The Importance of Hippa and Ferpa to Human Services - and the consequences of violations.

Brief History

Hippa was passed in 1996 for various reasons. Two important ones were
1. Congress recognized the need for privacy and security standards and the potential for abuse and compromise due to electronic medium such as email and social networking that was fast emerging.

2. Before Hippa, there was no Uniformity and rules varied from by state and organization. There was confusion as to which rules were applicable. The following are a few of the highlights in Hippa News[i] over the last decade, this is not an exhaustive list:

·       January 1, 2012 - HIPAA X12 standards Version 5010 compliance date. These standards are for the electronic transmission of certain health care transactions. Health care providers, health plans, and clearinghouses are required to conform. These standards are necessary to prepare for the implementation of ICD-10-CM scheduled for October 1, 2013.

·       May 23, 2008 - National Provider Identifier Compliance Deadline for Small Health Plans and the end of NPI Contingency Period.

·       April 21, 2005 - Security Compliance Deadline.

·       July 30, 2004 - Standard Unique Employer Identifier compliance deadline.

·       October 16, 2003 - Transaction and Code Sets - expected date of compliance for small health plans and covered entities that filed a compliance plan to delay implementation.

·       April 14, 2003 Privacy compliance deadline.

·       February 20, 2003 - Security Standards published.

·       February 20, 2003 - Modifications to Transactions and Code Sets Regulation and Implementation Guide Addenda Published.

·       October 16, 2002 - Transaction and Code Sets - expected date of compliance for covered entities that did not file a compliance plan to delay implementation.

·       August 14, 2002 - Final modifications to the Privacy Rule published.

·       May 31, 2002 - CMS announced the adoption of the EIN as the standard unique identifier for employers in the filing and processing of health care claims and other transactions.

·       December 28, 2000 - Privacy Final Rule Published.

·       August 17, 2000 - Transaction and Code Sets Final Rule Published.

·       August 21, 1999 - Deadline for Congress to enact legislation governing the privacy of individually identifiable health information standards. Because Congress failed to meet the deadline, HIPAA requires the Secretary of Health and Human Services to promulgate such standards by regulation.

·       November 3, 1999 - Privacy NRPM (Notice of Proposed Rule Making) published.

·       August 12, 1998 - Security NRPM published.

·       June 16, 1998 - National Employer Identifier NRPM published.

·       May 7, 1998 - National Provider Identifier NRPM publishedTransactions and Code Sets NRPM published.

Ferpa, also known as The Family Educational Rights and Privacy Act was signed into law by President Gerald Ford in 1974. Whereas Ferpa protects the privacy of student records Hippa protects the privacy and security of a patient’s health records and information.
Congress has amended FERPA a total of nine times in the nearly 28 years since its enactment, as follows[ii]:

·       P.L. 93-568, Dec. 31, 1974, effective Nov. 19, 1974 (Buckley/Pell Amendment)

·       P.L. 96-46, Aug. 6, 1979 (Amendments to Education Amendments of 1978)

·       P.L. 96-88, Oct. 17, 1979 (Establishment of Department of Education)

·       P.L. 101-542, Nov. 8, 1990 (Campus Security Act)

·       P.L. 102-325, July 23, 1992 (Higher Education Amendments of 1992)

·       P.L. 103-382, Oct. 20, 1994 (Improving America's Schools Act)

·       P.L. 105-244, Oct. 7, 1998 (Higher Education Amendments of 1998)

·       P.L. 106-386, Oct. 28, 2000 (Campus Sex Crime Prevention Act)

·       P.L. 107-56, Oct. 26, 2001 (USA PATRIOT Act of 2001)

      Hippa and Ferpa are important Federal Laws and fall under Civil Rights category. Any report of breach in security or confidentiality reported to the Federal Government is administered by the OCR (Office of Civil Rights. As mentioned earlier, there was no standard procedure for monitoring and protecting patients and students privacy. Congress enacted Hippa to improve the efficiency and effectiveness in the electronic standards of health transactions and to protect the privacy and security of patients.

Ferpa on the other hand protects the privacy of student records in those schools that receive Federal Funding under programs administered by the United States Dept. of Education. This would include public schools, medical and other professional schools. Institutions are not allowed to share any personally identifiable or educational records without the students or parents consent. Private and religious schools are generally exempt from Ferpa.

Hippa and Ferpa are very important in the Human Services field for many reasons. On a personal level, I can say that they facilitate some level of trust between a patient/student and the institution that possesess such records. In this current era of identity theft, stalking, and other criminal activity, it becomes important to secure and protect the privacy of clients who are entrusting a human services worker with their life’s history.  Breaking that trust is detrimental to the whole meaning of the word service connected with the word human. We are attempting to serve human beings who are often vulnerable, for instance, an abused woman. It is crucial to keep that type of clients’ information secure and private lest their address becomes public knowledge.

Violations have happened and the fines can be quite steep from losing one’s job to actual imprisonment. One example of a violation involves the social network FaceBook. A group of 13 emergency workers started a page with good intentions to just talk about the day’s activities. However, as is often the case on social networks, people forget that it is not a very private medium and that it is in fact very public. People let their guard down and divulge frustrations related to the days dealings with their clients. That is exactly what happened with this group on FaceBook and they were fired. The hospital reasoned that anyone who had access to the page could put enough information together to identify patients.

If your employer does not have a counseling program set up in house, then perhaps you may want to suggest one. Employees need a place to safely vent their frustrations and learn some techniques in dealing with the stresses that accompany a human service workers job. Expecting employees to “just handle” the public is unrealistic and counter-productive to providing service to the public. Also remember that talking about your clients outside of work, no matter how rude and belligerent they behave, betrays trust and can cost your job or career. In a worst-case scenario, it can land you some jail time. One of the best bits of advice is from an ancient proverb, “Do to others as you would have them do to you.” Remember, you are not only a public servant while on the job; when you leave the office; you become part of the public. If you had to go to your office to obtain help, how would you want to be treated?  How would you want your records taken care of? Someone in an office is probably processing some record of yours perhaps your doctor, lawyer, college, or your dentist.

Hippa and Ferpa are in place to insure that our information remains private. That includes becoming a verbal vault that safeguards the public’s privacy. As a social worker/human services worker, we have a solemn duty to honor those that depend on us for help when they are often in a crisis emotionally and physically.

---

[i] All Things Medical Billing ( 2012). History of HIPAA. ONLINE] Available at: http://www.all-things-  

  medical-billing.com/history-of-   

  hipaa.html. [Last Accessed January 30, 2013].

[ii] U.S. Department of Education (Last updated June 2002). Legislative History of Major FERPA

  Provisions. [ONLINE]    

   Available at: http://www2.ed.gov/policy/gen/guid/fpco/ferpa/leg-history.html. [Last Accessed January

   31,2013].

List of Social Issues

Recently I read a blog that had a list that the blog writer felt are social issues that need solving immediately. These issues cover global and national issues that affect all of society, usually in a negative manner. Let’s face it; if they weren't negative, they probably wouldn't be an issue! The list is quite extensive but lacks a few issues such as anti Christian sentiment discrimination and violence, government corruption, other STD’s besides HIV/Aids, teen suicide, teen substance abuse, gang violence (aka domestic terrorism) the cost of education, and illegal immigration. The writer did mention global terrorism, economic issues, gender issues, and health issues. To read the article, see the link below (Updated for 2018 but essientially the same). Here’s his extensive list.

List of Social Issues in Today's Society

·       Alcoholism

·       Food and Drug Safety

·       Tax Reform

·       Church-State Separation

·       Global Warming

·       Birth Control

·       Abortion

·       Suicide

·       Drug Abuse

·       Capital Punishment

·       Media, Sex and Violence

·       Animal Rights

·       Homosexuality

·       Poverty

·       Women's Rights

·       Anti-Muslim Discrimination and Violence

·       World population

·       Same-sex marriage

·       Organ & body donation

·       Human Rights

·       Environmental Pollution

·       Children's Rights

·       Corporate Downsizing

·       Defense Spending and Preparedness

·       Euthanasia & assisted suicide

·       Eating Disorders

·       Unemployment

·       Homelessness

·       Racial profiling

·       Welfare

·       Recycling and Conservation

·       HIV/AIDS

·       Civil Rights

·       Genetic Engineering

·       Consumer Debt and Bankruptcy

·       Obesity

·       Terrorism

·       Judicial Reform

·       Censorship

·       Violence

·       Academic Freedom

·       Gun Control

·       Gender issues

·       Environmental issues

·       Single Parenting

·       Child Labor

·       Immigration

·       Tobacco

·       Nuclear Proliferation

·       Ageism

·       Stress

·       Cancer

·       Prostitution

·       Gay Marriages

·       Education

·       Health Care Reform

·       Embryonic Stem Cell Research

·       Affirmative Action

I don’t know if this person is a social worker or not, but it doesn’t matter, because the list is fairly accurate. A person does not need a degree in social work in order to have an intelligent assessment of the social issues facing our world. After all, the first social workers did not attend college including a man named Jesus and all his apostles. Jesus a social worker? Yes indeed! He fed the poor, clothed the naked, cured the diseased, provided counseling, encouraged spirituality, loved the prostitutes, loved society’s outcasts of that day, and confronted injustice when necessary. I believe he was more than just a social worker, nevertheless historically,  social work began as a work to care for the poor, (read the “Poor Relief Laws”, aka Elizabethan laws of 1601.)
             Over the coming months, I shall attempt to cover each of these social issues and give my input or viewpoint on the matter. I will approach the subject from a historical, present day, perspective and a future oriented perspective.  Some of these issues will necessarily incorporate moral issues, and there is no other way to approach them. For instance, gang violence is not just an issue of cognitive dysfunction or behavior modification. When people murder, steal, intimidate, or rape others then people are breaking the law and so it will be necessary to address the purpose of laws in a society.

            Indeed some are breaking the law because of deep internal conflicts from abusive childhoods, but we can’t try to fix a person’s internal conflict without teaching them how to be productive members of society. That will necessarily involve teaching them the value of being law-abiding citizens regardless of the economic benefits, or lack of benefits. In short, we teach people to view the laws as tools to respect human life and as a means of playing a role in the perpetuation of our culture, values, society, population and identity as a people. We also teach them how to change unjust laws through peaceful means rather than through violence.

            Frankly, in my humble opinion, most of the social issues today are moral issues, not civil rights issues. I hope to make a case for that assertion over the coming months. For instance, what is the difference between a personal value and a moral issue? A personal value is something that is personally important to us, while a moral value concerns itself with right and wrong. An absolute moral value may not be held as personal value, but every personal value becomes a moral value to that person. The question becomes, “Are a person’s moral values in tune with the majority of society’s moral values?” 

            For instance, racial discrimination is a moral value. Is it right to discriminate, or treat a human being differently, based on race? We are not just talking about discrimination against African Americans, but against European Caucasians, Asians, Mexicans, Middle Eastern, and others. In southern America, after the civil war, blacks were discriminated against solely because of their skin color.  On the other hand, was it just the south that discriminated against African Americans? After the civil war, the government created few laws to protect the freed slaves. Consequently, the southern states enforced the “Black Codes,” a set of laws designed to keep the freedmen under the rule of white aristocrats in the south. The Black Codes listed what blacks could and could not do; they could not assemble, bear arms, or testify against whites in court. They could not vote, were not allowed to become literate (i.e. little to no education) and their freedom of speech was severely limited.

            Is this a personal values issue or a moral issue? To southern whites it was a personal value issue, yet at the same time, it became their moral code; even becoming codified in southern law. These laws eventually led to the complete separation of whites from blacks in restaurants, hotels, and even water fountains. Before northerners become too smug after reading the previous statement consider this. When Martin Luther King Jr. visited Chicago, for a peaceful walk and demonstration, he was met with bricks, spittle, and insults. The animosity was so great in Chicago that Mr. King stated, “I have never been to a more hate filled city than Chicago, Illinois! That’s a startling statement from a man who had been thrown in jail in the south, and lived where blacks were routinely lynched, murdered, and mistreated.

            The reaction in Chicago was an expression of a personal value that had become a personal moral value. To the ones hurling insults, it was wrong for Dr. King to be in Chicago marching for the African

American communities’ constitutional rights to vote, have equal access to work, and so forth. To Dr. King the separation of blacks and whites was not just a personal value but also a deeply held moral value of society at large. African Americans did not ask their ancestors to be kidnapped and enslaved. Nevertheless, they were here and had been freed via a great civil war that divided a nation. If they were now freed and considered Americans, then they had the moral right to the same constitutional freedoms as every other man. Racism is not a values issue, nor a civil rights issue. Racism is a moral issue because at the root of racism reside distrust and hatred.

            This raises another issue. Who determines what is right or wrong, and how do we establish moral laws that are fair to all and not easily changed? If moral laws are easily changed then there can be no security for society, because one day racism may be immoral while the next day moral. For a society to continue in peace and security laws must be established that benefit the whole nation not just a select few. 

When personal values become exalted above moral values then we soon begin experiencing a kind of democratic anarchy. Everyone demands their rights, while society’s moral laws are put on the back burner and everyone does what is right in their eyes.

 “To hell with the laws of nature, to hell with the laws of evolution, to hell with absolute laws, to hell with Gods laws. All that matters is that I get what I have a right to.” We are experiencing this democratic anarchy right now in America. Unless we return to a healthy respect for rule by law versus rule by mob, then the divisive, acrid mistrust will only deepen and our social ills will continue in their downward spiral. 

            Economic freedom is seen as a civil matter, yet is it a deeply moral value?
Is it right or wrong for a person to be forced to redistribute his wealth?  Does a person have the moral right to pursue economic freedom or be subject to the whims of the state? Does a poor person have the right to access to education, and temporary government assistance or is it moral to ignore them and leave them to fend for themselves? Is it morally right to assume that every poor/homeless person is lazy without visiting them and asking how they ended up homeless? I’ve talked to homeless families in which the father was working but simply could not earn enough to pay for rent. That’s life in America in the 21^st century. All of our previous assertions have to be reevaluated and in most cases discarded in today’s society. Is it morally right for the government to enact laws that are impractical, economically useless, and actually hurt society rather than helping?  Is it morally right or wrong for those laws to continue because someone in government is too proud or afraid, to admit the law does not work?

            These types of moral questions must be addressed by today's social workers. We can no longer cling to our pet philosophies that have proven to fail. If we are to be true social workers, we must return to the foundation of social work and seek what is best, based on absolute moral values, not personal values that become unstable and changeable moral values, resulting in the present day democratic anarchy. 

            I will begin addressing some of these issues listed, in the coming months ahead, so stay tuned! For further reading: Social Issues in Today's Society.

Dan Dickerson

Domestic and Verbal Abuse

Note:
This is a message board response from my class in Crisis Intervention, Domestic Abuse.

I received an A for this response (short essay).




This is a subject that I've been studying on my own over the last year and found the chapter on it very interesting. I especially like the Learned Helplessness/Battered Woman Theory section of the book.  Over the last year I've had the opportunity to talk to/counsel several battered women and almost everyone said that after a while they began to believe what their abusers said to them was true. It's pretty rare that physical abuse is absent of verbal abuse. Learned helplessness is, at its basic principle, an adoption of false beliefs about reality. The abused initially thinks about escape and rejects the accusations against her yet gradually begins to believe the words spoken to her and then begins adapting her behavior to accept the abuse. In some cases she actually believes that she deserves the abuse because, in her mind, it's all her fault. The response is much like the famous experiment by Martin Seligman and Steven Maier.

They had initially observed helpless behavior in dogs that were classically conditioned to expect an electrical shock after hearing a tone. Later, the dogs were placed in a shuttlebox that contained two chambers separated by a low barrier. The floor was electrified on one side, and not on the other.
There's more detail to the experiment than what I'm sharing,  but eventually a set of dogs who had not been classically conditioned simply jumped over the low barrier to escape the shock. However the dogs that had been conditioned, did not even attempt to escape because the had been conditioned to "believe" that there was no escape and therefore just endured the shock.

The classic definition of learned helplessness is, "When people feel that they have no control over their situation, they may also begin to behave in a helpless manner. This inaction can lead people to overlook opportunities for relief or change."
It's also related to a belief that their locus of control is outside of themselves. They feel that external forces are in control of their destiny and that they can do little to change it, not realizing that everyone has an internal locus of control that can be activated at any time.

I dare not compare humans to dogs but the effect of environmental conditioning is undeniable.The key though to understanding the dynamics of domestic abuse, in my opinion, is that some women do not adopt this belief, or eventually come to reject the false beliefs and escape, while many believe the lies of verbal abuse spoken over them. I've read of some women becoming so hopeless and feeling so helpless, that they committed suicide; deeming that choice a better alternative to a life of degradation through physical and verbal abuse.

As a future Family Counselor and Human Services worker, it is the most agonizing thing in the world to watch someone return to an abuser, even though they've been warned, counseled, given shelter numbers and other resources that can help them escape. Frankly, it is one of the most frustrating experiences imaginable. I pray to God that I never receive a call or hear the news of one being hospitalized (or worse) that I've tried to help.