Quick Hits (page 4)
Medical Privacy Laws Frustrate Police
By: Matt Apuzzo, (AP)
HARTFORD, Conn. - Sgt. Andrew Gallagher knew the 9-year-old boy was hospitalized, but that was about all. The Stamford police investigator tried to reason with a nurse: He was investigating a car accident. He needed to know the boy's condition.
Not a chance, he was told. The hospital could not even confirm the boy was in the building.
So Gallagher drove to the hospital, 45 minutes away, figuring a uniformed officer would have better luck in person. A Yale-New Haven Hospital security guard stopped him in the lobby and said Gallagher needed to see a hospital attorney in another building.
This is life under the Health Insurance Portability and Accountability Act, a sweeping overhaul of the federal health care privacy laws that took seven years to craft.
Since the law took effect in April, some investigators who once had easy access to hospital emergency rooms have found even the most basic information hard to come by.
A small-town Kansas police chief says he could not verify the whereabouts of two patients, even though both were wanted for murder.
Nurses in South Carolina refused to tell a detective whether a shooting victim was alive, and said that even if he was he could not be questioned without his family's approval.
Privacy advocates say police have the same access to information as before the law took effect and can get anything they need with a warrant. But police predict it is only a matter of time until a case falls apart or a suspect escapes because of bureaucratic roadblocks.
HIPAA specifically allows hospitals to release information if police believe a crime has been committed. But legal experts say the new rules are so dense and the threat of liability so great that most hospitals are choosing silence in the name of HIPAA.
"I said, 'Do you want somebody who has just been charged with first-degree murder walking around your city after walking out of your hospital?'" Great Bend, Kan., Police Chief Dean Akings remembers asking a nurse in May, while trying to locate two suspects wounded in a shoot-out.
Akings said the nurse responded: "That's our problem."
A hospital is the first stop for many police investigations. Medical records can pinpoint a suspect - or clear one. Family and friends gather at the victim's bedside, all but lined up to be interviewed while their memories are fresh. Witnesses and suspects who might disappear tomorrow can be found in a hospital emergency room.
Before HIPAA, access to these sources was not a legal question because health care privacy was not spelled out. Now that it is a matter of law, hospitals are guarding information that used to flow freely.
"In staff training, you're told that if you don't know the answer, if you don't know whether you can answer, send them to so-and-so. Send it back upstream for someone else," said Kimberly Greaves, a Georgia health care attorney who provides HIPAA training and advice to doctors and hospitals.
Still, she predicted that both sides will get used to the new rule.
The HIPAA coordinator at Yale-New Haven Hospital declined to comment for this story, saying she needed to review the questions with other departments.
Gallagher said Yale-New Haven's attorney eventually reached the 9-year-old's mother, who agreed to be interviewed. He said he has no idea what would have happened if she had declined.
North Charleston, S.C., Detective Chris Widmer was investigating a shooting during a botched robbery in June. The victim could help identify the shooter, but hospital administrators refused even to say whether the man had survived.
"Here you have somebody who's shot, who's the victim of a crime, and we have to get authorization from the victim and the victim's daughter to talk to him?" Widmer said.
Peter Swire, who served as former President Bill Clinton's counselor on HIPAA policy and helped craft key parts of the law enforcement exceptions, said patients are getting the benefit of the doubt that investigators used to enjoy.
If police find that frustrating, he said, they can get a warrant for a patient's arrest or for any evidence they need.
"Many people don't want to talk to police, and we have due process before they have to talk," Swire said.
Doctors see a medical benefit to the law. If medical records are potential police records, patients will be less likely to see a doctor and more likely to lie, said Dr. Donald Palmisano, president of the American Medical Association.
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Tan 'n' Trends
Growin' Our Own (page 4)
What a Good Teacher Can Do
By: Candy Cotton
When I say a 'good' teacher I mean a superlative, motivating, close-to-genius one. Everyone called this one Auntie - even her students. Especially her students.
She taught in a one room schoolhouse up in the Santa Cruz Mountains. Yup, there was one up there. At least, there was one until Auntie retired. She taught grades K through 8, all subjects, by herself. Righteous pioneer type shit, y'know? Except it wasn't all that long ago and Auntie didn't just teach the three Rs. She could also teach algebra, trigonometry and physics, and had done so at a prior teaching job.
Speaking of righteous pioneer shit though, the lady had it down. She lived in an area called Mount Herman near Santa Cruz, California. It's a heavily wooded, very quiet area. In fact, there is a large religious retreat there. Her place was farther up the hill, past the retreat. She bought the property and built a house on it. I mean she built the house. Two story yet. Yeah, she got help with the electrical and plumbing stuff she didn't know or couldn't physically handle, but there wasn't much she couldn't do. Bless her heart.
One of the interesting things about this particular area of the Santa Cruz Mountains is what some enterprising people do with the trees. Yes, all most all the residents in the county are tree huggers so logging is, quite naturally, out of the question. No, these trees are put to very good use -- growing weed.
By placing a fairly small plant in a rather large pot filled with good soil and peat moss the enterprising person then places the potted ... er ... pot on the fork of a branch. I'm serious. How the watering is handled I don't know, but I do know that I have never seen an undernourished tree pot plant.
Most of these growing setups have to be in an area where there is decent sun. The Mount Herman area provides that in abundance. Those 'tree' plants I have spotted seem to be around 10 to 20 feet off the ground in pine trees. I have never seen any ladders or ropes, but I would assume that is how people get the pots into the trees in the first place.
It is actually a pretty cool setup if you ask me. People, for the most part, do not look up. Well, not unless Superman is flying around the area. Most people tend to look down, making sure no hole in the sidewalk will swallow them up I guess. Check it out sometime. Just watch people walking. They don't look up unless there is a real good reason to do so. And it would be damn near impossible for a helicopter doing a fly over to spot the weed in branches of a tree. And how would police mark the spot, the exact tree. Not very likely.
After Auntie retired from teaching she put all of her considerable skills and energy into her house and yard. She spent weeks researching what flowers would grow in the open patches of sunshine and the large plots of dappled shade under the trees. She got seeds from catalogs and from friends, cajoled cuttings from acquaintances, swapped seedlings with neighbors. It got to the point where complete strangers were giving Auntie seeds and so on.
I think that's how the trouble all started, too.
As you may well expect with a teacher of Auntie's caliber, her students remembered her very fondly. She would have visits from this one or that nearly every month. One particular summer day she had a visit from ... I'll call him 'Ned'. Ned had been all the way through Auntie's school - the entire nine years. He started out as a loud, boisterous hellion who wanted only to play cops and robbers so he could get the bad guys and left as, well, as much a gentleman as a thirteen year-old can be. Auntie also tamed a lot of little animals at that school (did I mention she had a wooden paddle?).
Anyway, Ned came to visit Auntie. It was his first visit to her Mt. Herman house, so she gave him the grand tour. She showed him how she built the place and then landscaped around it. Afterwards she got them both a cold beer and took him out to the patio she'd made with slabs of slate.
Now it was his turn. He began to recount what he'd been doing since his eighth grade graduation. He told her he'd graduated high school as class valedictorian, gone on to major in criminal justice at University of California, Santa Cruz and had maintained a B+ average all four years there.
Ned told Auntie that it was because of her he learned the value of having a good work ethic and reaching for your goals. He told her he went on to graduate among the top five in his class at the California Highway Patrol Academy. He had come to visit specifically to show her his shiny new badge. By the time he finished telling her all this and handed her the badge to look at she couldn't see very well because she was crying with happiness and pride for him.
During this discourse, however, Ned's attention seemed to be somewhat distracted. He kept glancing over to a sunny spot near the edge of Auntie's property. When he was through with his story he casually mentioned to Auntie that she hadn't told him what kind of flowers she had growing out in the back yard.
She set out to rectify her omission immediately. She showed him the hostas and the lobellias, the day lilies and the lavender, the Scotch broom and the lilac bushes. The poppies on the other hand were all located on the very northernmost side of her property. In fact, those beautiful and very colorful poppies may not have been on her property at all. Just very close.
"Erm, Auntie? Do you know that those are 'papaver somniferens'?"
"Let's see, 'papaver' is Latin for poppy, yes? And 'somniferens', hmmm, Sleepy Poppies?"
"No Auntie, OPIUM poppies!"
(All together now, everyone give a look of extreme concern. You know the one - one eye kind of squinted and the opposite eyebrow waaaay up your forehead.)
After a few rounds of "Oh my word no!" and "Yes, Auntie." Ned went on to explain to he that she was doing something very illegal. Auntie, in tears, asked if Ned intended to arrest her. He replied that of course he wouldn't, not her. (!!!) Of course, as well known as Auntie is, I do believe that if Ned had arrested her, he would be in the unemployment line by the end of the day. I kid you not at all.
"Where did you get these poppies, Auntie?"
"Oh I don't remember! When I was gathering all the plants together I got things from everyone I know and from folks I didn't know at all. I can't remember what I got, nor from whom!" It wasn't like she did not know half the bloody county. She had only taught for 40 plus years, come on, get real.
I know Auntie and she is not only an extremely intellectual person, she also has quite a bit in the way of 'street smarts'. Now, I do not believe for a second that she would ever willfully harvest the opium and then sell it. She had an excellent retirement income, plus oil income, plus natural gas income along with stocks, bonds and some mutual funds. To say she was hurting for cash just would not fly.
Auntie did things her way and, to use her expression, the "devil take the hind most." No, she was not a smuggler and she was no dealer or wholesaler either. And yes, she knew exactly what kind of poppies those were. Auntie just did not care. Beauty is simply that -- beautiful. And to say that something is beautiful but at the same time illegal made no sense to her. So, she just flat out ignored laws she did not like. I like her attitude.
Ned then informed her they had to pull up all the poppies. A fairly lengthy argument ensued with Auntie on the side of beauty and Ned on the side of THE LAW.
I've got to give Auntie credit - she damned near won the argument. But, alas, her pretty poppies all wound up out of the ground and shredded into the compost pile. I, for one, truly hope that old Ned's conscience was stinging him for a good long time. What a jerk. Some people have no eye for art or natural beauty. What a shame.
Of course, resourceful lady that she is, Auntie never told Ned about the envelope of seeds stashed in the back of her refrigerator for the next year! I told you she had street smarts.
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Pipeline (page 4)
Wrong way Smugglers
By: Staff Reporters (AP)
PINE VALLEY, Calif. (AP) - An interstate surrounding a Border Patrol checkpoint in the pine-covered mountains east of San Diego is turning into a nightmare for motorists. Many residents say they avoid the remote area after dark, fearing they may collide with immigrant-smugglers who increasingly are avoiding inspectors by driving the wrong way on the freeway.
A 30-mile stretch of Interstate 8, the main artery between San Diego and the desert of southeastern California, has been the site of crashes and hair-raising close encounters for years. But local commuters and California Highway Patrol officers say the wrong-way drivers have become an almost nightly occurrence since the summer.
Smugglers seem to know that Border Patrol and CHP vehicles won't chase them as they speed westbound in the two eastbound lanes of I-8.
"I think they learned they get away with it," said CHP Sgt. Leslie Lazo, who dispatches patrol cars on the freeway. "It's just a recipe for disaster."
Immigrants usually cross the U.S.-Mexico border on foot in the rough desert east of San Diego, then cram into a van or pickup truck headed north. As they approach the westbound I-8 checkpoint, where two Border Patrol officers peer into vehicles and search any deemed suspicious, smugglers will steer up a 20-yard slope into the eastbound lanes, often at night with their headlights turned off.
On Aug. 31, a Chevrolet Astro Van drove against oncoming traffic for about 17 miles before swerving back into the westbound lanes. The van, reaching speeds of about 100 mph, spun out of control and flipped twice before crashing, sending 19 suspected illegal immigrants to hospitals. The driver escaped.
In June 2002, a van carrying 27 people collided with a Ford Explorer: Five people in the van, including the driver, died, as did a New Mexico man in the sport utility vehicle.
Wrong-way driving reflects smugglers' growing desperation since federal authorities began Operation Gatekeeper in 1994, making it more difficult to cross the border between Tijuana and San Diego. The increased patrols near metropolitan San Diego have pushed migrant flows to the east.
Neither the Border Patrol nor the CHP keeps statistics on wrong-way drivers, but the outbreak appears concentrated in rural San Diego County. The Arizona Department of Public Safety and the Border Patrol in El Paso, Texas, haven't seen similar upticks, officials said.
Mary Schoepper, a 67-year-old real-estate broker who lives about three miles from the border in east San Diego County, has been behind the wheel in two near-collisions with wrong-way drivers since spring - one at night and one in the middle of the afternoon. Now, she checks into motels rather than drive home after late nights at work.
"When I first moved out here, you used to look out for deer crossings," said Schoepper, who has lived in the hamlet of Boulevard since 1988. "Now you look out for deer crossings and Mexicans driving the wrong way on the freeway."
Sandy Williams, 55, nearly collided with an oncoming pickup truck as she approached the Border Patrol checkpoint one night last year with her two young grandchildren. She estimates the truck was going 70 mph, headlights off, when she swerved twice and spun out in the dirt.
"I get shivers just thinking about it," said Williams, whose husband, a volunteer firefighter in Campo, hears at least two wrong-way driving incidents a week on his scanners. "That everything turned out OK is just a complete miracle."
Local officials and residents are clamoring for help - including calling for a guardrail on the freeway's dirt median, more lighting and metal spikes on entrance and exit ramps. But the problem defies easy answers.
San Diego County Supervisor Dianne Jacob is suggesting a median rail that would run about 30 miles from the checkpoint to the Imperial County line, where the Anza-Borrego Desert State Park spills into flat desert. But, she notes, that may just push smugglers further east.
"It's like a sieve," she said.
Pedro Orso-Delgado, the district director for the state transportation department, says a guardrail may only encourage smugglers to drive on the wrong side of the freeway for longer distances.
Motorists have circumvented metal spikes in other smuggling corridors by laying plywood boards over them or using tires filled with silicon gel.
Michael Crowley, a lawyer who represented a man convicted in one wrong-way crash, said determined smugglers will always find a way around the inspectors: An easy answer to the residents' concerns would be to dismantle the highway checkpoint, which others have criticized as inefficient.
For now, the CHP relies on portable metal spikes - a suitcase-size device that, when rolled across the freeway, disperses 110 hollow nails. And the agency's El Cajon office, which patrols an area about twice the size of Rhode Island, this month increased the number of squad cars assigned to the notorious stretch of Interstate 8.
One CHP car often perches in the eastbound shoulder on a 45-degree slope across from the checkpoint. Wrong-way drivers have been jumping the dirt median up to 30 miles east, where the land is flatter. The incidents typically occur between 5:30 p.m. and 2 a.m., according to the CHPs' Sgt. Lazo, but daytime crossings are becoming more frequent.
Immigrant smugglers can't predict when the checkpoint is manned - staffing hours are changed. Some, instead of crossing the median, make a U-turn to avoid inspection.
Jenny Putnam, 39, was approaching the checkpoint one July morning when she saw a late-model Lincoln Continental pull a U-turn just before the checkpoint, whose flashing lights were warning motorists to stop. The Lincoln sped toward her at about 100 mph.
"We were all just swerving to get out of the way," she said. "It was a split-second reaction from everyone."
Wade Rowley, 47, called for a protest of local residents Saturday near the checkpoint. The civilian contractor from Campo says he's considering prohibiting his teenage son from driving home from work at night and asking his daughters to avoid school activities that require night-driving.
"It's just a matter of time before there is more carnage on the road," he said.
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