Other School Staff and HIPAA

[OyWithThePoodles, RN]

*No Facebook please*

Yesterday I had a little...tiff...with my principal. Here's the deal: SORRY SO LONG, GUYS.

The phone in my office and the phone for the after-school program are apparently on the same line. Meaning a few things: 1.) When I call a parent a different number than the schools shows up. 2.)If the parent calls that number back, they don't get my office, they get either the AP's office or the after school care line. Never me. And most importantly 3.) At times when I pick up my phone I hear the after school program people's phone conversations with other people. I assume they can do the same at times with me.

So yesterday they were talking about some of the other phone lines being fixed over Spring Break. I asked if the issue with my phone and hearing others conversations had been fixed and I am told "No, I'm not paying for an extra line."

Okay...but my concern is that if I am on the phone and they pick up, they can hear my conversation about a student, thus violating HIPAA. The secretary pipes up and says "Well, after 1:30 (what time the ASP person comes in) you just won't be able to use your phone and it will be her turn." Okay, so all the injuries and illness I have after 1:30 I can send to you to call home, right?

Principal then says, "Well, she is bound by the same HIPAA laws as you, so even if she does overhear something, she knows not to tell. So it is not an issue." I was literally speechless so just said "All right then." And went to my office.

Here is my issue. First I don't think the program director is bound by HIPAA, FERPA maybe, but no HIPAA (guys, let me know if I am wrong!), as she is not a certified employee. Also, for example, say I am working at the hospital and a tech and I are in the cafeteria discussing our patient and another nurse from another unit overhears our conversation about the patient, who just so happens to be her sister's friend, regardless that she is a nurse and bound by HIPAA, it has still been violated.

I am just frustrated and confused. I trust the program director and I am sure that if she picked up the phone and I was on it she would hang up (like I do when I hear her convos) but what if I was talking about her neighbors kiddo, and she then goes and tells her other neighbor...UGH. Am I making too much out of this???

[OldDude]

I think you've shown due diligence in your concern for privacy issues. You MUST communicate with parents and if the line you are talking about is the only one available...so be it. Even though the person you are concerned about is "unlicensed" she is still an employee of the school district and bound to all federal privacy laws and could be answerable for such a violation from eavesdropping on your phone conversation.

[OyWithThePoodles, RN]

Thank you, OD. It does no good to argue with her, since she is always right. But I wanted to scream "IT DOESN'T MATTER IF SHE DOESN'T TELL, IT'S STILL A VIOLATION." But I didn't.

[WineRN]

Also, for example, say I am working at the hospital and a tech and I are in the cafeteria discussing our patient and another nurse from another unit overhears our conversation about the patient, who just so happens to be her sister's friend, regardless that she is a nurse and bound by HIPAA, it has still been violated.

This. I am unsure if anyone outside of the nurse is bound by HIPPA, but because you are, you need a private line.

[OyWithThePoodles, RN]

This. I am unsure if anyone outside of the nurse is bound by HIPPA, but because you are, you need a private line.

I wish!!! She told me that she was not paying for another line. So frustrating. And parents never listen to the voicemail I leave telling them to call the school number, so when they call back and it rings to a place where no one ever is...Grrrr.

[NurseBeans, BSN, MSN, RN]

My understanding of HIPPA is that only healthcare professionals are bound by it. In other words, a nurse talking to a teacher about a student health matter (if the teacher doesn't need to know) violates the law. But a teacher telling another teacher about a student health matter, regardless of how they know the information, is just gossip. It may violate FERPA, but that's the thing about being a school nurse; we are bound by education and healthcare laws. I have gone around in circles with a parent who is a nurse trying to get her to understand that teachers can't violate HIPPA laws, because those laws only apply to healthcare personnel. Any other people talking about people's health matters are just being nosy gossips.

[OyWithThePoodles, RN]

Yeah, I did a little digging last night and found this:

"In most cases, the HIPAA Privacy Rule does not apply to an elementary or secondary school because the school either: (1) is not a HIPAA covered entity or (2) is a HIPAA covered entity but maintains health information only on students in records that are by definition education records” under FERPA and, therefore, is not subject to the HIPAA Privacy Rule."

From this website: 513-Does the HIPAA Privacy Rule apply to an elementary or secondary school | HHS.gov

And I understand the things like info in the 504's, IEP's, Physicals, etc. because they are a part of the student record, but things like a phone conversation, which isn't...

I mean the guidance counselor is entitled to confidential conversations, I feel I should be as well.

It also states that because our "patients" are billed that they aren't covered under HIPAA. (Unless of course they are a medicaid billed student) So who knows, all the words started running together after a while so I gave up on it.

[OyWithThePoodles, RN]

That should say students aren't billed, but it will not let me edit.

[halohg, RN]

*No Facebook please*

I assume they can do the same at times with me.

Well let's start with this... first confirm with the aftercare they can actually hear your conversation, and let them know you can hear theirs as well. I would not want a shared line under any circumstances, whether is was my phone conversations about dinner plans, my private conversations with other district nurses, let alone conversations with a parent. If it's true escalate up the chain of command.