“Requiring law enforcement to obtain a warrant before accessing the prescription history of any Rhode Islander provides a judicial check to ensure that investigations are legitimate,” said Sarah J Fessler, MD, Rhode Island Medical Society (RIMS) president. “Judicial review should remain the standard by which police gain access to such sensitive information.”
Fessler was speaking at the RIMS offices on Promenade St to implore Governor Gina Raimondo to veto “a law that would allow law enforcement access to confidential healthcare information without a warrant.” Specifically, writes the American Civil Liberties Union of Rhode Island (ACLU), “the law would grant some state and federal law enforcement agents access to the state’s Prescription Drug Monitoring Program (PDMP), which contains information on every prescription for a controlled substance dispensed by Rhode Isalnd pharmacies, including cough syrup, common painkillers, and various other routinely prescribed medications.”
“Our state’s PDMP is a medical decision making tool,” said Fessler, “Rhode Island’s opioid crisis is a medical one that until now has been – rather successfully – treated as such. Allowing law enforcement access to the private prescription histories contained in the PDMP threatens the sanctity of the doctor-patient relationship, and it could make patients less likely to seek and accept appropriate medical care. Our Department of Health already has the data and the authority to detect potential prescription drug diversion. This law provides a solution to a problem that does not exist – and threatens the medical privacy of all Rhode Islanders.”
“We are concerned that these bills, if signed into law, may drive patients ‘underground’ and away from the care that they need and have the unintended effect of increasing the number of overdoses,” says the letter, in part.
The letter praises Raimondo’s efforts to combat the opioid epidemic that is sweeping Rhode Island at the rate of about one death per day. But this bill “interjects law enforcement into that approach and invades the privacy and confidentiality of Rhode Islanders’ healthcare information.” As result of other General Assembly actions and a gubernatorial task force working with prescribing professionals, the number of opioid prescriptions has dropped by almost 25 percent since 2013, placing Rhode Island near the top of state efforts. By comparison, both Massachusetts and Connecticut are behind Rhode Island locally and only West Virginia is beating the state nationally.
Among the many organizations signing the letter urging a veto are the Mental Health Association of Rhode Island, the Opioid Treatment Association of Rhode Island, the American Civil Liberties Union of Rhode Island, the Substance Use and Mental Health Leadership Council of Rhode Island, the Rhode Island Health Center Association, and the Rhode Island Dental Association.
The bill was championed by Attorney General Peter Kilmartin‘s office and as Steven Brown of the ACLU pointed out, no proponent seems to have made a compelling argument about why the bill was needed or why the system currently used, which requires a judicial warrant, is inadequate. The legislation was among the most highly contested votes in this year’s General Assembly session, as the videos below amply demonstrate.
“This bill strikes at the heart of doctor-patient confidentiality and undermines the public’s faith in our state Department of Health to be a protector of the deeply private information kept in its care,” said Brown, “If police wanted to search the medicine cabinet in your home, they would need a warrant. The fact that the medicine cabinet is stored electronically shouldn’t change that equation. In fact, it’s worse. Unlike the PDMP, your actual medicine cabinet contains only the medicines you are using now, not an entire history of your prescription use. We urge the Governor to veto this dangerous bill.”
J Clement Cicilline, president of the Mental Health Association of Rhode Island, writes, “While law enforcement has an extremely important role to play in Rhode Island’s opioid crisis, patient privacy and access to treatment must remain foremost in our efforts and approach to deal with this major health problem. There should be no compromise when it comes to respecting and protecting the rights of individuals to a privileged relationship with their treatment providers. Otherwise, fewer and fewer people will get the help they so critically need.”
The bill was sponsored by Senators William Conley (Democrat, District 18, East Providence, Pawtucket), Cynthia Armour Coyne (Democrat, District 32, Barrington, Bristol, East Providence), Leonidas Raptakis (Democrat, District 33, Coventry, East Greenwich, West Greenwich), Michael McCaffrey (Democrat, District 29, Warwick) and Frank Lombardi (Democrt, District 26, Cranston) and on the House side by Representative Joseph McNamara (Democrat, District 19, Warwick, Cranston), who chairs the House Health Education and Welfare Committee and is also the chairman of the Rhode Island Democratic Party.