## Facts

- A Cincinnati Enquirer reporter requested copies of Cincinnati Health Department lead-contamination “notices of violation” (“lead citations”) issued to private property owners.
- Citations were issued after a child living at a property was found to have an elevated blood-lead level, prompting inspection and an abatement order.
- The citations were standardized multi-page enforcement forms that identified the property by address, described lead hazards, and required abatement.
- Each citation included a sentence stating that a child residing at the property had an elevated blood-lead level.
- The citations did not include the child’s name, date of birth, age, or other direct identifiers, and contained no clinical details beyond the elevated test result.
- The Health Commissioner and the City denied the request, asserting the citations contained protected health information barred from disclosure by HIPAA.
- The Enquirer sought disclosure under Ohio’s Public Records Act, R.C. 149.43.

## Issues

1. Whether the lead citations are “public records” subject to disclosure under R.C. 149.43 and not covered by a state-law exemption.
2. Whether HIPAA’s privacy rule bars disclosure of the lead citations and, if so, whether HIPAA preempts Ohio’s public-records disclosure requirement for these documents.

## Decision

- The Ohio Supreme Court granted a writ of mandamus compelling the City and Health Commissioner to disclose the lead citations.
- The court held the citations are public records documenting the Health Department’s enforcement activities.
- The court rejected claimed state-law exemptions (including “medical records” and privacy-based exemptions) because the citations were enforcement/abatement documents and did not identify any individual patient.
- The court held HIPAA did not prohibit disclosure because the citations did not contain individually identifiable protected health information as presented.
- The court concluded there was no HIPAA-based preemption barring disclosure in these circumstances and awarded costs to the relator.

## Legal Principles

- Records created and kept by a public office that document the office’s activities are presumptively subject to disclosure under R.C. 149.43 unless a specific exemption applies.
- Public-records exemptions are construed narrowly, and ambiguity is resolved in favor of access.
- Enforcement and abatement notices addressing property conditions are not “medical records” merely because they reference a health-related trigger for governmental action.
- HIPAA’s privacy rule restricts disclosure of “protected health information” only when the information is individually identifiable; a nonidentifying reference to a health condition, without patient identifiers, may fall outside HIPAA’s nondisclosure bar.
- HIPAA preemption requires a conflict between federal privacy restrictions and state disclosure law; where the disputed records do not contain protected health information subject to HIPAA’s restrictions, preemption does not apply.

## Conclusion

The court ordered disclosure of the lead-hazard citations because they were public enforcement records under Ohio law and did not include individually identifiable health information that HIPAA would prohibit releasing, so federal law did not preempt the state public-records mandate.


State ex rel. Cincinnati Enquirer v. Daniels, 108 Ohio St. 3d 518, 844 N.E.2d 1181 (Ohio 2006)