This paper describes the flow of mental health information through Cuyahoga County's criminal justice system and how HIPAA and state laws limit this movement and, as a result, impede treatment of the mentally ill. The paper also explores the County's recent efforts to develop a new information management system that can legally and responsibly improve information sharing to address problematic gaps in the justice system.
This paper was produced following interviews with professionals from Cuyahoga County, Ohio who work with the mentally ill or developmentally disabled in criminal justice settings. It describes how the police department in the small city of Shaker Heights has experienced a surge in the number of "regulars" with behavioral health disorders following defunding of mental health services. In response, Cuyahoga county recognized the need to share information between community health providers and the local police, courts, and the jail to help improve diversion programs and improve continuity in care. As part of the process to improve inter-agency information sharing, Cuyahoga County mapped the application of HIPAA and Ohio law to its information sharing needs and realized that, with the use of informed consent and other resources, medical privacy laws were not an insurmountable obstacle to inter-agency communication. The county has set up a program called "In Jail" that has enhanced the ability to collect important information at booking and build connectivity among systems.