Health Departments and the Disclosure of COVID-19 Patient Identifying Information
The Health
Insurance Portability and Accountability Act (HIPAA) privacy rule generally prevents
the disclosure of a patient’s personal health information without the patient’s HIPPA
authorization. However, an exception to
HIPPA permits disclosing this information to first responders in certain
circumstances, including lessening a serious and imminent threat to health and
safety of the public, first responders and inmates.
The Illinois
Attorney General has advised that sharing COVID-19 patient identifying information with first responders is permissible under the HIPPA
exception, but has left decision to local health departments. The Illinois Department of Public Health (“IDHP”), however, issued guidance on April 1,
2020, recommending that local health departments not disclose COVID-19
patient identifying information to law enforcement. The IDHP based this guidance on its opinion that disclosing COVID-19 identifying patient information to
first responders would have limited value and provide first responders with a
false sense of security because of a high number of asymptomatic cases may not
have been tested yet and people who have tested positive may no longer be contagious. Instead, the IDPH recommended that first responders
take appropriate protective precautions when responding to all calls.
Illinois counties have responded in different ways to this issue. DuPage and Will County Health Departments have voluntarily provided
COVID-19 patient addresses to first responders. However, other Illinois counties have refused to provide information to first responders, sparking several lawsuits, a few of which are discussed below.
Cook County
The Northwest Central Dispatch System, a consolidation
of 911 dispatchers, filed a lawsuit on April 20, 2020 against
the Cook County Department of Public Health, its administrators and Cook County
Board President Toni Preckwinkle. The lawsuit sought a temporary restraining
order (TRO) forcing the county to disclose the names and addresses of COVID-19
patients. On May 1, 2020, Cook County Judge Anna
Demacopoulos denied the TRO. During the hearing, the
judge reiterated the IDHP’s guidance and voiced concerns over maintaining
the privacy of medical information and whether police would respond more slowly
if they knew they could be exposed to the virus. The judge also questioned whether
releasing this information would make first responders safer, reasoning that because
of the high number of asymptomatic cases and testing gaps, first responders are
no more safe if they know a person’s name. Addressing discrimination concerns,
the judge said that disclosing COVID-19 patient identities threatens
stigmatizing infected people and harming minorities and undocumented residents who
have complicated relations with the police. She also noted that some might feel
discouraged from getting tested for fear of appearing on the list, which could
exacerbate the virus’s prevalence in those communities. The judge set another hearing for early June.
McHenry County
On April 10,
2020, McHenry County Judge Michael Chmiel entered a TRO requiring the McHenry County Department of Health to disclose COVID-19
patient names to emergency dispatchers. The TRO requires
COVID-19 patient names to be purged from the dispatch system seven days after
the health department deems the patients are no longer contagious and also
requires all information received by the dispatch system to be kept
confidential. The judge’s order comes after a lawsuit filed by the McHenry County Sheriff and a
separate lawsuit filed by Algonquin, Lake in the Hills, McHenry City, and
Woodstock Police Departments. The Sheriff’s Office claims
that the names of infected COVID-19 patients will only be shared by dispatchers on a call-by-call basis to protect
the health of officers responding to emergency calls. The County Department of Health has filed a reconsideration request and a motion to dissolve the
temporary restraining order, which is slated to be considered on May 18, 2020.
Lake County
On April 28,
2020, the Lake County Sheriff’s Office filed a lawsuit to force the Lake County
Health Department to provide the names and addresses about
COVID-19 patients in the county after the Health Department refused the Sheriff's request to confidentially disclose this information. The matter was heard by Judge Daniel Jasica on May 1, 2020, who urged
both parties to engage in settlement discussions. Similar to the legal
challenge in McHenry County, the Lake County Sheriff’s Office claims that
receiving this information is vital to preventing the spread of the virus and protecting first
responders and the community. In response, the Health Department reiterates the
IDHP’s recommendation that disclosing patient identifying information gives law
enforcement a false sense of security, because the county has many asymptomatic
individuals who have not been tested and increases the risk of mishandling
private medical information. This case is ongoing.
Post Authored by Eugene Bolotnikov, Ancel Glink
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