My child was discovered to have lice at school.

1. The children were immediately lined up together to go to the nurse office for a lice inspection. My child was the only one told to take her belongings. Of course, the other children figured out that my child had lice. A notice was sent home to the parents, so they also know my child has lice.

2. My child noticed a notebook on the nurse's desk entitled "Lice". When the nurse opened it, my child could see student names. The nurse's office confirmed that it does keep the names of students who have had lice in a notebook on the desk.

Any thoughts?

I don't think a school is going to have to abide by HIPPA. Keeping the notebook on a desk is stupid. And their method of having her grab her things and leave right then wasn't too tactical.

I'm learning that FERPA kicks in where HIPAA leaves off. FERPA protects all student records including health records.

Ok, there is a difference here between deliberately revealing medical or student records and what occurred here.

Was the school being stupid in singling out your child? I would say so. Did the violate HIPAA? No.

Was the nurse careless in allowing your child to see the notebook? Yes, Was it a violation of HIPAA or FERPA? No.

The most the school and the nurse are guilty of is carelessness.

So Hipaa / Ferma regulations only apply to intentional (not negligent) acts? What accountability does a school have then for publicizing a child's health condition - and one with a social stigma to boot? What incentive is there for a school to be protective of a child's private information?

Please indicate if you are an attorney or HR professional in your response. Thanks for your input.

Then what would constitute a Hipaa/Ferma violation? BTW, please indicate if you are an attorney or HR professional. Thanks.
Purposely divulging confidential information would be considered a violation.

Is divulging private health information only a violation if it's intentional (not accidental)?

Is divulging private health information only a violation if it's intentional (not accidental)?
It applies to any way you use it. You are giving out someone else's information that you were responsible for so yes it does and you can be in a lot of trouble and pay up to if not more than a $100,000.00 fine

Is divulging private health information only a violation if it's intentional (not accidental)?

A Hipaa violation is a violation. It doesn't matter if it is intentional or not.

Document the mistake... document what you have done to prevent it in the future and if it is turned in as a complaint more than likely you will just get a warning to be more careful in the future.

Shirley

It turns out that negligence can result in a Hipaa violation. For example, improperly disposing of medical records is grounds for a Hipaa violation. Invasion of privacy, whether intentional or not, is also grounds for a Hipaa violation.

Thanks again for your input.

Yes, negligence is definitely a HIPAA violation. If I were your child's school nurse and I was overheard at a local eatery talking about your child having lice, and your next door neighbor overheard, I could definitely be held liable.

However, and by no means do I mean to undermine your concern here, lice is very common in schools. And, did you know, that it is actually the cleanest kids that get lice? Yup, true story. You see, lice like the clean hair not the oily and dirty hair.

Kids who wash their hair every night tend to get lice more than those who wash every other night, or who have very oily hair. My daughter got it one year and I was crushed, "I'm the dirty parent" I thought. But the school nurse advised that I wash her hair every other night, spray a spritz of hairspray in her hair in the mornings and put her hair in a pony tail if she chose to wear her hair long, and voilà, we have never had lice again.

Back to your original question, yes, this very well could be a HIPAA violation. But nothing really worth reporting to the medical authorities. Just talk to the school administrator about it and it should be cleared up promptly.

Since part of the precaution is to remove your child's belongings and to have them sent home, ( normally requird) and it is also required for them to stay at home till it is cleared up. And of course a warning letter is normal if not required also.

So by putting two and two together everyone can always figure out who it is,

And as noted, heck mine got it a couple times ( love it on boys, just have their heads and problem solved..

The two previous posters are right: there's no need for any legal action here. But the school does need to understand and adhere to Hipaa/Ferma laws. The school doesn't want to acknowledge that it has a responsibility to figure out how to prevent a breach of privacy. If the school can't perform health inspections without breaching privacy, then it needs to defer to the parents and/or their pediatricians.

These laws were created for a reason. In my child's case, the ramifications of exposing her lice have already included shame and may include lowered self-esteem, taunting, ostracism, etc. - for years to come. Kids and their parents have looonnng memories. I doubt we'll see invites from them again.

I also wouldn't want a personal health condition exposed to my co-workers by my employer. So my empathy extends to children.

Anyway, thanks for your input. It has been an interesting discussion.

Thank you for your replies.

My child was suspected of having lice. Instead of sending her to the nurse discreetly, a lice inspection was immediately and simultaneously conducted on her and her classmates. Then she was told to gather her belongings and go home.

An anonymous notice was sent to her classmates' parents but of course the kids knew who had the lice. We won't be seeing invites from those people again.

The school acknowledges that the class knows. It refuses to acknowledge that it violated her privacy and refuses to change its procedures for similar situations. That's all I want.

But their attitude is that "it's just a child" and "it's just lice". Since when are children and their families not covered by Hipaa or Ferma??

Thank you for your replies.

My child was suspected of having lice. Instead of sending her to the nurse discreetly, a lice inspection was immediately and simultaneously conducted on her and her classmates. Then she was told to gather her belongings and go home.

An anonymous notice was sent to her classmates' parents but of course the kids knew who had the lice. We won't be seeing invites from those people again.

The school acknowledges that the class knows. It refuses to acknowledge that it violated her privacy and refuses to change its procedures for similar situations. That's all I want.

But their attitude is that "it's just a child" and "it's just lice". Since when are children and their families not covered by Hipaa or Ferma???



From what I can tell some States have non-disclosure policies but head lice are not a medical condition and, therefore, are not covered by HIPAA.

School Boards have been sued over this same issue (public examination/disclosure). Some have won, some have lost.

If they refuse to change the policy - and I'm sure they've run this past their Attorneys - perhaps they should become better educated about head lice.

Legality aside - how terrible for your child!

I've merged your two threads since they relate to the same issue.

Lets look at your two points:

1) your daughter was singled out because she had to take all her things.
2) your daughter saw a notebook listing children diagnosed with lice

1) Since the proper treatment was to remove all belongings to prevent further infestation, the school was caught between a rock andf a hard place. Even though the fact that your daughter had lice could be INFERRED from the way she was treated, the school did not overtly violate HIPAA by treating her according to proper treatment guidelines. Even though you can infer someone pleading the 5th Amendment is guilty, you can't prove it by their use of the 5th Amendment.

2) Did the school nurse leave the book under the eyes of your daughter or did she have a reasonable expenctancy rhat your daughter wasn't going to snoop? The exact circumstance of how your daughter saw this book would have a bearing on whether the nurse was careless or not.

Personally I see no HIPAA or FERMA violations here.

And, to put a positive spin on it, if they have a book of students with lice, it's quite possible that a lot of the other kids have had it, and thus they are going to handle this with an "eh" attitude. Have there been a lot of other incidents with kids being singled out and teased because of it?

So it seems that the question that would be posed to the school in a Hipaa/Ferma dispute is: did you have any other options that would have protected this child's privacy? I've shared one idea with the school. I'm sure an attorney could share some too. People get creative when money is involved.

This thread has also created the disturbing proposition of group health visits - group patients with the same ailment into the same visit. The healthcare provider could argue it had no choice - due to cost.

But you'd have a choice not to participate - whereas school children don't. And if you participated, you'd hope not be in the same visit as one (or more) of your peers.

Johnny breaks his leg, they put it in a cast, he appears at school the next day in the cast. Now everyone knows he broke his leg. Is this a HIPAA violation? By treating Johnny, the healthcare professional inadvertently revealed his diagnosis. Should he be fined?

Yes we want to and need to protect people's privacy, but that can only go so far. And I think you are expecting it to go a lot further than it can.

HIPAA is nowhere near as absolute as many people think. And, in this case, there wasn't a HIPAA violation. No one came out and said that your kid had lice. People may infer it, but that isn't something that HIPAA concerns itself with. If you saw someone going into Planned Parenthood, a methadone clinic, or a psychiatrist's office, you might assume certain things, but that doesn't mean that any of those spots have violated HIPAA.

I agree that negligence can also cause a HIPAA violation.

I am an HR Professional... 25 years to be exact.

Shirley

Scott - Your scenario doesn't work for this thread. 1) You have chosen to expose your broken leg by attending school. 2) A broken leg has no social stigma.

If you had an embarrassing health condition, say an STD, you wouldn't like it shared with your peers without your consent. A good bet says that you'd be looking into Hipaa laws at that point.

There's a famous quote about injustice that I can't locate right now but the gist is that injustices will exist until those who haven't experienced them are willing to acknowledge and speak out against them.

And I don't believe the stigma about head lice is as bad as you say it is. Yes I know my scenario is a stretch, but it does have validity.

Maybe I hold the position that an STD has no social stigma and can be publicized without consent. :-)

Unfortunately lice does have a major social stigma in our culture, even though it has nothing to do with hygiene. Kids talk. And they remember. And they can be mean. And their parents can be too. We'll see how many invites we get from them now. That's quantifiable.

Students can be very cruel to other students. I raised 4 children and yes there were a couple of times they came home with head lice and we had to do the treatment.

Our school was much more professional in it's approach and I am truly thankful for that. The child is called to the office and taken to the nurse's station. They are checked over and if they have lice the parents are called and the child is sent home.

Nothing is in the child's file or noted in a notebook, at least not where anyone could see. The other students are simply told that Diania is ill and will not be coming in for a couple of days.

I would hope that all school would show the students such respect for their feelings, unfortunately this school did not. Children have feelings that are easily hurt and they do not easily get over traumatic events and to a child this was a traumatic event.

So often the child feels he/she is being punished for having head lice and that somehow it is their fault and that they are dirty or unclean. "Cooties" is a big one and it will follow the rest of the school year.

How unfortunate that your child had to endure this, and I truly hope that it never happens again. My daughter is a second grade teacher and there is a shampoo you can use on the child's head that will prevent lice infestation. I do not remember the name of it, but it works remarkably well. You might do some research and find out what it is. She uses it on my grandaughter and she has never had a lice infestation.

Shirley

Shirley - Thanks for the kind words. As a parent, you know how you look at their sweet little faces and want to protect them from every hurt. They're so vulnerable.

I've been braiding and spraying her hair as a precaution since I have no idea how/where she got infected. It was interesting to learn that lice can't live long away from a host - therefore are typically passed from person-to-person.

I'm talking to the school district's governmental department now with the simple goal of changing the process to protect children's privacy, dignity, feelings, etc. Wish me luck.

I wish you luck with talking to the School. Yes, I truly know the feeling after raising 4 of my own and several foster children it is hard not to feel for them and want to do what you can to take the hurt away.

If only everyone could experience that.

Shirley

Scott - Your scenario doesn't work for this thread. 1) You have chosen to expose your broken leg by attending school. 2) A broken leg has no social stigma.

If you had an embarrassing health condition, say an STD, you wouldn't like it shared with your peers without your consent. A good bet says that you'd be looking into Hipaa laws at that point.

You are aware that, in some jurisdictions, if you have certain STDs the healthcare provider is required to inform the state health department, which will then try and find all your sex partners so that they can be informed and tested for the disease? And yes, I have a feeling that Sue (or Johnny) is going to have a pretty good idea who the person is who may have infected them. The state feels the benefits of preventing the unknowing partners from infecting others outweighs the initial diseased person's right to privacy.

And, as you have found out, lice is contagious. The school may have been able to handle your child quietly and privately, but then how do they justify checking the other kids, to prevent it spreading?