Border Patrol vs. HIPAA

November 14, 2008

Do any other providers along the (Mexican) border have this problem .

We're transferring a patient to another medical center away from the border

and stop at a U.S. Customs and Border Protection check point. The driver of

the ambulance stops and is asked by an agent if he is a U.S. citizen, where

are you going, who's in the back, etc. while the handler and dog move around

the back for a sniff. The agent with the dog asks that the back door be open

because the dog has detected hidden humans. The driver gets out, opens the

back door and the attending medic is then asked of his citizenship as well

as the patient's.

My questions are how far do we allow the agent to search the ambulance and

make patient contact before it becomes a privacy violation? Who has more

rights: the patient or the quest for safer borders? What would the agent do

if the medic or patient states that the patient is a Mexican (or other

country) citizen?

We've addressed this problem with the sector chief in the past but the issue

is challenged occasionally.

Solutions?

Susie Jechow, LP

Del Rio

November 15, 2008

Now, Renny, that's GREAT on-the-ground intelligence! And yes, once they

take charge of the patient, they OWN him, medical bills and all. LOL. So I

can understand why they just want to get you through and get on with their

business.

However, let me emphasize that every sector has different management. And

things vary even among individual agents and with shifts.

Example: I travel by a checkpoint every time I go to Sierra Vista to teach,

and I encounter a dizzying array of different attitudes among the agents.

Some recognize me and say " Hi and How are you? " Some that I have seen dozens

of times still ask me the question as though they were one of those dolls that

you pull the string on and they spout out a sentence.

One always asks me to open the back door of my minivan, while some don't even

glance inside.

So there are many variables.

GG

>

> In Presidio we do pass through a permanant BP check point about 50

> miles north on the way to the nearest hospital 90 miles away.

> Occasionally on the river road we also see BP agents and at times

> they actually help load patients. Only once in the years I have been

> in this area has any BP agent asked citizenship of our patient. At

> the checkpoint we are asked to radio when 5 minutes out and they wave

> us through. They have never stopped us. I actually asked if they

> would occasionally stop us just so any patient wanting to try and

> hide something on their person would think twice knowing they could

> be checked. The agent I spoke with said no, that if they established

> that the patient was illegal they had to take control of patient and

> would also then be responsible to pay for whatever medical care the

> patient needed prior to deporting them. I do not know if that

> statement is true or that is just his way of blowing off the

> question. But again they do not stop us and even when they help us

> on scene they do not check citizenship. The BP here does have a

> Paramedic and some EMT's at times that actually will even go with us

> on a bad call but again they do not ask citizenship.

> Now I have not worked very much in Presidio the past year so some of

> that might have changed but have not seen any changes on the 3,4 days

> a month I work.

>

> Renny

>

> >

> > Do any other providers along the (Mexican) border have this

> problem .

> >

> > We're transferring a patient to another medical center away from

> the border

> > and stop at a U.S. Customs and Border Protection check point. The

> driver of

> > the ambulance stops and is asked by an agent if he is a U.S.

> citizen, where

> > are you going, who's in the back, etc. while the handler and dog

> move around

> > the back for a sniff. The agent with the dog asks that the back

> door be open

> > because the dog has detected hidden humans. The driver gets out,

> opens the

> > back door and the attending medic is then asked of his citizenship

> as well

> > as the patient's.

> >

> > My questions are how far do we allow the agent to search the

> ambulance and

> > make patient contact before it becomes a privacy violation? Who has

> more

> > rights: the patient or the quest for safer borders? What would the

> agent do

> > if the medic or patient states that the patient is a Mexican (or

> other

> > country) citizen?

> >

> > We've addressed this problem with the sector chief in the past but

> the issue

> > is challenged occasionally.

> >

> > Solutions?

> >

> > Susie Jechow, LP

> >

> > Del Rio

> >

November 15, 2008

In Presidio we do pass through a permanant BP check point about 50

miles north on the way to the nearest hospital 90 miles away.

Occasionally on the river road we also see BP agents and at times

they actually help load patients. Only once in the years I have been

in this area has any BP agent asked citizenship of our patient. At

the checkpoint we are asked to radio when 5 minutes out and they wave

us through. They have never stopped us. I actually asked if they

would occasionally stop us just so any patient wanting to try and

hide something on their person would think twice knowing they could

be checked. The agent I spoke with said no, that if they established

that the patient was illegal they had to take control of patient and

would also then be responsible to pay for whatever medical care the

patient needed prior to deporting them. I do not know if that

statement is true or that is just his way of blowing off the

question. But again they do not stop us and even when they help us

on scene they do not check citizenship. The BP here does have a

Paramedic and some EMT's at times that actually will even go with us

on a bad call but again they do not ask citizenship.

Now I have not worked very much in Presidio the past year so some of

that might have changed but have not seen any changes on the 3,4 days

a month I work.

Renny

>

> Do any other providers along the (Mexican) border have this

problem .

>

> We're transferring a patient to another medical center away from

the border

> and stop at a U.S. Customs and Border Protection check point. The

driver of

> the ambulance stops and is asked by an agent if he is a U.S.

citizen, where

> are you going, who's in the back, etc. while the handler and dog

move around

> the back for a sniff. The agent with the dog asks that the back

door be open

> because the dog has detected hidden humans. The driver gets out,

opens the

> back door and the attending medic is then asked of his citizenship

as well

> as the patient's.

>

> My questions are how far do we allow the agent to search the

ambulance and

> make patient contact before it becomes a privacy violation? Who has

more

> rights: the patient or the quest for safer borders? What would the

agent do

> if the medic or patient states that the patient is a Mexican (or

other

> country) citizen?

>

> We've addressed this problem with the sector chief in the past but

the issue

> is challenged occasionally.

>

> Solutions?

>

> Susie Jechow, LP

>

> Del Rio

>

November 15, 2008

I work for Pedi. transport team for a hospital with a base in Brownsville

and Corpus Christi.

We accept the fact we will be stopped at Sarita, Fal. or Laredo BP check

points. We tell the parents before we take them along that we can not

violate federal law. If they do not have US citizenship or temporary green

card then they sit in the front seat at their own risk of being pulled out.

We will not lie to a federal agent. If you get pulled out at the check

point, we can not help you. Your best course of action is to make

arrangements before your child is transported with immigration or send a

family member with a green card with the child.

That being said. There was an emergent transport that a Border Patrol

followed us the entire way up going code to Corpus from Harlingen carrying

the mom because the child was critical and we couldn't fly due to weather.

He allowed us to get the parent to sign surgical permits then she was

process for temporary statis at Corpus Christi office. That showed alot of

kindness on the part of the Border Patrol.

The Border Patrol has been very good to us. We have a good working

relationship.

Of course, we have attended several times to many Border patrol officers

accidents as well. We do over a thousand transports up and down 77 and 281 a

year.

Also, If you want to get one of your co-workers strip searched at the check

point .... waste morphine along the bumper of an ambulance to be switched

out. Don't ask me how I know... Muhahahaa!

Being in EMS and a sick sense of humor goes hand and hand,

Penny Engelking

Paramedic

>

November 15, 2008

Gene:

I work with Renny,and we radio the checkpoint of our impending arrival and that

usually suffices. I have also taken two of border patrols detainees and had to

have their agents go with us. This is standard for any law enforcement agency

for individuals in their custody. As with anyone who comes into our country,we

the US are responsible for their care in a custodial situation(14th amendment US

constitution). I also think its a moral responsibility.

Respectfully,

Rabbiems

SSG.

R.Borenstein(Retired)

Re: Re: Border Patrol vs. HIPAA