Balancing Data Privacy With Access to Health Services and Research: Facilitating Confidential Information Sharing in US Multisystem Collaborations.

This article addresses data privacy issues as they relate to multisystem collaborations for prearrest deflection into treatment and services for those suffering from a substance use disorder. The authors explore how the US data privacy regulations pose barriers to collaboration and care coordination and how data privacy regulations affect researchers' ability to evaluate the impact of interventions intentioned to facilitate access to care. Fortunately, this regulatory landscape is evolving to strike a balance between protecting health information and sharing it for research, evaluation, and operations, including comments on the newly proposed federal administrative rule that will shape the future of deflection and health access in the United States.

A Data-Driven Response to the Addiction Crisis in Hamilton County, Ohio.

CONTEXT: For more than a decade, the state of Ohio has been an epicenter of the opioid crisis. Multiple interventions have been deployed to address this crisis and reduce opioid overdoses and overdose deaths in the state. The Hamilton County Addiction Response Coalition (HC ARC) and its strategic, countywide prearrest diversion (LEAD) and deflection (QRT) programs have been at the forefront of this effort in Cincinnati, Ohio. Operating since April 2018, these programs have continued to grow and improve and have been successful in connecting hundreds of citizens to needed treatment and other social services. PROGRAM: HC ARC combats overdoses and overdose deaths by utilizing cross-sector planning and collaboration to operate 2 countywide programs: Quick Response Team (QRT) and Law Enforcement Assisted Diversion (LEAD). IMPLEMENTATION: The QRT and LEAD programs leverage partnerships with law enforcement, public health, addiction and mental health services, reentry services, and trained peer supporters. The QRT emphasizes triage, assessment, and connection to appropriate services for people with recent nonfatal drug overdoses and provides outreach and education in hot spot communities. LEAD provides diversion from the criminal justice system into long-term case management for nonviolent individuals with low-level offenses who also struggle with substance use disorder, mental health, homelessness, and/or poverty. EVALUATION: QRT and LEAD team members routinely track and record client contacts and outcomes using a centralized electronic case management platform. Data are extracted and analyzed by the evaluation team to examine indices of program success and provide ongoing feedback to the QRT and LEAD teams. DISCUSSION: HC ARC has implemented, tested, expanded, and now standardized its prearrest diversion programming. It has built a sustainable model to improve health and health equity for marginalized individuals whose needs intersect across health care, public health, community-based social services, and the criminal-legal system. Collectively, this work offers a guide for implementation and best practices for the following: detailed planning, policy, and procedure development; identification of key leaders and community partners; and methods to evaluate program operations to make data-driven decisions and real-time program adjustments.

Compliance Is Doable! A Framework for Navigating Privacy Regulations in Public Health and Public Safety Partnerships.

The past decade witnessed an explosion of public health/public safety collaborations. Many emerged as pragmatic responses to the opioid epidemic, where communities struggled to help individuals at risk of fatal and nonfatal overdoses. Multidisciplinary programs formed to actively engage people with services, including harm reduction, treatment, and peer support, instead of arrest. These initiatives blur traditional lines between public safety, health, treatment, and services. Novel applications of HIPAA and 42 CFR Part 2 created confusion, sometimes discouraging new ways of doing business and other times leading to a disregard for individual privacy protections in the interest of "doing the right thing." Neither is ideal. In this article, the authors present a framework for collaborations to navigate issues related to privacy, review relevant laws, provide a practical application to public health/public safety partnerships, and offer practice pointers. With this resource, stakeholders are empowered to create effective and compliant overdose response programs.