1. CONFIDENTIAL HEALTH CARE INFORMATION New “Release” and “Exchange” Forms Kathe Reed-McKay, Coordinator Health Services May 2006

2. Purpose of the new forms Comply with HIPAA, FERPA and RCW: 70.02 Comply with OSPI Guidelines for Handling Health Care Information in Schools (1995)

3. Reasons for the new forms Physicians, clinics and agencies were increasingly refusing to honor our forms Ensure student confidentiality per law Staff and District Support

4. HIPPA (April 2003) Health Insurance Portability and Accountability Act Federal Law Protect individuals’ privacy rights pertaining to information in medical records School districts must comply when requesting medical records

5. FERPA Family Education Rights and Privacy Act Federal Law Protect individuals’ privacy rights pertaining to information in educational records. School districts must comply

6. WA State Laws OSPI guidelines re: Health Care Information in Schools (Sept. 1995) These guidelines are based on RCW 70.02 which s more restrictive than HIPAA and FERPA P+P defines who could be considered “health care providers in the school setting: School Counselors, Psychologists, OT’s, PT’s, SLP’s, and Nurses.

7. SO……. Districts must be HIPAA compliant when requesting records from a health care provider. The records then become educational records under FERPA. Except….. RCW 70.02 is more restrictive than FERPA about “third party” health care information.

8. THIRD PARTY HEALTH CARE INFORMATON Health records that are generated by a health care provider. Sent in response to an authorization to release confidential health information. Contain information that cannot be re- released (even to parents).

9. Third Party Health Care Info… PER STATE LAW: THIRD PARTY HEALTH CARE INFO IS CONSIDERED HIGHLY CONFIDENTIAL AND CAN ONLY BE VIEWED BY THE PERSON(S) REQUESTING AND LISTED ON THE RELEASE FORM.

10. Third Party Health Care Info… Contains info that cannot be disclosed/shared unless: The persons receiving are health care providers acting on behalf of a student. OR Need to know for reasons of student health or safety. Read 70.02.05, 1 (a)-(e)

11. Third Party Health Care Info… Usually needed to assist school staff with educational placement or accommodations. Requestor should inform parent of how info will be used to benefit the student Once obtained, interpreted and educational relevance is determined, records must be shredded (document on release). If records are maintained, they must be kept in the requesting staff member’s personal records and not in the confidential or cum file. Do not request information if you do not need it.

12. HIPAA Reminder: HIPAA covered entities can share health care information with non-HIPAA covered entities, such as school districts without a release BUT…they are not required to do so.

13. RELEASE OF INFO FORM One form for ED or HEALTH records request Now HIPAA Compliant Specific name of requestor(s) Include title(s) as well Specific info requested Purpose of request Rights and legal-eze 90-day limit no longer a requirement

14. RELEASE of info…. For receiving or providing written health or educational records. request written health records only when it is vital to your work. The EXCHANGE of info form might fit your needs better. No longer any 90-day limit but…

15. Communicating without a release… RCW 70.02 lists conditions for that Health Care Providers (HCP) may disclose without a release. Read this law as if you were the HCP or if you called a HCP to discuss or share your health care info without a release. THE LAW DOES NOT REQUIRE THE PROVIDER TO RELEASE INFORMATION without a signed authorization. This is an option that is rarely used in the schools.

16. EXCHANGE OF INFO Authorization to Exchange info- usually verbal. For ED or HEALTH information No 90-day limit NOT FOR THIRD PARTY HEALTH INFO

17. Examples: Using an “Exchange” form Counselor contacting agency to share information. SLP needs to communicate with the Feeding Clinic re: school concerns School nurse want to share blood sugar results monthly with physician. Home/Hospital specialist needs documentation to determine eligibility.

18. QUESTIONS?? Would there be a time I would need to fill out both? Maybe but use the exchange and be specific about what you need.