Imagine you are an elderly person with Alzheimer’s, recovering from a stroke or suffering from paranoid schizophrenia. You are grateful for access to a four-hour-a-day program at an adult center.
Then you get letter from the state, dated Feb. 1, that begins in big, bold letters, “Notice of Change in Medical Necessity and Eligibility Criteria for the Authorization of Adult Day Health Care Services.” For someone in your condition, that’s pretty scary.
What does it mean? The letter explains: “The changes in the law are reflected in the Welfare & Institutions Code. On March 1, 2010, new laws will become operative reflected in sections 14522.4, 14525.1, 14526.2 and 14550.6 of the W&I Code. In addition, section 14525 will become inoperative and sections 14522.3, 14526.1 and 14550.5 in the W&I Code will become inoperative and will be repealed on March 1, 2010.”
This is utterly incomprehensible gobbledygook.
Then there’s the kicker: “You may also talk with your personal health care provider to find services that meet your medical needs.” Not unreasonably, some folks freaked out, believing they were being bumped from the program.
This letter went out to more than 49,000 people – though an estimated 8,000 to 16,000 will be affected by the changes. The department needed to send a letter only to those who would actually be terminated from the program. In short, the department unnecessarily frightened tens of thousands of frail people.
To add insult to injury, days later these 49,000 people received a second letter telling them that the previous letter “mistakenly included your Social Security number in your address that was printed on the outside of the envelope. We are providing you this notice because it is possible that someone could use your information to commit identity theft.”
That letter then tells people to call one of the three credit bureaus and “immediately place a free fraud alert on your credit files.” What?
Medical professionals who care for these people received no advance notice of either letter. But they have received panicked calls from people who don’t know what to do.
How did this happen? Someone at the Department of Health Care Services sent the Social Security numbers along with names and addresses to a mailing vendor. The department admits the error in this case, but says that it routinely sends out Social Security numbers to vendors who use Social Security numbers to identify their patients. What?
This incident reveals a number of flaws that need to be remedied immediately:
• Don’t use Social Security numbers as identifiers and don’t allow vendors to do so.
• Write letters in plain English that the ordinary person can understand.
• Notify providers in advance of letters going to frail people so they can help them.
Most important, the department needs to hold somebody accountable for the privacy breach. The person who sent out the Social Security numbers should be fired. Beyond that, it’s clear that this department, headed by David Maxwell-Jolly, is utterly disconnected from the elderly people it serves. This department needs a major culture change in the way it conducts business.