Posted by: Robert Markette
July 05, 2006

Last week, the Department of Health and Human Services Office of Civil Rights (OCR) published a Privacy Rule Emergency Preparedness Tool. This is not a tool to help you with overall disaster planning. It is, instead, a tool to help covered entities determine what information they may disclose in responding to requests for PHI as part of disaster preparedness. You can download the flowchart from OCRs website.

This tool does not address disclosures that may be necessary in responding to a disaster. This tool address the question What PHI can I disclose as part of efforts to prepare for a disaster. This issue has come up as federal, state and local governments have been engaging in disaster planning over the last year. After hurricane Katrina and with the growing concern of the Bird Flu, more federal, state, and local agencies have begun to engage in disaster planning efforts, for example, efforts related to evacuation planning. As a result, many state and local governments are seeking information on individuals to identify those, for example, who would need to be evacuated in advance of a disaster.

This tool was developed in response to specific issues that arose when disaster planning for persons with disabilities. Covered entities needed to know what information they could disclose and to whom they could make the disclosures. However, the tool works for any PHI. The tool is not designed to help you with your own disaster planning, but simply to help you make the correct choices when disclosing PHI as part of disaster planning efforts.

The tool covers not only disclosures to public health authorities, but also to other providers. The tool states that disclosing PHI to another provider in advance can be a treatment disclosure, if it is for purposes of ensuring continuity of care. The tool uses the example of a group home disclosing PHI to another facility to which the group home residents would be evacuated in the event of an emergency. This may not be as important to home health agencies or home health hospices, as you will not be evacuating your clients. An inpatient hospice, on the other hand, may very well need to consider this kind of effort. (For those of us in the Midwest, evacuations may not be necessary, but you may need a place to move patients if your building is damaged by floods, etc.)

You should also know that this tool is not designed to assist you with disclosures related to responding to an actual disaster. OCR offered some guidance in that area in the wake of Katrina. There are a number of additional avenues to disclose PHI in responding to an actual disaster. For example, you may disclose PHI for treatment purposes and for certain notification purposes.

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