Health Department to share COVID patient info following suit

By 
Sam Klomhaus – Enterprise Staff Writer
Tuesday, October 27, 2020
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Park County Health Officer Dr. Laurel Desnick works on her laptop while testing occurs at the downtown Livingston testing clinic June 30.

Enterprise photo

The Park County Health Department will now report addresses of active COVID-19 cases to first responders after the city of Livingston filed a lawsuit demanding the information.

This is a change from how the Health Department previously handled things, according to the department’s website.

“The PCHD and EMS had previously agreed to allow individuals to choose whether to have their address information released,” an announcement on the Health Department’s website read. “Alternatively, individuals were offered the option to disclose their diagnosis voluntarily when calling for Emergency Services. The choice will no longer be offered.”

The city of Livingston filed a lawsuit in Montana Sixth Judicial Court Oct. 19 against the Health Department, the Board of Health, and Health Officer Dr. Laurel Desnick requesting the court compel the Health Department to provide first responders with data on positive COVID-19 cases in the county.

According to the filing, Wilsall Fire & Ambulance is out of service and the Park County Sheriff’s Office has lost its north county deputy to quarantine after unknowingly coming into contact with a patient who was COVID-19 positive.

Gov. Steve Bullock issued a directive April 7 allowing local health departments to share some medical information with emergency service providers.

“Knowing this information allows emergency response employees the opportunity to seek timely medical care and to make informed decisions about addressing potential health issues,” the city’s filing states.

The filing goes on to say the directive “creates a duty for public health officials to specifically protect emergency response employees by providing a mechanism for pre-response identification of patients and locations where emergency response employees would encounter a potentially life-threatening infectious disease.

According to the city’s filing, the directive is “specifically intended to protect the health of emergency response employees.” 

The city’s filing claims the governor’s directive is also intended to protect emergency response employees as a limited resource.

The directive allows dispatch centers to get a daily updated list of positive COVID-19 cases from local public health officials, according to the filing, and dispatchers can use the list to inform emergency service providers if they are dispatched to an address containing a positive COVID-19 cases.

The state of Montana reports there were 79 confirmed active COVID-19 cases in Park County as of Tuesday morning.

According to the filing, the directive and the Health Insurance Privacy and Accountability Act (HIPAA) both allow for the  disclosure of the “minimum necessary protected health information” to emergency service providers who could come in contact with a person with COVID-19 “for the purposes of controlling the spread of COVID.”

When asked by the city for a list of addresses of positive cases, according to the filing, Desnick initially declined to provide the information but after some conversations agreed to provide the information.

In July, as Park County started getting positive COVID-19 cases, Desnick agreed to ask COVID-19 patients if they consented to have their addresses shared with emergency services personnel, as well as if they agreed to voluntarily inform 911 of their COVID-19 status should they call emergency services while infected.

According to the filing, Desnick’s rationale for limiting the shared information was patient privacy.

In July, Livingston Fire & Rescue Crews stopped responding to areas south of Emigrant for a short time because the city felt the county was withholding patient information. That issue was resolved quickly.

The filing states dispatch has not received a list of COVID-19 cases since Sept. 25, and that multiple attempts to get COVID-19 patient addresses were met with “resistance, silence, and outright refusals.”

According to the filing, on Oct. 6 LFR, Wilsall Fire and the Park County Sheriff’s Office responded to a delirious patient in Wilsall and, unaware the patient and multiple family members were COVID-19 positive, treated the patient while wearing masks and gloves, but with no additional personal protective equipment.

The responders did not find out the patient was COVID-19 positive until they arrived at the hospital.

According to the filing, if the responders had been notified of the patient’s COVID-19 status, the Wilsall first responders would have waited for LFR to arrive with full personal protective equipment before doing anything.

The city is also aware of at least one city employee who tested positive for COVID-19 and was never asked about releasing their address, according to the filing.

The filing states, “There is no authority that allows Desnick, the board, or the county, to disregard the directive of the Governor, the limitations imposed by the state and federal laws, directives, and rules, inclusively.”

The filing also states, “Desnick, the Board, and the county have a clear legal duty to transmit health information including names and addresses of COVID-19 patients to the designated dispatcher for inclusion in the CAD system for the protection of emergency response employees that may respond to those individuals or at those addresses.”

“Desnick, the Board, and The County have breached the duty they owe to emergency response employees and first responders for a known risk,” the filing states.

If the Health Department had decided not to produce the information, according to court documents, a hearing was scheduled for Wednesday morning.

LFR Chief Ken MacInnes and City Manager Michael Kardoes did not immediately respond to requests for comment Tuesday.

“I’m very happy that it’s settled,” Desnick said Monday. “We need to just focus on our work.”