Maine first responders ask governor for addresses of COVID-19 infections amid PPE shortages
Police and fire chiefs statewide have asked for the addresses in order to help departments ration PPE when responding to calls
KITTERY, Maine — The HIPAA patient privacy law does not apply to law enforcement and first responders during the coronavirus pandemic, permitting public safety agencies to access protected health information in order to better prepare emergency response.
That is if states allow them to.
The town of Kittery was the first community in Maine to request to Gov. Janet Mills and the state's Center for Disease Control and Prevention that law enforcement and first responders be able to obtain addresses of confirmed COVID-19 cases, in order to properly prepare for emergency calls amid ongoing personal protective equipment shortages.
Many rang the alarm about the town's request being a Health Insurance Portability and Accountability Act (HIPAA) violation, but it's not. "I wouldn't have access to it, the Town Council wouldn't," said Kittery Town Manager Kendra Amaral. "It would just be police, fire and dispatch."
A HIPAA-covered entity may disclose personal health information to law enforcement without the individual's signed HIPAA authorization in certain circumstances, including when a law enforcement official is reasonably able to prevent or lessen a serious and imminent threat to the health or safety of an individual or the public.
In the context of the coronavirus crisis, "The (Privacy Rule) recognizes that various agencies and public officials will need protected health information to deal effectively with a bioterrorism threat or (public health) emergency," according to the U.S. Department of Health and Human Services. "To facilitate the communications that are essential to a quick and effective response to such events, the Privacy Rule permits covered entities to disclose needed information to public officials in a variety of ways."
Emergency services in New Hampshire and Massachusetts are already getting these addresses as a result of authorization by their respective state agencies.
In Portsmouth, officials get addresses daily through the state's E-911 headquarters, Police Chief Robert Merner said last week. For example, he explained, if a first responder is dispatched to a specific address where someone has tested positive for COVID-19, an E-911 dispatcher will send that information to the officer's mobile data terminal.
At present, that's not happening in Maine. Per state law, the state's CDC releases publicly only the gender, age range and county of residence of the positive individual, which is in line with federal policy.
"Every fire chief in southern York County is saying the same thing," said Kittery Fire Chief David O'Brien. "It's simple, if you don't have enough PPE to go around, you try to ration your PPE for the calls that you need it for."
As of Monday, there were 633 confirmed coronavirus cases in Maine and 19 related deaths. York County has the second highest number of cases behind Cumberland County.
Amaral penned a letter to the state on April 6 outlining the "devastating impacts" an undetected COVID-19 exposure could have on the town's lean-staffed emergency departments.
She said obtaining these addresses are "vital" to protecting her first responders.
In response to Amaral's letter, Robert Long, communications director for the Maine CDC, said in a statement to Seacoast Media Group, "As is the practice in most states, the Maine Center for Disease Control and Prevention lists confirmed cases by gender, age range, and county of residence. This system protects patient privacy as we continue to work with the Department of Public Safety to ensure that first responders have the equipment and guidance they need to do their jobs safely."
On Monday, Amaral said the town had not received a formal response from the state, but it was her impression "the state is not receptive to that."
"We are now trying to work every possible angle to make sure we have as much PPE as possible to protect the staff," she said. "We're talking to the state seeking additional PPE, the Kittery Together volunteer group is making masks for public safety, and we're working with (Portsmouth Naval Shipyard) and their 3D printers. We're also trying to buy it on the private market."
She added, "if (addresses) are not going to be a tool, we need to get all of the others tools in the tool box."
Amaral said she'd been watching commenters weigh in on social media about the town's request, many of whom suggested first responders should simply treat every emergency call like a positive coronavirus case.
"The idea of going into every site as if every person is infected is all well and good if we have sufficient PPE," she said.
Last week, Merner said first responders in Portsmouth are wearing different kinds of PPE based on whether the person they're responding to is confirmed positive or not – an N95 mask with other protective gear if they are, and a surgical mask if they aren't.
City dispatchers, Merner said, are asking everyone seeking a response from police or fire if there is anyone at the address exhibiting symptoms. If the answer is yes, they'll also wear an N95 mask to those calls.
Amaral said Kittery has such a limited supply of PPE that "if we know we're going into an address where someone has tested positive, we'll feel a lot better using that Tyvek suit (than if they weren't)."
"We're trying to do everything there is to protect our first responders, police fire and EMS, everything possible,"' said O'Brien. "And this is just one more piece of the puzzle to do that and they've denied it."
Last month, officials in Massachusetts issued an order allowing the addresses of positive COVID-19 cases be given to local boards of health and first responders. After the state of emergency is over, the order states, the addresses will no longer be attainable.