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Counties call for help on health law

MONROE - Monroe County officials hope a consultant will help them figure out what a new federal patient confidentiality law says and whether they're in compliance.

As counties and health agencies in the nation try to decipher the regulations in the Health Insurance Portability and Accountability Act, Monroe County is hoping to get ahead of the regulatory curve.

Commissioners last week instructed Monroe County Administrator Charles Londo to begin looking for a consultant to help them with the project.

“I'd rather do it now than wait until next September and figure out we're nowhere near being in compliance,” Commissioner Bill Sisk said.

The Health Insurance Portability and Accountability Act -signed into law Aug. 21, 1996 - allows workers who change jobs or lose their jobs to retain health insurance even with pre-existing medical conditions. The law has evolved to include regulations to protect the privacy and confidentiality of medical records.

Over the last five years, the federal government has been working to create uniform health records regulations that all federal, state, and local agencies will have to follow, though the law applies to all workers. Last year more than 1,500 pages of regulations were released.

Monroe County officials said that at least five departments will be affected by implementation of the rules next year, in particular those that generate medical records. Because the Health Department, jail, youth center, and Fairview county home have to adhere to the regulations, they are all vulnerable to penalties if changes aren't implemented in time.

“It is just huge,” said Colleen Hinzmann, director of the county's information technology department. “There are so many regulations, and trying to figure out what applies to us and what doesn't has been difficult to ascertain.”

Monroe County purchasing chief Mike Bosanac said departments already could prepare for a significant amount of adjustments in the way medical records are recorded and maintained.

“We're talking about a wholesale change in policies by our departments that are affected,” Mr. Bosanac said. Along with tightened information security, the county also may have to make what Mr. Bosanac termed “modest modifications” to its facilities in order to comply with the new regulations.

Mr. Londo said some health-care providers in the area are planning to spend at least $75,000 on consultants to help them come into compliance with the new law. But the county's anticipated costs probably would be much lower because of the limited scope of its health-provider activities.

“We're looking at somewhere around $25,000 to $40,000 [in consulting fees] where we can get a plan, pick it up, and go with it,” Mr. Londo said. “We've got about a year, so we're a little ahead of the ballgame here.”

Health officer Larry Stephens of the Lenawee County Health Department said his department is trying to get a handle on what the federal regulations are and whether the county is in compliance.

“The state of Michigan is barely beginning the process so we're not getting a lot of guidance,” he said. “We're just trying to get our hands on the literature and then try to decipher it in language that is understandable. That is difficult to do.”

Like Monroe County officials, Mr. Stephens said he plans to look to how other counties respond to the changes while creating his own policies. He said budget constraints would make it impossible for Lenawee County to hire a consultant.

“We're trying to call our peers to see what they're doing. Unfortunately, they seem to be just in the dark as we are,” he said. “Networking is key to our ability to be in compliance. We'll have to learn from what others are doing.”

Many Ohio counties are using consultants to help them work toward compliance. James King of Benefits Comprehensive is helping several county agencies in northwest Ohio make sense of pending regulations, including Wood and Lucas counties and Toledo Public Schools.

He said his company has been helping clients for more than a year with updates on procedures and clarifications.

Jim Wells, a Benefits Comprehensive consultant for Lucas County, said the county has achieved compliance in several areas. He said much of what's left to be done will occur with upgrades in technology.

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