HIPAA & Confidentiality

What is HIPAA? In 1996, Congress passed the Health Insurance Portability & Accountability Act, or HIPAA. In 2000, the Department of Health & Human Services issued final regulations under HIPAA establishing privacy standards for certain protected health information and final regulations became effective April 14, 2003.

 

What is Protected Health Information?
Protected Health Information (PHI) is health information created or received by a health care provider, health plan, other agencies; and includes written, electronic, or oral communication of individually identifiable health information which relates to the past, present, or future physical or mental condition of the consumer and can be used to identify the consumer.

How does HIPAA affect you?
As a NAMI Maine Respite Provider, you are expected to know, understand and comply with this federal regulation. You have a responsibility, both legally and ethically, to the families to protect their privacy. All information given to NAMI certified respite providers is confidential. This means you cannot discuss anything regarding a child or his/her family with anyone else, with the exception of NAMI Maine Respite Care Services personnel. WhenNAMI certified providers are in a community setting they should not identify the child in their care as being part of NAMI MAINE Respite Care Services. Providers cannot discuss specific information about families or children with other providers, or other families with whom they are working, or the general public.

Exceptions as a Mandated Reporter
NAMI Maine Respite Providers are mandated reporters of suspected abuse and/or neglect of children. Abuse and/or Neglect can be defined as "a threat to a child's health or welfare by physical, mental, or emotional injury or impairment, sexual abuse or exploitation, deprivation of essential needs or lack of protection from these, by a person responsible for the child". (Title 22 - Chapter 1071 of the Child and Family Services and Child Protection Act).

If a NAMI Maine Respite Provider suspects abuse and/or neglect of a child, they must take responsibility for calling the DHHS at 1-800-452-1999 with their concerns about the care and safety of a child

Violations of HIPAA & PHI
Violation of the regulations carries significant civil penalties, criminal fines, and even jail time. Civil penalties are $100 per violation per person up to a maximum of $25,000 per person per year per standard violation. Criminal penalties vary, but can include: up to a $50,000 fine, 1 year in prison, or both, for inappropriate use of PHI; up to a $100,000 fine, 5 years in prison, or both, for using PHI under false pretenses; or up to $250,000 fine, 10 years in prison, or both, for the intent to sell or use PHI for commercial advantage, personal gain or malicious harm.

Mandatory Reporting:  NAMI Maine Respite Providers are mandated reporters of suspected abuse and/or neglect of children.  Abuse and/or Neglect can be defined as "a threat to a child's health or welfare by physical, mental or emotional injury or impairment, sexual abuse or exploitation, deprivation of essential needs or lack of protection from these, by a person responsible for the child" (Title 22 -Chapter 1071 of the Child and Family Services and Child Protection Act).  If a Respite Provider suspects abuse and/or neglect of a child, they must take responsibility for calling DHHS directly with their concerns about the care and safety of the child.

 

 

Funding for this program provided by the Department of Health and Human Services