Sorry - had to step away.

Questioning continues - focusing on whether Bernard properly reported. She testifies that she immediately contacted their social work to provide supports and reporting.

Defense introduces exhibit H (docs produced by IUHealth in this matter) No objection from AG.

Bernard: IUHealth social work made a report to Ohio DCS, and learned that it had already been reported locally.

DCS made a plan, and cleared the patient to go home with her mother.

This long line of questioning from defense - not going to go into detail - is really just very thoroughly establishing the process used by Bernard to report abuse according to state and IUHealth requirements.

It's doing a very good job of establishing that Bernard followed the rules to the letter, when it comes to the abuse reporting issue raised by the state.

TPR is back (terminated pregnancy report referenced by AG earlier).

Noting that TPR is publicly available, and always produced. And that it contains broad information like age, sex, race, etc.

Presumably establishing that this broad information is clearly legal to share publicly.

Moving on to the HIPAA issue now. Establishing Bernard's understanding and training about HIPAA as well as Indiana's state privacy regulations.

Bringing up the repro rights rally from June 29th that Bernard attended again. Again, going over the details of her conversation with a doctor at this rally where she mentioned the patient in question.

Establishing that she did share information, but not protected health information.

Bernard was not concerned that a reporter overheard her because her comments contained no protected health information.
We're now discussing the Indy Star story itself. Noting the Bernard was surprised that the story was specifically about the patient she discussed, but not that her name or the information she discussed was in it. She testifies that she was under the impression that it was a broader, mroe general piece.

Testifying that she was surprised by the media frenzy, which directed significant harassment and personal attacks her way. Touching on the accusations (ed note: stoked by Rokita publicly) that she made it up at the time.

Was also surprised that people didn't know that

Mentions that Fox news picking up the story increased the heat. (Ed. note: Rokita ran directly to Fox news with this, and used them to announce his prosecution of Bernard.)

Defense counsel raises that IUHealth produced a HIPAA breach risk assessment and admits it into evidence.

Determined the risk assessment found that no protected health information was provided because re-identification was unlikely.

Determined that at the time of the interview, patient was not identifiable, and that the provider was careful to protect the patient's identity.

[Objection from AG]

Defense: IUHealth privacy also put a sensitivity alert on the patients file, Bernard is aware and familiar with these alerts.

Once again, with this line defense is carefully establishing, as they did on the abuse issue, that Bernard carefully followed privacy law.

Defense wraps up. Prosecution preparing to redirect/cross.

AG hammering on the Star article.

Bernard sticking to her point that she never released private patient information.

"Would you agree that you used your patients information in furtherance of your advocacy." (not exact quote)

Bernard responds that she shared an example, without releasing specific patient information.

All AG is doing now is essentially using questioning to argue that IUHealth's policy is ... perhaps in violation in state policy? This is always a bizarre line and I've never understood where he's going with it.

Directing attention to the IUHealth Policy

"When appropriate, the social worker or the physician will make a verbal report."

AG is intentionally conflating an OR with an AND. Bernard doesn't fall for it.

"Are you hiding behind IU Health's policies."

Objection, overruled.

Returning to analyzing her media appearances. To not much end at this point.

This line of AG's questioning would appear to be a weird attempt to hold Bernard accountable for abuse the child might've received after the abortion was performed.

Which is strange, since DCS reporting requirements have been established as having been fulfilled.

"Speaking to a reporter is not required be law, is that correct?"

"No, I don't think there is anything in Indiana law that requires me to speak to a reporter."

L O L

This cross has essentially failed to establish any new facts that would be relevant to this specific case against Bernard or whether she violated privacy or child abuse reporting laws.

Cross is finished. Board is asking questions now.

"Is it a custom to go through the social worker to report, rather than personally."

It's Bernard's impression that all doctors go through the social worker.

Questions mostly focusing on details of the dr/social worker reporting procedure. No fireworks here.

"I take it you were pretty upset that you were being called a liar in the press"

"That was less concerning than the threats and the verbal harassment I was receiving."

Would you agree that it's important to maintain confidentiality, even if it means being called a liar? "Yes."

"How often does this happen." "Very frequently."

Asking why the girl was sent home for five days to live with her perpetrator.

Bernard "unfortunately, it's often the case that it's unclear."

"Only DCS can remove a patient from their lawful guardian."

Bernard: "I can't speak to the decisions that DCS makes. I imagine it's a difficult decision."

"If you had known about the attention, would you have handled the interview differently."

"I've thought about that a lot. I'm not sure. I think it's important for people to know the effects of these law. Including how even children are being harmed by them. I certainly didn't anticipate that this story was going to be about her."

"I have very mixed feelings about the way it was taken, and about how ultimately her address was released."

"Should you be even more restrictive of what you share?"

"I certainly think this case has brought to light the fact that even when not releasing PHI, people will use these stories and their information to their own political agendas."

I'm looking at Rokita here.

Brief questioning to Bernard to confirm that she has been trained on reporting requirements. (Yes)

Also establishing that more publicly identifying information is in the publicly available TPR than she shared with press.

Line from AG about her "political agenda."

Dr. Bernard capably responds that she doesn't think her advocacy for comprehensive reproductive healthcare is a political issue at all. But rather a public health issue for which there is medical consensus.

[Not a quote, I'm condensing]

Questioning about whether she's responsible for this attention.

Her response is that this happened primarily due to state political figures exploiting the story.

New witness - IU Health Social worker.

Questioning from defense establishing her role and duties and her relationship with patient privacy as well as reporting.

Establishing familiarity with Dr. Bernard. "I work with maternity services, and Dr. Bernard is a physician within that group."

Now establishing that she was the social worker involved by Dr. Bernard in reference to the patient.

Moving through the timeline/details of the case that have already been covered. Establishing that the social worker's testimony matches Bernard's.
Now we are establishing details about the social worker's qualifications, department structure, and work duties.

"I've never known a physician to make a report."

Establishing that social workers traditionally make DCS reports to the abuse occurred in. As happened here.

Stepping away during this line of questioning -- again detailing the process she used, as a social worker to report abuse and work with the patient.
New witness being sworn in. Riley's director of integrated care management. Questions establishing her social work background and her qualifications and work history.
Now questioning about training on abuse and neglect reporting. She has received it, but can't testify to the training that all depts receive.

Lots of questions about the IUHealth reporting policy here - she's the owner of the document and keeping it updated.

Essentially, just showing the board that the policy is kept up to date and was in effect during the incident at hand.

This line of questioning continues -- re-hashing qualifications, and the order of events. I wanna stress something that bothers me.

I understand it's not part of this case, and really *can't* be due to the specific complaint.

BUT IT REALLY BOTHERS ME that the AG gets to use this to telegraph his fake concern for this child rape victim when the origination of ALL of this was his attempt to prevent a doctor from providing that *child* with a legal & necessary abortion.

We should not let that get lost in this.

Indiana AG, a very publicly pro-life ideologue, made it a mission to punish a doctor for helping this kid. Period. Punished her in the press. And is trying to punish her in the courts and before the medical board.

None of these proceedings have any bearing on the welfare of that child.

We're on ANOTHER BREAK.

Can't blame 'em. This thing is Looooooong.

I'm gonna pee and find a snack - we'll be back when they reconvene.

So far I feel like AGs performance here has been just embarrassing for them. They've offered very little that contradicts Bernard's case. They've focused mostly on trying to raise vague concerns and smoke about irrelevancies.

I'm not a mind reader, but it's hard to see how the medical board gets to a finding against Bernard based on the facts presented.

We're back! We're now doing a deep dive into the specifics of HIPAA. I've missed who this witness is - will try to get it when I can.

State questioning appears to be establishing what de-identified info (PHI) can in fact be shared under HIPAA.

This continues to be a weird line for them - since there has been no evidence brought that Bernard actually shared PHI. Wondering if they are gonna get to something about that.

State is now displaying the Star article that started all of this.

Establishing that Bernard shared the age, state of origin, and medical condition
-- pregnant and a victim of abuse and implied to be female. Also disclosed that she was referred by a child abuse doctor, and that she was the child's doctor. And the approx. date of treatment of the patient.

Perhaps building a case that this info amounts to an unlawful sharing of PHI.

Now understanding that this witness is a private HIPAA expert witness from the state. Now testifying that Bernard's disclosures were in violation of HIPAA.

Objection from defense that the example they are using is irrelevant and that counsel is misrepresenting OCR guidance.

State establishing that Bernard could've have refrained from revealing the patient was from Ohio.
State witness testifying that IUHealth was incorrect in their risk assessment.
Stepping away again, hope to get back for defenses redirect on this witness

Back just in time for cross on the states expert witness.

We're now talking about HIPAA's specific definition of PHI.

Establishing that it's the witness opinion that Bernard didn't share anything called PHI under the statue other than the interpretable category of "catch all" for things that could conceivably used to identify a patient but aren't direct information.

Witness confirmed that the state's complaint only references the date, and not the more vague "catch all" for potentially unique info that the state is raising, for the first time, this afternoon.
Now we're talking about the number of girls under fifteen in Ohio who received abortions. The number is 57. Showing that the mention of Ohio did not amount to unique characteristics under the statute.

This witness is obviously going to get hammered on redirect and that's happening.

Counsel is showing ably that state's witness isn't relying on the state's own claim (which only relied on the date) but rather is concocting a fairly arguable opinion based on a collection of factors that haven't been considered as part of this case.

Witness admits that age, state, and medical condition - with no other information - doesn't violate HIPAA.

LOVE THAT OCTOMOM is in the mix.

Defense is showing that this is used, in HIPAA, as an example but is not relevant to this case.

Total of 6 cases at OCR related to HIPAA. Majority are related to documentary crews in hospitals.
Defense is establishing that IUHealth and witness could reasonably come to different conclusions in their risk assessment. And, importantly, that this doesn't necessarily mean IUHealth was wrong on the facts of their initial assessment.
I think the state has probably scored some good points with this expert witness. But on the balance, I think defense has done an able job showing that the math in these risk assessments is fuzzier than the state wanted to admit.
Board member asking how the disclosure of the full identity of the patient can be linked to Bernard, when it was due to a story at a Columbus paper she never spoke to, going on information from law enforcement providers.
"Information was dug out by DCS and law enforcement, how does that implicate Dr. Bernard?"

"Even if Dr. Bernard had not opened her mouth, that person would have eventually been identified in court. That would've happened anyway."

Clear that this board member just isn't buying the state's argument that she impermissibly revealed the patient's identifying information.

A back and forth about whether HIPAA applied to the cops or other people than Bernard. Which is all just very weird and feels like irrelevancies. This case is about whether Bernard herself violated patient privacy.
Defense is pointing out that while the AG's position is that this was PHI that could be used to identify the patient while at the same time claiming at the time that the patient literally didn't exist.