1. Ok so what rights do we have to info?

    Should I write up a form letter release to have parents sign in order to get immunization records etc. from MD offices? Or, are the MDs reponsible for that? I've had secretaries tell me that they can't even MAIL ( could see them hesitate about faxing things) me shot records for students without parental authorization. We all know how hard it is to pin parents down!! What am I supposed to do about F/U for injuries etc? I am almost afraid to ask parents why their kids were seen in the ER if they don't offer the reason first!

    Bergren....you must know about this stuff!

  2. Visit Mrs.B profile page

    About Mrs.B

    Joined: Oct '02; Posts: 30; Likes: 1
    RN @ Hampton Bays HS


  3. by   bergren
    Before I say anything else, HHS has not provided guidance on the interaction of HIPAA and FERPA. It is not because they have not been asked. We are at a disadvantage because most schools are exempt from HIPAA, because we are already covered by FERPA. But that makes doctors VERY uncomfortable sharing information with us as they are required to make sure anyone they release information with must protect it as well as a HIPAA entity. It is a rare school that protects the privacy of student health information to the level required by HIPAA. And how we handle health information is not usually addressed in the district notice of information practices required by FERPA. That would be a good summer project - to get your privacy and security practices tightened up to satisfy the docs and get the district to put that into their FERPA information notice. Doctors can be fined $25,000 per incident (that means per kid) of releasing information inappropriately. So tht explains their relcutance to share when the school nurse calls.

    It would be a good idea to have a release at your end available, but it has to be HIPAA compliant. Ther is a long list of criteria to make it HIPAA compliant.

    Each states situation about immunizations is different.
    Immunizations have been exempted by HIPAA by some states attorney generals. Contact your state school nurse consultant
    and find out
    1. If your state is one of them.
    2. If it is not, what they are doing about it.

    According to HHS sponsored HIPAA seminar I attended here in Chicago on March 2nd, paper to paper fax machines are NOT considered electronic communication. There are precautions that meed to be met though. See my article:

    Bergren, M. D. (2001). The facts about faxing. Journal of School Nursing,17(4), 210 -212.

    Other articles to help get you HIPAA/FERPA compliant:

    Bergren, M. D. (2001). HIPAA hoopla: Privacy and security of identifiable health information. Journal of School Nursing, 17(6), 336 - 341.

    Guidelines for Protecting Confidential Student Health Information
    Available for purchase at www.nasn.org/bookstore.htm and other places. GREAT HELP is you ahve not even begun to institute confidentiality practices, and it is cheap. $13 if you are a NASN member.

    Health and Health Care in Schools, Health Privacy Rules Become Effective April 14

    Health and Health Care in Schools, The Other Health Privacy Law: What FERPA Requires of Schools

    NASN Issue Brief, School Health Nurse's Role in Education, Privacy
    Standards for Student Health Records

    Bergren, M. D. (2001). The facts about email. Journal of School Nursing, 17(5), 274-77.

    Bergren, M. D. (2001). Electronic records and technology. In N. Schwab & M. Gelfman (Eds.) Legal issues in school health services: A resource for school nurses, administrators and attorneys. North Branch, MN: Sunrise River Press.

    Bergren, M. D. (1999). Legal issues: Office management practices. Journal of School Nursing, 15(3), 40 - 41.

    Bergren, M. D. (1999). Criteria for software evaluation: Legal issues Journal of School Nursing, 15 (2), 32-33.

    There is an HHS speaker on HIPAA at the NASN national conference in Cincinnati in June www.nasn.org
  4. by   Mrs.B

    Unfortunately, I will not be able to make the national conference in June (I will be 7 mos pregnant!). But I will do my best this summer to try to bring the district up to speed. I'm sure the administration hasn't even heard of HIPAA!

    Again, thanks for your help!
  5. by   teeituptom
    I remeber back when, where everyone went hippa hippa hooray, I know that was terrible
  6. by   kids
    or how we try to reduce the HIPPA headache for everyone...

    I work in a 14 provider Peds Clinic and deal daily with requests for information from schools.

    We always prefer the parent calls us and requests a copy of the info they want and picks it up (usually later the same day unless the chart is off in another department and we can't get it right away). We confirm the identity of the person picking it up.

    We will fax immunization records to the school nurse if the parents call us and request it. The catch is we call the school and get their fax number and the name of the nurse we are directing it to. And we keep a paper trail.

    Another is the meds in school forms...in theory the parent has us to fill out the form (we have the generic form approved by all of our local districts) at the time the Rx is written or at the back to school well child visit. In reality the parent ends up filling in their portion of the info at the school and signing the form when they try to give the meds to the school and find out they can't...the school faxes the form to us for completion/confirmation and the Docs sig. Very much a grey area. Again, we confirm the fax # and the nurses name AND we confirm with the parent that they originated the form before returning and document the paper trail.

    3 of our Docs are neglect/abuse/sexual abuse medical investigators (we have 2 SANE nurses on staff with 1 on at all times). Many of our patients are in foster care. Because of the special circumstances those kids present we apply the rules to all patient: any other type of info/record requests must come thru the "propper channels" ie; a signed ROI that specifies the info being requested. The ROI can be faxed but the info is always returned via USPS with restricted delivery.
    Last edit by kids on Jun 10, '03
  7. by   Shamrock
  8. by   Nurserose
    Hi All,
    This year to help me with obtaining information when needed from a student's health care provider, I added a release of information statement to my permission form. This way when the parent returns this form to the school at the first of the year, I have signed permission to obtain info about that student. I am hoping this will solve any problems next year. I start back to school on 7/14/03, cause we are on a year round rotation. 9 weeks on and 3 weeks off (have 5 weeks in the summer). This means, I get 3 weeks off in Sept., Dec., and March. Works out prettly good so far.

    Hope this will work for you too,
  9. by   Suezq
    Mrs B,
    As a fellow New Yorker, I ran into the same issue, when I spoke to our school physician he told me that in NY, immunization records are not covered by HIPPA...So, just call and ask to have them faxed. Or even better, have the parents call and have them faxed. Keep in mind that everyone is a bit anxious about HIPPA and may give you grief about sending/faxing them to you. Good luck!