An appellate court ruled ZIP codes of people who received mental health treatment while in the Cook County Jail are protected information not subject to the Freedom of Information Act.
A three-justice panel of the Illinois First District Appellate Court found that the Cook County Health and Hospitals System was right to refuse a FOIA request by plaintiff Judy King seeking the ZIP code information.
King’s request came after a public meeting of the hospital system’s finance committee discussing potential locations for community triage centers. In the meeting, the committee reviewed internally generated maps showing the Roseland area has the greatest concentration of people who received mental health services from the county while detained at the county jail. Based on this information, an argument was made that Roseland would be an appropriate site for a new triage center.
King requested all data the county used to make that determination, and the hospital system responded by providing her its color-coded maps. While the maps do show demarcated areas representative of ZIP codes, the ZIP codes themselves are not identified. Arguing that the county had not provided the requested information – namely, the data used to create the maps – King filed suit in the circuit court.
The hospital system responded that it had provided King what she wanted – the maps the finance committee used to make its decision – and said the ZIP code information was exempt from FOIA under federal rules regulating the Health Insurance Portability and Accountability Act. King disagreed, saying ZIP codes are not governed by HIPAA because they cannot be used to identify the individuals who received mental health treatment.
The court sided with King, and the county appealed.
In its appeal, the hospital system maintained that complete ZIP codes are protected under the state’s Confidentiality Act as well as under HIPAA. It contended it could release partial ZIP codes, but not the complete numbers.
The Confidentiality Act regulates information and communication about mental health services and developmental disability services. Because there is a stigma associated with these services, to encourage people to obtain the services they need, the act protects mental health and developmental disability records from disclosure.
“The issue in this case involves the intersection of two strong public policies: the open disclosure of government records as relayed in FOIA and the confidentiality of mental health records and communications as stated in the Confidentiality Act,” Justice Jesse G. Reyes wrote in the appellate opinion.
Courts generally interpret FOIA as indicating that all public body records are open for inspection and that exemptions should be read narrowly. The Confidentiality Act, however, protects any information that indicates a person has received mental health or developmental disability services. HIPAA protections are similar.
The court noted language within HIPAA that specifically mentions geographic identifiers including ZIP codes. The section notes health information may only be released if such identifiers are redacted.
While acknowledging that unredacted ZIP codes are confidential under the law, King asserted that she should still be entitled to them because they cannot be used to identify individual recipients of services. The court said that doesn’t matter.
“Along with the plain language of the Confidentiality Act, it is Illinois’ strong public policy in favor of the confidentiality of mental health information that informs and guides this opinion,” Reyes wrote. “While FOIA serves to promote transparency in government actions, even FOIA recognizes that there are exceptions to this rule.”
The court remanded the case and ordered King be provided with redacted ZIP codes in response to her FOIA request.
Justice Robert E. Gordon and Justice Bertina Lampkin concurred in the judgment and opinion.