Jones v. Shelby Cnty. Gov't Civil Serv. Merit Bd., W2012-00191-COA-R3-CV
| Decision Date | 14 November 2012 |
| Docket Number | No. W2012-00191-COA-R3-CV,W2012-00191-COA-R3-CV |
| Parties | TIKITA JONES v. SHELBY COUNTY GOVERNMENT CIVIL SERVICE MERIT BOARD & SHELBY COUNTY DIVISION OF HEALTH SERVICES |
| Court | Tennessee Court of Appeals |
Appeal from the Chancery Court of Shelby County
Kenny W. Armstrong, Chancellor
This is an appeal from an administrative decision on the termination of the employment of a municipal employee. The appellant employee was fired from her job with the appellee municipal health department for accessing patient medical records without authorization. The appellee civil service merit board of the municipality conducted an administrative hearing and upheld the termination of her employment. The employee filed a lawsuit in chancery court seeking judicial review of this decision. The trial court affirmed the decision of the civil service merit board and upheld the termination. The employee now appeals this decision, arguing that her due process rights were violated and that the decision of the civil service merit board was not supported by substantial and material evidence. We affirm.
Tenn. R. App. P. 3 Appeal as of Right;
Judgment of the Chancery Court is Affirmed
This appeal involves the termination of the employment of a long-term municipal employee for accessing the patient medical records of her adult daughter without authorization. In 1987, Petitioner/Appellant Tikita Jones ("Jones") began working as an employee of the government of Shelby County, Tennessee. In 1993, Jones was promoted to the level of Clerical Specialist A and transferred to the Respondent/Appellee Shelby County Division of Health Services ("the Health Department"). At the Health Department, Jones worked in a health clinic as a clerical specialist. Her duties included making appointments for patients, providing general information to clients, and compiling and assembling information. Jones was authorized to access certain information in the medical records of patients of the Shelby County health clinic, for the limited purpose of performing these job duties.
In September 2009, Jones' adult daughter ("Daughter"), then 19 years old, became a patient of the clinic where Jones worked. Daughter was diagnosed and treated for a socially sensitive medical condition, not otherwise specified in the appellate record. In the months that followed Daughter's admission as a patient of the clinic, Jones accessed Daughter's medical records several times.
Approximately a year later, one of Jones' co-workers filed a complaint against the Health Department, unrelated to this case. The witnesses named in the co-worker's complaint included Jones, as well as other co-workers. Triggered by the co-worker's complaint, in September 2010, the Health Department initiated an investigation regarding Jones. In the course of the investigation, Jones was apparently asked to give an explanation for her actions in accessing Daughter's medical record. In response, on September 16, 2010, Jones wrote a letter to the Health Department's human resource manager, stating:
As a result of the investigation, the Health Department filed charges against Jones for accessing a family member's medical records without a work-related reason for doing so. On September 20, 2010, a letter was hand-delivered to Jones, informing her of allegations that she violated the Health Department's confidentiality agreement, violated HIPAA,1 and"intentionally failed to carry out instructions." The letter described the conduct that was the subject of the charges and informed Jones that the potential discipline included termination of her employment:
Attachments to this letter showed that Jones accessed Daughter's patient account on four separate occasions. Specifically, on December 7, 2009, Jones accessed 14 screens in Daughter's medical record from 11:09:30 a.m. to 11:10:59 a.m., and on that same day she accessed two more screens in Daughter's record from 11:35:16 a.m. to 11:36:37 a.m. On January 11, 2010, Jones accessed six screens in Daughter's medical record, two of which were lab reports, and had the account open for over a minute. Finally, on March 10, 2010, Jones accessed 16 additional screens in Daughter's medical record, six of which were related to lab reports, for approximately two minutes. The letter informed Jones of a Loudermill hearing,2 scheduled a week later on September 27, 2010, to allow her to present reasons why she should not be disciplined for these actions.
The Loudermill hearing was conducted a week later as scheduled. At the hearing, Jones represented herself.3 She acknowledged that she had been trained on the requirements of HIPAA and the Health Department's guidelines on confidentiality. Jones conceded that she had accessed Daughter's medical records, but she presented an e-mail from Daughter, dated three days before the hearing, indicating that Daughter had authorized Jones to access Daughter's records. The record indicates that Jones acknowledged at the hearing that she understood the requirements for a proper authorization form and the requirements fornotation of the release of such information in a disclosure log, and that she had complied with neither requirement.4
After the Loudermill hearing, on September 30, 2010, the Health Department director hand-delivered a letter to Jones with her findings and her determination on the charges. The letter indicated that the director had determined that, although Jones had received training as to HIPAA and the Health Department confidentiality requirements and procedures, she had nevertheless "knowingly accessed protected health information for a patient in our clinic - who happened to be your family member." The director noted that there was no signed authorization form and no notation in the disclosure log, so "the process for release of medical information was not followed." As to the email from Daughter indicating that Daughter had authorized Jones to access her medical records, the Department director noted that the email was dated well after Jones accessed Daughter's information, and said that she could not conclusively determine that the email was actually from Daughter. The letter concluded by informing Jones that her employment with the Health Department was immediately terminated.5
Jones appealed her termination to the Respondent/Appellee Shelby County Civil Service Merit Board ("Board"). The Board conducted an evidentiary hearing on the matter on February 8, 2011. Jones retained counsel for this proceeding and the Board heard testimony from five witnesses.
Jones testified at the Board hearing. Consistent with the findings from her Loudermill hearing, Jones testified that she had undergone extensive training and was familiar with the HIPAA standards that were applicable to her job. Jones explained that it was her understanding that if a patient called into the office and requested information from the patient's own medical record and the caller could give identifying information such as a date of birth, social security number, or the like, then she was permitted to give them certain information. In contrast, if the patient presented in-person at the clinic and requested information or medical records, then Jones understood that an authorization form must be signed and that Jones was required to fill out a disclosure log. Asked about a policy thatrequired calls from family members to be handed off to another employee, Jones claimed she was unaware of it. Jones acknowledged that if she had in fact accessed a family member's medical records without permission, it would be a violation of HIPAA and a serious breach of patient privacy.
Jones conceded that she accessed Daughter's medical records, but asserted that, in each instance, she had received prior authorization from Daughter to do so. On December 7, 2009, Jones said, Daughter called her at work and wanted to make an appointment at the clinic because the medicine she was prescribed was not working. On that occasion, Jones testified, she told Daughter to wait and to give the medication a chance to work, so no appointment was made for Daughter. Asked about the fact that, on that occasion, she had accessed Daughter's account in several areas unrelated to appointments, Jones emphasized that she was not trying "to check anything out or to do anything because . . . [Daughter] had already given [her] the information [about her condition] . . . I was the one who encouraged her to come because of this outreach that the Health Department was having." Jones explained that she had accessed multiple screens in Daughter's records because Daughter wanted to know which of her prescribed medications was causing a negative reaction, to gather information for Daughter's private physician if she decided to go there...
To continue reading
Request your trial