In 1996, Congress passed the Health Insurance Portability and Accountability Act. The positive benefits to you included a guarantee that you could maintain health insurance coverage for pre-existing condition if you change carriers, and that no health care provider could disclose medical information without your expressed consent. But HIPAA came with a significant downside for us at the synagogue.

Health care providers (including hospitals and nursing homes) may not disclose anything about a patient to anyone he or she has not authorized. This restriction includes clergy. Combined with new protocols for minimizing hospital stays, it has become virtually impossible for the Bikkur Cholim committee and me to know in a timely manner about an illness without a contact from the patient or family member.

In fact, even when I visit the hospital, if the patient has not specifically designated a religion AND a willingness to be visited by clergy, the information about hospitalization does not appear on the religious census report made available to me. Some hospitals are more diligent than others in collecting the information. (My experience in Alexandria has not been positive in that regard. In fact, INOVA Alexandria Hospital was recently removed from the Jewish Chaplaincy Service rotation because the number of Jewish patients reported did not justify the assignment. Either we have gotten much healthier, or the HIPAA requirements are not being met by patients.)

Certainly, we do not need to be the first call made on behalf of a patient. But you will help us provide support and avoid damaged feelings if you put the synagogue office near the top of the list of calls to make when an illness occurs, especially a hospitalization (including happy events like a birth), as well as the patient's desires about visits and outreach. Waiting for us to find out on our own will certainly result in an unnecessary delay. I can report that much resentment can be attributed to people assuming our care giving team knew more than it did.

What is true of illness is true of other news as well. I try not to take it personally when congregants celebrate life cycle events and do not let us know at the shul until they are well in the past. I must admit that it is difficult, especially when I hear critical comments from friends of the celebrants about the synagogue's apparent lack of interest. Please do not assume we hear about good news or, God forbid, bad news from the legendary grapevine. My experience is that the grapevine works only for news you do not wish other people to know.

Help us help. And thanks in advance.