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