HIPAA and Minor Volunteers

psu_213, BSN, RN · Dec 29, 2014

I am interested to hear the answer (I for one do not know). I will say, however, that allowing minors access to PHI could lead to problems.

brownbook · Dec 30, 2014

I don't know. However why would volunteers be accessing PHI? Anyone who has access to computers would need a course and training that should cover HIPAA, they would also need a log in ID. If it is patient's charts, again what would they be doing with them?

JustBeachyNurse, LPN · Dec 30, 2014

That's why healthcare facilities do not hire minors in any position of direct patient care or access to confidential patient information. Minors are usually handing out water or visitor passes with only access to public information (name, room number) not phi.

WalldancerNIT · Dec 30, 2014

We are a small, very rural, primary care clinic. We have a local vocational school that trains CNAs and MAs. Some start classes in high school, which has clinical training as part of the program, so there has to be something they're using. I emailed the department head of the votech but have not yet heard back (they are on holiday break).

Our volunteer wants to enter the medical field and will be doing an internship through her high school and will be with us every afternoon through May. She won't learn anything by handing out water and we don't have visitor passes. I'd like to teach her how to do very basic scrubbing of the next days charts, BP checks, etc. If she does not have access to our computers, I will have no work for her. There is no job at our clinic that does not involve PHI, besides custodial work, after hours.

I conduct the HIPAA training at our facility and plan to put her through the full training I would give any employee. She will sign a confidentiality agreement, but I'm wondering if her parents also need to sign as well? Plus, would like to see if there is actual policy concerning this, but I have not had any success with Google, Esq.

Esme12, ASN, BSN, RN · Dec 30, 2014

Even as a volunteer they are bound by the facility rules and HIPAA. They require the same training as any other volunteer/employee. I would think that the parents would have to sign that the volunteer took the training and understands to responsibility. My vote would be to have the parents sign as well.

JustBeachyNurse, LPN · Dec 30, 2014

We are a small, very rural, primary care clinic. We have a local vocational school that trains CNAs and MAs. Some start classes in high school, which has clinical training as part of the program, so there has to be something they're using. I emailed the department head of the votech but have not yet heard back (they are on holiday break).
Our volunteer wants to enter the medical field and will be doing an internship through her high school and will be with us every afternoon through May. She won't learn anything by handing out water and we don't have visitor passes. I'd like to teach her how to do very basic scrubbing of the next days charts, BP checks, etc. If she does not have access to our computers, I will have no work for her. There is no job at our clinic that does not involve PHI, besides custodial work, after hours.
I conduct the HIPAA training at our facility and plan to put her through the full training I would give any employee. She will sign a confidentiality agreement, but I'm wondering if her parents also need to sign as well? Plus, would like to see if there is actual policy concerning this, but I have not had any success with Google, Esq.

Check with legal. Minor children cannot legally enter into binding contracts or confidentiality agreements. You could also contact OCR.

Start here: For Covered Entities and Business Associates

Red Kryptonite · Dec 30, 2014

My employer has a high school volunteer program to help interested teens get experience in direct patient care. Usually they have indicated they will pursue nursing after high school, but we also have a couple teen volunteers who are aiming for medical school. As far as I know, they have no access to PHI. There is no reason for them to be getting into charts. The ones who help with direct care shadow the CNA and must always be supervised by the CNA while performing care. The CNA does the charting. The others just do things like answer call lights, bring water and snacks, stock linens, sit with restless or lonely patients, that kind of thing.

The situation in the OP is different, because it's not a care facility. If she must have access to PHI in order to work in her internship, then yes, I guess her parents would have to sign too. I agree with checking with whomever does the legal work for this clinic, but it seems to me that if the clinic is going to offer this to the local high schools, this should have been worked out beforehand.

Esme12, ASN, BSN, RN · Dec 30, 2014

It isn't even so much access to the charts....it is just simply overhearing discussions about patients as well. Studetns need to understnd that anything they see or hear is confidential and protected.

JustBeachyNurse, LPN · Dec 30, 2014

It sounds like this site wants the students to have computer access to patient phi. Personally I would take issue with this as a patient if it's a HS health care interest student and not a student enrolled in a CNA type class.

Why is a health care interest student going to be doing BP checks? Breaking down/scrubbing charts? This sounds like an overwhelming amount of responsibility and exposure to PHI for a HS student.

WalldancerNIT · Dec 30, 2014

I agree with checking with whomever does the legal work for this clinic, but it seems to me that if the clinic is going to offer this to the local high schools, this should have been worked out beforehand.

She approached us, we don't have a designated program, per say. Again, we are very rural (located in a field, essentially, 40 minutes from the nearest hospital). We all wear many hats and have to contract out our legal services. I, like everyone else out here, has tasks outside of our traditional "scope" because there is just no one else to do it. The Medical Director is aware of everything and understands her license is on the line for mistakes, but the alternative option is critically delayed care or no care at all (many residents refuse to go to the hospital, even with MI sxs). We are the wild west, folks.

Likewise, the students in this tiny town have few opportunities unless they want to work in the fields. I am not going to turn someone down is interested in learning about alternative career paths. I'd like to do our best to protect our patients, ourselves, our facility and her, so I'm trying to research my best options and again, hope for the best.

Esme12, ASN, BSN, RN · Dec 30, 2014

She approached us, we don't have a designated program, per say. Again, we are very rural (located in a field, essentially, 40 minutes from the nearest hospital). We all wear many hats and have to contract out our legal services. I, like everyone else out here, has tasks outside of our traditional "scope" because there is just no one else to do it. The Medical Director is aware of everything and understands her license is on the line for mistakes, but the alternative option is critically delayed care or no care at all (many residents refuse to go to the hospital, even with MI sxs). We are the wild west, folks.
Likewise, the students in this tiny town have few opportunities unless they want to work in the fields. I am not going to turn someone down is interested in learning about alternative career paths. I'd like to do our best to protect our patients, ourselves, our facility and her, so I'm trying to research my best options and again, hope for the best.

I agree....why don't you call the department of health and human services and ask?