Sharing Information

1. Sharing Information Gus Guardino, M.Ed., CAS The Hospital School Program

2. Purpose • To familiarize school staff with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) • To familiarize school staff with the Family Educational Rights Privacy Act 1974(Amended in 1994)

3. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) U.S. Department of Health and Human Services (U.S. DHHS) was required to develop a series of rules governing health information. Intended to standardize communication of electronic health information between health care providers and health insurers. Intended to protect the privacy and security of individually identifiable health information.

4. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) The HIPAA governs how “covered entities” may use and disclose protected health information. Who are covered entities: Health plans (insurers, HMOs, Medicaid, etc.); Health care clearinghouses (entities that help health care providers and health plans standardize their health information) Health care providers who transmithealthinformation in electronicform in connection with a HIPAA transaction.

5. Are Schools Considered “Covered Entities” Under HIPPA School nurses and school-based health clinics are easily recognized as traditional health care activities Should be closely examined under HIPAA to determine if they are “covered entities.” LEA’s may be engaging in activities that qualify the LEA as a “health care provider” under the HIPAA definition. LEA employee may conduct hearing assessments or provide health-related services to a disabled student. LEA conducts one or more HIPAA transactions electronically in order to obtain payment for that service from a third-party payer (such as Medicaid), the LEA would become a covered entity under HIPAA.

6. What Information is Regulated by HIPAA Protected health information (PHI) PHI is information held or disclosed by the covered entity in any form (electronic, paper records, oral communications) that: Identifies an individual, and relates to: a. the individual’s past, present, or future physical or mental health or condition; b. the provision of health care to the individual; or c. the past, present, or future payment for the provision of health care to the individual

7. Exceptions to the Definition of PHI Education records covered by FERPA Records of students held by post-secondary educational institutions or of students 18 years of age or older, used exclusively for health care treatment and which have not been disclosed to anyone other than a health care provider at the student’s request Employment records held by a covered entity in its role as employer

8. Schools Nurses under HIPAA Does the school nurse, as part of her school nursing work, ever transmit health information electronically in connection with a HIPAA transaction? Does the school nurse’s employer ever engage in HIPAA-covered transactions?

9. Compliance with HIPPA Follow confidentiality rules. Nurses are well grounded in confidentiality, but is your teaching staff? Model and promote confidentiality Don't post lists that identify students with health conditions Don't email information that contain personal information about a student's health concerns Protect faxes - Talk with your school administrator about the fax policy at your school. Which select staff may retrieve faxes? Does the school prohibit students and parent volunteers from retrieving faxes? Is the fax machine in a secure location? Use HIPAA compliant releases when requesting health information

10. Consequence for Noncompliance Personal fines from $25,000 to $250,000 Up to ten years in prison

11. Family Educational Rights Privacy Act 1994 Federal law that protects the privacy of student education records Law applies to all schools that receive funds under an applicable program of the U.S. Department of Education FERPA gives parents certain rights with respect to their children's education records These rights transfer to the student when he or she reaches the age of 18 or attends a school beyond the high school level

12. FERPA Rights • Parents or eligible students have the right to inspect and review the student's education records maintained by the school • Parents or eligible students have the right to request that a school correct records which they believe to be inaccurate or misleading. • If the school decides not to amend the record, the parent or eligible student then has the right to a formal hearing. • After the hearing, if the school still decides not to amend the record, the parent or eligible student has the right to place a statement with the record setting forth his or her view about the contested information. • Schools must have written permission from the parent or eligible student in order to release any information from a student's education record • This includes health-related data

13. FERPA Exceptions • School officials with legitimate educational interest • Other schools to which a student is transferring • Specified officials for audit or evaluation purposes • Appropriate parties in connection with financial aid to a student • Organizations conducting certain studies for or on behalf of the school • Accrediting organizations • To comply with a judicial order or lawfully issued subpoena • Appropriate officials in cases of health and safety emergencies • State and local authorities, within a juvenile justice system, pursuant to specific State law

14. FERPA and Directory Information Schools may disclose, without consent, "directory" information such as a student's name, address, telephone number, date and place of birth, honors and awards, and dates of attendance Schools must tell parents and eligible students about directory information and allow parents and eligible students a reasonable amount of time to request that the school not disclose directory information about them Schools must notify parents and eligible students annually of their rights under FERPA The means of notification is left to the discretion of each school

15. The Protection of Pupil Rights Amendment (PPRA) • Concerned with surveys and other activities which gather information on: • Political affiliations or beliefs • Mental or psychological issues • Sex behavior or attitudes • Illegal, anti-social, self-incriminating or demeaning behavior • Critical appraisals of other individuals • Legally recognized priveleged or analogous relations (i.e. lawyers, physicians and ministers) • Religious practices, affiliations or beliefs • income

16. PPRA Requirements • Prior written consent • Allow the parent opportunity to opt out their child from participation • Inform parents of their rights under PPRA at least annually at the beginning of the school year

17. Consequences for Noncompliance All federal funds will be withheld

18. In Summary • Please be sure to find out whether your school district qualifies as a “covered entity” and educate your staff • Best practice would be to make sure all information contained in a student’s record, whether school or medical, remains confidential • Remember, information that should remain confidential disclosed to others may not only embarrass the student… • It may also cause dreadful consequences for the one who divulges the protected information