Sunday, May 22, 2005

HIPAA v the jury selection committee

Guess who loses?

I recently got a summons for jury duty, with my show-up date smack in the middle of my latest round of cancer testing. Since this testing involves injecting me on several consecutive days with a very expensive drug, and then conducting blood tests and whole body scans, it is very difficult to schedule. And since my cancer was invasive, this follow-up testing is very important, and not something I want to defer because of a jury summons.

I could defer my jury duty to some time within the following four weeks, except that I also have in hand paid-for unrefundable plane tickets which place me 2,500 miles away from the end of June until the beginning of August. I may end up not using these tickets if I need surgery and/or radiation, which, as I have mentioned at least a thousand times since the beginning of May, my endo thinks is "likely".

Given these circumstances, in which the usual deferrment would not be suitable due either to my absence or surgery/radiation treatment recovery, I sought an excuse.

The juror affadavit form requires a doctor's note if you are seeking an excuse for medical reasons, so I called the endo's office and they sent over a nice, generic note: (paraphrasing) "(me) has been our patient for several years and her condition makes her unsuitable for jury duty at this time. Please excuse..."

Wheels of juror selection having finally turned 'round, I received last week a postcard saying your request to be excused does not meet statutory requirements. In other words: request denied, show up or get in trouble.

I flailed around the automated phone system trying to get a deferred date far enough out that both my treatments and/or my vacation would be over, but had no luck. Finally, I found a number to speak to an actual human. She was kind and explained to me that my excuse request was denied because it was not specific.

I replied that my medical condition is none of her business. She agreed. She did assure me that they don't keep any of this information on file, it goes immediately into the shredder, but that doesn't make me feel any better. Some random flunky in the juror selection office is sitting on a goldmine of potentially damaging health information, because the bureaucracy doesn't trust that we're not trying to skive* off jury duty. The kind woman offered no remedy, but suggested I contact the legislature.

I know a lot of people find jury duty to be obnoxious, but I would think that the legislature would at least trust that people's doctors would not write them excuse notes that aren't warranted. I would expect a doctor to have the guts to say, "I'm sorry, Mr. Smith, there's no medical reason for you to be excused, so I can't give you a letter."

Then there's the HIPAA aspect of this issue. On the one hand, doctors have had this entire new, huge layer of bureacracy imposed on them to protect patients' healthcare information. On the other hand, here is the legislature insisting that the jury selection committee needs to know exactly what's wrong with you, and then they will decide whether or not you are fit for jury service.

I rather think my doctors are much better qualified to make that decision, and I think it's outrageous that current state regulations require me to disclose confidential health information in order to be excused from jury duty. Maybe when I'm done with this upcoming visit to CancerLand, I can write a few letters and see about getting something done about this.

(*) NOTE: Skive is British slang, roughly equivalent to cutting class, or more specifically, feigning illness to cut class. The term was brought to my attention in Harry Potter and the Order of the Phoenix, in which enterprising young wizards Fred and George Weasley perfect their Skiving Snackboxes. One half of a toffee makes you deathly ill, the other half cures you -- of course they were very popular among the students.

1 comment:

Henry Stern, LUTCF said...

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Joan:

First, I'm sorry to learn of your illness, and certainly hope for a full recovery (or at least remission).

Second, the nice jury lady is incorrect: this is not for the legislature. It IS an issue regarding Protected Health Information, and I doubt very much that her office is in compliance with those guidelines. HIPAA is Federal: local ordinances do not supercede it.

The enforcement arm of HIPAA is CMS, and the site you want is:

http://www.hhs.gov/ocr/hipaa/

They take this stuff VERY seriously.

Good luck!