Wow, Somerville is really digging themselves into a hole, but where do I go from here?

Today I've found out that:

1) The Health Commission person (a nurse) is willing to get me a parking permit: "If your client can not request a permit perhaps the ordering Physician/NP/PA without identifying information other than the client's neighborhood might be useful if you want a permit"

I'm not sure quite what that's supposed to mean, but it sounds as if they will respect a person's privacy if a physician tells them to, but not if a licensed mental health counselor tells them to. Discrimination based on type of disability, anyone? I wrote back and said that I'm not aware if the person has a physician, but I'm a licensed mental health counselor who is happy to sign anything they'd like me to, and was told that in that case, I should ask the person's family members to go to the visitor parking place and disclose the personal information the person doesn't want disclosed.

(I'm getting really tired of the unsolicited advice about what I should do with a client about whom I've purposely not given any details, as well as the serious disrespect from a fellow healthcare professional who continually assumes that I don't know how to make clinically appropriate decisions regarding my client.)

2) Various agencies, such as Early Intervention and an in-home therapy program for teens, have permits assigned to their agency. They aren't required to provide any sort of list of clients they see. The permits cost more than for an individual provider, but the city apparently relies just on the professionalism of the licensed clinicians as enough assurance that the staff aren't parking in Somerville for nefarious purposes.

But since I'm self-employed, I have to provide my client's identifying info? What.


Jodie said...

In nurse speak, she's looking for an "order" for a parking permit, but she seems to be saying that only someone with prescriptive authority can give such an order. Is there maybe a way to challenge *that* part with a higher-up?

eeka said...

I think she was looking for an order for the person to see me, then since there wasn't one, decided I wasn't really providing something legitimate.

She's the director of health, and I got to her by first writing to the civil rights person. Hmm, maybe time to talk to the mayor?

Mr Punch said...

What's at issue is not disclosure of the patient name, but the name plus health status -- so a family request for a permit might not compromise confidentiality (there are many reasons for wanting a permit).

Beyond that, I'm sure Jodie's right. The issue of which health professionals can operate independently under various circumstances is of course perennial and fiercely contested.

eeka said...

Well, me requesting a permit as a healthcare provider would be me disclosing my relationship with the person -- totally illegal without permission.

Person doesn't have family, and won't trust anyone with a copy of the bill or lease. Person has rather disorganized thinking and I don't think understands/trusts why the city suddenly needs this when they haven't before. I've always come to do therapy, so it must seem kind of odd that I suddenly suggested getting this parking permit that I've never asked for before. Given the level of disorganized thinking, I really can't ethically say I'm no longer coming if the permit isn't obtained.

realsupergirl said...

If you haven't already, I think it's time to give the mayor's office a call.

eeka said...

On Monday I e-mailed everyone in the mayor's office (not sure who specifically to contact), mostly focusing on how this person said I could get a permit with a letter from "the ordering physician" and explaining that referrals and/or consent to talk to physician can't be required for MH services in this state, so they should accept a letter from me saying services are necessary. No reply back.