# Inappropriate Pics Found on PT



## nwhitney (Aug 5, 2013)

I had a situation the other day at work and I'm curious how others would have handled it.  I'll tell you what happened and then later how I dealt with it.

I work as an EMT for what is essentially the county drunk tank.  In addition to the police bringing in intoxicated individuals we also drive around the city limits and transport people to the drunk tank.  So two of our EMT's picked up a man and after admitting him we began to go through his property like we do with everyone.  While going through his bag I found a book from the library about beginning ballet.  The book was marked to pictures of little girls stretching.  Inside the book were photos ripped from books. These pics were of unclothed minor girls. If I had to guess I would say the youngest was 8-10.

How would you have handled this?


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## Wes (Aug 5, 2013)

Depending on your state's laws, you might find yourself in a mandatory reporting situation.


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## DesertMedic66 (Aug 5, 2013)

Contact PD and let them deal with it.


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## Clipper1 (Aug 5, 2013)

If you work for a county facility you should have a policy for reporting inappropriate behavior and incidents which may require law enforcement involvement.  If you do not know the policy, contact your supervisor, HR department or a Social Worker.  Some states have a mandated reporting time if you know about possible child abuse. Don't go over that reporting time by wasting it on an anonymous forum. Seek the correct answers in your own workplace.


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## MedicBender (Aug 5, 2013)

DesertEMT66 said:


> Contact PD and let them deal with it.



This. Immediately.


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## nwhitney (Aug 5, 2013)

I am a mandatory reporter.  Here's the thing those pictures were torn out from a library book.


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## nwhitney (Aug 5, 2013)

DesertEMT66 said:


> Contact PD and let them deal with it.



I did contact PD and they came down to view the pictures but I couldn't give them the PT's name without violating HIPAA.


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## Clipper1 (Aug 5, 2013)

MedicBender said:


> This. Immediately.




If the person is a patient at the facility and is not an immediate threat, it is best to inform the supervisors first. Without having the paperwork to show this person arrived with the photos or some warning the police are coming, this could backfire on the op.  Yes you would need to give the patient's name for the possession of property. Follow policy unless you know the children in the photos which then would be a child abuse issue for mandated reporting.


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## nwhitney (Aug 5, 2013)

Here's a little bit more to the story.  An officer came down and viewed the pictures.  He said that while the pics are obviously inappropriate they are considered "artistic" and without knowing the name of the PT he can't run his name to see if he is a SO and if possession of these pics violate and parole/probation conditions.  The officer contacted the on-call sex offender detective and she reiterated what the officer said.


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## nwhitney (Aug 5, 2013)

Clipper1 said:


> MedicBender said:
> 
> 
> > This. Immediately.
> ...



I did contact my supervisor first which is policy.


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## Summit (Aug 5, 2013)

Clipper1 said:


> If the person is a patient at the facility and is not an immediate threat, it is best to inform the supervisors first. Without having the paperwork to show this person arrived with the photos or some warning the police are coming, this could backfire on the op.  Follow policy.



This.

Particularly since the OP says the pictures were from a library book and thus presumably from some library educational book (and thus presumably not the mandatory reportable child abuse), though the patients purposes were clearly not educational. This issue could complicate the medical privacy protections vs mandatory reporting. It is best to let a supervisor figure that out for you.


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## medicdan (Aug 5, 2013)

nwhitney said:


> I work as an EMT for what is essentially the county drunk tank.



HIPAA is widely misunderstood... if you are not working for a "covered entity", i.e. a company that bills CMS, the law does not apply to you. Your department may have their own medical privacy or confidentiality policies, but I highly doubt  it would in this case... 

Even if HIPAA applied, this may be considered an appropriate release of information... but that decision lies with your supervisors, I presume.

I guess i'm a little confused... and apparently not well versed in child pornography law... do you have any evidence that this individual has done anything illegal, i.e. a "hands on crime"? Presumably possessing these materials as a part of the complete books isn't problematic... so why is it when ripped out? Is this a legal issue or one which you just find morally problematic?

As with may things here, we aren't giving you legal advice, and it seems you have already contacted your supervisors...


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## nwhitney (Aug 5, 2013)

emt.dan said:


> HIPAA is widely misunderstood... if you are not working for a "covered entity", i.e. a company that bills CMS, the law does not apply to you. Your department may have their own medical privacy or confidentiality policies, but I highly doubt  it would in this case...
> 
> Even if HIPAA applied, this may be considered an appropriate release of information... but that decision lies with your supervisors, I presume.
> 
> ...



I suppose I should make this clear, I am not asking for legal advise.  Just curious how others would respond in a similar situation.

HIPAA does apply to us and a similar state law and agency policy.  It was a tough situation because while we don't know if a crime had been committed it's pretty clear those pics are inappropriate.  When our EMT's were on scene picking this guy up the cops were initially there but took off and his bag wasn't searched until he got to me.  The cops were sympathetic to our situation.

This bothers me both on moral and legal grounds. I think we may have found a work around for the future as this guy is a regular.


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## Clipper1 (Aug 5, 2013)

HIPAA is very misunderstood and some will use it as an excuse to not report abuse or illegal activity.  Mandated reporting of abuse (child, elder) and HIPAA should have been covered THOROUGHLY at hire and reviewed at least yearly.  This should also be in writing in the P&P manual.  Any questions should be addressed up the chain of command with the knowledge for your state and agency.  HIPAA has some very specific exemptions when it comes to reporting abuse and PD with criminal activity. Time review your own manual. This applies to everyone.


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## Mariemt (Aug 5, 2013)

Why would a library book had undressed girls,  even for ballet? To me that's strange.

Hipaa is thought of as a need to know sort of thing. If someone is endangering others , it is a need to know. As a mandated reporter, it is your job to report illegal activity. It is law that you do. You would be stuck here if hipaa didn't have allowance for this. Now whispering to your neighbor about this patient would be a violation of hipaa, but contacting the correct authorities would not.

Now, were these pictures considered child pornography? I don't know, I didn't see them. I guess you could ask yourself if any children were harmed in the making of them, would the possession of them put children at harm? National Geographic has pics in their magazines that are not considered pornographic.

In our state, we may alert our supervisor but we are not to leave it there. If we feel any sort of abuse,  neglect etc is taking place it is our responsibility to make sure the proper authorities are alerted and if the supervisor does not agree with your accusations, they may decide not to turn it in. Then it is your butt. You were the mandated reporter. The supervisor is not the proper authority..
I think in this case I would have went ahead, told PD,  if he had prior record in this, the pics would have been a violation of his probation.


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## nwhitney (Aug 5, 2013)

Mariemt said:


> Why would a library book had undressed girls,  even for ballet? To me that's strange.
> 
> Hipaa is thought of as a need to know sort of thing. If someone is endangering others , it is a need to know. As a mandated reporter, it is your job to report illegal activity. It is law that you do. You would be stuck here if hipaa didn't have allowance for this. Now whispering to your neighbor about this patient would be a violation of hipaa, but contacting the correct authorities would not.
> 
> ...



The ballet book didn't have the pics of undressed girls.  The photos were tucked in between the pages of the book.  The cop and detective said the pictures themselves were not considered child pornography but "artistic".  The problem is the cop doesn't know if possession constituted a crime without know the PT's name and I couldn't give his name because as the cop said the pics were "artistic".  The photos weren't some Polaroids the of kids that were in danger.  I'm glad I called the cops to come down and take a look at what I found. I just don't know how I could have released the mans info without violating HIPAA.  

Had the police brought the man in then when I searched the bag I could have done it in front if the cop.  That's our plan for next time the guy comes in by the cops.


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## xrsm002 (Aug 5, 2013)

Child pornography refers to pornography depicting sexually explicit activities involving a child. (Wikipedia definition) 
 If they were just nude pictures of kids in non sexually explicit ways then they are "artistic" there are family nudist camps throughout the U.S.


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## nwhitney (Aug 5, 2013)

Thanks for all the comments I found them useful and interesting.
In a nutshell besides calling my supervisor and the police I don't feel there was anything I could really do but you all gave some good things to think about.


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## mycrofft (Aug 5, 2013)

nwhitney said:


> I am a mandatory reporter.  Here's the thing those pictures were torn out from a library book.



Call the library.



I think it's been covered adequately.

Unless I was law enforcement I'd be keeping my hands out of personal belongings. They have to catalog them and if the arrestee/detainee declares stuff is missing, guess who's going to catch the mudpie on that one.


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## Achilles (Aug 5, 2013)

mycrofft said:


> Call the library.
> 
> 
> I think it's been covered adequately.
> ...



If they're going in a psych ward, they should be taken away. You don't want a 5150 PT carrying a 9 Mm through the ED.


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## NJEMT95 (Aug 5, 2013)

Giving a pt's name to LEO is not a violation of HIPAA. JEMS had an article about this recently: http://www.jems.com/article/administration-and-leadership/pro-bono-reporting-drugs-illegal-activit


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## Tigger (Aug 5, 2013)

Achilles said:


> If they're going in a psych ward, they should be taken away. You don't want a 5150 PT carrying a 9 Mm through the ED.



Hopefully the ED is searching these patients as well.

Heck at our big hospital every pt and family member gets searched.


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## mycrofft (Aug 6, 2013)

Achilles said:


> If they're going in a psych ward, they should be taken away. You don't want a 5150 PT carrying a 9 Mm through the ED.



The OP's job description might include going through belongings, but if it doesn't, then ought not to, just separate the pt from the thingies. Pockets examined too? Lean on the wall and cough while unrobed? (Be surprised what can drop loose then).:blink:

Before being "drunk tanked" or psych-held the belongings would be (ought to be) taken (along with shoe strings, belts, ties, hats, handkerchiefs, maybe socks*); if admitted or incarcerated, clothes are removed as well. But EVERYTHING gets cataloged.

"Wristwatch, men's, Timex, digital on plain silver colored metal stretch band".

"Check".

"Pictures of naked little kids".

Check...Wha?!". h34r:



* EDIT: Socks. I've seen them used to plug up drains or toilets. I cut a guy down who hung himself with socks. I saw a guy coshed by an inmate who put two socks into the toe of another, soaked the toe section in water, then used it like a "lock in a sock" club to smack the guy in the back of the head.


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## nwhitney (Aug 6, 2013)

*Update*

Part of my job is to go through and inventory the pt's property and give them a copy at discharge.  The city I work in decriminalized public intoxication so when the police bring people to use the are not under arrest but placed on a civil detox hold.  Unless the cops have PC they can't search a pt's bag only their person for valuables.  That came directly from the police.

Anyways I called the state dept. of human services child abuse division for guidance on the issue.  I explained the circumstances and the child abuse office agreed that I couldn't give the pt's info to the police without violating confidentiality.  So unfortunately it doesn't sound like I could have really done anything more.


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## nwhitney (Aug 6, 2013)

NJEMT95 said:


> Giving a pt's name to LEO is not a violation of HIPAA. JEMS had an article about this recently: http://www.jems.com/article/administration-and-leadership/pro-bono-reporting-drugs-illegal-activit



It would have been for me since there was no indication of illegal activity.


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## Clipper1 (Aug 6, 2013)

nwhitney said:


> It would have been for me since there was no indication of illegal activity.



This is why most facilities have a policy for a supervisor or administrator to be notified for police involvement unless someone is in immediate danger.


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## Rialaigh (Aug 6, 2013)

nwhitney said:


> Part of my job is to go through and inventory the pt's property and give them a copy at discharge.  The city I work in decriminalized public intoxication so when the police bring people to use the are not under arrest but placed on a civil detox hold.  Unless the cops have PC they can't search a pt's bag only their person for valuables.  That came directly from the police.
> 
> Anyways I called the state dept. of human services child abuse division for guidance on the issue.  I explained the circumstances and the child abuse office agreed that I couldn't give the pt's info to the police without violating confidentiality.  So unfortunately it doesn't sound like I could have really done anything more.




I guess I am thoroughly confused by this whole situation. 

So your an EMT that can bring people to a location against their will without law enforcement for something that is not considered a medical emergency and hold them against their will and search their property? 

You can hold them against their will for something that your city decriminalized? 

You can search their property for something that is not even associated with a crime or a medical emergency?


I guess I am confused by the concept of a civil detox hold and what rights you guys have to hold and search people while admitting they are not being held for a crime or being treated for a medical emergency...just seems odd to me


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## nwhitney (Aug 6, 2013)

Rialaigh said:


> I guess I am thoroughly confused by this whole situation.
> 
> So your an EMT that can bring people to a location against their will without law enforcement for something that is not considered a medical emergency and hold them against their will and search their property?
> 
> ...


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## Rialaigh (Aug 6, 2013)

nwhitney said:


> I know it might seem odd but yes to all of that.
> 
> If the cops bring people in then the cop places them on a civil detox hold.  If we pick them up then we place them on a civil detox hold.  We're deputized by the county sheriff's office so we can legally do this.  We can legally hold people up to 48 hours but typically its 4-8 hours. It's a fairly unique setup.  I don't really think many other metropolitan cities have anything like this.
> 
> ...




I think its a great idea, If your acting as law enforcement during the hold (by holding them, etc...) and your deputized then I would assume any searches would have to follow all state laws and your departments (law enforcement agency) policy for such things. I would be wary that anything found during a search would not be admissible in court because they were searched while they are not suspected of a crime (your admitting to hold them for something thats not a crime). 



As far as the original question, I would document in detail everything that was found including the pictures (on the document belongings). I would report it to the immediate supervisor, and I would immediately drop it after that and not worry about it. Specifically tell the supervisor your unsure if this is legally reportable to other law enforcement and that you will wait for their decision, then document the conversation. Personally I wouldn't bother reporting this, but to CYA you have to have the conversation with a supervisor and you have to document that you are unsure what is legally applicable and you will await their direction.


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## Aidey (Aug 6, 2013)

I would think the searches are kosher, since it is a detox center they have a legitimate interest in making sure no drugs or alcohol are being brought in.


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## mycrofft (Aug 6, 2013)

Rialaigh said:


> I think its a great idea, If your acting as law enforcement during the hold (by holding them, etc...) and your deputized then I would assume any searches would have to follow all state laws and your departments (law enforcement agency) policy for such things. I would be wary that anything found during a search would not be admissible in court because they were searched while they are not suspected of a crime (your admitting to hold them for something thats not a crime).
> 
> 
> 
> As far as the original question, I would document in detail everything that was found including the pictures (on the document belongings). I would report it to the immediate supervisor, and I would immediately drop it after that and not worry about it. Specifically tell the supervisor your unsure if this is legally reportable to other law enforcement and that you will wait for their decision, then document the conversation. Personally I wouldn't bother reporting this, but to CYA you have to have the conversation with a supervisor and you have to document that you are unsure what is legally applicable and you will await their direction.



1. You can't "act as a law enforcement officer". You are, or you aren't. 
2. A chain of custody needs to be established to make most physical evidence admissible as more than hearsay (as in "Yes, I saw that property in this person's possessions", versus having something logged in by evidence number and description under two signatures). 

nwhitney, I am assuming your employer is the LE department?

At any rate, done good. Watch out for sharps in property , also infections filth.


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## nwhitney (Aug 6, 2013)

mycrofft said:


> 1.
> 
> nwhitney, I am assuming your employer is the LE department?
> 
> At any rate, done good. Watch out for sharps in property , also infections filth.



Not part of the LE department, we are a nonprofit agency.


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## mycrofft (Aug 6, 2013)

Be sure to raise this question with your managers.


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## tacitblue (Aug 6, 2013)

Aidey said:


> I would think the searches are kosher, since it is a detox center they have a legitimate interest in making sure no drugs or alcohol are being brought in.



The search is kosher but only to look for dangerous items and to catalog contents. Since there is no probable cause, I would think that any evidence of criminal activity found during such a search couldn't be used legally against the patient. 

A note to the OP, HIPAA and other privacy laws/policies do not apply when you think the patient could hurt themselves or others through criminal activity.


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## JPINFV (Aug 6, 2013)

tacitblue said:


> A note to the OP, HIPAA and other privacy laws/policies do not apply when you think the patient could hurt themselves or others through criminal activity.



Except no one is in direct danger. Sick, disgusting, and foul? Sure, but if he's ripping them from legal books than the worst thing he's done is theft and vandalism. You can argue gateway, but if we want to argue that someone getting off on ballet girls (regardless of how sick and demented that is), than what does that say about people who play Grand Theft Auto?


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## tacitblue (Aug 6, 2013)

JPINFV said:


> Except no one is in direct danger. Sick, disgusting, and foul? Sure, but if he's ripping them from legal books than the worst thing he's done is theft and vandalism. You can argue gateway, but if we want to argue that someone getting off on ballet girls (regardless of how sick and demented that is), than what does that say about people who play Grand Theft Auto?



In this case, no. Unless of course the pictures showed children actually being harmed and there was reason to believe the patient was responsible.


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## exodus (Aug 7, 2013)

nwhitney said:


> I did contact PD and they came down to view the pictures but I couldn't give them the PT's name without violating HIPAA.



And exactly, which part of HIPAA would that violate?  (Hint: None.) 

Edit: There are also exemptions for LE conducting an investgation


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## DesertMedic66 (Aug 7, 2013)

exodus said:


> And exactly, which part of HIPAA would that violate?  (Hint: None.)
> 
> Edit: There are also exemptions for LE conducting an investgation



That's what I was thinking. I'm just going to give the officer the patients name, not anything medically related about that.


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## Handsome Robb (Aug 7, 2013)

nwhitney said:


> I suppose I should make this clear, I am not asking for legal advise.  Just curious how others would respond in a similar situation.
> 
> HIPAA does apply to us and a similar state law and agency policy.  It was a tough situation because while we don't know if a crime had been committed it's pretty clear those pics are inappropriate.  When our EMT's were on scene picking this guy up *the cops were initially there but took off and his bag wasn't searched until he got to me.*The cops were sympathetic to our situation.
> 
> This bothers me both on moral and legal grounds. I think we may have found a work around for the future as this guy is a regular.



I bolded an important point. Maybe it's just me and experiences that I have but the patients that are going for psych or to the alcohol recovery center always get a quick run through of their stuff on scene before they get transported. I've found too many weapons and had too many of them go ballistic on me. Anything I seem dangerous either goes in my possession or the entire bag stays in my possession until we get to wherever we are going.



tacitblue said:


> A note to the OP, HIPAA and other privacy laws/policies do not apply when you think the patient could hurt themselves or others through criminal activity.



Definitely a valid point but I don't think intent can be implied. Is it morally wrong? Yes. Is it legally wrong to possess it in the assumed intent? Questionably yes. Can you prove intent to harm other through simple possession in an intoxicated man's bag? Definitely not.


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## nwhitney (Aug 7, 2013)

Robb said:


> I bolded an important point. Maybe it's just me and experiences that I have but the patients that are going for psych or to the alcohol recovery center always get a quick run through of their stuff on scene before they get transported. I've found too many weapons and had too many of them go ballistic on me. Anything I seem dangerous either goes in my possession or the entire bag stays in my possession until we get to wherever we are going.
> 
> 
> 
> Definitely a valid point but I don't think intent can be implied. Is it morally wrong? Yes. Is it legally wrong to possess it in the assumed intent? Questionably yes. Can you prove intent to harm other through simple possession in an intoxicated man's bag? Definitely not.



On scene we search their person for dangerous items.  Their belongings go in a plastic bag and ride upfront away from the pt.


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## nwhitney (Aug 7, 2013)

exodus said:


> And exactly, which part of HIPAA would that violate?  (Hint: None.)
> 
> Edit: There are also exemptions for LE conducting an investgation



Turns out that would be a violation of HIPAA in this case.  Two different supervisors, our agency attorney, and our HR rep all have said so.  Also the state dept. of human services also agreed it would have violated HIPAA and state law.


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## BGKc00rs (Aug 8, 2013)

DesertEMT66 said:


> That's what I was thinking. I'm just going to give the officer the patients name, not anything medically related about that.



That is exactly what I was thinking.  You are reporting possible abuse and nothing about the medical condition.  I would not hesitate to report something like this either to the supervisor or the police.


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## Draconicwraith (Aug 8, 2013)

I fail to see how HIPPA can stop us from reporting a possible crime.  Or, for that matter, how this would violate HIPPA in this situation.  Giving the name alone has nothing to do with HIPPA, since nothing medical is being reported.


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## socalmedic (Aug 8, 2013)

I don't normally get involved in this, but here goes what I know. below in italics are excerpts from the CFR, in bold are my interpretations. 

Disclaimer: only you know the whole story, but based on how I understand the event I think all these sections apply and you bet I would report it, using the appropriate procedure. 

In CA, I am required to report directly to LEO and file a written report within 24 hours to CPS/HHS. the opinion of my supervisor has no baring on how this is filed. If I tell my Sup then he is now required to submit a report as well in addition to mine. employees of the same organization who are reporting the same event may be included by name on the same report. ex, CPS would get a report from me with both my name and my partners name, from the fire department with all the FF's names, from the SO with every officer who was on scene documented, and from the hospital with every person who provided care to the patient.

I hate to say it but in the simplest form of the law your supervisors and lawyer are wrong. by posting here you felt there was a legitimate violation and failed to properly report the incident to the authority who is responsible for identifying if law was broken. we are not cops, we do not have the right or authority to judge if a crime has been committed. we have the responsibility to inform an LEO of all the information we know so that they may investigate.

"_To respond to a request for PHI for purposes of identifying or locating a suspect, fugitive, material witness or missing person; but the covered entity must limit disclosures of PHI to name and address, date and place of birth, social security number, ABO blood type and rh factor, type of injury, date and time of treatment, date and time of death, and a description of distinguishing physical characteristics. Other information related to the individual’s DNA, dental records, body fluid or tissue typing, samples, or analysis cannot be disclosed under this provision, but may be disclosed in response to a court order, warrant, or written administrative request (45 CFR 164.512(f)(2))_"

*this sections tells you what you are permitted to disclose to Law enforcement or the authority having primary investigative responsibility when you are required to report, you are legally requested to report, or if any other section states that you may report*

"Child abuse or neglect may be reported to any law enforcement official authorized by law to receive such reports and the agreement of the individual is not required (45 CFR 164.512(b)(1)(ii))."

*this may not apply here, however the pictures where not part of a complete book, by separating them from the original source they are no longer considered academic. artistic is interpreted differently by individuals and can per interpreted differently based on the age of the child. key to remember here is that you as the mandatory reporter are not conducting the investigation. Once you have the feeling that abuse or neglect MAY have occurred you MUST report this in most instances, to the authority responsible for determining if a crime has been committed. ie, giving the LEO the information necessary to determine if the person is a known or suspected offender. additionally public intoxication is usually an immediate cause for revocation of probation or parole in which the person has very reduced rights to privacy.*


_"(1) Permitted disclosures. A covered entity may, consistent with applicable law and standards of ethical conduct, use or disclose protected health information, if the covered entity, in good faith, believes the use or disclosure: 
(i)(A) Is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public; and (B) Is to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat. (45 CFR 164.502(j))"_

*child pornography is known to cause serious psychological harm to children and has lasting affects for the rest of the victims life. possession of child pornography is a felony and not a victim-less crime, it can be prosecuted without the child in questions knowledge. while we have already agreed that these pictures were torn from a different book can you identify what book they came from? did you see the library book with missing pages? if not can you be absolutely positive that they are from a legitimate academic or artistic source? remember just because they came from a book or magazine does not make it legal, freedom of the press has its limitations. I would report let the experts decide if its a violation of law*


_"Except when required by law, the disclosures to law enforcement summarized above are subject to a minimum necessary determination by the covered entity (45 CFR 164.502(b), 164.514(d)). When reasonable to do so, the covered entity may rely upon the representations of the law enforcement official (as a public officer) as to what information is the minimum necessary for their lawful purpose (45 CFR 164.514(d)(3)(iii)(A)). Moreover, if the law enforcement official making the request for information is not known to the covered entity, the covered entity must verify the identity and authority of such person prior to disclosing the information (45 CFR 164.514(h))."_


*basically if the cop says that they need the information for a legitimate investigation, YOU MUST PROVIDE THAT INFORMATION, once you have identified who the officer is. HIPAA is meant to protect PHI but is not to interfere with reporting crime when you believe in good faith that a crime has been committed by the individual in question.*


http://www.hhs.gov/hipaafaq/permitted/law/505.html 

here is a link to the HSS FAQ, do not rely on these summaries but instead use them to guide you through the actual CFR (Code of Federal Regulations) here:


http://www.gpo.gov/fdsys/pkg/CFR-2011-title45-vol1/pdf/CFR-2011-title45-vol1-sec164-512.pdf


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## JPINFV (Aug 8, 2013)

Draconicwraith said:


> I fail to see how HIPPA can stop us from reporting a possible crime.  Or, for that matter, how this would violate HIPPA in this situation.  Giving the name alone has nothing to do with HIPPA, since nothing medical is being reported.




...then why aren't positive tox screens automatically reported to the police? After all, if you're high on meth, you've committed a crime. This is ignoring the fact that it's questionable that a crime was committed. It's gone from "kiddy porn" to "ballet pictures."


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## Clipper1 (Aug 9, 2013)

socalmedic said:


> In CA, I am required to report directly to LEO and file a written report within 24 hours to CPS/HHS. the opinion of my supervisor has no baring on how this is filed.



It seems you are quoting a child abuse statute for reporting. Without knowing the type of photos, it would be difficult to go by that statute. If it was just sketches or magazine type photos, you could not use that statute which means you would need to check your policy for involving law enforcement.  Employers really hate the police coming in and interrogating everyone along with a big media scene which could also violate the privacy of other patients without some warning especially if the person in question is already in custody and not of immediate harm to anyone.  Pornography also has room for interpretation. Some would claim taking a photo, even just a bare butt shot, of a newborn is pornography.  A lot of parents have been dragged through the legal system since places like Walgreens are required to report actual photographs of naked children.  An explicit cartoon could be pornography to some. There are numerous prime time shows on TV which could be too pornographic for some which others might only rate as PG. 

If the photos in question has looked like child pornography, at least one of the several people mentioned would probably have taken a closer look and initiated some investigation.


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## socalmedic (Aug 9, 2013)

socalmedic said:


> Disclaimer: only you know the whole story, but based on how I understand the event I think all these sections apply and you bet I would report it, using the appropriate procedure.
> 
> *artistic is interpreted differently by individuals and can per interpreted differently based on the age of the child.*






Clipper1 said:


> It seems you are quoting a child abuse statute for reporting. Without knowing the type of photos, it would be difficult to go by that statute...
> 
> ...Employers really hate the police coming in...



may I suggest that you read the entire post... I made it fairly clear TWICE that I had not seen the photos in question and that it would be based solely on interpretation... 

my stance is still that if the child between the ages of starting school and the age of consent you should probably not have nude pictures of them, even if they are your own children. just because its printed on magazine paper does not make it legal, my friend prints his own magazines in his garage and they are the same quality print as anything you buy at the store. does this give him the right to print images of naked children? not in most communities.


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## JPINFV (Aug 9, 2013)

socalmedic said:


> my stance is still that if the child between the ages of starting school and the age of consent you should probably not have nude pictures of them, even if they are your own children. just because its printed on magazine paper does not make it legal, my friend prints his own magazines in his garage and they are the same quality print as anything you buy at the store. does this give him the right to print images of naked children? not in most communities.



I guess I need to throw out my OB/Gyn book, because I'm pretty sure there's a rather graphic picture of congenital adrenal hyperplasia in it.


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## Clipper1 (Aug 9, 2013)

socalmedic said:


> may I suggest that you read the entire post... I made it fairly clear TWICE that I had not seen the photos in question and that it would be based solely on interpretation...
> 
> my stance is still that if the child between the ages of starting school and the age of consent you should probably not have nude pictures of them, even if they are your own children. just because its printed on magazine paper does not make it legal, my friend prints his own magazines in his garage and they are the same quality print as anything you buy at the store. does this give him the right to print images of naked children? not in most communities.



I did read your post. I was referring to the part where you would call the police.



> In CA, I am required to report directly to LEO and file a written report within 24 hours to CPS/HHS. the opinion of my supervisor has no baring on how this is filed.



In a controlled situation where you already have the property and the person in your facility, it would be best practice to continue to maintain control over that situation by advising your employer. Other patients do not need to have their schedule interrupted or privacy compromised needlessly.   Your employer will then be directly responsible



JPINFV said:


> I guess I need to throw out my OB/Gyn book, because I'm pretty sure there's a rather graphic picture of congenital adrenal hyperplasia in it.


That is also a good point since we do have photos of sexual abuse which include children in our medical library. The photos could have been cut out of any medical text if the are not sexually explicit.


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## Handsome Robb (Aug 9, 2013)

JPINFV said:


> I guess I need to throw out my OB/Gyn book, because I'm pretty sure there's a rather graphic picture of congenital adrenal hyperplasia in it.



Dude stop twisting people's answers. That's obviously in an academic capacity. It doesn't take a doctor to figure out he's not talking about medical textbooks


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## JPINFV (Aug 9, 2013)

Robb said:


> Dude stop twisting people's answers. That's obviously in an academic capacity. It doesn't take a doctor to figure out he's not talking about medical textbooks


Yes, and it doesn't take a doctor to understand we're dealing with hearsay and no actual knowledge of what the pictures contained. They've been described as girls doing ballet or as naked girls, which regardless seem to have come from a published book. Somehow I don't think there's very many books containing naked ballet girls out on the market. However my knowledge of the availability of books containing girls doing ballet or how easy it is to find pictures of naked girls that aren't medical in nature, yet published is [thankfully] significantly lacking. 

So the question is, are these naked girls, or girls doing ballet? It doesn't take much to see the substitution there, but there's a rather significant legal difference.


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## socalmedic (Aug 9, 2013)

JPINFV said:


> I guess I need to throw out my OB/Gyn book, because I'm pretty sure there's a rather graphic picture of congenital adrenal hyperplasia in it.



Never thought I would have to ask you to re-read my post. you disappoint me with your recent change in agenda. you used to be one of the more knowledgeable and helpful posters here, lately though the only thing you have to contribute is snarky one liners taken out of context. I remember when Mr. Brown started to act this way as well.



Clipper1 said:


> I did read your post. I was referring to the part where you would call the police.
> 
> 
> 
> ...



this will be my last response to you on this topic... here it goes.
yes, in a controlled situation I would call for Law Enforcement. A controlled situation is the best time to do it, he isnt going anywhere and the cops have time to investigate before the subject even knows what up. lastly, your supervisor does not take responsibility because you told him and you never loose the responsibility to report as a mandatory reporter. 

I seriously doubt the "media" will be anywhere near the facility at all. they wont know what is happening until an arrest is made, which at that point the subject will be long gone from the facility. and for the record, I don't really care about the public inebriates schedule, If they had things to do that day they shouldn't have been out drinking.

good bye everyone, Robb hold down the fort for me.


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