Safety and Risk
- Demonstrate understanding of HIPAA by identifying and classifying patient information that meets the criteria for Protected Health Information (PHI).
- Describe basic safeguards CHWs should use to protect a patient's PHI.
- Define "mandated reporter" and explain when a CHW can or must disclose PHI to a third party.
- Identify the types of older/dependent adult abuse and what APS can do.
- Identify the types of child abuse and what CPS can do.
Privacy, Safety, and Risk in CHW Work
Privacy, safety, and risk issues happen in healthcare — including in community health work. Accidental information breaches and physical or mental health crises occur. As a CHW, it's your responsibility to address these within your scope of practice.
HIPAA and Protected Health Information
HIPAA (the Health Insurance Portability and Accountability Act, 1996) is a federal law protecting the privacy and security of health information.
PHI (Protected Health Information) is any information that can identify a patient AND relates to their health status, care, or payment for care. PHI includes medical records, billing, and even conversations between patients and providers.
Types of PHI identifiers
- Names or parts of names
- Geographic identifiers
- Dates directly related to a person
- Phone number details
- Email address details
- Social Security details
- Vehicle license plate details
- Fingerprints, retinal and voice prints
- Photographic identification (face or equivalent)
- Fax numbers
- Medical record numbers
- Health insurance beneficiary numbers
- Account details
- Device identifiers and serial numbers
- Website URLs, IP addresses
PHI takes many forms
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Patient rights under HIPAA
How to protect PHI
Double Lock Rule
Two layers of protection — like a locked filing cabinet inside a locked room. Unauthorized individuals must bypass both. If one is compromised, another protects PHI.
Patient safety and risk management
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Disclosure is permissible
Tips: Confirm identity before disclosing. Disclose only PHI directly relevant to the recipient. Disclose only PHI the patient has consented to. Keep a record of all disclosures.
Mandated reporter guidelines
Four situations where CHWs may be required to report. For each, first ask: is the risk imminent? If yes, immediate action is required.
Patient intends to harm themselves
What are some steps CHWs can take if they're unsure whether to report certain information, and who can they consult?
How might reporting sensitive information impact both CHWs and clients, and what choices can CHWs have in making reports?
Apply your knowledge: Helping Carlos
Carlos, a new CHW, is unsure about identifying and protecting Protected Health Information. Can you help him?
A CHW jots a patient's name and upcoming appointment date on a sticky note and leaves it on their car dashboard. Is this a PHI concern?
Match each mandated-reporter situation with the imminent-risk action a CHW should take.
Adult Protective Services (APS)
APS is a social services program for older adults (60+ in California) and adults aged 18–59 with disabilities. APS workers investigate cases of abuse, neglect, or exploitation. They collaborate with physicians, nurses, paramedics, firefighters, law enforcement, and CHWs.
Types of older adult and dependent adult abuse
- Physical abuse
- Sexual abuse
- Emotional or psychological abuse
- Neglect
- Abandonment
- Financial abuse
- Self-neglect
What APS does
- Determines if a response is warranted and how quickly to dispatch a social worker
- Conducts private in-person interviews
- Investigates protective issues
- Conducts strength and needs assessments
- Provides linkages to community resources
- Establishes a plan of action and follows up
Child Protective Services (CPS)
CPS is a division within the California Department of Social Services (Children and Family Services Division). Their primary objective: ensure the safety and welfare of children and adults by promoting family preservation, personal accountability, and independence.
The Continuum of CPS Services
Step 1: Prevention & Family Strengthening
- ✦Family Resource Centers — support, education, resources
- ✦Home Visiting Programs — support and education to expectant and new parents
- ✦Parenting Education Programs — parenting skills, stress management, child development
- ✦Community Awareness Campaigns — prevention awareness and reporting procedures
What CPS can do
Mandated reporting in brief
- Who is a mandated reporter? You are.
- When MUST you report (or face a fine)? When you observe, have knowledge of, are told about, or reasonably suspect abuse, neglect, or self-neglect.
- Should you investigate first? No. You don't have a duty to investigate — only to report.
- Call 911 first for immediate danger.
Which of the following are true about a CHW's duty as a mandated reporter? Select all that apply.
🌟 Lesson takeaways
Privacy and safety in CHW work means understanding HIPAA, recognizing the many forms of PHI, and applying safeguards (the double-lock rule, secure digital practices, careful communication). Beyond protection, you're a mandated reporter — there are times you CAN disclose PHI and times you MUST. APS and CPS are your partners for adult and child welfare; you don't need definite proof to report — just reasonable suspicion. When in doubt, consult your supervisor.
Great work! At the end of this module, you'll join a live discussion with your cohort and an instructor. We'll see you there.