Legal Preparedness to Share Information During Disasters Denise Chrysler, J.D., Director The Network...
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Transcript of Legal Preparedness to Share Information During Disasters Denise Chrysler, J.D., Director The Network...
Legal Preparedness to Share Information During Disasters
Denise Chrysler, J.D., DirectorThe Network – Mid-States Regional CenterUniversity of Michigan School of Public Health
Presented May 8, 2013National Disaster Epidemiology Workshop
Thank you!!
for your work to protect our community…..everyday and during extraordinarily conditions
Legal Preparedness to Share Information, May 8, 2013 2
Who are we and what do we do?
At no cost, the Network provides public health legal support:
»Technical assistance»Resources»Opportunities to build connections
With a single point of entry to experts on a wide-range of topics, it’s practical, reliable and seamless.
Legal Preparedness to Share Information, May 8, 2013 3
Public Health Topics
»Cross-border public health
» Emergency legal preparedness and response
» Environmental public health
» Food safety
»Health reform
»Health information data sharing
» Injury prevention and safety
»Obesity prevention
» Public health agency accreditation and shared service delivery
» Public health statutes and regulatory information
» Tobacco control
» Tribal public health law
»And other topics
Working with experts around the country, the Network provides support on a variety of topics:
Legal Preparedness to Share Information, May 8, 2013 4 4
Data flows like a river
Legal Preparedness to Share Information, May 8, 2013
State Public Health
Local Public Health
Media
Public
CDC
Emergency Responders
Red Cross
Other states
Patient Physician
Laboratory
- Determine the data sources and recipients- Identify the data elements- Analyze law that governs each transfer- Deal with data dams and data diverters
Law enforcement
Family
5
Law governs every aspect of data
Legal Preparedness to Share Information, May 8, 2013
Law friend or foe?- How does law help you do your
job? - How is law a barrier?
UseCollection
Sharing Protection
6
Wish list
Legal Preparedness to Share Information, May 8, 2013
Challenge Solution
Collecting data
Using data
Sharing data
Protecting data
7
This presentation is for informational purposes only. This presentation represents my understanding of various laws, and is not intended as a legal position or advice from the Network for Public Health Law or the University of Michigan School of Public Health.
For legal advice, attendees should consult with their own counsel.
The Fine Print
Legal Preparedness to Share Information, May 8, 2013 8
Surveillance Investigation Action
Collection
Legal Preparedness to Share Information, May 8, 2013 9
Collection & use of data
» Authority established by state law
» Public health broad authority to collect data to prevent and control disease and protect public health (1977 S. Ct opinion, Whalen v Roe)
» Corresponding duty to protect information
» HIPAA should not impede public health data collection functions
» HIPAA allows health care providers to provide identifiable health information to public health authorities and their agents for public health purposes
» FERPA may be barrier to obtaining info from schools
Legal Preparedness to Share Information, May 8, 2013 10
Public Health and Law Enforcement Datasharing: Benefits & Challenges
» Law enforcement as “police”
» Overlapping but distinct missions and approaches that are complementary and conflicting
» PH as agent of police (2001 S. Ct opinion, Ferguson v. City of Charleston)
» Joint investigationso Evidence - Fourth Amendment warrant for search and seizure
o Interviews – Fifth Amendment right against self-incrimination
» Joint planning and trainingo Model Memorandum of Understanding
o Forensic epidemiologyLegal Preparedness to Share Information, May 8, 2013 11
Sharing Data
Legal Preparedness to Share Information, May 8, 2013
What?
With whom?
For what purpose?
Competing interests: protect individual privacy, protect the public, inform the public
12 12
Challenges in Sharing Data»PH data – state law mostly governs (varies)
»Each data type may be controlled by own law
»Legal interpretations necessary–when in doubt lawyers say “no”
»De-identification (HIPAA’s influence) & re-identification risk
ˉ No reasonable basis to believe that the information can be used to identify an individual
ˉ Lack of statistical expert
»Media: Guidance on the release of information concerning deaths, epidemics or emerging diseases (AHCJ)
Legal Preparedness to Share Information, May 8, 2013 13 13
Michigan’s HIV confidentiality law
Sec. 5131.
(1) All reports, records, and data pertaining to testing, care, treatment, reporting, and research, and information pertaining to partner notification under section 5114a, that are associated with the serious communicable diseases or infections of HIV infection and acquired immunodeficiency syndrome are confidential. A person shall release reports, records, data, and information described in this subsection only pursuant to this section.
Legal Preparedness to Share Information, May 8, 2013 14
Nebraska’s communicable disease lawR.R.S. Neb. § 71-503.01
When case reports and positive lab results must be reported to a public health agency, “such reports or notifications and the resulting investigations shall be confidential except as provided in this section, shall not be subject to subpoena, and shall be privileged and inadmissible in evidence in any legal proceeding of any kind or character and shall not be disclosed to any other department or agency of the State of Nebraska.”
The section allows non-identifiable information to be reported to CDC to further the protection of public health and identifiable information to be provided to other health departments to ensure that investigations deemed necessary are made.
Legal Preparedness to Share Information, May 8, 2013 15
State Privacy Laws:
Legal Preparedness to Share Information, May 8, 2013
»Laws vary in addressing privacy concerns and scope of permissible sharing
»ASTHO Legal Barriers Project Public Health and Information Sharing Toolkit – use State Analysis Guide to identify relevant privacy laws and conditions for disclosure
16 16
Protection of data
Legal Preparedness to Share Information, May 8, 2013
»Freedom of Information laws (a/k/a Sunshine laws, Public Records laws)
»Ensure open government
»Government limited in ability to restrict access to data
»General rule: Must provide information requested unless an exemption applies
»May be problematic in the event of a public health emergency
17 17
Common exemptions
Legal Preparedness to Share Information, May 8, 2013
Information not subject to disclosure under another law
Personal privacy
Health information or records
Business information
Investigatory record
National and/or state security18 18
Legal Preparedness to Share Information, May 8, 2013
»What data challenges do you face?
»How have you resolved datasharing concerns?
»Is law a barrier to data collection, use, sharing, or protection needed to protect the public?
»Do you have legal counsel available who assists you in meeting datasharing needs?
»What is on your wish list to make your job easier?
»How can we (CSTE, Network for Public Health Law and ASTHO) help?
Your turn!
19 19
Thank you for listening
Denise [email protected]