HIPAA/Medical Release for Emergency Situations?
December 15, 2014 7:35 AM   Subscribe

In the event of an emergency, what can be done to ensure that doctors/hospital can share information with another unrelated adult?

My partner and I live several hours away from anyone we're legally related to. There's a surgery in the cards in the next year or so for him, which got us thinking. We're in the process of getting all the necessary HIPAA forms in place with our regular doctors so that my doctor can share my medical info with him, and his with me. I believe that will cover us for his surgery as well, since we'll make sure to sign a HIPAA release in place as part of the pre-admittance process. But now we're wondering about emergencies - if I'm in a car accident and rushed to the ER, for example, is there anything we can put in place, or that we can carry in our wallets, that says "yes, please tell this person what's going on"?

I don't think we need healthcare power of attorney here, since we're less worried about making major decisions and more about not being uninformed in the event that they'll only talk to a legal relative. Beyond basic "person I love is hurt" anxieties, there are specific health issues at play that make an open line of communication between doctor, partner, and patient super-important for both of us.

Possibly relevant details: we are unmarried, though we do live together. USA, New York state.

tl;dr: with basic HIPAA releases in place, what can I do to make sure that care providers can (legally) talk to my partner if I'm under emergency care, and vice versa?
posted by okayokayigive to Law & Government (16 answers total) 2 users marked this as a favorite
Get married?

I mean, that's by far the easiest way to make sure that your partner can not only talk to your doctors if you're unable to, but actually make medical decisions for you.
posted by Oktober at 7:46 AM on December 15, 2014 [2 favorites]

Generally, doctor's forms ask on your release forms who they are allowed to communicate with. If they don't, send a letter that's notarized specifically allowing that discussion. Or, just get the healthcare power of attorney, which you should have anyway.
posted by dpx.mfx at 7:49 AM on December 15, 2014

Short answer: without marriage, you do need power of attorney or if not you, an established power of attorney / next of kin willing to consent to passage of information and/or decision-making to you.

Otherwise there's really nothing in writing/legal that confirms your relationship status, intimate though it may be.
posted by drpynchon at 7:49 AM on December 15, 2014 [2 favorites]

Why not just get the healthcare power of attorney or whatever the equivalent is in your state?

It's what the health providers in an emergency situation are likely trained to expect and will hopefully respect, if you try some special snowflake solution AND you run into a particularly persnickety healthcare worker things are more likely to go poorly.
posted by sparklemotion at 7:52 AM on December 15, 2014

Off the top of my head here: don't most modern cell phones have an ICE button that could be used for exactly this reason (car accident, etc.)?
posted by Melismata at 7:55 AM on December 15, 2014

Off the top of my head here: don't most modern cell phones have an ICE button that could be used for exactly this reason (car accident, etc.)?

That just gets you a "loved one is hurt" call (if the EMTs call that number). It doesn't get you the "open line of communication between doctor, partner, and patient" that OP is asking for.
posted by schroedingersgirl at 8:11 AM on December 15, 2014 [1 favorite]

You absolutely need a power of attorney.
posted by roomthreeseventeen at 8:20 AM on December 15, 2014 [1 favorite]

Best answer: You're apparently looking for a one-way communication channel -- healthcare provider can give information to your partner. Having your HIPAA forms on file with both your primary physicians and your local hospital should satisfy this need. The forms are not generally "one-time", but held on record until explicitly revoked. In an emergency away from home, a quick call to the primary physician of record can enable the emergency provider to recognize the right of your partner to be informed. You can each carry a card that informs emergency personnel that you want your partner notified and how to reach the physician who has the form.

However, realize than in an emergency when one of you is unable to speak for themselves, providers will prioritize looking for a TWO-way channel. They need someone who, upon being informed, can give legal consent to the recommended course of treatment. Waiving your privacy rights through HIPAA does not make your partner a decision-maker, nor does it necessarily give them a place on any "must contact" list. It just enables the provider to answer your partner's questions once they are asked. If the situation is dicey, you have no guarantee that any resources will be given to seeking out someone who cannot legally consent to treatment.

If you trust your partner, get the PoA. You can agree between yourselves how you want the power to be exercised. If you'd rather that a certain family member be consulted if possible, that's a simple promise between you, but your partner will be able to make decisions in a crisis when next-of-kin can't be reached.
posted by peakcomm at 8:42 AM on December 15, 2014 [4 favorites]

Response by poster: Thank you all! peakcomm, that's exactly the kind of info I was looking for. It's certainly not a trust issue - I just wasn't sure that PoA would cover anything beyond the decision-making part of things.
posted by okayokayigive at 8:57 AM on December 15, 2014

If you live in NYS, the document you want is a health care proxy. I recommend executing several originals and then making numerous copies.

If anything happens prior to executing this doc, there's always lying: "yes, this is okayokayigive's spouse" --- not opining on the legality/morality of this, but it's what I would have done prior to executing a proxy w/ my now-husband, especially as to simple things like obtaining information/access.
posted by melissasaurus at 9:31 AM on December 15, 2014

I think what you're looking for is a health care proxy or advanced directive.
posted by tckma at 9:46 AM on December 15, 2014

Even if you're married you should have a power of attorney for healthcare, (especially true for all you gay couples out there! It sucks but prejudice is alive and well.) In California it's built into the Advance Directive and your hospital or MD will usually have a fill-in-the-blanks one you can use. They are good for your state only, technically, but from what I hear other states will often honor them.

Give a copy to your doctor. Keep a copy on your fridge or over the door of your house (along with notes about allergies to meds, health problems, etc). The EMTs here are trained to look there for an envelope like this. Keep a copy for each other in your glove boxes. I would guess, but don't know, that most places will accept an online copy from your email.

From what I understand, most places are really really happy to have official, pre-planned guidance about who they can talk to and who they can't.

As for disseminating information, I wrote a letter naming everyone I was okay with the hospital talking to (a long list because I'm not a private person), and I attached it to the Advance Directive. They seemed to think this would do.
posted by small_ruminant at 9:50 AM on December 15, 2014

Best answer: I am a doctor in NY state (not YOUR doctor, obviously, but I can speak to what hospitals want and will accept in this state).

What you want is a New York health care proxy form. This is easily downloadable online here. A proxy formatted for a wallet card is here.

The form can be as simple or as elaborate as you and your partner choose to make it if you have specific preferences that you absolutely want communicated (i.e., absolutely no blood transfusions etc). In its simplest form it basically just gives a named person authority to make medical decisions on behalf of the patient IF the patient is unable to make them for himself. If you want your proxy to be able to make decisions about feeding tubes/hydration you must say "my proxy knows my wishes". You can also indicate if you want to be an organ donor but that part is optional.

The person designating the proxy basically just names the proxy and then signs the form in the presence of 2 adult witnesses. The person being designated as the proxy cannot be a witness. None of the people signing the form needs to be a medical professional, lawyer, or anything official.

The second and most important part of this is that if no one can find the health care proxy form, it cannot be enforced. You should definitely give a copy to your primary care doctor, who will likely scan it into their system, but if you're worried about this being an issue it's useful to also keep a scanned copy somewhere at home or even on a USB keychain so that all you have to do is find a computer and you have a copy to wave around.

However, it's also mandatory that anyone being admitted to a hospital in NYS be offered a health care proxy form as part of their admissions paperwork (which also includes cute little detachable wallet cards) so even if you guys don't do any of this stuff it's likely that your partner will get a chance to sign one before surgery.
posted by The Elusive Architeuthis at 11:14 AM on December 15, 2014 [3 favorites]

Best answer: Addendum: you do not need or especially want a power of attorney for this process. That might be useful in other states but in NY the health care proxy form was specifically created for the exact scenarios you describe.
posted by The Elusive Architeuthis at 11:17 AM on December 15, 2014 [1 favorite]

Response by poster: Oh, wow. Thanks, Elusive!!
posted by okayokayigive at 11:38 AM on December 15, 2014

Nthing Health Care Proxy in NYS. We have the standard form on file in our local hospital and we have one that was executed by our attorney in case we need it for other purposes. Even though my husband and I are married, we have different last names and it's a good idea to have one on hand anyway.
posted by bedhead at 12:20 PM on December 15, 2014

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