An exception to federal medical privacy law allows health departments to warn police and firefighters responding to a home where someone has tested positive for COVID-19.
But that’s not happening in the county that is home to Chicago, one of a handful of jurisdictions where patients’ rights are trumping first responders’ need to know.
Police and firefighters are fuming that the Cook County Public Health Department, which serves the largest county population in Illinois, is refusing to share the information.
“We run into dangerous situations on a constant basis, but COVID-19 is different,” said Joseph Lukaszek, police chief in Hillside, Illinois. “I could possibly die from this or bring this home and my wife and children could die. I have a responsibility to my family, and it doesn’t make any sense that we can’t get information that can save our lives.”
His officers’ safety and ability to respond to the public’s needs are compromised, he said.
A coronavirus alert also would help first responders plan to take extra precautions or carry extra equipment such the N95 masks that are in short supply.
First responders are fighting for coronavirus alerts in several states in counties across the U.S.
Massachusetts was the first state to order public health officials to share addresses, and Alabama followed. Maine and parts of California are not providing address lists. In Minnesota, first responders pressured the governor to issue an executive order directing the release of addresses, but police in the state say they are not receiving the information.
Florida initially refused to share addresses of people who tested positive, but the state relented, partly because a local sheriff waged a media and Facebook campaign to change the policy.
Mike Chitwood, sheriff of Volusia County, Florida, badgered health officials to release names through social media posts and interviews with local newspapers.
“We can’t just fight this sticking to the same old tactics and rules we’ve gone by in the past,” he wrote on Facebook.
The town of Kittery, Maine, started lobbying state officials after first responders said they couldn’t get the list while their counterparts in neighboring Massachusetts and New Hampshire could.
The dispute in Cook County escalated Thursday when the Northwest Central Dispatch System, a 911 service in the region, filed a lawsuit demanding that the county release the data so dispatchers could pass it on to first responders.
The fight is one of many legal boundaries tested by the coronavirus crisis, which has emptied prison and jail cells, spawned unprecedented stay-at-home orders and brought the country’s economy to its knees.
The privacy protections in the federal Health Insurance Portability and Accountability Act (HIPAA) normally would prohibit the release of sensitive medical information.
The Department of Health and Human Services released guidance last month pointing out that HIPAA has an exception to help first responders avoid infections, and HHS said the coronavirus crisis meets the criteria.
Under the exemption, states and localities are permitted to provide the information to first responders but are not required to do so. States and localities have responded in different ways.
In Pennsylvania, county governments determine whether to release the information to first responders.
Allegheny County has opted in, and Ralph Sicuro, president of the International Association of Firefighters Local 1 in Pittsburgh, said the information has been crucial.
“Nothing is going to guarantee we are not going to be exposed, but it is a tool that we are using when we respond to a structure so that we can take extra precautions,” he said. “It gives you peace of mind of knowing what you are dealing with.”
The information has helped with contact tracing, the process of learning who might have been in contact with someone who has tested positive. It also helps determine whether first responders have been infected while on a call, he said.
“It has expedited our ability to backtrack anyone that has become sick and come in contact with someone who tested positive,” Mr. Sicuro said.
Critics say coronavirus alerts would create an unfair stigma for those with COVID-19.
“Putting names on a list that is disclosed to first responders will affect the particularly vulnerable population who live in fear and shadows,” said Robert Greenwald, director of the Center for Health Law and Policy Innovation at Harvard Law School. “This population won’t get tested, and that is the last thing we want to happen.”
He said he understands the first responders’ concerns but added that information about test results creates a false sense of security.
“First responders have to use universal precautions against COVID-19 on all calls, or in the overwhelming majority of times they are not protecting themselves,” he said.
Identities are protected even when the information is shared. First responders learn through their call response system that an address is associated with someone who has tested positive, but the name of the person is omitted.
That information remains in the dispatch computer for a short time, usually 14 days, but sometimes as long as a month. Only first responders racing to that address receive the information.
“We are not asking for gender, age or any personal information, and we are not asking to keep this information indefinitely,” said Tom Weitzel, police chief in Riverside, Illinois. “I don’t understand the resistance. We are not asking it to be public.”
Mr. Greenwald said giving out addresses breaches a line.
“Addresses are a proxy for the name,” he said. “They are just trying to say we are not going for the names, but at the local level when you start creating a list of addresses you can create a list of names of people in the house.”
In Illinois, a Cook County commissioner introduced a resolution Thursday that would require address-sharing with first responders.
“This measure will increase the safety of everyone,” Commissioner Scott Britton said.
A vote on the measure was tabled until next month. One commissioner said he feared the list would unfairly target illegal immigrants.
Illinois Attorney General Kwame Raoul issued a legal opinion last month saying local health boards may share addresses, but his advisory opinion is not binding and does not say the law compels sharing.
“The AG’s opinion carries some weight, but it is not necessarily dispositive whether the ordinance is enforceable,” Mr. Greenwald said.
Rachel V. Rose, a lawyer who specializes in HIPAA law, said the HHS guidance is redundant because the disclosure to first responders already exists in HIPAA and related rules and regulations.
She said people with communicable diseases such as hepatitis C or tuberculosis fall under various HIPAA exceptions.
“I’m surprised people are raising this as a HIPAA issue because I don’t think people who are raising that are looking at the exceptions the government already put into place,” she said.
Chief Lukaszek said it was frustrating to be battling his county’s health department over the issue.
“Honestly, I truly have the opinion that if this information was available to us and an officer gets sick, I think Cook County should be held responsible if they die,” he said.