Aug. 7-20, 2003
VOL 122 NO. 28
By Eileen Jevis/ SUN staff writer
SUN photo(s) Paul Finch
In recent months, many hospital patients have found themselves without spiritual care during their stay at a health care facility. The days of clergy or health care ministers casually stopping by a patient’s sick room could very well be on the decline. Now, if a patient desires a visit by a priest, hospital chaplain, or member of the clergy, he/she will need to make his/her wishes known to the hospital staff upon admission. In the past, chaplains had access to patient lists and were able to visit those on the list that indicated their religious preference or desired a visit by a member of the clergy. In addition, past practices allowed hospitals and health care providers to contact parishes and clergy to inform them of a patient’s stay.

“Are any among you sick? Let them call for the presbyters of the Church, and let them pray over them, anointing them with oil in the name of the Lord; and the prayer of the faith will save the sick persons, and the Lord will raise them up; and if they have committed sins, the sins will be forgiven.” (James 5: 14-15). The church teaches that the Anointing of the Sick confers special grace on Catholics experiencing grave illness or old age. It unites the sick persons to the passion of Christ, gives them the courage to endure suffering, grants the forgiveness of sins, restores health, or prepares them for passing to eternal life. What happens then, if hospital patients fail to notify a spiritual leader of their admittance into a hospital?

Father James Carey, pastor of St. Leo’s Parish in Tully, shared just how devastating the consequences can be when spiritual leaders are not notified. “A parishioner at my former parish was hospitalized and by the time I was informed about it — a day or two later, the parishioner had died. Now, if I know that a parishioner is going into the hospital, I anoint them with the Sacrament of the Sick before they go in.” While this may be an extreme example, ministers and clergy are justifiably concerned about new restrictions brought about by the 1996 privacy act which went into effect in April of this year.

The Health Insurance Portability and Accountability Act of 1996, (HIPAA) was the result of efforts made by the Clinton Administration and congressional healthcare reform proponents to reform an ineffective health care system. The objectives of the legislation were to assure health insurance portability for pre-existing medical conditions, reduce healthcare fraud and abuse, enforce standards for health information, and guarantee security and privacy of health information. While these objectives certainly sound straightforward, the actual implementation of them is proving to be expensive, filled with obstacles, and creating complications that have yet to be fully realized.

Healthcare providers, insurers and all government-funded health organizations have had to train and educate staff to be in compliance with the new requirements. Most have had to upgrade computer software to ensure that health records and patient information are not easily accessible to unauthorized users. According to information obtained by HIPAA Solutions Enterprise Systems Group Inc., “Some experts are estimating the costs of achieving initial HIPAA compliance (not counting ongoing compliance training and monitoring once implemented) at over $66 billion dollars and climbing.” The cost for some organizations to become HIPAA compliant may very well put them out of business.

The federal privacy rule has been implemented to guarantee patients access to their medical records as well as to limit the outflow of patient information. Under the law, hospitals and health care providers are required to activate a comprehensive privacy policy and to obtain the patients’ consent to disclose any information about them. Patients can now decide whether their personal information, including their religious affiliation, will be included in the patient directory.

Not only does the privacy act restrict the flow of information about the patients’ presence in the hospital; it also affects the way in which the religious ministers find out about the patients’ hospitalization. The law has created an obstacle for health care ministers and clergy to visit patients who need or want spiritual support. If patients come into the hospital and fails to indicate a religious preference, they will not receive a visit from a spiritual leader. “There are different interpretations of the law,” stated Leslie Newman, HIPAA Security Officer at St. Camillus Health and Rehabilitation Center in Syracuse. “There is still a lot of confusion out there. We are still setting up protocols and will continue to err on the conservative side to avoid sanctions.” The patients who are admitted to St. Camillus are required to fill out an “Opt Out” form upon arrival. The form gives them the opportunity to indicate whether they want their name, room number or general physical condition published in the St. Camillus’ directory. Patients also have to give their permission to have their name given to a clergy member. “If the patient does not check the box stating they do not want the clergy notified, we are allowed to give their name to a priest if they are Catholic. However, the priest does not have access to a list of names from any other denomination,” said Newman.

Sister Jacqueline Spiridilozzi, OSF, a spiritual caregiver at St. Joseph’s Hospital Health Center expanded on this: “In the past, a Catholic priest saw the comprehensive list of both denomination and parish. He would perhaps visit a Catholic patient who was not a member of his parish, but whom he knew. Now, unless he knows the person is in the hospital, the patient could be just a few feet away and not get visited.” Sister Jacqueline knows that things are easier at St. Joseph’s than at other hospitals in the Syracuse area. “Because we are a Catholic hospital, it is our practice that every patient will be visited by someone from the spiritual care department, regardless of their denomination and whether or not they state a religion on their admissions form,” said Sister Jacqueline. This includes patients from out of town or emergency room patients. “Other hospitals don’t have the pastoral staff that we have here. They cannot visit every patient and if they are called, they will zero in on the denomination they represent. If the patient refuses pastoral care, we respect their wishes. However, it is initially offered to everyone,” explained Sister Jacqueline.

The new HIPAA law is especially difficult on the parish priests. “HIPAA has certainly tightened up confidentiality in the hospitals, but to another degree, it has complicated the work day of a typical priest,” said Father Michael Taylor, OFM Conv. Sister Jacqueline agrees. “It is very hard on parish priests who are so conscientious. A visit by a parish priest is very important to many patients who have a strong tie to their parish and their priest. Often, it’s important to them to see their own priest or clergy member,” explained Sister Jacqueline. “However, they are frequently satisfied to speak with one of the spiritual ministers on staff. We offer all patients the option of a visit by a minister or priest from their denomination, especially if they would like to receive the sacraments.”

The enforcement of the HIPAA law has had additional negative consequences for those in need of spiritual support. St. Camillus can no longer put a remembrance plaque on the wall to memorialize those patients who have died. “Unless it is authorized by a family member or a power of attorney, we can no longer hang the plaque,” stated Newman. “We also can no longer publish their name in our newsletter under the ‘Remembering Spirit’ column.”

The common message from all health care providers and spiritual ministers is the importance of communication. “People need to communicate what they want for themselves in an acute care facility,” said Newman. “It’s very important to have someone who can act on their behalf –– a health care proxy or a power of attorney. It’s putting the individual in control and forcing them to deal more with death and dying,” explained Newman. Sister Jacqueline couldn’t agree more. “The patient or the family has to take responsibility to make their spiritual needs known,” said Sister Jacqueline. “If a person knows that they are being admitted into the hospital, they or a family member needs to contact their parish priest.”

Some parish priests are beginning to anoint the sick before they are hospitalized. It is becoming more common for parishes to offer the sacrament of the sick during a monthly service. In addition, pastors continue to make it known through the parish bulletin the importance of calling the rectory in the event of an upcoming hospital stay.

The Anointing of the Sick used to be called “Last Rites. ” However, now it is not meant to be received only at the end of life. Parishioners who are ill in any way can request the sacrament. The church believes that this is a way to perpetuate Jesus’ ministry of healing the sick. Spiritual leaders feel that it is critical to have clergy available when a family member is faced with tragedy or a difficult decision, such as whether or not to discontinue life support. Therefore, they are understandably concerned about the spiritual well-being of the sick and the roadblocks that have been set before them by HIPAA.

What happens if a patient dies without receiving the Anointing of the Sick? “Don’t forget the mercy of God,” stated Sister Jacqueline. “He is with all of us at our time of need.”

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