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Fort Hood opens debate about secrecy of medical records
The Hill ^ | 4/8/2014 | Kristina Wong

Posted on 04/08/2014 4:26:28 AM PDT by markomalley

Army officials say one thing that could have helped prevent last week’s shooting at Fort Hood is better information sharing with commanders about the mental and behavioral health histories of incoming soldiers.

The shooter, Spc. Ivan Lopez, 34, had arrived at Fort Hood, Texas, in February after being stationed for four years at Fort Bliss, Texas. By the time of his transfer, Lopez had a history of mental health issues, including anxiety and depression, and was prescribed a number of prescription drugs, including Ambien.

But receiving commanders at Fort Hood would not have been privy to Lopez’s health history.

“Here's the biggest problem we have. … It’s a dilemma,” said Army Chief of Staff Gen. Ray Odierno. “The problem is sharing information and how you protect an individual's rights with sharing information, so the commanders and the people at the lower level understand that, maybe, there was a previous problem.”

Under the Health Insurance Portability and Accountability Act (HIPAA), a soldier’s mental and behavioral health record is kept private from his or her new commander. Thus, while physicians at a new base would have access to soldiers’ health records, a commander would not.

“If a soldier has mental health counseling at Fort Bragg, N.C., and he moves to Fort Carson, Colo., sometimes we have difficulty moving that information with them, because of patient HIPAA, frankly. And so, that's the concern. And so, we are trying to develop systems that enable us to do some of that, but it is difficult,” Odierno said at a Senate Armed Services Committee hearing on Wednesday.

Army officials say they have developed a new software program called "Commander's Risk Reduction Dashboard," which allows commanders to consolidate information from multiple Army databases on which soldiers in their units have been involved with "at-risk behaviors," but it is not known whether it was used to consolidate information on Lopez.

The only circumstances where a commander would be alerted by a mental health professional about a solider is if there were signs the solider would act in violence against him or herself, or others, a Pentagon spokeswoman said. That step is required under the Duty to Warn Act. 

Although an Army psychiatrist had “fully examined” Lopez the month before last Tuesday’s shooting rampage, there was no sign he was a threat to himself or others, Army officials said.

Lopez also had a clean “behavioral” record, Army Secretary John McHugh said at the hearing. “No outstanding bad marks for any kinds of major misbehaviors that we are yet aware of.” 

Army officials said they faced the same issue with Maj. Nidal Hasan, who opened fire at Fort Hood in 2009, killing 13 and injuring more than 30. 

“We had a flavor of that with Maj. Nidal Hasan in that the receiving commander was not aware of some of the disciplinary issues that he had, some of the academic issues that he had that, over time, added to his challenges,” McHugh said.

“So, part of the problem is HIPAA and who has access to what kind of medical records, behavioral health records,” McHugh said.

Army officials say extensive background screening takes place before a soldier is accepted into the service.

"Applicants with a history of conduct that shows that they have views that are inconsistent with Army values are denied entry based on questionable moral character," said Army spokesman George Wright. 

However, after that, mandatory behavioral health screening is done once a year, according to McHugh.

“So, we're trying to keep as close a watch on our soldiers as we can. But clearly, we believe there are more things we can do to identify problems in the more discreet stages of their development, try to get soldiers added help where, under our current toolkit, it may not be so obvious," he said.

McHugh said another part of the lack of information sharing is the “age-old culture of the military… that you’re given a new start with every permanent change of station.”

“We've made a lot of progress in making the relevant information aware and available to receiving commanders, but we still have some challenges on what we're allowed to do legally,” McHugh said.

The gap in information comes at precisely the same time of a period of high-stress for the service member, according to military mental health professionals.

“Changing locations, changing duty stations, changing jobs — things of that nature is going to bring upon stress,” said retired Navy Master Chief Petty Officer Maurice Wilson, president and executive director of Reboot, a nonprofit that helps veterans transition to civilian life.

Currently, there is a mental health program, “inTransition,” that can help a service member adjust to his or her new base, but it is voluntary, the Pentagon spokeswoman said.

Warrior Transition Units help injured soldiers transition back to work if they are unable to do their job, but Lopez’s mental and behavioral issues never rose to that level, she said.

Wilson said offering more mental health services during a transition from one base to another could help with the stress.

“You don’t know what anxieties people are bringing in, and what they’re accumulating,” he said. 

Army officials also acknowledge the stigma against seeking mental health assistance contributes to keeping problems from one’s commander.

"The challenge we face, particularly as we look at what occurred just yesterday at Fort Hood, is that we are doing everything we can to destigmatize … reaching out for help, before it becomes a larger problem," McHugh said.

TOPICS: Extended News; Government; US: Texas
KEYWORDS: fortbliss; forthood; hipaa; ivanlopez; murderers; privacy; texas
How about just letting soldiers exercise their constitutional rights and bear arms?

Nah, can't do that, can we?

1 posted on 04/08/2014 4:26:28 AM PDT by markomalley
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To: markomalley

That’s number one

Two is that this nutcase was recruited. And then worse he was passed along.

Open med records? Privacy issues are not the same in the military. So that a a different conversation within the army. But I will bet everyone that came in contact with this guy is not surprised this happened.

And if one of them had any character they’d come out and say it was not ptsd and put a stop to that whole fiasco

But this guys med records are not the issue that’s just the hand wringers mumbling. This guy was nuts and no one around him needed to look at his records which would’ve shown what they already knew , except that he was on side effect inducing mess

None of these lazy cowards would have done anything about him any sooner had they known that

2 posted on 04/08/2014 4:50:40 AM PDT by stanne
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To: stanne

The media keeps saying that he was screened for PTSD and implying that there were red flags that led to the screening, but ALL soldiers who’ve been deployed are screened now. If there are additional mental health issues, a PTSD screening will happen as part of the evaluation.

3 posted on 04/08/2014 5:54:56 AM PDT by Marie (When are they going to take back Obama's peace prize?)
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To: Marie

“The media keeps saying...” Whatever they want to say in order to advance their agenda, without picking up a medical journal, a book, or asking a question of a psychiatrist.

Anyone with an ounce of curiosity, an inkling of intellect, or one care about the military would question this.

PTSD is post trauma. After trauma, the very last thing someone wants to do to feel better is cause more trauma.

The media has the nation’s consciousness stuck on this, and not only providing opportunity to bash and denigrate their loathed military, giving their friends in the Chamber of Commerce mafia, the Pharmaceutical industry, cover

I am sick over this.

This guy was on a bad drug. He did not suffer from PTSD to begin with, and he was nuts when the army let him in and pushed him along.

But PTSD does not cause people to shoot other people.

I want this to stop

4 posted on 04/08/2014 6:14:46 AM PDT by stanne
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To: markomalley

This hot head, who didn’t want to wait until the next day for his leave forms. spent eight minutes driving around the base shooting people. It is pathetic that on a military installation there was no one armed who could have plugged this predator when he left the first killing to get to his car.

The idiots are running things in this country.

5 posted on 04/08/2014 6:17:29 AM PDT by txrefugee
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To: markomalley
Privacy laws are crippling the nation:
1.LE is not privy to records - medical (mental), education and even some criminal.
2. Parents are not allowed to see the grades of their college students.
3. Employers are not allowed to even inquire about an applicants attendance, quality of work, disciplinary action, etc. - only, did that person work for you and when did they leave.
4. and much more.


6 posted on 04/08/2014 6:57:10 AM PDT by elpadre (AfganistaMr Obama said the goal was to "disrupt, dismantle and defeat al-hereQaeda" and its allies.)
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To: markomalley

HIPAA protects murderers, just not us.

7 posted on 04/08/2014 7:28:19 AM PDT by TurboZamboni (Marx smelled bad and lived with his parents .)
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To: markomalley

I had a thought about this medical issue for gun ownership. To those who propose creating a medical police state to deny RKBA to those with certain predicted liklihods of crime, I offer this question:

“If you think that average Americans like 50-year-old ladies who are prescribed Ambien or Prozac should be prevented from buying guns because that puts them at risk for committing violent gun crimes, then shouldn’t we also keep guns out of the hands of other populations who are at even greater gun crime risk? Hmmm?

“So let’s make it illegal for black men to own guns until/if they reach one of the following milestones:
1. Get married.
2. Get a job.
3. Get a degree.
4. Get to age 40 without a criminal record.”

8 posted on 04/08/2014 7:50:42 AM PDT by Atlas Sneezed (Lose to Cruz - 2016!)
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To: elpadre

1.LE is not privy to records - medical (mental), education and even some criminal.

My education and medical records aren’t the government’s business.

2. Parents are not allowed to see the grades of their college students.

Sure they are. Just say: “I’m cutting off the money if you don’t show me your grades.”

3. Employers are not allowed to even inquire about an applicants attendance, quality of work, disciplinary action, etc. - only, did that person work for you and when did they leave.

Nonsense. Employers may ask all they want. Granted, the former employer might not want to disclose for their own reasons. But that’s a perceived liability issue, not a privacy issue. I’ve been asked, and I’ve answered honestly.

9 posted on 04/08/2014 7:53:32 AM PDT by Atlas Sneezed (Lose to Cruz - 2016!)
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