Karen Erwin, RN, MSN Education School Nurse Consultant July, 2014

 HIPAA-Health Insurance Portability and Accountability Act 1996, Public Law  Initially developed to protect insurance coverage for those who had lost or changed jobs – Prevented denial of health insurance by new insurer based on preexisting medical conditions  Intended to ensure that an “personally identifiable information” (PII) is appropriately protected

 Student’s name  Student’s parent/guardian or other family member names  Student’s or family’s address  Personal identifies, such as social security, student ID number, etc.

 Other direct identifiers, i. e. student’s DOB, place of birth, and mother’s maiden name  Other information that, alone or in combination, is linked or linkable to a specific person

 Prior written consent for sharing PII required  Consent includes 1. Specific records to be disclosed 2. Purpose of disclosure stated 3. Party or class of parties to whom disclosure may be made are identified

 Does HIPPA privacy rules allow a healthcare provider to disclose PHI about a student to a school nurse or physician?  2008 USDHHS ruling: Yes. The HIPAA Privacy Rule allows covered health care providers to disclose PHI about students to school nurses, physicians or other health care providers for treatment purposes, without the authorization of the student or student’s parents

 HIPAA Privacy rule does provide for individually identifiable health information to be shared when necessary to support quality healthcare and to protect public’s health Example: Student Immunization Records, where state laws require immunizations for entry into school

 Family Educational Rights and Privacy Act (FERPA)  Enacted in 1974 to protect student education records  Applies to all public and private schools that accept federal funds

 Records directly related to a student and maintained by the educational agency  Student health records included in Cumulative Folder  Special Education records

 Supportive Services Documents (school nursing notes related to specific office visit)  Except for electronically billed statements, student health records in the educational setting are exempt from HIPAA

 Includes anything that enables a student (especially one with special healthcare needs to: 1. Attend school 2. Maintain (or improve) health status during school day 3. Progress toward independence in self-care 4. Achieve educational success

 Required School Forms 1. Preventative Health Exams 2. Immunization history 3. Dental exam/screening 4. Vision Exam 5. Results of health prevention screenings (vision, hearing (required) and BMI (optional)  Medication Administration Record

 Health office visits  Parental Consent for health services  Communication (written or by phone) with parent and/or health care provider  Retain records 6 years after student leaves school district then destroy (# L2352 Student Cumulative Health Record, KY Local Agency Retention Schedule, Public School District Student Records, 2014)

 Educational records  Nurse’s personal notes

 If keeping a health room log, only enter date, time and name of student, time of discharge (all other info such as C/O, treatment, etc. PII)  Record student visit into individual health record and destroy log  No sticky notes from school staff  When day is over, place log in secure location

 NASN School Nursing: A comprehensive Text, 2 nd Edition (2013) Ch 9, pp  U.S. Department of Education, The Privacy of Student Information, A Resource for Schools

 Karen Erwin, KDE School Nurse Consultant  Sandi Clark, KY DPH School Health Nurse Consultant