August 7, 2002
JEFFERSON CITY — New privacy laws are interfering with the ministry of pastors in some Missouri hospitals.
The regulations are part of the federal Health Insurance Portability and Accountability Act (HIPAA), which is designed to protect patients’ confidential medical records. But as some Missouri Baptist ministers have discovered, the law has other consequences patients might not expect.
Randy Miller, pastor of Second Baptist Church in Fredericktown, first encountered the new rules this summer while visiting a hospital in Cape Girardeau. As usual, Miller stopped by the chaplain’s office to check the registry of patients.
"Because of this right to privacy, the book is no longer available," he said.
Then he discovered that he could not visit any patient unless the family had given consent to the hospital.
"It severely limits the ministry to my congregation," Miller said. "I spend a lot of time in hospitals."
Some hospitals have overreacted to the new rules, acknowledges Jerry Sill, general counsel for the Missouri Hospital Association. Hospitals face fines up to $50,000 if they are in violation of the privacy law, he noted.
The rules, which also apply to nursing homes, clinics and other health care providers, will be enforced as of April 2003. The next few months will be an adjustment period as the new systems get up and running, Sill said.
"The problem is hospitals have a lot of processes in place," he said. "They have to go back and review everything that has any relation to patient medical information."
According to the law, hospitals can keep directories listing a patient’s name, room number, general condition and religious affiliation. The list can be made available to clergy, as well as anyone who asks for the patient by name. Patients have the right to ask not to be included on the list at all or to keep some of the information from being disclosed.
Hospitals are not required to keep the list, but Sill said he expects most will provide the information.
Dick Millspaugh, director of chaplaincy services at Boone Hospital Center in Columbia, said chaplains on staff at hospitals will have limited access to patients’ medical records as needed.
"It’s going to make a significant impact on a lot of people," Millspaugh said of the new regulations. "But the impact on clergy in general will be minimal."
Some Missouri Baptist pastors, however, think the law is a subtle attempt to divorce spiritual healing from medical healing. Another challenge is that each hospital interprets the rules differently.
Mike Bronson, pastor of First Baptist Church in Louisiana, volunteers once a week as a chaplain at Pike County Memorial Hospital, in addition to pastoral visits. Frustrated by the restrictions of the new privacy regulations, Bronson talked to hospitals officials.
"We’re hoping we do have it resolved," he said.
But the law has gaps that may prevent families from getting the spiritual counseling they need, pastors fear.
"A lot of questions have not been addressed," Miller said. "There’s some ramifications that are not very clear."
For instance, Miller is concerned that a family could be in a crisis situation and he might not be permitted in the emergency room to pray with them because they have not had time to give consent.
Sill said that technically, ministers probably would not have access to emergency room patients, but pointed out that family members are not affected by the privacy policy.
One of the biggest questions for hospitals will be who qualifies as clergy. In addition to ministers of congregations, Sill said institutions may have to recognize any self-proclaimed prophet. Meanwhile, deacons and lay ministers will probably have to ask for patients by name to get information.
Millspaugh suggested that pastors and church members with questions or concerns about privacy policies talk to the chaplaincy department or administrators at the hospitals they visit.
