Because federal laws allow states some latitude in regulating certain aspects of information sharing, laws on this topic vary from state to state. Some states have begun to enact laws that support—or even require—the sharing of information about children involved in multiple systems.
While HIPAA establishes a minimum level of privacy protection for health care records, states are free to enact laws that provide greater protections for such records. For example, if a health care provider receives a subpoena for a patient’s records, HIPAA allows the provider to release the records without the patient’s consent if the person seeking the records demonstrates having made a reasonable effort to notify the patient—or if that person obtains a court protective order. However, a state may enact laws or regulations that prohibit health care providers from releasing records upon receipt of a subpoena that is not accompanied by a court order. That is the case in Pennsylvania, where mental health care providers cannot disclose records in response to a subpoena alone.
Both HIPAA and federal drug and alcohol regulations defer to state law concerning the age when a minor (as opposed to the minor’s parent or guardian) controls release of the minor’s records. That is why, for example, one state can have a law saying that 14 year olds can give consent for sexually transmitted disease testing and that minors who consent to such testing then control all records related to the testing, while another state can set the age at 16.
Certain federal privacy laws apply only to specific entities. For example, federal drug and alcohol regulations apply only to “federally assisted” programs, which are defined in 42 CFR § 2.12(b). As a result, states may implement their own laws and regulations to cover non-federally assisted drug and alcohol treatment programs.
To find out more about relevant state laws, visit the Child Welfare Information Gateway. For more information about state juvenile agency records provisions, visit the National Juvenile Information Sharing Initiative Online Legal Search Tool.
 45 C.F.R. § 160.203.
 45 C.F.R. § 164.512[e][ii] and [v].
 55 Pa. Code § 5100.35[b].
 45 C.F.R. § 164.502[g]; 42 U.S.C. § 290dd-2[b]; 42 C.F.R. § 2.14[a] and [b].