We have a provision in our code that allows for the temporary placement of a mobile home/travel trailer for the term of a medical hardship. We require that the applicant submit a note from a medical doctor stating that the individual has a medical need to have this dwelling...either the applicant will live in it, or a caretaker. In some cases the doctor is very specific with the applicant's medical condition (even though we don't ask for such details). These applications are renewed every year, requiring that notices be sent out to neighboring property owners. Occasionally we get a letter of remonstrance from a disgruntled neighbor. Once we make a decision (most likely approval) of the renewal, our typical mail-out protocol requires us to send out the final decision, along with exhibits to the applicant, and any interested parties (i.e. the disgruntled neighbor). Of course, the doctor's note is an exhibit, since it's a part of the review criteria.
The big question is: Are we violating HIPAA by sending out the doctor's letter as an exhibit to the final decision? I think that we are... The letter is also part of the file, and therefore, part of public record...so in theory, anyone can come in and request to see the file.
Also, what kind of solutions would you recommend? We thought of creating some sort of notarized affidavit by staff, stating that the applicant provided a doctor's note (and return/shred the doctor's note)...or creating a form for the doctor to simply sign....or having the applicant sign a waiver (although I don't think this would resolve HIPAA violations).
In one case, the doctor's note mentions a patient having AIDS!...and I know I definitely wouldn't want that sent out to my disgruntled neighbors, or have that available for viewing by the public!