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March 20, 2020 – Infection Protocol and HIPAA Compliance

INFECTION PROTOCOL RECOMMENDATIONS

Individual buildings may adjust these protocols in whatever ways make the most sense for each board and building.

The following suggested protocols and steps are built around recommendations from the Centers for Disease Control (CDC). 

Resident Communication Regarding Potential or Actual Infections:

Based on the criteria provided by the CDC, if you have or potentially have been infected by the COVID-19 virus, please notify your primary health care provider and FILL IN:  GENERAL MANAGER NAME in the Management office.  FILL IN:  GENERAL MANAGER NAME will respect your privacy and identity, but will be able to take steps to assist you and to implement precautionary & preventative measures for the community as a whole. 

The following is the criteria from the CDC.  If you fit any of these criteria, please contact FILL IN:  GENERAL MANAGER NAME:

  • You have traveled within the past 14 days to any of the CDC Risk Level 3 countries, which currently include:
    • China
    • Europe
    • Iran
    • Ireland
    • Malaysia
    • South Korea
    • United Kingdom
  • You know that you have been in direct contact with a person who has contracted COVID-19
  • You have symptoms of the COVID-19 infection and you do not have a diagnosis from a medical professional.  Symptoms include:
    • Fever
    • Cough
    • Shortness of Breath
  • You have a confirmed diagnosis from a medical professional for a COVID-19 infection

Management Response to Identified Residents:  

Direction from the CDC is that anyone who fits the above criteria should be quarantined for at least 14 days. If you, or anyone in your household, fit this criteria, please self-quarantine in your home or, if possible, in another location. 

If anyone is to be quarantined in the building, please follow the guidelines below:

  • Notify the management office of any need to leave your unit and when you will return.  If possible, a 30 minute notice will be helpful.  Our team will takes steps, if possible, to arrange for an isolated elevator for you to use.   We can also take steps to disinfect and sanitize any portions of the building that might be affected in the path of travel.
  • For garbage disposal, please schedule with management team to leave garbage bags outside your door.  We will arrange for disposal.
  • Coordinate with the management team for deliveries, packages and groceries that you may have arranged.  We will deliver to your door and leave items outside your door.  Please do not retrieve these items until we have left the area.
  • Note that our management team will not enter any units where there is a quarantine. If there is an emergency, we will take steps to follow CDC guidelines.

We know that if you are under quarantine, it may be a time of heightened anxiety and concern for you.  We will do all we can to be helpful to you and compassionate about your situation.  At the same time, we want to take precautionary & preventative steps to protect other residents and our team so that we do not spread infections any further – and so that our team is able to continue to support you and all of the residents in the building.

These are quickly changing times and we will keep you updated as new information arises and if protocols need to be changed or augmented. 

Management Internal Protocol If a Resident a Lab-Confirmed COVID-19 Diagnosis:

  1. Ensure that the Local Health Department is notified
  2. Only notify personnel that need to know (Senior Manager, Matthew Holbrook, and Applicable Team Members) and instruct not to disclose the person’s identity or address
  3. The community can be informed that a confirmed diagnosis has occurred in the community as long as the information is vague – DO NOT SHARE PERSONAL IDENTIFIABLE INFORMATION SUCH AS NAME OR ADDRESS
  4. Follow the CDC guidelines for sanitization
  5. Shred the written notification of the person’s name/address and delete any e-mails with the person’s name/address
  6. Infected person should be self-quarantined for at least 14 days
  7. Verify with your Local Health Department upon a lab-confirmed diagnosis as they should provide guidance on a case-by-case basis regarding how much information can/should be shared with the community.

HIPAA COMPLIANCE

Thoughtful questions have been raised regarding HIPAA compliance amidst the COVID-19 situation. Please provide the questions and answers below to your Boards via e-mail or in your next Management Report:

Which Government Agencies Are Responsible for HIPAA Compliance?

HIPAA Compliance ultimately falls under the jurisdiction of the Federal Department of Health & Human Services (HHS) Office for Civil Rights (OCR). Enforcement is carried out by the California Department of Public Health as well as Local Health Departments.

Does the HIPAA Privacy Act Even Apply to Action?

It does not appear that the HIPAA Privacy Act applies to Action since Action is not a health plan, health care clearinghouse, health care provider, or Business Associate. A Business Associate is defined as a company that performs functions that require the transmission of protected health information to a health plan, health care clearinghouse, or health care provider.

If HIPAA Does Apply, Which Sanctions & Penalties Have Currently Been Waived?

  • the requirements to obtain a patient’s agreement to speak with family members or friends involved in the patient’s care. See 45 CFR 164.510(b).
  • the requirement to honor a request to opt out of the facility directory. See 45 CFR 164.510(a).
  • the requirement to distribute a notice of privacy practices. See 45 CFR 164.520.
  • the patient’s right to request privacy restrictions. See 45 CFR 164.522(a).
  • the patient’s right to request confidential communications. See 45 CFR 164.522(b).

See the HHS Full Waiver here: https://www.hhs.gov/sites/default/files/hipaa-and-covid-19-limited-hipaa-waiver-bulletin-508.pdf

     

If HIPAA Does Apply, Is Management Allowed to Notify the Local Health Department?

It appears that Management is allowed to notify the local health department of the person’s name & address, if informed of a COVID-19 diagnosis.

If HIPAA Does Apply, Is Management Allowed to Notify Other Residents in the Community of a Lab-Confirmed Diagnosis?

While we are not permitted to publish the person’s name & address to the community, per the local health department we can communicate a vague message that there has been a lab-confirmed case and recommend people to follow the local health order and CDC guidelines. The local health department should also provide guidance on a case-by-case basis regarding how much information we can/should share with the community.

Is Management Allowed to Ask Residents to Notify Management If A Resident Is or Is Potentially Infected with COVID-19?

Based upon our research & discussions with the Department of Health & Human Services (HHS), OSHA, the California Department of Public Health, and the Orange County Health Department—it does appear that Management can ask residents to notify Management if they are or are potentially infected. It is the resident’s choice whether or not they choose to share this information.

Should Employees Notify Their Supervisor If They Have COVID-19 Symptoms?

Yes. Per the CDC’s Interim Guidance for Businesses and Employers, “Employees should notify their supervisor and stay home if they are sick.”

Boards are encouraged to consult association counsel and their local health department for confirmation of the above research and any additional inquiries.