Unique Provisions in Some
State Laws
We also found a few additional
notable patterns in state laws.
Fewer than a quarter of states had
language that addressed any of the
following: disclosure to contacts
of a person with a communicable
disease, in some cases including
prehospital personnel exposed to
the bodily fluids or respiratory
droplets of a person with particular
infectious diseases; disclosure
of public health information by the
state to federal public health offi-
cials (most state statutes specifi-
cally mention the Centers for Disease
Control and Prevention or
the HHS); secondary disclosure
of personally identifiable information
provided by the health department
to a third party; or when
certain types of health threats may
or must be disclosed to law enforcement.
In a few states, disclosure
of certain personally identifi-
able health information from one
state agency to another even
appeared to be prohibited. For
example, in Connecticut, the
Medicaid program could only obtain
information that supported
payments for the care of individuals
receiving medical assistance.33
Although this may be an
important protection, this approach
may indicate a lost opportunity for
collaboration between the health
care delivery and financing system
and public health authorities seeking
to design or deliver interventions
for at-risk populations. We also found that Montana was
the only state that explicitly allowed
public health officials to release information
to another state to
continue health services to the
named person or to undertake
public health efforts to prevent
or interrupt the transmission of
a communicable disease or to
alleviate and prevent injury
caused by the release of biological,
chemical, or radiological agents
capable of causing imminent disability,
death, or infection.34
Other than in Montana and in
some other states that allow disclosure
when necessary to protect
the public’s health, we found no
provisions that addressed whether
restrictions on the use of public
health information could be
waived in the event of a public
health emergency. Few states explicitly
allowed the sharing of
public health information with law
enforcement or exchange with the
federal government.