CPS pics and hippa question

[guest83140]

Hello everyone, if I may I would like to ask two questions in one thread. The mother of a 15 yo girl with a std told the counselor to contact the boy so he could be checked. The counselor came to me and i said the mother should go thru the doc. The counselor tells the princ. who comes to my office twice and calls the mom on my speakerphone telling her to tell the boy. The mom claims the boy here are no longer together. The principal sends the call in to me who threats cps on her if she doesn't have the parent him back saying they were informed. So the mom claims she tried to go over to the boy's house to contact him but needed his address since her daughter doesn't know it. I gave it to her bc the prin. is so insistent he's going to save all the kids from this and keeps coming and asking was it done. Did I violate hippa law? Another situation, AP comes with a girl bc she got a whiping and has bruises and is going to report but brings girl in to my office and pulls out her cellphone camara and starts taking pics. My superior says I can be liable for allowing this. I told her should I tell her to take pics elsewhere like her own office vs mine? What are you thoughts? Thanks.

[LACA, BSN, LPN, RN]

Both instances are HIPPA violations. On the second count, I don't know how liable you would be because it wasn't your camera phone...but if it was in your office, you could be liable.

On the first situation, it was a violation of the boy's privacy to give his address, regardless of what the principal said. If the mother needed the address so bad, she could have gone some other route and gotten it. The principal should have stayed out of it, it's not really their place to deal with something like that. I would think that you and the counselor could have handled it on your own.

Honestly, I would love to see what Bergren says about this...she always seems to give great advice and she knows where to find the answers!!

[Rosie67]

I am sure Martha would have plenty to say. We have had discussions on a listserv recently. Most issues in schools are FERPA and not HIPAA. These discussions prompted me to download the US Department of Education -Joint Guidance on the Application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996(HIPAA) To Student Records- Published in November 2008-- Whew! Still red tape and some gray areas but has specific answers that apply to school health issues.

[LACA, BSN, LPN, RN]

Where did you download that from?

[Rosie67]

http://www2.ed.gov/policy/gen/guid/fpco/doc/ferpa-hipaa-guidance.pdf-- This is the address- I'm not good at links and fancy computer functions, so you'll have to copy and paste the link. If it doesn't work then search US Department of Education FERPA HIPAA. That should get you there.

[DistrictNurse19]

Contact your local health department for guidance regarding partner notification. Hopefully your LHD has an STD clinic. Depending upon the type of STD, it may be reportable by state law, and the health department has an obligation to help notify partners. The physician (or laboratory) should already have notified the LHD regarding the girl's positive diagnosis. This situation of notifying partners should not even be considered a duty of school personnel (in my opinion!) Good Luck!

[bergren]

I agree with the comments above. In fact, I am worried that the mom was making up the STD story to get the boyfriend's contact information. The address of any child is directory information and not subject to FERPA nor HIPAA, but I would not have given it out in the circumstances you describe. Tracking down partners is the role of the health department, not the school.

If a child has injuries that warrant a photograph, take them to the ER. The ER is set up for this scenario, the school is not. You don't have authority to photograph a child without written parental permission and it is not the role of the school or the nurse to investigate child abuse. The exception would be when the police or CPS will request that the school photograph the injury (Schwab & Gelfman, Legal issues in school health services: A resource for school nurses, administrators and attorneys. IUniverse ). The school reports suspicions, and they investigate. Make very detailed written documentation of what you see.

[Flare, ASN, BSN]

If the boy needed to be contacted, it should have been through the diagnosing doctor or the local health department. The principal can push and whine all she/he wants, but at the end of the day you cannot go on a parent's alleged report of a communicable disease, nor can you release that type of info.

The only time I have ever taken a child's photograph in a medical sense was with a parent present because of a mysterious rash that was fading after benadryl administration (and before md visit.)

Trust your instincts. If what you are doing feels like the wrong choice, it probably is.