Health Care Agency - What's Up - keeping staff informed and current

Issue 14-05

May 2014

Inside this issue …


Celebrating Nurses Week, May 6-12

Patients often recognize that a nurse is the health care professional with whom they and their families have the most direct contact. However, they might not realize that nurses also are leaders in improving the quality of care and expanding access to care. That’s why May 6-12 is celebrated as National Nurses Week, an annual opportunity for communities to recognize the full range of nurses’ contributions.

This year’s theme, “Nurses: Leading the Way,” recognizes nurses as leaders who improve the quality of health care. The public holds nurses in high regard and trusts them to advocate for patients. Nurses practice in diverse roles, such as clinicians, administrators, researchers, and educators.

There are currently more than 500 nurses who are employed by the Health Care Agency who provide quality health care services to improve community health outcomes. HCA nurses work in the community, in clinics, and in institutional settings providing direct patient care, case management, health education and connection to resources and services.

HCA thanks and recognizes all of our nurses and commends you for your positive contributions and dedication to the community and clients we serve!

National Nurses week is celebrated annually by professional associations, health care facilities, governments, and communities from May 6 (National Nurses Day) to May 12, the birthday of Florence Nightingale, the founder of modern nursing. Visit the National Nurses Week website for more information.

An event was held on May 6 at the 17th Street patio to recognize HCA nurses for their contributions and dedication to the community and clients we serve. A Board of Supervisors Resolution to recognize May 6-12, as Nurses Week in Orange County was also presented to Dr. Handler, Pat Orme and Donna Fleming.
An event was held on May 6 at the 17th Street patio to recognize HCA nurses for their contributions and dedication to the community and clients we serve. A Board of Supervisors Resolution to recognize May 6-12, as Nurses Week in Orange County was also presented to Dr. Handler, Pat Orme and Donna Fleming.

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Compliance UpdateResist the urge to snoopCo-worker snooping on computer of another co-worker

In September 2013, San Francisco General Hospital had a patient go missing, only to be found deceased almost three weeks later in a stairwell. On January 24, during a routine audit of the records of high profile cases, it was found that four San Francisco General employees had been snooping in the deceased patient’s records without authorization. The employees were caught and placed on administrative leave. Eventually, two were terminated and a third resigned; the fourth returned to work.

Patient-record snooping grabbed news headlines on May 4, 2014 when Huping Zhou, 47, of Los Angeles became the first person sentenced to four months in prison for misdemeanor HIPAA offenses for accessing confidential records without a valid reason or authorization, according to the U.S. Attorney’s Office in the Central District of California.

What do these news stories teach us? As the old adage goes, “learn from the mistakes of others.” A considerable amount of our agency’s resources have been dedicated to HIPAA privacy and security compliance, such as IT Security reminders that pop into your inbox, reminders about changing your password, videos showing how to send an encrypted email, Annual Compliance Training, protecting patient privacy and the Compliance Corner reminders in the What’s Up Newsletter. However, even with all of these reminders, there have been HIPAA breaches.

This urge to peek, also known as snooping, is the act of accessing medical records without authorization or for a legitimate business reason, both of which are a violation of patient data privacy regulations.

Similar to the recent and highly publicized retail store breaches, theft and hacking are usually considered the biggest threats to the security of patient information. A single snooping incident might not be as large or noticeable as the theft of a laptop containing private data on 100,000 patients for example, but on the other hand, what snooping lacks in scope, is more than made up for in frequency.

With the recent implementation of the CHS electronic health record (EHR) and the planned “go live” date of the BHS EHR, it is important to remember the significance of HIPAA Compliance. The workforce must remember, the EHR has auditing tools which exist to stop misuse and limit privacy violations by seeing, recording, and analyzing user activity in the EHR. Details, such as who’s supposed to have access to someone’s patient information, who has been looking at a particular patient’s information, how long one has been looking at a record, what is being looked at, and whether information was printed, are only several of the many functions. For electronic health records to achieve Meaningful Use Certification, the audit functionality must be present. Once unauthorized access is found, the Office of Compliance will conduct breach risk assessments which may lead to notifying Deputy Agency Directors, the California Department of Health Care Services (DHCS), the Federal Government’s Department of Health and Human Services (HHS), and the patient. The state and federal reporting puts the Health Care Agency on the radar for auditors and investigators to come knocking at any moment.

Accessing patient medical records without authorization for a business reason is a violation of federal law and may also result in penalties and fines.

This article serves as a reminder to control the curiosity to view a patient’s medical record without authorization. Make sure you complete the training and follow the privacy and security policies. When you are not sure, ask. If you have any questions or would like customized training, please contact the Office of Compliance. You may report anonymously to the Compliance Hotline at (866) 260-5636.

 Compliance Hotline (866) 260-5636-The HCA Compliance Program offers a confidential telephone hotline to vice your concerns about any situation that may conflict with Compliance Program principles. You may call the hotline 24 hours a day, 7 days a week at the number shown above.

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Team Excellence Award logoCall for 2014 Team Excellence Award nominations

The Health Care Agency/OCEA Labor Management Committee (LMC) is seeking nominations for the annual Steve Ambriz Team Excellence Award. The award is designed to recognize the qualities and characteristics of effective work teams and emphasizes key elements of the Leadership Development Program.

Please take this opportunity to nominate a team, program, or department within the Health Care Agency that excels as a unit. Visit the LMC Team Excellence Award Intranet webpage at for application criteria, details about previous winners, and additional information about what makes an excellent team. A nomination form can also be downloaded at The deadline to submit nominations is Friday, July 18, 2014. The members of the LMC look forward to receiving your team’s nomination!

Previous winners of this award include the WorkingWELL team, Costa Mesa Collaborative Court team, Alcohol and Drug Abuse’s Drug Court, Adult Mental Health Services’ Anaheim Clinic, Correctional Mental Health team from Correctional Health Services, Public Health’s San Onofre Nuclear Generating Station Offsite Dose Assessment Center (ODAC) team, the Tobacco Use Prevention Program (TUPP), Children and Youth Services West Region program, Public Health’s Certified Unified Program Agency (CUPA) Used Oil Program, and Family Health Division’s Childhood Lead Poisoning Prevention Program.





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Election workers needed for June!

HCA is the agency providing the most volunteers to the Primary Election to date – more volunteers are still needed!  The Orange County Registrar of Voters is recruiting over 6,500 volunteers for the upcoming June 3, 2014 Statewide Direct Primary Election. County of Orange employees have exceptional skills that are important with assisting voters during Election Day operations. The County Employee Poll Worker Program allows employees to participate in the democratic process by serving as poll workers, and receive their regular day’s pay along with a paid stipend for volunteering.  By volunteering, you help provide trained staff at polling places on Election Day, increase and strengthen the availability of bilingual poll workers, and provide a reliable source of trained poll workers.

To sign up to be a County Employee Poll Worker, please visit their website at Select ‘Poll Worker’ and ‘County of Orange’ as the organization, and make sure to complete all of your information and your supervisor’s name, email address and phone number. For additional information on the various Election Day volunteer opportunities, job descriptions, and stipends, please visit

County of Orange employees have the opportunity to make a difference in our community, contribute to our government’s democratic process, and provide quality service to Orange County residents. If you have any questions or would like additional information about the County Employee Poll Worker Program, please contact Espie Martinez at (714) 567-7575 or

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Director receives 10-Years of Service Award

Congratulations to HCA Director Mark Refowitz on celebrating 10 years of dedicated service to the County. A certificate and 10-year service pin was presented to Mark to commemorate the occasion.HCA Director Mark Refowitz











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CHS staff receive recognition

Mike Graham, RNMike Graham, RN and Katy Marinazzi, Chief Pharmacist Katy Marinazzi, Chief Pharmacist

Hat’s off to Correctional Health Services (CHS) Electronic Health Record Project Leaders Mike Graham and Katy Marinazzi who have been working tirelessly for the last 18 months to lead the CHS team through the implementation of the new electronic health record (EHR).  Mike and Katy served as liaisons between the CHS program, HCA IT and the EHR vendor, leading the way through planning, customizing, testing, training and finally implementation.  The hours leading up to implementation were long and the work voluminous, but they kept their positive attitudes and focus on success.

The planning, customization and training phases required long meetings, collaboration with staff and HCA IT, hands-on testing, and communication to all involved parties. Mike and Katy were committed to a successful implementation and their attention to every detail was evident throughout the process.

On January 7, 2014, the EHR went “live” for the adult jails.  Both were on-site from the very beginning and throughout the day and evening, assisting users, communicating any problems with the vendor, and working with management and HCA IT to address issues. They both continued their hands-on assistance for the first few weeks of implementation and to this day, make rounds to work through issues with staff. They consistently make themselves available to staff for questions and assistance.

On March 18, 2014, the EHR went “live” for juvenile hall including Orangewood and Pulmonary Disease Services (who utilize the CHS pharmacy for TB medication dispensing). Once again, Mike and Katy led the team through the process (after months of planning and training for the juvenile side).

The implementation phase of the electronic health record is far from the final phase of the project. Mike and Katy are as involved as ever, meeting weekly with the involved parties, assisting staff, communicating issues, etc. This has been their full-time job for the last year and a half and the CHS team (adult and juvenile) are extremely grateful for everything they do.

Maria Rienzo, Comprehensive Care Registered NurseMaria Rienzo, Comprehensive Care Registered Nurse

Congratulations to Maria Rienzo who has been selected as a finalist for the prestigious’s Giving Excellence Meaning (GEM) Award.

Working for CHS for more than 16 years, Maria’s most recent achievement has been working with the flu epidemic and prevention in the Orange County Jail system. Maria and her team were tasked with immunizing thousands of patients. She took on this task with great enthusiasm, energy, and passion.

Maria organized mass educational events, providing education and encouragement to our high risk patients to accept a flu vaccine. In 12 days, she administered 3,451 vaccines. To date she has lead the team and vaccinated a total 4,819 patients! This was accomplished because she truly cared that this often overlooked and under-served population receive care comparable to the community. She talked one-on-one with many inmates who had questions and concerns, and made sure they understood the benefits of receiving a flu vaccine. Because our inmates flow out into the community after incarceration, her preventative measures really helped the community at large decrease total number of flu cases. This was of extreme value to the CHS program as Maria’s dedication directly impacted the quality of life for our patients and their families when they return home. the website and the magazine publishes award-winning news circulated regionally to a combined audience of more than 600,000 Registered Nurses. This award is a national program to honor nurses and the extraordinary contributions they make to patients and communities. The nurses chosen for this award are nominated by a colleague because they exemplify outstanding clinical knowledge and nursing expertise in caring for patients.


Mayra Davila, Comprehensive Care LVN Mayra Davila, Comprehensive Care LVN

Congratulations to Mayra Davila on receiving a Certificate of Recognition from the Orange County Sheriff’s Department Medal of Valor Program. Maria received acknowledgement for the life saving measures she provided as one of the first responders during a serious medical emergency that occurred in Theo Lacy Facility Module on July 4, 2013. 

Mayra was able to recognize the severity of the situation and came up with the most effective plan to care for the patient while waiting for further assistance to arrive.  Mayra and the deputies who responded to this incident were honored at the 26th Annual Medal of Valor Luncheon held April 17, 2014.  The ceremony marked the culmination of a year of excellence and an opportunity to honor the outstanding men and women who serve our community.

For the past 26 years, the Orange County Sheriff’s Department Medal of Valor Selection Committee and the Orange County Sheriff’s Advisory Council review nominations for the Medal of Valor Program.  Selected men and women from the Orange County Sheriff’s Department and their partners are honored for their meritorious service to the residents of Orange County.

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June Health Observances

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The only courage you ever need is the courage to live the life you want. —Oprah Winfrey

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What's UP is a newsletter for employees of the County of Orange, CA, Health Care Agency.

Tricia Landquist
Deanne Thompson
Anne Fialcowitz

Phone (714) 834-6644
FAX (714) 834-7644
Pony Bldg. 38-S, 4th Floor 

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