Page 117 - MMP-N-NJ CCN 21st Century School Nurse Leadership Book

Health Insurance Portability and Accountability Act (HIPAA)
Privacy of student information: https://nces.ed.gov/pubs2006/stu_privacy/healthrecords.asp
FERPA and HIPAA FAQs: https://www.hhs.gov/hipaa/for-professionals/faq/ferpa-and-hipaa
State of New Jersey Department of Education. Student health records: http://www.state.nj.us/
education/students/safety/health/records/

Be sure to understand FERPA in addition to HIPAA regarding the role of the school nurse. In 1996,
Congress enacted the Health Insurance Portability and Accountability Act (HIPAA) to ensure
continued health insurance coverage to individuals who change jobs, and to establish standards
regarding the electronic sharing of health information. For purposes of HIPAA, “covered entities”
include health plans, health care clearinghouses, and health care providers that transmit health
information in electronic form in connection with covered transactions (45 CFR 160.103).

Technically, schools and school systems that provide health care services to students may qualify as
“covered entities” under HIPAA. However, the final regulations for the HIPAA Privacy Rule exclude
information considered “education records” under FERPA from HIPAA privacy requirements. This
includes student health records and immunization records maintained by an education agency
or institution, or its representative; as “education records” subject to FERPA, these files are not
subject to HIPAA privacy requirements. In addition, school nurse or other health records maintained
on students receiving services under the Individuals with Disabilities Education Act (IDEA) are
considered “education records” and subject to that Act’s confidentiality provisions. Consequently,
these records are subject to FERPA and not the HIPAA Privacy Rule.

Nevertheless, certain activities, when performed by a school, could be subject to other provisions of
HIPAA that concern electronic transactions. According to the preamble to the December 2000 final
rules, “the educational institution or agency that employs a school nurse is subject to our (HIPAA)
regulation if the school nurse or the school engages in a HIPAA transaction.” HIPAA transactions are
defined in the Code of Federal Regulations (CFR) as “the transmission of information between two
parties to carry out financial or administrative activities related to health care,” including submitting
claims. However, consent must still be secured under FERPA before the records are disclosed.

Individuals with Disabilities Education Act (IDEA)
Code law document: http://uscode.house.gov/view.xhtml?path=/prelim@title20/chap-
ter33&edition=prelim
U.S Department of Education: https://sites.ed.gov/idea/
State of New Jersey Department of Education IDEA: http://www.state.nj.us/education/spe-
cialed/idea/reauth/

The Individuals with Disabilities Education Act (IDEA) was an updating of the 1975 Education of
All Handicapped Children Act (EHA). Under the Act, a free and appropriate education includes
the provision of special education and related services without charge, and must be in conformity
with the Individualized Education Program (IEP). Special education and related services must be
documented in an IEP or an individualized family service plan (IFSP) (Cedar Rapids Community
School District v. Garret F., 1999; Wolfe & Selekman, 2002).

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