Most of the headlines surrounding the roll out of the Affordable Care Act have focused on the government’s inability to solve a myriad of technical problems with the recently launched online health insurance marketplace, Healthcare.gov. However, experts say that Obamacare could also have a substantial impact on physical security at hospitals and other healthcare facilities when the law goes into full effect beginning next year.
Due to provisions within the law that relate to reimbursement for Medicare and Medicaid, Ben Scaglione, director of healthcare security services for G4S and a member at large on the board of the International Association for Healthcare Security and Safety (IAHSS), says that hospitals are being forced to make tough spending decisions regarding support services which include security.
“What healthcare is starting to see right now is a loss in Medicare and Medicaid funding. What Obamacare has setup is that hospitals get a basic set of reimbursement or a basic number of dollars and then to get more of those dollars, it is based on (the hospital’s) clinical data and patient satisfaction data. They have to meet certain national guidelines that are going to be changing over the next couple of years in order to get that higher level of reimbursement,” Scaglione explains.
According to an article published earlier this month by USA Today, the healthcare industry has announced more than 41,000 layoffs so far this year, the third most of any other industry.
“Of course, whenever they layoff people and they want to make extra money they cut security because they think, ‘oh, well look at all this money over here, we’ll just cut that out and life will be wonderful,’” says Caroline Hamilton, president of Fort Lauderdale, Fla.-based security consulting firm Risk and Security, LLC. “Then, of course, it isn’t but that’s what happens when you’re an operating expense and you’re not self-funding or revenue generating.”
As a result, many hospitals are trimming internal security personnel from their payroll and outsourcing the job to contract guard services providers.
“My company has been seeing and I know several other contract guard companies have also been seeing a replacement of in-house security staff because we can provide that service at a cheaper rate,” says Scaglione. “And I think across the country you’re seeing that, you’re seeing hospitals contact out management of support services and completely contract out support services so they can focus on clinical services.”
Just because hospitals may eliminate internal security officers in favor of contract guards, however, doesn’t mean that there will be a drop in the quality of service, according to Hamilton.
“I work with a lot of hospitals that have their own, in-house departments and I also work with hospitals that have contract guards and I’ve found that the guard services have really dramatically improved,” she says. “Through the IAHSS, the training level of the guards has improved a lot. I think a lot of the guards are better equipped to deal with threatening situations and I know that management at a lot of the guard companies are stressing guard response to things like workplace violence incidents and things like that. For a hospital that has a limited budget, that’s not always a bad way to go because having your own proprietary guard service is a full-time job for somebody and if you have a limited staff, you don’t want your one security director to be spending all of his time scheduling and checking people.”
As more people obtain health insurance, there will also subsequently be more patient records that have to be kept secured by healthcare providers. Although the protection of patient information is already regulated under the Health Insurance Portability and Accountability Act, more commonly referred to as HIPAA, healthcare organizations are not a stranger to data breaches. Earlier this month, laptops containing information on more than 700,000 patients were stolen from an office building in California.
To prevent these types of records from being compromised, Scaglione said that hospitals and other healthcare facilities should place an increased emphasis on access control and making sure that proper protocols are followed.
“Putting a card reader on a door doesn’t mean it’s going to be more secure if the staff props the door open or leaves the door open,” he says. “It’s really ensuring those processes are working the way they’re supposed to be.”
In addition, Hamilton says that healthcare organizations also need to be cognizant of the dangers posed by petty criminals, as well as organized crime rings looking to steal this new influx of sensitive patient information.
“This is going to be an additional thing that hospitals and all healthcare providers start taking a tougher look at besides just stamping the HIPAA requirement and saying, ‘yeah, we meet that,” Hamilton says. “And again, a lot of times the weakness is in physical security and not in the IT department. In Miami, they have organized gangs that try to get their girlfriends on the payroll of hospitals just so they can steal the data and not so that they can sell it, but what they want to do is file false income tax reports because it’s incredibility lucrative.”
With more people having health insurance, Scaglione said there will also undoubtedly be more people visiting emergency rooms, which has the potential to raise tension levels in what is already one of the most high-risk areas of a hospital.
“Those people that haven’t had healthcare (insurance) for a long, long time and now have access to healthcare, obviously they wouldn’t have primary physicians so they’re going to go to the emergency rooms across the country which is really going to inundate those hospitals that were probably already very busy even more,” says Scaglione. “These particular patients are probably some of the most difficult in the sense that they have multiple problems, not only physical but psychological. So, the emergency rooms tend to be violent places and now everybody is assuming that’s probably going to increase as people become more insured and use that insurance.”
While Hamilton agrees that hospital traffic will go up, she believes that it will actually reduce stress on emergency departments
“I think it’s going to reduce the pressure on emergency rooms and put pressure on the rest of the hospital and also physician practices. Poorer people and those on Medicaid are using the emergency room as their primary care physician, which is a problem (the healthcare law) was supposed to address,” says Hamilton. “That might reduce the impact on the emergency department, which is the entry point of a lot of problems.”
