NEWS, COMMENTARY, AND ARTS BY PSYCHIATRIC SURVIVORS, MENTAL HEALTH PEERS, AND OUR FAMILIES
VOL. XXXV NO. 1
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FROM THE HILLS OF VERMONT
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SINCE 1985
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SUMMER 2020
COVID Sweeps US Psych Hospitals
Data suggests that 100 or more patients may have died of COVID-19 while in locked psychiatric hospitals around the country, with more than 40 patient deaths in New York alone. These are high-risk settings for contagion “invisible to much of the world,” said a news report in the New York Daily News on May 3. Vermont officials say there have been no patients who have tested positive in any psychiatric unit in the state, but have also confirmed that there has not been any hospitalwide testing. According to a Department of Health protocol, residents in settings with multiple occupants are tested only if one staff person or resident has a positive test and despite active screening, no suspected cases have been identified, Commissioner Sarah Squirrell said. Some states do not provide a breakdown of COVID-19 tests or deaths by facility, according to a May 17 article in the New York Times, making it impossible to identify total numbers. NBC News said in a May 13 report that it had identified 1,450 COVID-19 cases at state mental health facilities in 23 states and Washington,
D.C., “roughly double the total in the federal prison system.” It said that the numbers, provided by state health officials, “are likely an undercount since 16 states did not provide data.” Its report did not include the number of deaths.
NBC News said in a May 13 report that it had identified 1,450 COVID-19 cases at state mental health facilities in 23 states and Washington, D.C., “roughly double the total in the federal prison system.” However, in New York, the state with the highest number of deaths in the United States, the Daily News reported that more than
40 patients had died in New York state-run psychiatric hospitals as of early May. There had been 259 positive tests among the approximately 3,500 patients at 23 New York facilities as of April 23, according to an April 25 New York Gazette article. In Massachusetts, the state health data showed 17 deaths at its Tewksbury State Hospital as of June 6. Of its 308 patients, 170 had tested positive. Lemuel Shattuck Hospital in Jamacia Plain had 99 positive tests among its 211 patients, and between one and five deaths. Numbers below five are not specified to protect against patient identification. New Jersey, also particularly hard hit by the coronavirus, had 13 patient deaths as of early June, according to its state web site. New Jersey and Massachusetts are among the very few states providing a breakdown for psychiatric hospitals. Of the more than 1,000 beds at three state-run psychiatric hospitals, 270 patients and 488 staff had tested positive as of June 6, the New Jersey health data indicated. Neither New York numbers nor the Tewksbury (Continued on page 4)
Sharing of Records Is New Default By ANNE DONAHUE Counterpoint
MONTPELIER — Despite a state commitment to “produce broad awareness of the policy change and to inform people about … their rights related to the disclosure of health records,” only three of 22 people surveyed by Counterpoint in May had heard that information is now available to their health providers without their consent. The legislature authorized the state to change its health information exchange system as of March 1, but only after “creation of patient education mechanisms and processes [that will] enable patients to fully understand their rights regarding the sharing of their health information.” Counterpoint sent a survey to psychiatric survivors and consumers who have active leadership roles in the mental health system, and most said they had not heard about the change in policy that removed the patient consent requirement. Under the new law, a patient can still refuse to have records shared but must take action to have record-sharing blocked. Prior to March 1, records were kept confidential except in an
emergency unless a patient had given direct consent. Although a majority said that they generally thought it was helpful for any of their providers to be able to access their records from their other providers, 18 of the 22 did not trust either their provider, the electronic medical system, or both, to keep information confidential. The survey participants came from across the state, ranging from Brattleboro to Springfield to Barre to Burlington. Vermont’s statewide health information exchange gathers records from all health care providers into a central database, which any provider can access after certifying that they are using the information for the care of the specific patient. Until this year, however, patients were supposed to be asked by their providers whether they consented to the exchange being used for them. Except in emergencies, the system could only be accessed if there was a patient consent in the record. In 2019, the Department of Vermont Health Access reported that the system was failing in its goal to help provide better care for patients because so few people had provided consent.
10 The Arts12
10-Year Plan For a Holistic, Integrated System
It said that after aggressive outreach to get providers to ask their patients for consent, the percentage increased from 19% in 2017 to 35% in 2018, but that was still far too low a number to make the system useful. In a report to the legislature, DVHA said that it had looked at practices in 40 other states and found that most only allowed patients to block information sharing or gave patients no option against being included, and only three states required patient consent in the way Vermont did. That meant “Vermont is out of step with national trends in health data exchange policies,” the report said. DVHA said Vermont’s policy was “minimizing the health records available when clinicians provide care.” It said it should be changed so that consent is assumed unless a patient directly informs a provider that they do not want it shared, which is called an opt-out policy. The legislature passed a bill in 2019 that permitted the change in 2020, as long as DVHA developed a “robust” plan with “strategies to inform each Vermonter about the [health (Continued on page 4)
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What WRAP Is Worth