Clarifying HIPAA opt-out
The Association for Healthcare Philanthropy has long appreciated the implications of the Health Insurance Portability and Accountability Act of 1996 upon the fund-raising efforts of health provider development departments and institutionally related foundations. Consequently, I enjoyed the succinct commentary by Christopher Cloud, a fund-raiser and HIPAA compliance officer at New York-Presbyterian Hospital and Weill Medical College of Cornell University, New York ("Fund raising hits a privacy barrier," Jan. 13, p. 21).
I noted one critical statement from Cloud that misleads the reader regarding the use of the opt-out clause. It is true that after April 14 the health provider (hospitals and others) must provide patients a notice of privacy practices; however, there is no requirement that opt-out language be included in the notice. The notice is intended only to provide information about how the provider will use patient information for medical care, billing and healthcare operations. Fund raising is included in regulations as part of healthcare operations, whether conducted through the provider?s development office or its institutionally related foundation. As executives in this field, we know fund raising could be dealt a chilly hand if the opt-out option was included in the notice of privacy practices, jeopardizing AHP?s member efforts to raise more than $8 billion for the benefit of local communities as it achieved in 2001. It is imperative that healthcare fund-raisers know that it is only necessary that the opt-out language be included in solicitations made to grateful patients and not as part of the notice of privacy practices. For the latest AHP analysis on the application of HIPAA regulations on fund raising, please visit our Web site at ahp.org.
Again, I applaud you on a well-researched article, as we must all work to educate our stakeholders, including the public, on this issue.
President, chief executive officer
Association for Healthcare Philanthropy
Falls Church, Va.
An unfair transplant system
Robert Sade's commentary ("Why illegal aliens get a place in line," March 31, p. 16) on the Duke University Medical Center case sounds like an apology for the current organ donation and transplantation process.
What he does not explain (and therefore does not defend) is how the donor organs in the unfortunate Santillan transplant were offered to a Duke patient (who was presumably the correct blood type and next on the priority list), declined (apparently for medical problems with the recipient, which raises the question why he was still on the list) and then offered to the Santillan girl, who obviously wasn't on the list for these particular donor organs. What happened to the poor patients who should have been next on the waiting list for those organs is another question.
This seems like a sloppy and unfair aspect of the system that neither Duke's statements nor Dr. Sade addressed.
Edward John Noble Hospital of Gouverneur (N.Y.)
St. Lawrence County, N.Y.
A safe bill
Jeff Tieman's article, "Little room for error" (March 17, p. 8) discussed several tactics on improving patient safety. The House of Representative bill passed recently is a good strategic initiative to encourage hospitals to begin looking at ways to improve patient safety in a nonpunitive environment.
This bill will not only allow patient safety organizations to make recommendations to providers, but it also will encourage hospitals to begin sharing root-cause analysis and strategies they have implemented to prevent specific medical errors with other hospitals. Rep. Pete Stark's (D-Calif.) comment that this bill "will not improve patient safety" is incorrect.
This bill will provide an environment where hospitals can learn from each other's mistakes, thus working to improve patient safety.
Department of Health Information Management
University of Pittsburgh
A salute to military healthcare
What a tremendously informative and positive cover story you wrote on the outstanding job our military colleagues are doing in support of Operation Iraqi Freedom ("Hospitals get battle-ready," March 31, p. 4). These men and women are consummate healthcare professionals and leaders.
I know this firsthand, having had the pleasure of serving with Col. David Rubenstein-who runs Landstuhl Regional Medical Center in Germany, where war wounded are being treated-on the American College of Executives' Board of Governors. We at the ACHE are always very proud of our military colleagues but now more so than ever.
Executive vice president
Methodist Health System Foundation
American College of Healthcare Executives
Regarding your article on H-1B visas for registered nurses ("Importing controversy," March 31, p. 20), how can I obtain more information on the restated visa rules?
I understand that a facility must have a minimum requirement of a bachelor's degree for registered nurses to be eligible for an H-1B visa. Has this changed? Our facility does not require a minimum of a bachelor's-we hire associate degree nurses as well as diploma nurses as long as they have a Texas license. I was wondering if the new rules allow us to petition nurses under the H-1B visa.
Human resources director
Val Verde Regional Medical Center
Del Rio, Texas
Editor's note: Contact the Department of Labor for a full restatement of the H-1B visa policy. Originally created for high-tech workers with four-year degrees, the new guidelines allow hospitals and recruiters to bring nurses without four-year degrees to work in the U.S. Call 866-487-2365 or use this link to the department's Web site:
http: wdr.doleta.gov/readroom/FedReg/ final122001.htm.
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