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health (Florida)
Florida's statutes
contain numerous provisions related to public health (the
preponderance clustered in Title 29, chapters 381-408) that
aim to "promote, protect, and improve the health of all
people in the state."
The statewide data
collection and reporting of "diseases, illnesses, injuries,
and hazards to human health" requisite to these objectives
are generally exempt from HIPAA preemption.
The state Office
of Vital Statistics is authorized to receive, via local registrars,
certificates of live birth, death, or fetal death (382.005).
Births that occur within a hospital or health care facility
must be reported by a head of that facility. Births that occur
elsewhere must be reported by the health professional attending,
or by the parents if no health professional was present (382.009).
Death and fetal death reports must include certification of
the cause of death or fetal death by a physician, midwife,
hospital administatrator or medical examier (382.008).
Every state-licensed
practitioner (whether of medicine, osteopathic medicine, chiropractic
medicine, naturopathy, or veterinary medicine), every hospital
licensed by the state, and every state-licensed laboratory,
that diagnoses or suspects the existence of a disease
of public health significance must immediately report
the facts to the state Department of Health. (381.003)
The department
may obtain and inspect copies of any medical
records, records of laboratory tests, or other medical-related
information for reported cases of diseases of public health
significance. Release of medical records and medical-related
information to the department by a health care practitioner,
licensed health care facility, or laboratory, or by an authorized
employee or agent of any of these, does not constitute a violation
of the confidentiality of patient records. A health care practitioner,
health care facility, laboratory, or their employee and agents
may not be held liable in any manner for damages and are not
subject to criminal penalties for providing patient records
to the department in such circumstances. (381.0031)
Information that
is obtained by the Department of Health, a county health department,
healthy start coalition, certified rural health network, a
panel or committee assembled by the department, a county health
department, healthy start coalition, or certified rural health
network is confidential and is exempt from public records
reporting laws (such as 119.07). That includes all "portions
of meetings, proceedings, reports, and records." In turn,
confidential information obtained from such entities by health
care facilities and health care providers is also confidential
and exempt from public reporting laws. (381.0055)
As part of the
prevention and control of vaccine-susceptable diseases, the
state has an "automated, electronic and centralized"
registry of immunizations. The registry may be accessed by
schools, licensed health care facilities and licensed health
care providers, with the latter permited to both inspect individual
records and update them when immunizations are given. Note
that parents/guardians may refuse permission for a child's
inclusion in this registry, using a form obtainable from the
health department or a health care practitioner. (381.003)
HIV test results
are given special confidentiality
protections. In general, such results may not be disclosed
to anyone other than the subject or the subject's legally
authorized representative, without the specific consent of
the subject or the subject's legally authorized representative.
Exceptions include: health care providers consulting between
themselves or with health care facilities to determine diagnosis
and treatment; health care providers or facilities engaged
in the distribution or processing of body parts and tissues;
health facility committees engaged in program monitoring;
authorized researchers; and persons authorized by specific
court order (381.004)
Note that the Department
of Health is charged with targeted outreach efforts for a
variety of programs, and some of these may require targeted
uses and disclosures of health information: pregnant women
(381.0045); HIV and AIDS (381.0046); primary and preventive
health (381.005); family planning (381.0051); dental health
(381.0052); comprehensive nutrition (381.0053); environmental
health (381.006); Health Communities, Health People (381.734);
sickle-cell (381.815); cancer prevention and early detection
(381.91, 93);
For the purposes
of maintaining a central registry of brain and spinl cord
injuries, health agencies, health facilities and attending
physicians are required to report within five days after identification
or diagnosis of any person who has a suffered same. The consent
of such person shall not be required. (381.74)
Each person who
makes a diagnosis of or treats a person with a sexually transmissible
disease and each laboratory that performs a test for a sexually
transmissible disease which concludes with a positive result
[must] report such facts as may be required by the department
by rule, within a time period as specified by rule of the
department, but in no case to exceed 2 weeks. The Department
of Health must "consider the need for information, protections
for the privacy and confidentiality of the patient, and the
practical ability of persons and laboratories to report in
a reasonable fashion." To ensure the confidentiality
of persons infected with the human immunodeficiency virus
(HIV), reporting of HIV infection and acquired immune deficiency
syndrome (AIDS) must be conducted using the HIV/AIDS Reporting
System (HARS) developed by the Centers for Disease Control
and Prevention of the United States Public Health Service.(384.25)
For purposes of
STD contact investigation, the department of health and its
authorized representatives may interview, or cause to be interviewed,
all persons infected or suspected of being infected with a
sexually transmissible disease for the purpose of investigating
the source and spread of the disease and for the purpose of
ordering a person to submit to examination and treatment as
necessary. All information gathered in the course of contact
investigation shall be confidential and exempt from public
records disclosure laws. No person who is infected with a
sexually transmissible disease, or suspected of an infection,
who reveals the name or names of sexual contacts during the
course of an investigation shall be held liable in a civil
action for such revelation, unless the revelation is made
falsely or with reckless disregard for the truth. (384.26)
All information
and records held by the department or its authorized representatives
relating to known or suspected cases of sexually transmissible
diseases are strictly confidential and exempt from the provisions
of s. 119.07(1). Information can only be released (1) with
the consent of all persons to whom the information applies;
(2) for statistical purposes, summarized so that no person
can be identified; (3) to appropriate medical personnel and
state agencies, to meet the reporting requirements of the
law; (4) in a medical emergency, to the extent necessary to
protecet the life or health of a named party, (5) pursuant
to a subpoena, in which case the information should generally
be sealed, unless otherwise agreed by all the parties. (384.29).
If an EMT, paramedic,
or other person involved in patient transport comes in contact
with a person subsequently diagnosed as having an infectious
disease, the facility that received the patient must notify
the affected person(s) within 48 hours of the confirmed diagnosis,
and advise him/her/them about any treatment. Such notifications
are to be "done in a manner which will protect the confidentiality
of such patient information and shall not include any patient's
name." (395.1025)
This does not exhaust
the list of public health statutes and administrative regulations
with privacy implications.
See also:
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