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Confidentiality

 
​Parents and students have an expectation of privacy where the student health information is concerned which is supported by ethical and legal considerations. Legal sources of privacy and confidentiality protections include the U.S. and state constitutions, federal and state laws, and case law. The Public School Code, at 24 P.S. Section 1409, states that all health records established and maintained pursuant to the requirements of the School Code shall be confidential, and their contents may be divulged only when necessary for the health of the child or at the request of the parent or guardian to a physician. Nurse practice regulations, addressing standards of nursing conduct, require a registered nurse to safeguard the patient's dignity, the right to privacy, and the confidentiality of patient information. 49 PA Code Section 21.18 (a)(4)
 
The regulations addressing standards of nursing conduct also state that the "Code of Ethics for Nurses with Interpretive Statements" (ANA, 2015) should guide the nurse's practice. Provision 3 of the Code of Ethics states: "The nurse promotes, advocates for, and strives to protect the health, safety, and rights of the patient." The nurse safeguards the patient's right to privacy. Associated with the right to privacy, the nurse has a duty to maintain confidentiality of all patient information. Only information pertinent to a patient's treatment and welfare is disclosed, and only to those directly involved with the patient's care. In general, only that information directly relevant to a task or specific responsibility should be disclosed.
 
Pennsylvania Department of Education Regulations: Title 22 Education, Chapter 12 Students and Student Services
Section 12.41 Student Services​ Note: Subsections (a), (b)(1), (c)(4) and e
 
Family Educational Rights and Privacy Act (FERPA)

FERPA protects the privacy of student education records. The student health record is included in the definition of an education record. The law applies to all schools that receive funds under an applicable program of the U.S. Department of Education.

Health Insurance Portability and Accountability Act (HIPAA)

Effective January 25, 2013, the U.S. Department of Health and Human Services published modifications to the HIPAA rules. These rules include clarification regarding the disclosure of immunization records between medical providers and schools. The health care provider may disclose proof of immunization to a school as long as they have obtained and documented the agreement from either a parent/guardian for unemancipated students or the student, if an adult or emancipated minor. This agreement may be oral or in writing but must be documented by the health care provider. Authorization is not required for the use of an immunization registry.
Joint Guidance on the Application of the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) To Student Health Records   This document explains the relationship between FERPA and HIPAA. The question most frequently asked pertains to disclosure by a health care provider of protected health information about a student to a school nurse or physician. This is addressed by question #6 in the document.
The answer is yes. The HIPAA Privacy Rule allows covered health care providers to disclose PHI about students to school nurses, physicians, or other health care providers for treatment purposes, without the authorization of the student or student's parent. For example, a student's primary care physician may discuss the student's medication and other health care needs with a school nurse who will administer the student's medication and provide care to the student while the student is at school.
 

​Updated: April 2018