This article addresses data privacy issues as they relate to multi-system collaborations for pre-arrest deflection into treatment and services for those suffering from a substance use disorder. The authors explore how the United States’ data privacy regulations pose barriers to collaboration and care coordination, as well as how data privacy regulations affect researchers’ ability to evaluate the impact of interventions intentioned to facilitate access to care. Fortunately, this regulatory landscape is evolving to strike a balance between protecting health information and sharing it for research, evaluation, and operations, including comments on the newly proposed federal administrative rule that will shape the future of deflection and health access in the United States.