GREELEY — An Associated Press (AP) story recently reported that roughly two-thirds of states’ health departments, including Colorado, share the addresses of people who have tested positive for COVID-19 with local first responders. Additionally, that same report found that Colorado is among 10 states that also shares the names of those infected at the addresses.
However, not all Colorado jurisdictions are participating in the practice, and some civil liberty organizations are opposed to the process.
“The information could actually have a chilling effect that keeps those already distrustful of the government from taking the COVID-19 test and possibly accelerate the spread of the disease,” the Tennessee Black Caucus said in a statement to the AP.
Others say it’s a violation of privacy laws and question why first responders aren’t already practicing universal precautions.
Who is bound by federal Health Insurance Portability and Accountability Act (HIPAA) medical privacy regulations is complicated, said Mary Achziger, president of the board of directors of the Evans Fire Protection District and former Weld County dispatcher. Achziger said it all boils down to how the information is disseminated and in the case of dispatchers, who employs the dispatcher.
“HIPAA controls only apply to an agency that is involved with electronic transmitting of medical information and billing ambulance doctors,” Achziger said. So, if an ambulance company manages its own dispatch, those dispatchers would be bound by HIPAA.
A follow-up report by KRDO in Colorado Springs quoted Colorado Department of Public Health and Environment (CDPHE) sources as confirming the practice in Colorado, adding CDPHE and local public health agencies are not bound to HIPAA, which is supposed to protect medical information of patients, and agencies can share that health information back and forth among each other.
It is “recommended that the minimum necessary” information be disclosed to accomplish the intended purpose of the disclosure, the KRDO story reports, adding CDPHE is allowed to release “medical records and other individually identifiable health information used or disclosed by a covered entity in any form.”
The practice is known as “premise warnings” and has been used for decades both Achziger and Weld County Commissioner Chairman Mike Freeman said. It began in the early 1980s with the initial outbreak of Acquired Immune Deficiency Syndrome (AIDS).
Medical premise warnings for such things as MRSA, tuberculosis and other communicable diseases faded out because of security concerns and the ability for that information to become public record, Achziger said.
“Those were stopped and removed because of a fear of violating HIPAA and because of the concept that every responder should already be responding with universal precautions,” Achziger said. “You don’t need to tell them you should be wearing gloves because they should be wearing them anyway.”
The practice has continued mostly for first responder safety issues, but also for other reasons such as disabled residents who might not be able to get out of a home on their own in the case of a fire.
“If we were to send paramedics out to a residence and an adult who is an alcoholic got very obnoxious attacked one of them, we would put a warning on the home that said we have a person in this home that may do this,” Achziger added. “So we know if they go again, it might happen, and we’d send an officer with them.”
Despite what is happening at the state and national level, Weld County residents can be assured their personal medical information is not being shared.
The fact dispatchers working at the Weld County Regional Communication Center are Weld employees and are not bound by HIPAA, does not change anything, Freeman said. Weld does not share or collect information. There is a prescribed routine dispatchers follow when calls for help are made, and it is very limited in scope.
“When someone calls in, they are asked if anyone in the house has flu-like symptoms,” Freeman said. “If they say no, then away (first responders) go. If they say yes, they ask follow-up questions like if they have a cough or are short of breath. If they say yes, then when they are dispatched, they tell personnel that universal precautions apply, and that’s it.”
Individual departments take over from there, following their own specific protocols. In Evans, that means one firefighter goes into the home in full personal protection equipment. That firefighter then decides if he needs more help.
“We are limiting the exposure of our firefighters,” Achziger said. “They are immediately quarantined if they are exposed. We are not taking any risks. It’s hard for our guys to completely social distance. They share a kitchen and a common area at the station.”
Freeman added whatever is found at the scene is not reported back to dispatch, and nothing is stored by Weld County pertaining to COVID-19 for future use.
“Dispatch never has personal information,” Freeman said.