Are Forensic Evaluations “Health Care” and Are They Regulated by HIPAA?

Forensic mental health providers (FMHPs) typically do not release records to the examinee. The Health Insurance Portability and Accountability Act (HIPAA) federal regulations might change this position, given that they have created a basic right of access to health care records. This legislation has led to a disagreement regarding whether HIPAA regulates forensic evaluations. The primary argument (and the majority of scholarly citations) has been that such evaluations do not constitute “health care.” Specifically, in this position, the nature and purpose of forensic evaluations are not considered related to treatment (amelioration of psychopathology) of the patient. In addition, it asserts that HIPAA applies solely to treatment services; thus, forensic evaluations are inapplicable to HIPAA. We describe the evidence for and against this argument, the strengths and limitations of the evidence, and recent court decisions related to it. The weakest part of the “HIPAA does not regulate forensics” argument is that HIPAA has no exclusion criteria based on type of services. It only creates an inclusion criteria for providers; once “covered,” all services provided by that provider are thence forward “covered.” Authoritative evidence for patient access can be found in the HIPAA regulations themselves, the US Department of Health and Human Services’ commentaries, additional statements and disciplinary cases, the research literature, other agency opinion, and legal opinion. It appears that the evidence strongly suggests that, for those forensic mental health practitioners who are covered entities, HIPAA does apply to forensic evaluations. The implication is that FMHPs potentially face various federal, state, and civil sanctions for refusing to permit patient access to records.     

Democratization and political corruption in the Philippines and South Korea: A comparative analysis

The Philippines and South Korea have long had difficult corruption problems. More recently, both have experienced significant democratization. This article compares the two cases, first developing an analysis of corruption in each country, then laying out their reform strategies and assessing their effectiveness, and finally exploring the contrasting relationships between democratization and corruption that are found in these countries. The Philippines confront reformers with more difficult challenges, beginning with the size and decentralization of the society, but other contrasts are important as well. The political will required to produce successful reform has been lacking in the Philippines, for a variety of reasons, while recent anti-corruption initiatives in Korea have had stronger backing. Recent Korean reforms also emulate the successful approaches of Singapore and Hong Kong in important ways. By itself, democratization will not check corruption in either country, but where reform is accompanied by significant resources and where democratic accountability complements political will--more true of Korea than of the Philippines--significant progress can be made.     

Trainees,trainers and the training of trainers: Reform of local administration in Russia

Power at the centre of the Russian state is divided, weak and lacking in legitimacy although management in the regions, while formally bureaucratic, also depends for its effectiveness on relationships of patronage and exchange of favours. In these circumstances, the design and implementation of a reform programme for the civil service is a brave endeavour, and one which is likely to be protracted and punctuated by setbacks. Paradoxically, although there is acknowledged to be a great need for training and retraining, there are also large obstacles to applying the new knowledge and skills. This predicament is compounded by deficiencies in the provision for training. These inauspicious conclusions have implications for strategies of technical assistance and, in particular, the danger that such initiatives unintentionally become part of the problem rather than its solution. The article draws upon three visits by the author to Western Siberia as part of two EU TACIS projects.     

Beyond crime seriousness: Fitting the punishment to the crime

This paper presents an exposition of how the factorial survey approach may enhance empirical assessments of the complex judgment principles involved in public views of just punishments for convicted offenders. Ratings of the appropriateness of sentences given across 50 typical crimes obtained from a household sample (N=774) of the Boston SMSA and several special-interest samples in 1982 are examined in three alternative ordinary least-squares (OLS) regression equations. These analyses show there is not a one-to-one direct relationship between public perceptions of the seriousness of criminal acts and desired sanctions. Crime seriousness is modified by the characteristics of the offenders and victims and by the consequences of the crimes. Preferred punishments also vary in severity by demographic, experiential, and attitudinal characteristics of the persons who make the judgments.     

The Anti-Poll Tax Movement: a Pressure Movement?

The anti-poll tax campaign has been the subject of scant empirical or theoretical analysis. One explanation lies in the difficulty of locating the campaign within existing theories of pressure groups or social movements. This article argues for the creation of a distinct model of protest, based upon the concept of a pressure movement, to explain a campaign that was single-issue, decentralised, non-hierarchical and variable according to location. Distinctions between pressure groups and social movements have become increasingly arbitrary with the rise of groups lacking formalised membership. Pressure movements are thus likely to form key contestatory actors in future years.