CHEYENNE - Advocates for the mentally ill and developmentally disabled said Tuesday that a federal judge's order clarifying procedures for investigating alleged abuse is a landmark decision that will help patients nationwide.

The order and an accompanying settlement agreement will allow Wyoming Protection and Advocacy System Inc. unaccompanied, reasonable access to the Wyoming State Hospital and Wyoming State Training School when the group believes abuse or neglect has occurred or may occur.

"We are very pleased with the result and believe that the access issues are now resolved," said Jeanne Thobro, executive director of Wyoming Protection and Advocacy, which filed a lawsuit against the state. "We also believe that the negotiated settlement agreement will be a model for the nation and is truly a landmark event."

The 15-page agreement was filed Friday in U.S. District Court of Wyoming in Cheyenne along with the order by Judge Alan B. Johnson.

The judge ruled that patient privacy laws such as the Health Insurance Portability and Accountability Act, or HIPAA, and the Medicaid Act do not bar the State Hospital in Evanston or the State Training School in Lander from disclosing health information to Protection and Advocacy, a federally funded nonprofit group authorized by Congress to monitor treatment of mental health patients in all 50 states.

The data must be disclosed as long as the federal nonprofit meets all requirements under several federal laws that guide its efforts.

The State Hospital provides inpatient psychiatric care for Wyoming residents, while the Training School serves people with developmental disabilities and traumatic brain injuries. Both are administered by the state Department of Health.

Kathy Karpan, attorney for Wyoming Protection and Advocacy, said it was the first case in which a federal judge ruled whether HIPAA's privacy rule prevents P&A from obtaining patient records when no guardian is available to give consent.

P&A officials and attorneys general in many other states were watching the Wyoming case, Karpan said, adding that Johnson's decision may pave the way for similar agreements elsewhere.

"There's some direction now on HIPAA and people can move off the procedural question and get back on track on the substantive issues that affect the lives of this vulnerable population," she said.

Karpan said she and Misha Westby, state senior assistant attorney general, worked out most of the details with Johnson's blessing.

"In the legal world, the state and P&A felt like we hit a home run together," she said. "Look at the resources we'll save - the time and resources across the country - and it's Wyoming pioneering."

Karpan said copies of the judge's order and the agreement were being distributed Tuesday to delegates at a national convention of mentally ill patients' advocates in San Diego.

Protection and Advocacy had filed suit against the state a year ago, alleging that health officials had not followed through on a 2002 settlement in a case known as the "Chris S." lawsuit to improve conditions at the State Hospital.

Last April, Johnson dismissed most of the claims except the plaintiff's contention that the state had impeded P&A's access to patients and patient records.

"I'm hopeful that going forward we can work cooperatively to improve care for these unfortunate citizens of Wyoming that are suffering from mental illness and developmental disabilities," Wyoming Attorney General Patrick Crank said Tuesday.

Leland Clabots, the Health Department's deputy director of administration, said he doesn't believe the ruling will affect current care.

"I think we have always been geared to doing what is in the best interest of the patients," he said. "What it does is clarify the procedures that we would all go through in protecting the health of the patient but also providing access."

Under the agreement, Protection and Advocacy must be allowed unaccompanied access to the State Hospital and State Training School and need not provide advance notice when it has probable cause to believe that abuse or neglect has occurred or might occur.

For general, non-emergency visits, P&A must provide requests in writing at least two business days in advance.

Protection and Advocacy must be provided access to any records of patients with mental illness if authorized by the individual or legal guardian.

The organization is also to have access to records if the person, because of his or her mental or physical condition, is unable to authorize access; if the patient does not have a legal guardian or the guardian is the state; and if P&A has probable cause to believe the individual has been or may be subject to abuse or neglect.

NewsTracker

* Last we knew: A federal judge had allowed portions of a lawsuit to proceed that claimed the state was hindering access by an advocacy group to psychiatric patients' records at the Wyoming State Hospital.

* The latest: The case was dismissed, and the judge approved a settlement agreement outlining how the group can investigate reports of abuse of mentally ill patients.

* What's next: Other states may take notice and negotiate similar agreements with advocates.

Capital bureau reporter Robert W. Black can be reached at (307) 632-1244 or robert.black@casperstartribune.net.