Exam 4: Legal Basis of Public Health

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The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects patient health data. The HIPAA Privacy Rule may affect how a public health department can conduct, process, and collect information from providers or institutions required to protect personal information. However, there are important exceptions to the HIPAA Privacy Rule that permit activities for public health purposes that would otherwise be restricted.
The following two permitted exceptions are most relevant to public health programs:
-The public health exception. It allows hospitals, laboratories, and physicians to share protected health information related to reportable illness with public health agencies or officials.
-The judicial and administrative proceedings exception. A public health department may be ordered to provide protected health information gathered during an investigation. This might occur during a judicial hearing, or in response to a subpoena, request for discovery, or other legal process.

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The five sources of public health authority are:
-Constitutions. The U.S. Constitution is the source of all legal authority for the federal government. The U.S. Constitution and state constitutions are the source of all legal authority for states.
-Statutes. Congress passes laws giving power to agencies of the executive branch. Federal statutes establish federal public health agencies, programs, services, and appropriate funds for federal and state public health work. State legislatures pass state statutes that establish analogous state functions.
-Regulations. Legislatures give agencies power to make regulations that have the same force as statutes. Regulations are usually the process for establishing standards and procedures to implement statutes, which typically are written with broader language. The authority to develop regulations (often called "rule-making") allows agencies to quickly respond to new challenges or address technical issues and allows the legislature to defer to that department's expertise on that particular subject matter. Procedures for "rule-making" require opportunity for the public to participate.
-Common law or case law. This law is based on court decisions that create and reflect custom that provides judicial interpretation of statutes, regulations, etc. Court decisions establish "precedent" that is treated as authoritative. (This feature is unique to those governmental systems derived from the British legal system.)
-Executive orders. This is a policy directive, typically by the top executive, that implements or interprets a federal or state statute. When legislatively authorized, an executive order has the force of law.

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The authority to take actions on behalf of the public's health is derived from the broad governmental police powers established by the U.S. Constitution and further elaborated by state and local laws. The police power is the right of the state to take coercive action against individuals for the benefit of society.