Confidentiality (cont)

Consider the impact of federal privacy laws regarding health information on victims of sexual assault.

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule and its implementing regulations (found at 45 CFR Part 160 and Subparts A and E of Part 164), established national standards for the protection of certain individually identifiable health information created or held by health plans, certain health care providers, and health clearinghouses. With respect to disclosures to victim advocacy organizations, the HIPAA Privacy Rule permits hospitals and other health care providers to alert a victim advocacy organization to the presence of a victim of sexual assault at the hospital without giving any identifying information about the victim. Further, once the advocate is at the hospital, if the victim is informed in advance and agrees or does not object, or the hospital reasonably infers from the circumstances, based on professional judgment, that the victim does not object, then the Privacy Rule permits hospital staff to< introduce the advocate to the victim and share information pertinent to the advocate’s involvement in the victim’s care. For more information on the ability of a health care provider to communicate with persons identified by an individual as involved in the individual’s care, see A Health Care Provider’s Guide to the HIPAA Privacy Rule: Communicating with a Patient’s Family, Friends, or Others Involved in a Patient’s Care, available at

For more information about the HIPAA Privacy Rule generally, including the conditions under which other disclosures are permitted, visit the Department of Health and Human Services Office for Civil Rights (OCR) Web Site at for an array of helpful guidance documents and Frequently Asked Questions.

HIPAA is not the only federal law that governs victims’ privacy rights. Agencies that receive funding under the Violence Against Women Act (VAWA) must also comply with VAWA’s confidentiality provisions. These provisions require that a victim’s personally identifying information may not be released without a victim’s ritten, time-limited, informed consent or a court or statutory mandate.


Strive to resolve intrajurisdictional conflicts.

For example, maintaining confidentiality is often difficult in isolated or small communities where people know one another or word of a crime travels quickly (e.g., school campuses and tribal, military, religious, or immigrant communities). Special precautions must be taken in these situations to preserve confidentiality. Every effort should be made to avoid conflicts of interest (e.g., the investigator is the cousin of the suspect or the health care provider, or the advocate or interpreter is an acquaintance of the patient). Give patients as many options as possible to avoid these dilemmas (e.g., allow them to work with a different investigator or be examined at another site or by another examiner, if possible).

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