Healthcare providers are included as petitioners in several states’ ERPO laws. However, in states where healthcare providers are not included as petitioners, they still play a critical role in promoting the safety of their communities. If a patient shows or indicates that they pose a significant, imminent risk of violence to themselves or others, clinicians may file an ERPO petition, or contact law enforcement to inquire about filing an ERPO, in order to prevent the patient having access to firearms, limiting the risk and severity of self-harm or harm to others.
Even when there is not an imminent risk of firearm violence, it is always important to educate patients, families, and households about safe firearm storage. Healthcare providers should be able to share literature about safe storage and provide gun locks, if available, to patients and their families.
ERPOs are a critical life saving tool for clinicians. Learn more in the videos below:
Extreme Risk Protection Orders: What Clinicians Need to Know
This video is a Continuing Medical Education (CME) activity for clinicians interested in learning how ERPOs work and how they can be implemented in a clinical space. The video includes simulations of counseling strategies which demonstrate the ERPO petition process and its potential applications.
Extreme Risk Protection Orders: A Health Intervention for Preventing Firearm Suicide
This webinar provides a background on ERPO laws, the process of filing an ERPO, and clinical perspectives on cases where ERPO could be considered as a health intervention to prevent firearm suicide or other types of violence. Note: this webinar focuses on Maryland’s ERPO law, so may not apply to other states.
Screening for Firearm Injury Risk
Clinicians routinely ask patients about everyday habits and lifestyle choices, such as diet, exercise, alcohol and tobacco consumption, sexual activity, and more, to ensure the health and safety of patients and their loved ones. However, in these conversations surrounding health and safety, access to firearms rarely comes up. With gun violence increasingly identified as a public health crisis, and with firearm-related suicide as the leading cause of suicide deaths in the United States, it is increasingly important for clinicians to engage their patients about access to firearms, and screen their patients for firearm injury risk.
In this section, clinicians will learn methods for screening patients for firearm violence and injury risk in a variety of contexts, including for suicide, homicide, and domestic violence risk. Clinical approaches to discussing firearm access and injury risk with specific populations, such as minors, the elderly, and veterans, will also be explored.
The Clinical Scenarios listed here, created by the BulletPoints Project, a firearm injury prevention program funded by the State of California, provide thorough guides for working with patients at risk of committing harm with firearms–including when to know if an ERPO may be necessary for a patient in crisis. Please note that BulletPoints is based in California, and may cite or link to resources that are not available or applicable outside of that state. Learn more about the BulletPoints Project and its mission here.
Lethal Means and Safety Counseling
Reducing access to lethal means like firearms can profoundly impact the risk of an individual in crisis committing harm to themselves or others. Extreme Risk Protection Orders are legal interventions for individuals in crisis who present an immediate risk for committing firearm violence. However, there are other methods clinicians can use to reduce the risk of firearm violence for patients who may be at risk. Learn more about lethal means counseling from the resources here.
HIPAA, PHI, and Privacy Guidelines
Healthcare providers must uphold the HIPAA privacy rule and patient-doctor confidentiality when filing an ERPO petition. The US Department of Health and Human Services (DHHS) has provided guidelines to navigate disclosing protected health information (PHI) as part of an ERPO petition. Learn more about ERPOs, patient privacy, and PHI disclosures here.
5 / What constitutes a “serious and imminent” threat that would permit a health care provider to disclose PHI to prevent harm to the patient, another person, or the public without the patient’s authorization or permission?
If you are in immediate danger, please call 911.
If you are experiencing a crisis, please text or call 988.
The content of this website is not legal advice and is only intended for general informational purposes. If you need legal advice, please contact an attorney.