[spacemonkey36]

Hey,

I quit getting services/whatever from the last place because I felt like our "connection" was over, and the therapist/patient relationship and my own sense of trust was basically over-done-non-existant. Which really hurt, because I had a sneaking suspicion that the therapists, case managers, and workers, were discussing me amongst themselves, but had no proof.

Well, w/o going into a long story about how I met my new "therapist to be" it happens that she used to work there. And she was honest and told me she knew who I was already, and "had heard a lot about me around _______ Agency. Which, as she put it, "means that there were people you were being talked about to that had no business knowing anything--including your name...the fact that I even know your name (she wasn't involved in my care) should show something." I told her I already knew I was probably a "lunchroom joke" around there, and it was due to lies on the part of my family, and a misdiagnosis by an unsupervised 3rd year medical student at another facility, who was allowed to put an inaccurate psychiatric diagnosis about me on my medical record with no challenge or supervision.

Well, she and many others have "found their conscience," as I put it, and no longer work there. I trust her--I also am friends with her husband--and she has agreed to see me on sliding scale!!!

I told her, that my life is a lot different even than when at the prior place, and that I believe a person's recovery-medical or psychiatric-is in their hands. Doctors/pnurses, etc, can do their part and operate, or maybe correct chemistry, but the recovery--working the muscles that are weak after surgery, or the coping skills, and helping yourself heal after some trauma, or maybe after some kind of loss, is up to the person themselves. That too, is her philosophy. So, it sounds like a great fit.

But here's my dilemma. I have to decide whether or not to report the HIPAA violation to the proper authorities--which could affect my housing situation come September, and as of September, it's going to exceed the 3 year deadline I have to report the punishable violations, which were apparently very huge, and on multiple occassions.

My father, whenever I express negative feelings towards what has occurred with the previous organization (as does any member of my family), gets angry with me, and says something like, "I feel so upset when I hear you so angry and talk about them like that after all they did to help you." Well, the woman affiliated with them who helps out with housing, yeah, she's been indespensible, but the rest of them treated me like an imbecile (and I have had neuropsych testing, including an IQ test, which put me at 171--so I am not an imbecile), talked to me like I was 'crazy' and made me feel about 2mm tall. And always like I had done something wrong. I was on no pain meds, or "controlled substances" but they would UA me anyhow--and I always passed--not even one single test did I "fail," and I think that ticked them off. But no one ever acted like they trusted me. I told my CM about the sons I had at 16 and gave up for adoption~it had been a twin birth, but one of them did not make it...he died in an car wreck a few years ago...and my sister who has mental issues-putting it mildly--told them I was lying. I showed the CM their birth certificate, adoption papers, and the one son's death certificate. She accused me of downloading them and faking it.

I also had been in the process of being diagnosed by an independent rheumatologist with multiple autoimmune disorders. Diagnoses which were later confirmed. Apparently, I lied about that too.

I began drinking from the stress, which I have now been sober from for over 2 1/2 years, and I really haven't thought about them in a long time.

I don' want to risk my housing--without the help of the housing person, who is only loosely connected, and would likely help anyhow, but I am not 100% sure...I won't have funding to afford anywhere to go. I am having major hip surgery soon, and will still be recovering in September.

So, do I report the HIPAA violations? I would also need my new therapists' cooperation.

Thoughts anyone?

Thanks,
JJ

[Fartraveler]

I have no special experience in this field. But my feeling is that you should not take this task on. I realize this may come across as harsh, but I really do have a lot of sympathy for you in this situation you've described. However, in the situation a you've talked about it, I think that the potential costs to you outweigh any potential benefits.

As you have described this situation, you have a strong moral and ethical and even legal case.

However, if you pursue this, you will incur huge costs in time and emotional stress, not to mention it will undoubtedly cost $$$.

As you have undoubtedly realized, a person with documented mental health issues has little credibility in the eyes of authorities. As you've described your situation, you can easily be portrayed as someone who is unstable and untruthful, even if both those things are completely untrue.

And the only actual proof you have is something that your therapist told you in session. And you've described your therapist as someone who also has had conflicts with this center.

Credible proof would be contemporary documents. For example, if you had copies of emails in which people at this clinic were discussing you inappropriately, that would be proof.

A discussion with your therapist is not proof, regardless of the truth of what she told you.

And you say that you may be placing your housing in jeopardy? And are about to undergo major surgery that will require substantial recovery time? It sounds like those are the things you should be putting your efforts into.

I think that in practical terms, going after these people is just not worth it.

But you should definitely talk about it with your therapist.

Take care,
-Far

[gaia67]

I think you have a responsibility to report it; for the protection of current and future clients as well.

[WikidPissah]

Sometimes you have to protect yourself more than having to protect others. This case would (as fartraveler said) make life even more stressful. I just went thru a much simpler court battle, ended up in the hospital because of it. In court all your mental health info can be subpoenaed...and that is more painful than most people realize.

Walking away might be much better for your personal well being. Talk to your T about it.

Personally, I'd just move on. I wouldn't put myself through that stress. But only you know what you need to do for yourself.

[Perna]

It sounds like any possible HIPAA violations would be very complicated and hard to prove. HIPAA is mostly about your records, not whether people talk about you or not. Proving unauthorized people had seen your records and/or what they have been saying came from your records or was "made up"/conjecture, might be difficult. It sounds like the many people in the agency have certainly been unethical but not necessarily broken Federal or state laws. I'm with farmergirl/Chris, I'd just move on now that you are getting things in better shape for yourself.

[amandalouise]

Originally Posted by spacemonkey36

Hey,

I quit getting services/whatever from the last place because I felt like our "connection" was over, and the therapist/patient relationship and my own sense of trust was basically over-done-non-existant. Which really hurt, because I had a sneaking suspicion that the therapists, case managers, and workers, were discussing me amongst themselves, but had no proof.

Well, w/o going into a long story about how I met my new "therapist to be" it happens that she used to work there. And she was honest and told me she knew who I was already, and "had heard a lot about me around _______ Agency. Which, as she put it, "means that there were people you were being talked about to that had no business knowing anything--including your name...the fact that I even know your name (she wasn't involved in my care) should show something." I told her I already knew I was probably a "lunchroom joke" around there, and it was due to lies on the part of my family, and a misdiagnosis by an unsupervised 3rd year medical student at another facility, who was allowed to put an inaccurate psychiatric diagnosis about me on my medical record with no challenge or supervision.

Well, she and many others have "found their conscience," as I put it, and no longer work there. I trust her--I also am friends with her husband--and she has agreed to see me on sliding scale!!!

I told her, that my life is a lot different even than when at the prior place, and that I believe a person's recovery-medical or psychiatric-is in their hands. Doctors/pnurses, etc, can do their part and operate, or maybe correct chemistry, but the recovery--working the muscles that are weak after surgery, or the coping skills, and helping yourself heal after some trauma, or maybe after some kind of loss, is up to the person themselves. That too, is her philosophy. So, it sounds like a great fit.

But here's my dilemma. I have to decide whether or not to report the HIPAA violation to the proper authorities--which could affect my housing situation come September, and as of September, it's going to exceed the 3 year deadline I have to report the punishable violations, which were apparently very huge, and on multiple occassions.

My father, whenever I express negative feelings towards what has occurred with the previous organization (as does any member of my family), gets angry with me, and says something like, "I feel so upset when I hear you so angry and talk about them like that after all they did to help you." Well, the woman affiliated with them who helps out with housing, yeah, she's been indespensible, but the rest of them treated me like an imbecile (and I have had neuropsych testing, including an IQ test, which put me at 171--so I am not an imbecile), talked to me like I was 'crazy' and made me feel about 2mm tall. And always like I had done something wrong. I was on no pain meds, or "controlled substances" but they would UA me anyhow--and I always passed--not even one single test did I "fail," and I think that ticked them off. But no one ever acted like they trusted me. I told my CM about the sons I had at 16 and gave up for adoption~it had been a twin birth, but one of them did not make it...he died in an car wreck a few years ago...and my sister who has mental issues-putting it mildly--told them I was lying. I showed the CM their birth certificate, adoption papers, and the one son's death certificate. She accused me of downloading them and faking it.

I also had been in the process of being diagnosed by an independent rheumatologist with multiple autoimmune disorders. Diagnoses which were later confirmed. Apparently, I lied about that too.

I began drinking from the stress, which I have now been sober from for over 2 1/2 years, and I really haven't thought about them in a long time.

I don' want to risk my housing--without the help of the housing person, who is only loosely connected, and would likely help anyhow, but I am not 100% sure...I won't have funding to afford anywhere to go. I am having major hip surgery soon, and will still be recovering in September.

So, do I report the HIPAA violations? I would also need my new therapists' cooperation.

Thoughts anyone?

Thanks,
JJ

I cant tell you whether you should report this or not. only you know whether you should report it or not based on your own feelings and experience with this agency.

But I would suggest before making your decisions find out if that agency is a teaching agency. by that I mean is this agency one in which like here they do team teaching and team working for the better of their clients. here we have meetings and discussions about our clients so that we are all working on the same page. we also bring our problems with our clients to the team meetings to get suggestions on how to best help the clients. during these meetings we do share names of the clients and their backgrounds and their cases. this way when one of us is on vacation or manning the phones should that client have a problem we are all aware of whats going on and we can help this client through that crisis during the absence of their therapist, or through the night until they can get in to see their therapist. doing this doesnt go against the privacy laws. the privacy laws prevent us from going to people outside the agency and disclosing anything without the clients permission aka their friends , familys other treatment providers outside the agency.

if this place you are talking about is an agency that works the team approach or is a teaching agency they probably didnt break any laws. thats not saying you are wrong in how you feel, its natural to feel violated if you were not told you would be a topic of discussion among the other treatment providers.

money wise if you live in the USA there is no cost to you for reporting and prosecuting a treatment provider that breaks privacy laws. the way to do it is to contact the mental health agency that over sees therapists in your area. put in writing your complaint. they will call you for a face to face interview to discuss the problem, then if they feel a breach of privacy laws happened they will give notice to the offending therapist that they must attend an ethics review, why and who made the complaint.

Here in america anyone accused of a crime has the right to defend their self and also know who their accuser is and face their accuser. So you will also receive notice of when the ethics review is and when to appear to give your testimony.

it could end with the ethic review board upholding your accusation and taking action against the therapist or it could end with the ethics board finding no grounds for the accusation.

if a privacy law has been broken no trial happens unless you contact the civil rights department. they will take your statement, contact the therapist and ethics board. should they decide theres enough grounds to warrant prosecution they do so at no cost to you. the only thing you will have to do in the civil rights case is appear in court and give your sworn testimony before a jury and judge. the court costs are usually a part of what the person breaking the law has to do as restitution.

again we cant tell you what to do only you can decide to report or not. the cases around here that have been reported some were found to be upheld and the treatment providers sanctioned and other times it was called no grounds/unfounded. so it can go either way.

[ladyjrnlist]

Generally, "colleagues" are allowed to discuss your case amongst themselves with no HIPPA violation. Not saying it's right, but this could be a hard one to prove. You'd have to provie it damaged you in some way as well.

[spacemonkey36]

I'm gonna say for sure, I know that now is definitely not the time to be making any reports, whether I decide to or not: given the housing situation, etc...

I have documentation: a couple emails that the therapist printed out--I didn't bother to read them in their entirety. But she said very clearly, I was "discussed with people who had no business knowing anything about you..." But she did not leave because she had a dispute-it wasn't a "disgruntled employee" type of thing. I asked her that-what her reasons were for leaving.

What she said was that about a year ago, about 9 or 10 of the CM's and therapists got together-and had a "meeting," to discuss this type of thing: how clients were being discussed outside of their sessions and care, that some, as my case, were treated like the "lunchroom joke," and that all but one agreed it was something that had been eating at them all for some time. They each agreed that no matter what was said: they would print out and take with them inappropriate emails, and 3 of them did make HIPAA violation reports and the agency in one of those cases was successfully found to have violated HIPAA on 3 occassions, and they were fined $300K total, and warned that if there were any more violations, there would be some major "trouble," or essentially something to that effect. Truthfully, that's enough for me-albeit a small one, some measure of justice is better than none.

As a professional myself, yes, it's permissible to share a case with a collegue, seek their advice: but what is not okay, if you were to read through the HIPAA act itself, is to use identifying information-specifically, names, and other info where the other provider can know who that person is, and most definitely not okay to allow them to become the lunchroom joke. Or even as frustrated as you gets, say, "That Mrs. So-and-So in room 320 makes me so mad! You know what she did? She ______! What a crazy person!" And this was (a simplified version) of how they discussed not just me, but other clients as well. And that is a violation of HIPAA: it doesn't just apply to patient records in terms of documents, but any identifying patient information.

But you guys have excellent points: the housing situation right after major surgery; that yes, they could paint me as a "crazy, unstable and mentally ill" person and therefore unreliable, and even though not only is that not true, but neither is my therapist leaving because of being disgruntled. She took the job to save up enough to start her own practice so that she could afford to treat on a sliding scale; her husband makes bank at Boeing. They don't need her income; she is in it to help people who otherwise can't afford the therapy. There's no "Do you have insurance (I do, but my copays are ridiculous, and unaffordable b/c I only am part-time; they say nurses are in demand, but the hours I have to work are worrisome)? And there's no "cash on the day of the visit," and so forth...we discuss my budget, and I pay her as much as I am able to without denying myself things like groceries.

Yes, my credentials are up to date, but I no longer work in the field. Nursing is not what it was when I got into it, and I can't live with myself and continue doing what I was. I would see people diverting (stealing narcotics from patients, many of whom were severely in pain and/or dying), and it was happening so often, it was sickening. And also often, it was situations like mine: listening to other RN's discuss their patients much the way I know I was. It's not a pleasant feeling. So, yeah, I am broke much of the time.

But rich in other ways.

So no, I likely will not report it: at least until I am moved into my new place, and it's still within the 3 years you have to report HIPAA, and even then, if it's close, and there's a good reason, they can make exceptions. But I also need my therapists cooperation: and I know just how much that would be asking of her--she's got more at stake even than I do, and I will not ask her to stake her career if she isn't able to...I won't take someone's livelihood. Reputation, etc. Plus, it's true: it'd be a case, if taken to court, that would boil down to them not only ripping my life apart, but also presenting it as a smear not just on me, but my therapist. I was part of a class action lawsuit, and it was a six-year battle, and it was ugly...and I won't put myself (or anyone else) through that again... This is why lawyers are compared to politicians and used car salesmen (no offense to those who are respectable members of said profession...there are a few-my PI lawyer was wonderful-but my experience with attorney's has not been positive in general).

And really, there comes a time to let go and move on... Staying angry, and wanting to "get even" is really an unproductive use of my time, my therapist's. And besides, karma is a b****. It's out there waiting to kick your butt when you least expect it. And give them the satisfaction of knowing it bothered me??? Not a chance!

Thanks for your thoughts!

Blessings,
Jenna

[spacemonkey36]

PS: They are not a teaching agency....and I checked through the entire HIPAA act online, and it doesn't only apply to written records...you are not allowed to discuss a person-short of asking a faculty or senior member of staff for advice or actual assistance with patient care, and use identifying information.

They were talking about my medical history-amongst themselves...and, as my therapist has said, about my living situation, and my relationship with the providers that were involved with people who had no involvement, and "did not need to know" anything about me...that people who have not worked there in 2 years recognize me, and remember specific details-that's not good...plus there's a ton of other issues at play, but suffice to say, after reading the specifics of HIPAA, I have the three emails, and each of them is a violation.

But it's like I said-really, people like that are not worth my time...my life is a whole lot different now: my illness is way better under control. They essentially had said some horrible things to me, based on things that family members of mine had out and out lied about, and used it as "the holy grail," as if "of course she can't be telling the truth" type of thing, and honestly even though the whole thing reeks, I don't want to deal with it.

I can't put it past them to start a smear campaign, and I'm past that. I've been down the road before in court things--and yes, also reporting a physician. And none of it was very pleasant. And in the case of the doc, I was treated respectfully by the medical board, and the doc was reprimanded, but try and get care in that community again? Yeah, right. They're hard lessons to learn, but really valuable ones. Docs (and agencies) bind together, and CYA, so it's not worth the fight.

And the less I have to do with them, the better. Get my new housing, and forget about it--that's kinda the plan. Work with the new therapist, and keep working on the new life I have been building for myself.

[kitten16]

Wow, what a mess! I don't have a lot of advice, but it seems like you've gotten some good pointers on how to proceed.

Something jumped out at me about your new therapist -- you're friends with her husband? I know it happens, but therapists aren't supposed to have any connection with you socially. I'm surprised she took your case in this situation -- just seems a bit unprofessional. You need to start afresh with no new unthetical tendrils and incestuous connections between these separate areas of your life.

I'm not being all high-horse about this, honestly! It's just that I made this mistake myself, when one of my co-workers, Clive, told me his wife (I'll call her Anita) was a therapist. I had met her at a social function, and she seemed great. At that time my husband was looking for a therapist, and I figured the incestuous-work-therapy thing was diluted enough for him to start seeing her. (It wouldn't have been as cool if I had been her client.)

Anita turned out to be kind of strange -- she'd blurt out weird sex stuff out of the blue, and it kind of freaked out my husband. She seemed sort of obsessed with the subject.

My hubby didn't go into it, and I didn't feel I should grill him about it. It was his therapy, after all. But I began to wonder how much my husband might be telling her about us and our sex life. It was his perogative, of course, and these things are a huge part of why people go into therapy.

But I didn't want to ask about it, and suddenly (since I knew Anita as an acquaintance), it made me feel strange. My hubby had described her as sort of out-there, a kind of loose cannon. If Anita didn't have such hot professional boundaries, how much might she be telling her husband Clive about me, a guy I was working with on a daily basis?

Also, it wasn't fair to Clive! My husband told me that she'd said to him during a session, "Sometimes you just need a good f**k!" We both laughed about that, and suddenly I couldn't help picturing what Anita and Clive might be getting up to at home. It made it uncomfortable to see him at work. I felt I was on the verge of knowing WAY more about the poor guy than he even had a clue about!

Anyway, what a tough situation for you, and I hope your new therapy works out -- with this therapist or another. Way good that you got out of that unethical place.