Was this a HIPAA violation?

[abbaking]

Back in 1998, I was a teenager looking to do volunteer work at the local hospital. One of the requirements to do hospital volunteer work was to have a letter of recomendation from the high school guidance counselor/therapist.

I will read to you word for word what she had written to the director of the volunteer services department:

"________ is a good candidate for youth volunteer work. However, he has recently been diagnosed with impulsive ADHD. He will require strict supervision and structure in order to preform the duties of a youth volunteer."

I did not get the job

I think back to this alot. Was this a HIPAA violation on the part of the school guidance counselor/therapist?

Anything I can still do LEGALLY after 13 years or is it too late?

[JustBeachyNurse, LPN]

HIPAA doesn't apply to schools/teachers/principals/guidance counselors as they are not healthcare providers and they are not considered a "covered entity"

However FERPA (Federal Educational Rights Protection Act of 1974) does apply. (FERPA applies to all elementary, secondary and post-secondary public schools and most private schools.) The information in your school health records are considered 'education records'. (For example if I released all of my son's medical records when asked by the school nurse (it was not a realistic or pertinent request so of course I declined) the release/confidentiality of those records would not be governed by HIPAA but by FERPA. The counselor would need written permission from your parents/guardians (or you if you were 18 or older at the time) to release such information in a letter of recommendation.

Unlike HIPAA, FERPA 'punishment' applies to the educational institution and the primary punishment is withdrawal of federal funding. There are no individual/personal claims for relief permitted in FERPA like there is in HIPAA.

Either way it was unprofessional for your guidance counselor to submit such a letter of recommendation. Most likely 'punishment' would be handled at the school level not federal. The USDOE would keep track of violations and whether or not the violation was corrected before withdrawing federal funding (the only remedy).

[BeenThereDoneThat74, MSN, RN]

It's interesting that FERPA has been around for 30+ years, and HIPAA less than 10

[Bhavana]

after 13 years you are still thinking about this - and thinking of what you can get out of it? Let it go. Yes, it was wrong. It was also written around the time that ADHD was the diagnosis du jour in schools. Like most kids with the ADHD label, you have gone on to be successful in your life, and you should focus on that, and let go of the past. When I was a teen, my guidance counselor told my dad that all I needed was a good kick in the pants. Hmmm...wonder if I can sue him for inciting possible physical abuse?

[BabyLady, BSN, RN]

Our family doctor told our son that the reason why ADHD is so prevalent in the US is because most of the early settlers had it-that's why they could not get along in society in their old countries.Interesting theory.

I have another theory...the reason we have so much of it in the USA is we have this whole generation of people that don't discipline their children and people that are not qualified to make the diagnosis, are making the diagnosis.

Pediatricians, in my opinion, are not qualified to make the diagnosis.

Neither are a school counselor, a nurse, a principal or a general practice physician.

Would you let a dermatologist diagnose you with brain cancer?

Would you let a OB-GYN, who is a trained surgeon, do heart surgery on you or treat a cardiac issue?

Of course we wouldn't.

However, there are THOUSANDS of parents that let healthcare professionals or other folks, diagnose and treat our kids with ADHD that are not licensed Psychologists or Pediatric Psychiatrists.

I had a Clinical Psychologist as a professor once (rare in colleges)...he said that no reputable psychologist or psychiatrist will make an ADHD diagnoses before the child is at least 8 or 9 years old because there are so many other factors.

Most people don't even know what a child's attention span is SUPPOSED to be.

Kids that are 3, 4, 5 years old, even TWO, are being treated for ADHD which I think is utter and complete BS!!!!

[diva rn, BSN, RN]

]]I have another theory...the reason we have so much of it in the USA is we have this whole generation of people that don't discipline their children and people that are not qualified to make the diagnosis are making the diagnosis[/b']. [/b]

Pediatricians, in my opinion, are not qualified to make the diagnosis.

Neither are a school counselor, a nurse, a principal or a general practice physician.

Would you let a dermatologist diagnose you with brain cancer?

Would you let a OB-GYN, who is a trained surgeon, do heart surgery on you or treat a cardiac issue?

Of course we wouldn't.

However, there are THOUSANDS of parents that let healthcare professionals or other folks, diagnose and treat our kids with ADHD that are not licensed Psychologists or Pediatric Psychiatrists.

I had a Clinical Psychologist as a professor once (rare in colleges)...he said that no reputable psychologist or psychiatrist will make an ADHD diagnoses before the child is at least 8 or 9 years old because there are so many other factors.

Most people don't even know what a child's attention span is SUPPOSED to be.

Kids that are 3, 4, 5 years old, even TWO, are being treated for ADHD which I think is utter and complete BS!!!!

BabyLady,

We may take some heat for this theory, but I feel the exact same way for a lot of reasons I won't go into right now.

I worked as an elementary school nurse for 3 years and felt like I was cooking meth everyday with the amount of uppers I was dispensing to those kids daily....and before I get really jumped on..my own grandson (who is 8) is dx with ADHD and on one of those meds...I'm not crazy about it, but my daughter swears it helps, and I don't live in the same state.

That being said, I also don't think he is disciplined very well, he is a sweet kid, not bad kid, however, I think that while he was little, if he was made to sit down and stop acting out or jumping around the first time he was warned, or the second time and not the up to the 10th! time with no consequences.....then maybe he would not have been labled ADHD..... I really try to keep my mouth shut when I am there, but that is my opinion and I love him dearly.:redbeathe

diva

[tiroka03, LPN]

First of all, it sounds like you took this letter and turned it into something positive in your life. You are living proof that you have overcome this alleged ADHD.

However, I do believe there are people who really have the disability. But, people need to know they can overcome a lot of adverity that comes their ways. Not to accept and acquise to what other people say about you.

Personally I would drop it. Not that it doesn't have merit. But, inorder to concentrate on your future, there are always things you need to let go of in your past. If I held onto every wrong done to me, well I would be stuck back in the first grade. For my own peace, and that of my family, I have choosen to move on to more happy things. Letting go provides you with the space to create new and better things in your lfie.

Good Luck with however you deciede to pursue this

[BeenThereDoneThat74, MSN, RN]

BabyLady,

We may take some heat for this theory, but I feel the exact same way for a lot of reasons I won't go into right now.

I worked as an elementary school nurse for 3 years and felt like I was cooking meth everyday with the amount of uppers I was dispensing to those kids daily....and before I get really jumped on..my own grandson (who is 8) is dx with ADHD and on one of those meds...I'm not crazy about it, but my daughter swears it helps, and I don't live in the same state.

That being said, I also don't think he is disciplined very well, he is a sweet kid, not bad kid, however, I think that while he was little, if he was made to sit down and stop acting out or jumping around the first time he was warned, or the second time and not the up to the 10th! time with no consequences.....then maybe he would not have been labled ADHD..... I really try to keep my mouth shut when I am there, but that is my opinion and I love him dearly.:redbeathe

diva

Diva: love your post!! I'm sure my mom (as a grandmother) probably feels the same way. I can definitely relate, regarding the discipline issue. My daughter was tested (had the screening tool filled out by me, as well as 2 of her teachers). The responses were quite different (mine and the teachers). Her homeroom (+ 2 subjects) teacher said she was shocked when I sent in the form and note for her to fill out. Bottom line: she is a different child at home than in school. She has always been "spirited" (codeword: hyper:lol2:), and I have had many a conversation with people (friends, family, etc) that basically danced around asking me if she had ADHD. When she was evaluated, she happened to be in therapy for anxiety (a whole 'nother story, related to her father and our divorce and his new life). So I figured it wouldn' hurt to just rule it out: HW was becoming a struggle, getting to bed, limit setting, etc. Bottom line is this: She had very little consistancy in her for the last 6 years (thank to her father and I), 2 different houses, 2 sets of rules, and (I am embarrased to say) not the right kind of discipline. In school she is well behaved, gets her work done easy and promptly, and actually gets good grades. I absolutely did NOT want her on meds (she is already on meds for the anxiety). But I was interested in some assistance on ways to maintain limits at home. We're getting there, but it is not easy. It takes a lot of work on our part (my parents and her stepfather). Every day is a struggle, not 24 hours day, but we have at least one battle a day.

OTOH, I see some of her friends, classmates, fellow girl scouts (I am a leader), and some of the kids I care for at camp, and I am convinced that for every kid that is on Meds that shouldn't be, there is one that should be that isn't

[TinyHineyRN]

I was actually diagnosed myself with ADHD about a year ago and it is the most life-changing revelation I have ever experienced! I know it is a controversial subject and it is so hard to put what goes on in my head into words, but being treated has helped me so much personally and professionally.

Looking back, I have always had problems r/t ADHD but my brother had a very severe case as well as possible other mental inflictions. I remember telling my mom that I thought I had a problem and she told me, "You don't have ADD, your brother does." Well, yes, he does, but he is a waaaayyyy different person than I am!

I did very well in school despite the fact that I never cracked open a book. Even in nursing school I never studied, I never looked at my power points, I doodled in class. Nursing/health/medicine comes very easily and very naturally to me (don't hate me....I don't want to sound like I'm bragging b/c I'm not trying to!). I even went to a university and earned a BS prior to nursing school. How I graduated twice....I have no clue! How I passed the NCLEX....who knows. But I have been pretty successful so far.

The reason I finally sought out a professional diagnosis was b/c it was starting to affect my work. For example, I would have a pt ask for a drink and I would remember about 3 hours later! Not such a big deal when it came to things like drinks or blankets, but I didn't want to progress to the point that I would forget meds...not such a good thing!

I have been on Adderall for about a year and it has made all the difference. I am a much more productive person when I take it. I feel like it makes me a better nurse to my patients.

There is such a negative label on ADHD and I, for one, am not ashamed to admit that I take meds for it. Its not because I'm lazy or seeking meds.

As far as the note is concerned.....time to get over it!

[belgarion]

It's interesting that FERPA has been around for 30+ years, and HIPAA less than 10

Probably because of all those threats that "you know this will go on your permanent record!"