Q&A
Data sharing challenges between agencies for mental health crisis responses
1:25:02
·
7 min
Council Member Lee inquires about data sharing practices between agencies involved in mental health crisis responses. Representatives from various agencies explain their data collection and sharing practices, highlighting challenges due to HIPAA regulations.
- Health + Hospitals can access past B-HEARD responses and hospitalizations within their system for individuals meeting mental health assessment criteria
- HIPAA regulations limit the sharing of protected health information between agencies
- Each agency maintains its own data, leading to potential discrepancies in reported information
Linda Lee
1:25:02
So I'll go more into the budget questions later, but Just really quickly, going to the this is one of my, I guess, pet peeves is how to make sure that we're all sort of sharing data with respect to, you know, HIPAA laws and violations.
1:25:19
Right?
1:25:21
So if there's any techie people in the audience that are looking to do pro bono work for us, just, you know, come see me after this.
1:25:27
But do the BEHARD teams, FDNY, NYPD, and health and hospitals share data regarding past responses to mental health crisis these.
1:25:36
Right?
1:25:36
So if someone has been in the system before, how are we tracking these folks?
1:25:39
How are we making sure that there's some sort of history that follows them that we can tap into so that we can better treat them moving forward?
Jason Hansman
1:25:49
So I'm talking about from the from the h and h perspective.
1:25:52
Certainly, if someone has seen via be heard team and meets mental health assessment criteria in the field, we can see those past be heard response We can also see because of our electronic medical record other hospitalizations that might have occurred within the health and hospital system.
1:26:12
So if someone had previously been in the ER at Bellevue for instance, right, we would be able to see that interaction once we once that individual met mental health criteria, and we began to serve that patient on the ground.
Linda Lee
1:26:26
Right.
1:26:26
But then my question then is, how do you share that data with the other agency sitting here?
1:26:30
Right?
1:26:30
And I think that's the thing is, How do we make sure?
1:26:33
Because I gotta say, even within the health and hospital system, it's great.
1:26:37
But then from where you guys drop off to where they go to outpatient treatment, let's just say, how do we how do what system is in place to actually follow these folks?
Jason Hansman
1:26:47
So it certainly can be a little tricky as you as you mentioned with HIPAA and our ability to share protected health information of patients, especially, you know, if there's there's prior instances of hospitalizations, what that looks like, what we do do is we are looking at this data internally to h and h.
1:27:05
And when someone does have multiple instances, we are we are looking at that, those instances, and what we can do differently the next time.
1:27:13
So does that mean they need a higher level of support and service on that next interaction, we're gonna work with them in the field to get them connected to that higher level of support.
Linda Lee
1:27:22
Right.
1:27:23
And then I guess my question is for OCMH because as you guys are sort of the overarching, you know, coordinators of this program for be heard, How is there a system in place that that allows you all to follow someone through and also track whether they've had a previous, you know, if they've been seen previously by a BEHARD team?
Laquisha Grant
1:27:45
We do not attract that.
1:27:46
We don't look at any sort of medical data.
1:27:51
It so that would be h and h who has access to those sorts of medical records and as Jason just described.
1:28:00
Yeah.
1:28:00
And we and just to note, we don't share any data but from h and h or FDNY with NYPD, the data is shared amongst the these agencies.
Linda Lee
1:28:13
Okay.
1:28:13
And and for FTNY and EMS, do you guys all have access to this data as well?
1:28:19
Or do you have your own data?
Cesar Escobar
1:28:22
We every time a be her team responds, we generate you know, a call report for that particular interaction, and that information stays with us.
1:28:34
And because of HIPAA protection, we are not allowed to share much of that information.
Linda Lee
1:28:39
Okay.
1:28:40
So if I approached each of your agency's separately.
1:28:44
And I asked you for some demographic and also without revealing someone's identity.
1:28:49
Right?
1:28:49
And and, you know, incidences, would you guys all have the same answers?
1:28:53
I guess is my question.
1:28:54
Like, does is everything gonna add up to be the same?
Jason Hansman
1:28:58
We I think we would have we would have slightly different answers, and let me tell you tell you why.
1:29:03
Because when EMS responds, they're looking at that entire picture of everyone they respond to.
1:29:10
So They have everything from dispatch down to the people who are served on the on the ground.
1:29:16
Whereas, h and h, we only have the number of people and the information on the people that we're serving with our social workers on the ground.
1:29:25
So we have a piece of the pie.
1:29:27
It is I will say it is the same answer, but we are a subset of the larger answer of EMS.
Linda Lee
1:29:32
Okay.
1:29:34
If we could figure out how to get the whole pie, I think that'd be awesome because and and I know that may seem like I'm harping on the data point.
1:29:40
But the reason why I am sort of drilling down on this a little bit is because I think in order for us to figure out how to better respond and improve the program and help improve it, we need to get a clear sense of what the data is.
1:29:51
And I think right now, even I'm sitting here confused about, which information relies with which agency.
1:29:57
So I just want to be clear on my intentions of asking and drilling down these questions.
1:30:02
So if we can have maybe further conversations about this afterwards, that'd be great.
1:30:09
So going to I'm sorry.
1:30:12
I keep for forgetting to recognize council member Jaeger and Mealy.
1:30:15
I'm sorry, guys.
1:30:17
So I just wanted to take time to do that.
1:30:20
And really quickly, so Friday, the mayor announced Hurt, can you sort of talk us through the differences in the metrics that you are reporting on year over year?
1:30:30
For example, it doesn't seem like that we're getting data on the number of folks transported to community based health care sites as an example.
1:30:38
So and I know that previous reports have articulated average response times for be heard calls, but it's missing from the latest reports.
1:30:45
So do you know what the FY 24 average once time is, and does the city have plans to include this
Laquisha Grant
1:30:52
in upcoming reports?
1:30:54
Well, I'll speak to the the transports to did you say transport to the hospitals?
Linda Lee
1:30:59
Yeah.
1:31:00
Can we
Laquisha Grant
1:31:00
basically need a nurse to the health care?
1:31:01
That is that is a number that we continue to report.
1:31:07
So we I'm sorry?
1:31:09
Yes.
1:31:10
That is something that we continue to report.
1:31:13
So in the FY 24 data that we recently released, 43% were 43% of individuals that were assessed by the mental health clinicians on the BEHARD teams were either either stayed in the community in their homes where they or the homes or wherever the 911 call took place or were connected to a a local resource like a supporting connection center in East Harlem.
Linda Lee
1:31:47
Okay.
1:31:47
Thank you.
1:31:49
And just really quickly for budget purposes, for both H and H and FDNY EMS, could you give us the breakdown of the BEHARD audits and how much is allocated for personnel services versus OTPS?
Cesar Escobar
1:32:09
I don't have that right in front of me.
1:32:11
I would have to get back to you.
1:32:12
I certainly can provide that before the close of this hearing.
Linda Lee
1:32:16
Okay.
1:32:17
Perfect.
Jason Hansman
1:32:17
Yeah.
1:32:18
It's same for h h I.
1:32:19
I would just say that the majority is OTPS.
1:32:21
Alright.
1:32:22
I'm sorry.
1:32:22
The majority is PS is personnel services.
