[et_pb_section fb_built=”1″ _builder_version=”4.27.4″ _module_preset=”default” background_color=”#000a23″ background_image=”https:\/\/ehitoolkit.cste.org\/wp-content\/uploads\/2025\/10\/GettyImages-2161390459-scaled.jpg” parallax=”on” background_enable_video_mp4=”off” custom_margin=”-23px|||||” custom_padding=”0px||0px||true|false” border_radii=”off|||15px|15px” box_shadow_style=”preset3″ global_colors_info=”{}”][et_pb_row use_custom_gutter=”on” gutter_width=”1″ make_equal=”on” _builder_version=”4.27.4″ _module_preset=”default” background_color=”rgba(0,10,35,0.64)” width=”100%” max_width=”100%” custom_margin=”0px|auto||auto|false|false” custom_padding=”144px||11px||false|false” custom_css_main_element=”align-items:flex-end;” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][dipi_dual_heading first_heading=”Understanding HIPAA” heading_tag=”h1″ heading_display=”column” fh_padding=”0px|20px|20px|20px|false|true” 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_builder_version=”4.27.4″ _module_preset=”default” background_color=”rgba(0,10,35,0.64)” width=”100%” max_width=”100%” custom_margin=”0px|auto||auto|false|false” custom_padding=”0px||99px||false|false” custom_css_main_element=”align-items:flex-end;” global_colors_info=”{}”][et_pb_column type=”1_3″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”https:\/\/ehitoolkit.cste.org\/?page_id=4105″ button_text=” HIPAA and Tribal Sovereignty” button_alignment=”center” _builder_version=”4.27.4″ _module_preset=”default” custom_button=”on” button_text_size=”19px” button_bg_color=”RGBA(12,109,255,0.89)” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”https:\/\/ehitoolkit.cste.org\/?page_id=4107″ url_new_window=”on” button_text=” STLT Limits on Access” button_alignment=”center” _builder_version=”4.27.4″ _module_preset=”default” custom_button=”on” button_text_size=”19px” button_bg_color=”RGBA(12,109,255,0.89)” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][et_pb_column type=”1_3″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_button button_url=”https:\/\/ehitoolkit.cste.org\/?page_id=4109″ url_new_window=”on” button_text=” HIPAA Frequently Asked Questions” button_alignment=”center” _builder_version=”4.27.4″ _module_preset=”default” custom_button=”on” button_text_size=”19px” button_bg_color=”RGBA(12,109,255,0.89)” global_colors_info=”{}”][\/et_pb_button][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.16″ _module_preset=”default” positioning=”none” z_index=”2″ custom_margin=”|22px||22px|false|true” custom_margin_tablet=”|20px||20px|false|true” custom_margin_phone=”|10px||10px|false|true” custom_margin_last_edited=”on|phone” custom_padding=”21px||7px|||” border_radii=”off||||” 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custom_css_blurb_title=”text-transform: none;” locked=”off” global_colors_info=”{}”]<\/p>\n
When considering requesting access to\u00a0<\/span><\/span><\/span>electronic health information (<\/span><\/span><\/span>EHI<\/span><\/span>)<\/span><\/span><\/span>, it is important to understand the laws and statutes concerning the protection of health information at the federal and state levels. One commonly encountered barrier to getting access to EHI from\u00a0<\/span><\/span><\/span>healthcare organizations (<\/span><\/span><\/span>HCOs<\/span><\/span>)<\/span><\/span><\/span>\u00a0<\/span>is a limited understanding of the application of The Health Insurance Portability and Accountability Act of 1996 (HIPAA) to public health activities. This section provides a brief overview of HIPAA and the public health exception.<\/span><\/span>\u00a0<\/span><\/p>\n [\/et_pb_blurb][\/et_pb_column][\/et_pb_row][et_pb_row use_custom_gutter=”on” gutter_width=”2″ make_equal=”on” custom_padding_last_edited=”on|phone” _builder_version=”4.27.4″ _module_preset=”default” background_color=”#000a23″ width=”68%” width_tablet=”” width_phone=”90%” width_last_edited=”on|phone” custom_margin=”|auto|92px|auto||” custom_padding=”20px|45px|47px|45px|false|true” custom_padding_tablet=”20px|20px|20px|20px|true|true” custom_padding_phone=”10px|10px|10px|10px|true|true” border_radii=”on|15px|15px|15px|15px” border_width_all=”1px” border_color_all=”rgba(100,116,139,0.5)” border_width_bottom=”0px” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][et_pb_accordion open_toggle_text_color=”#0c6dff” open_toggle_background_color=”RGBA(255,255,255,0)” closed_toggle_background_color=”RGBA(255,255,255,0)” _builder_version=”4.27.4″ _module_preset=”default” toggle_font=”Poppins||||||||” toggle_text_align=”left” toggle_font_size=”22px” body_font=”Poppins|300|||||||” body_text_align=”left” body_text_color=”#FFFFFF” body_font_size=”19px” border_radii=”off|20px|20px||” border_width_all=”0px” global_colors_info=”{}”][et_pb_accordion_item title=”What is HIPAA? ” open=”on” open_toggle_text_color=”#0c6dff” closed_toggle_text_color=”#FFFFFF” _builder_version=”4.27.4″ _module_preset=”default” border_width_bottom=”0.8px” border_color_bottom=”#64748B” global_colors_info=”{}” toggle_text_color=”#FFFFFF”]<\/p>\n HIPAA is a federal law that sets national standards for protecting sensitive patient health information. HIPAA applies to health care providers, health plans, and health care clearinghouses<\/span>, known collectively as covered entities and,<\/span>\u00a0in certain cases, to their business associates (DHHS, 2019).\u00a0<\/span>A\u00a0<\/span>hybrid entity<\/span><\/a>\u00a0is an organization that performs both covered and noncovered functions. This designation allows segments of the organization to adhere to HIPAA regulations while exempting others.\u00a0It’s\u00a0a mechanism that provides flexibility for organizations with diverse operations. For more information on hybrid entities and how to receive the designation as a hybrid entity see the\u00a0<\/span>Network for Public Health Law\u2019s Hybrid Entity Toolkit<\/span><\/a>.<\/span>\u00a0<\/span><\/p>\n HIPAA\u2019s primary goals are to:<\/span>\u00a0<\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”What is the HIPAA Privacy Rule? ” open_toggle_text_color=”#0c6dff” closed_toggle_text_color=”#FFFFFF” _builder_version=”4.27.4″ _module_preset=”default” border_width_bottom=”0.8px” border_color_bottom=”#64748B” global_colors_info=”{}” toggle_text_color=”#FFFFFF” open=”off”]<\/p>\n The\u202fHIPAA Privacy Rule, issued in 2000, sets national standards for when and how\u202fprotected health information (PHI)\u202fcan be used or\u00a0disclosed\u00a0(DHHS, 2025). PHI includes any health data that can\u00a0identify\u00a0an individual and relates to their past, present, or future physical or mental health, health care services, or payment for care.<\/span>\u00a0<\/span><\/p>\n The Privacy Rule requires covered entities to:<\/span>\u00a0<\/span><\/p>\n However, the Privacy Rule also\u202fpermits\u00a0disclosures without individual authorization\u202fin specific cases,\u202fincluding to\u00a0<\/span>public health authorities (<\/span>PHAs<\/span>)<\/span>.<\/span>\u00a0<\/span><\/p>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”The Public Health Exception: What PHAs Need to Know ” open_toggle_text_color=”#0c6dff” closed_toggle_text_color=”#FFFFFF” _builder_version=”4.27.4″ _module_preset=”default” border_width_bottom=”0.8px” border_color_bottom=”#64748B” global_colors_info=”{}” toggle_text_color=”#FFFFFF” open=”off”]<\/p>\n Under HIPAA, PHAs are explicitly recognized as needing access to PHI to protect the health of communities (DHHS, 2023; CDC, n.d.). The Privacy Rule\u00a0permits\u00a0covered entities to\u00a0disclose\u00a0PHI without patient authorization to PHAs which are legally authorized to collect or receive such information for public health purposes. PHAs\u00a0require\u00a0HIPAA training that is similar, if not identical, to what providers in HCOs\u00a0are required to\u00a0take.\u00a0\u00a0<\/span>Recognized PHAs under HIPAA include state and local public health departments, Tribal nations, and the Tribal Epidemiology Centers.\u00a0<\/span>\u00a0<\/span><\/p>\n Examples of permitted disclosures:<\/span>\u00a0<\/span><\/p>\n This exception is crucial for\u00a0<\/span>state, Tribal,\u00a0local\u00a0and territorial<\/span>\u00a0(<\/span>STLT<\/span>) PHAs<\/span>s<\/span>\u00a0that need\u00a0timely\u00a0access to\u00a0<\/span>electronic health recor<\/span>ds (<\/span>EHRs<\/span>)<\/span>\u00a0for surveillance, investigation, and taking public health action. To learn more about privacy risk in public health, see the\u00a0<\/span>CSTE Learn training courses<\/span><\/a>\u00a0on this topic.<\/span>\u00a0<\/span><\/p>\n Key requirements:<\/span>\u00a0<\/span><\/p>\n \u00a0<\/span><\/p>\n<\/div>\n [\/et_pb_accordion_item][et_pb_accordion_item title=”EHI and HIPAA in Practice ” open_toggle_text_color=”#0c6dff” closed_toggle_text_color=”#FFFFFF” _builder_version=”4.27.4″ _module_preset=”default” border_width_bottom=”0.8px” border_color_bottom=”#64748B” global_colors_info=”{}” toggle_text_color=”#FFFFFF” open=”off”]<\/p>\n As PHAs move toward direct electronic connections with provider EHR systems, it is important to remember:<\/span>\u00a0<\/span><\/p>\n [\/et_pb_accordion_item][\/et_pb_accordion][\/et_pb_column][\/et_pb_row][et_pb_row _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.27.4″ _module_preset=”default” global_colors_info=”{}”][et_pb_blurb title=”Success Story : James Carrier, Maryland Department of Health ” use_icon=”on” font_icon=”||fa||900″ icon_placement=”left” content_max_width=”840px” _builder_version=”4.27.4″ _module_preset=”default” header_font=”Poppins||||||||” body_font=”Poppins||||||||” custom_margin=”|109px||109px|false|true” custom_padding=”34px|0px|34px|0px|true|true” border_radii=”on|15px|15px|15px|15px” border_width_all=”1px” global_colors_info=”{}”]<\/p>\n At the Maryland Department of Health, James Carrier and his team have transformed\u00a0<\/span><\/span>HIV\/STI\u00a0<\/span><\/span>surveillance by strategically expanding direct access to electronic health information across multiple systems \u2014 from hospital EHRs to the state\u2019s health information exchange and even to non-traditional data sources like the Maryland\u00a0<\/span><\/span>m<\/span>otor vehicle registry.\u202f\u201cThe best benefit of having direct access is, I don\u2019t even have to pick up the phone,\u201d Carrier explained<\/span>.<\/span>\u00a0<\/span><\/span>\u201c<\/span>I<\/span>f I\u2019m looking at\u00a0<\/span><\/span>[<\/span>a<\/span>lab<\/span>\u00a0<\/span>result<\/span>]<\/span>\u00a0<\/span>the same day, I can pull all the information I need and immediately move the investigation forward.\u201d\u202fBy focusing first on educating providers about public health authority and the mutual benefits of data sharing, the\u00a0<\/span><\/span>team built<\/span>\u00a0<\/span>trust and secured access without needing formal data-use agreements, enabling them to complete investigations faster and with greater accuracy.<\/span><\/span>\u00a0<\/span><\/p>\n [\/et_pb_blurb][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.27.4″ _module_preset=”default” background_color=”#000a23″ custom_margin=”10px|||||” custom_padding=”5px||9px|||” global_colors_info=”{}” theme_builder_area=”post_content”][et_pb_row _builder_version=”4.16″ _module_preset=”default” 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theme_builder_area=”post_content”][\/et_pb_blurb][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=”1″ _builder_version=”4.24.2″ _module_preset=”default” background_color=”#FFFFFF” custom_margin=”|20px||20px|false|true” custom_margin_tablet=”|20px||20px|false|true” custom_margin_phone=”|10px||10px|false|true” custom_margin_last_edited=”on|phone” custom_padding=”36px||4px|||” border_radii=”off|20px|20px||” border_radii_tablet=”off|20px|20px||” border_radii_phone=”off|15px|15px||” border_radii_last_edited=”on|phone” global_colors_info=”{}”][et_pb_row _builder_version=”4.16″ _module_preset=”default” width_tablet=”” width_phone=”90%” width_last_edited=”on|phone” custom_padding=”||7px|||” global_colors_info=”{}”][et_pb_column type=”4_4″ _builder_version=”4.24.2″ _module_preset=”default” global_colors_info=”{}”][dipi_dual_heading first_heading=”References ” heading_tag=”h1″ heading_display=”column” fh_padding=”0px|20px|20px|20px|false|true” sh_style=”background” sh_background_style=”normal” sh_padding=”0px|20px|20px|20px|false|true” sh_margin=”-30px|0px|0px|20px|false|false” fh_padding_tablet=”0px|20px|20px|20px|false|true” fh_padding_phone=”0px|20px|20px|20px|false|true” fh_padding_last_edited=”on|desktop” sh_padding_tablet=”0px|20px|20px|20px|false|true” sh_padding_phone=”0px|20px|20px|20px|false|true” sh_padding_last_edited=”on|desktop” sh_margin_tablet=”-30px|0px|0px|20px|false|false” sh_margin_phone=”-20px|0px|0px|0px|false|false” sh_margin_last_edited=”on|phone” module_id=”section1″ _builder_version=”4.27.4″ _module_preset=”default” first_heading_font=”Poppins||||||||” first_heading_text_align=”left” first_heading_text_color=”#000a23″ first_heading_font_size=”55px” first_heading_letter_spacing=”-5px” first_heading_line_height=”1.1em” second_heading_font=”Poppins||||||||” second_heading_text_align=”left” second_heading_text_color=”#071018″ second_heading_font_size=”80px” second_heading_letter_spacing=”-9px” second_heading_line_height=”1em” text_orientation=”left” custom_margin=”9px||10px||false|false” first_heading_font_size_tablet=”100px” first_heading_font_size_phone=”60px” first_heading_font_size_last_edited=”on|tablet” first_heading_letter_spacing_tablet=”-7px” first_heading_letter_spacing_phone=”-4px” first_heading_letter_spacing_last_edited=”on|tablet” second_heading_font_size_tablet=”100px” second_heading_font_size_phone=”60px” second_heading_font_size_last_edited=”on|tablet” second_heading_letter_spacing_tablet=”-7px” second_heading_letter_spacing_phone=”-4px” second_heading_letter_spacing_last_edited=”on|tablet” locked=”off” global_colors_info=”{}” overlay_bg_color_gradient_type_tablet=”linear” overlay_bg_color_gradient_type_phone=”linear” overlay_bg_color_gradient_type__hover=”linear” image_bg_color_gradient_type__hover=”linear”][\/dipi_dual_heading][et_pb_blurb image_icon_width=”40px” icon_alignment=”left” content_max_width=”100%” _builder_version=”4.27.4″ _module_preset=”default” header_text_color=”#071018″ header_font_size=”22px” header_letter_spacing=”-0.2px” header_line_height=”1.2em” body_font=”Poppins||||||||” body_text_color=”#64748B” body_font_size=”20px” body_line_height=”1.4em” text_orientation=”center” custom_margin=”1px||108px|0px|false|false” custom_padding=”|19px||19px|false|true” header_font_size_tablet=”22px” header_font_size_phone=”18px” header_font_size_last_edited=”on|phone” body_font_size_tablet=”” body_font_size_phone=”12px” body_font_size_last_edited=”on|phone” custom_css_blurb_title=”text-transform: none;” locked=”off” global_colors_info=”{}”]<\/p>\n Centers for Disease Control and Prevention. (n.d.).\u00a0<\/span>Health Insurance Portability and Accountability Act of 1996 (HIPAA)<\/span><\/i>. Retrieved May 2025, from Public Health Law: https:\/\/www.cdc.gov\/phlp\/php\/resources\/health-insurance-portability-and-accountability-act-of-1996-hipaa.html?CDC_AAref_Val=https:\/\/www.cdc.gov\/phlp\/publications\/topic\/hipaa.html<\/span>\u00a0<\/span><\/p>\n Chrysler D. and Milam S. (2019). HIPAA Hybrid Entity Toolkit. Network for Public Health Law.\u00a0<\/span>https:\/\/www.networkforphl.org\/resources\/resource-collection-hipaa-hybrid-entity-toolkit\/<\/span><\/a>\u00a0Accessed June 25, 2025.<\/span>\u00a0<\/span><\/p>\n<\/ul>\n
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