it here.

EMS 2.0

I am still digesting it, but found this post by “Ambulance Driver” to be very thought provoking.  Thanks to Scot Phelps for bringing it to my attention.

Ryan White Remedy Delayed

Yesterday, September 30, 2009, the Senate approved the language of the Legislative Branch Appropriations Act of 2010 and the President signed it the same day.

Why do we care about this?  This Act changes the expiration date of the current 2006 version of the Ryan White CARE Act to October 31, 2009.  Remember all the hullabaloo about the 2006 law leaving out the protections for EMS responders who treat patients that they don’t know have communicable diseases?  Well, we were counting on that being fixed in the 2009 readoption of the law.  It was set to expire yesterday, if not readopted.  Congress was not able to get that done in time, so they gave themselves an extension.  It seems all the focus on health care reform took time away from this part of health care law.

What does this mean to us?  People working with legislators in Washington are confident that the pre-2006 language will be voted into the new law, but it will take at least the next 30 days to get that made into law.  I’ll keep you posted.

Ryan White was a kid from Indiana who got HIV and AIDS from a blood transfusion and had a hard time with his school because they didn’t know a lot about how the disease was transmitted back in the 1980s.  His plight got the attention of the press and Congress, and a major HIV research and funding law, the Ryan White CARE Act.  This Act also provided for protection for EMS responders by requiring the hospitals to let us know when patients we bring them later get diagnosed with certain communicable diseases, including HIV/AIDS.

Ryan died in 1990.

Image from avert.org, used with permission.

Get Your Will For Free – This Saturday

There are still seats open at Saturday’s Event.  Will I see you there?  The following is from http://mercerwfh.eventbrite.com/.  Click on that link to reserve your seat at the free will event.

New Jersey State Bar Association Young Lawyers Division and the Wills for Heroes Foundation proudly brings the Wills for Heroes program to Mercer County. Wills for Heroes is a free and easy service that provides estate planning documents to first responders as well as their spouse or partner. If you die without a Will, New Jersey’s laws of descent and distribution will determine who will receive your property. Undoubtedly, your loved ones’ grief will be overwhelming; a clear expression of your intent, desires and wishes may help ease some of this inevitable burden. While nobody likes to think about an untimely death, it is best that you express your wishes through a written document. For your family’s peace of mind, please consider this invaluable opportunity, offered completely free to you and your spouse or partner. On Saturday, September 26, lawyers will be at the training center conducting the Wills for Heroes Day for first responder personnel along with their spouse or partner. Starting at 10:00am and ending at 3:00pm, volunteer lawyers will be available for appointments. Each appointment will last approximately one hour and at the conclusion of it you will have notarized legal documents. Registrants should indicate their preferred appointment time, beginning at 10am in 1 hour blocks. No appointments will be scheduled after 2pm. Since each individual consultation takes approximately one hour, we ask that spouses and partners sign up for back to back appointments and expect to spend up to two hours on site. The event is scheduled to take place at Capital Health Center at Hamilton, 1445 Whitehorse-Mercerville Road, Hamilton, New Jersey 08619. APPOINTMENTS ARE ON A FIRST-COME-FIRST-SERVED basis. Document products available include Last Will & Testaments, Durable Power of Attorney, and Advanced Healthcare Directives. ** If your estate exceeds approximately $750,000, this service is unavailable to you due to the complexity of your estate and the limited time to complete the legal documents. For determining if your estate is over $750,000, include your cash, personal property, stock and bonds, real estate equity, savings, and cash value of a whole/universal life insurance policy only. For more information on this program, please review the Wills for Heroes Foundation website at www.willsforheroes.org. Prior to your appointment, you will be provided with an estate planning questionnaire. This must be filled out and submitted at the time of your scheduled appointment. Your spouse/partner must fill out and complete a separate questionnaire. All registrations are to be completed online.

“No Comment”

I just saw this article on ZDNet (“How I tweeted my way out of spinal surgery“) which is just an example of how the media can make us look bad for following the law.  How many times has this happened at your organization?

A patient tells an outrageous story of something that happened in your ambulance or ER.  It’s outrageous:  If it really happened the way they said, you’d be firing people right and left and doing a root cause analysis.  What’s more outrageous, is that it didn’t exactly happen that way, and so the conclusions everyone is coming to about how your people should have reacted are inaccurate.  You want to set them straight, but you CAN’T.  Because in order to tell them why you never gave Mrs. Bad Outcome the drug she says she needed is because she told you she was allergic to it.  And you are prohibited by law from disclosing that bit of information!  Unless the patient signs this little form, which they never get back to you until the end of the next news cycle when it’s too late.  Everyone thinks you are hiding behind your lawyers and if you really didn’t do anything wrong you would just call the patient’s bluff.  But since you say “HIPAA prevents me from responding,” they believe the patient’s version of the facts must be the accurate one.

Sometimes, your lawyers and PR people want you to just let it go.  But sometimes, it’s not the press, it’s your county government or town council, or a potential business partner.  In that case, their perception of your patient care in a bad (and inaccurate) light will matter for longer than the next human interest news story, and you need to respond.  In those cases, we sometimes do ourselves a disservice by not expediting the signing of the release.

If your legal counsel, your board, or your management team has determined that laying all the cards on the table and defending yourself on the actual facts is the right move, you may want to avoid the “we can’t disclose this PHI” scene by taking a HIPAA compliant written authorization form to the patient at the first public complaint, so when you answer the accusations, you don’t say “we can’t tell you what happened,” but you can say “Mrs. Bad Outcome has given us permission to share this information. Let me have this cardiologist here explain how use of the drug she requested would have resulted in a worse outcome and how these three treatments we initiated here were consistent with our state protocols and the standard of care.”

Or maybe “Sorry, but even though the patient has disclosed to you her medical problems, she expressly refused to permit us to share any information about her treatment with you.”  This changes the situation from “hiding their incompetency behind the law” into “patient is a trouble maker wasting my time because she won’t let the provider explain.”

Remember, keep protected health information confidential, and respect the patient’s privacy, but passive aggression is not always your friend.

HIPAA Enforcer: New Director of OCR

Georgina C. Verdugo is the new Director of the Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services. As you know, OCR investigates complaints filed by the public and provides technical assistance and public education to ensure understanding of and compliance with Federal nondiscrimination and health information privacy laws.

Pro Bono Services Inspired by September 11

Last month, I wrote about the Wills for Heroes event in Cape May.  There is another event in Hamilton on September 26th.  For more information on volunteering as an attorney, witness or notary, please contact Karen Weiss at kweiss@sternslaw.com or 609-989-5002.

There are about 40 first responders from Mercer County and surrounding communities already signed up for this.

Wills for Heroes is a nonprofit organization created after September 11, 2001. The founder realized that many first responders, including some of those who died in the rescue operation after the attack,  do not have estate plans. Through Wills for Heroes, volunteer lawyers provide free legal estate-planning services, including living wills and health care proxies, to EMS, fire and police and their spouses.

If you’d like to host an event at your squad, police station, fire department, or ambulance service, contact me and I will put you in touch with the right people.

Googling Living Wills

Helen Oscislawski at Fox Rothschild has posted an interesting commentary on Google’s new service, uploading your living will to Google Health.  Helen’s blog post is here. She asks a really good question:  How will the doctor or emergency room know you have an advance directive on Google if you arrive in their care unable to communicate, which is exactly when a living will is supposed to work?

I’m thinking having the document on Google Health is probably better than having it in a file at home where you can’t find it, or locked in a safety deposit box, but you still have to communicate to your loved ones and your doctor that you have a living will or health care proxy, and liberally share the document and instructions around.  And if you do that, why would you need to upload it to Google?

Thoughts?

Paying Employees Out of Your Pocket

An appeals court in California just decided that a CEO, CFO, and a manager at a hotel could be held personally responsible for payment of back wages and accrued vacation time of employees who filed a suit in federal court under the Fair Labor Standards Act (FLSA).  The amount has not been decided yet, but the plaintiffs went after the individuals because the hotel/casino was in bankruptcy, and therefore could not be made to pay the claims.

Whether you own your ambulance service or are just an employee like the rest, if you have the responsibility to make decisions about how people get paid or record their time, this case tells us that the government can go after YOU if employees are not paid correctly.  Your employer can buy insurance that covers you even after bankruptcy, or after you don’t work there any more. This is a good reminder to do a periodic audit of your coverage, both personally and corporately.  Talk to your lawyer, insurance agent, CPA.  And of course, the best way to avoid a court order to pay back wages is to pay them correctly in the first place.

In New Jersey, depending on the way they write and communicate their policies, private employers may not have to pay out accrued leave when an employee quits or is terminated.  However, your actual practices have to reflect your written policies.  Having a policy and not following it consistently can be worse than not having a policy at all.

Volunteer Lawyers Needed for Wills for Heroes

 The New Jersey State Bar Association’s Young Lawyers Division is looking for volunteers to help first-responders in Cape May.

The division is working with the Wills for Heroes Foundation, a nonprofit group that helps emergency aid workers obtain free estate planning documents.   The Saturday event will be held at the Cape May County Public Safety Training Center in Cape May Courthouse.  It starts at 8:30 a.m. Attorneys do not need special qualifications.

Volunteers can serve as attorneys, witnesses or notaries. To volunteer or find out more, contact Karen Weiss at kweiss@sternslaw.com.

Following the event, Cooper Levenson April Niedelman & Wagenheim will host a reception at the nearby Bellevue Tavern.