[dontknownuthin]

A dean went to her campus medical clinic and advised medical staff that a particular student (their patient) was accused of selling her prescription. The student had not done so and the accusation later proved unfounded. The student was still in possession of the medication in question.

The clinic staff permitted the conversation with thecdean about the specific student, though no HIPPA waiver had been signed by the student, who was unaware of the conversation until weeks later.

The dean and clinic director claim that since no information was given to (only by) the dean, no HIPPA violation occurred.

As a result of the discussion, the clinic discontinued providing the student with her medication and service, which they previously provided. The service was for ADHD management. The student went off the medication cold turkey without medical supervision as a result. No effort was made to restore service to her after she was proven innocent of the allegation.

Did a violation occur in this scenario?':

[Fr_Chuck]

No violation, since this dealt with possible crime, and was being discussed, within guidelines that would be allowed.

The Dean, as part of her positions, would have authority to investigate issues like this. She could of course, just reported it, to campus police, or even city police. and read their investigation reports.

What effort did the student make, ( university not under any obligation to make effort) to start services back, when investigation proved no crime committed.

Student had ability to seek, outside source for medication, other than campus.

[ballengerb1]

You can just file the complaint with the Secretary of the Department of Health and Human Services (HHS) . Let them figure it out. I serioyus doubt that a DEan has any police authority. They can not detain or arrest so why would they have higher authority to investigate at a legal level to circumvent HIPAA. BTW its HIPAA not HIPPA

[Fr_Chuck]

It is not the arrest powers, but their authority to act, and investigate. Most large universities have a two fold system, where there are university police but also, in house, peer review of student behavior.

A Dean would indeed, investigate wrong doings of students, normally before, turning it over to the campus police.

Also, who do you think, the chief of police reports to, a Dean normally over special services ( or other title)

[ballengerb1]

I do not disagree with you but the university can not trump Federal law, assuming this is even a state school.

[ebaines]

I agree with Fr_chuck, but for a different reason. HIPAA applies to medical professionals - the dean is not a medical professional, so isn't bound by rules that prohibit sharing medical information. There is no violation if the dean informed the medical staff that the student had been accused of selling her prescription. Now, if the medical staff had confirmed to the dean that the student was indeed on the prescription, then that would be a violation. But according to the OP that didn't happen, hence there was no violation of HIPAA.

[joypulv]

I don't know about any 'HIPAA waiver.' Permission to share medical information among medical facilities/people is boilerplate wording on any papers you sign (often so tiny and light that your eyes go right over it).
But as said, the Dean isn't medical personnel. However, I wouldn't be surprised if there is boilerplate wording on the papers any student signs regarding virtually anything that happens on a campus, or even off, if it involves the school. That latter part is a big topic these days, with drugs and booze, after school events like proms and graduation. Even in my little podunk high school.
I suspect that the Dean did have the legal right to talk to the clinic under the terms of the contract between all students and the school.

More and more parents sue schools these days for liability.

[dontknownuthin]

Here's what happened to my understanding:

A young lady in a dorm who we will call Mary, accused another, Jill of selling prescription medication. Mary and Jill had many friends in common from the dorm, who consistently advised the Dean that the story was made up, and that Mary had a habit of making up rumors about others. Jill offered to show the dean that all of her medication was accounted for. She had just been prescribed the medication for the first time (she had been taking a different class and type of medication previously which she had discontinued the prior school year and was just getting back onto medication for ADHD) and had not yet started taking it, and she had all of the pills in her possession, in the original bottle. The accusation was deemed unfounded. The dean told Jill that the matter was concluded and that Jill was a good kid.

When Jill returned to her next medical appointment at the clinic on campus, she was told that she would no longer be treated on campus for ADHD. A meeting had been held between the physician treating her and the dean, who was an academic and administrator (not medical staff). Between the two individuals, the decision was made to discontinue the medication.

Jill's parents are now upset because they feel that the medical staff should not have entered into a discussion with the dean about Jill's medication absent Jill's written consent. Further, they feel it is an obstruction of Jill's ADA rights to unobstructed medical care for her learning disability of ADHD for the dean to have interfered in her medical treatment on campus. Jill's doctor from home advised Jill that she should not have stopped taking the medication without medical supervision.

I also have a child with ADHD. I work as a paralegal in an unrelated specialty, so the story interested me. Schools typically know that students have ADHD, but I'm wondering how far they can go. It sounds to me that the parents are right. It also sounds, whatever the laws, like it was dumb for the Dean to determine Jill had done no wrong, and continue thereafter to pursue the matter further. So, this is really just an academic question for me that caught my interest.

As for HIPPA wording, I just read the HIPPA laws and you can't just have boilerplate wording to give anyone and anyone permission. Specific people or entities have to be clearly named per the law. I'm sure people don't do it to the letter, but they are required to.

[J_9]

Most likely the conversation between the Dean and the clinic was held prior to the investigation deeming Jill not guilty.

With the that said, the school and the schools clinic are basically one entity as the medical staff are employed by the university. I can see where it may be confused with a violation, but most likely Jill's medical condition wasn't discussed, but the possibility of selling the medication, which is a felony, was the topic of discussion.

Medical providers can be held accountable if they continue to prescribe medication to patients who are known to, or at risk of, illegal activity when it comes to medications. Neither doctors or clinics are obligated to treat any or all patients.

This is a good lesson for Jill though. What prescriptions she takes are no one else's business. That is personal and private information that should be kept to herself.

Oh, and it's HIPAA with 2 A's. Not HIPPA with 2 P's.

[joypulv]

I have checked the box for release of medical information on many forms, and specific entities are not named. The wording is something like 'any medical provider with whom I may have involvement with' or something like that. It's possible that that isn't the letter of the law, but if the law says you have to give permission every time you go to a blood lab or doctor or other hospital, or your swabs are sent out, or any number of tests etc, then the bureaucracy would drag everything to a halt.

As for the Dean, did she contact the parents? Is the girl 18+? I don't believe that the school clinic is required by law to treat her, and if she had just started the medication, did they presume that there was no tapering down to do? The story is incomplete. The school may have offered a refund and told her she was free to leave, or be seen by her family doctor.

Sure, they can sue the Dean, sue the school. I don't think they will win anything. As for HIPAA, what they do or don't do won't reflect on her. A sanction, warning, fine, suspension, etc. - if anything. HIPAA turns down most claims, almost 100% I read. They are also understaffed so it takes a very long time. An ADA claim is similar - 3" thick claim forms, long waits, not much done. And just having ADHD doesn't qualify someone to file an ADA case. You have to have been declared disabled according to specific guidelines.

[J_9]

I would like to add that one of the most popular ADHD meds for college students is Adderall. Many student sell their Adderall to other students who don't have ADHD so that those other students can cram for studies. It is also common among students for weight loss.

The Dean is responsible for the students and was within her right to bring her concerns to the clinic. The clinic was within their rights to fire her as a patient to protect their own interests. Clinics and doctors fire patients every day.

[dontknownuthin]

Thanks. I'm still not buying that an administrator can be involved in student medical business though. For example, Northwestern University has a hospital... most staff and students use their advanced medical facilities. They are entitled, still, to medical privacy. Otherwise a teacher or dean could find ourmt if a colleague or student was pregnant, or sought therapy, or had AIDS, or whatever whatever private business. Any lawyers
Know about that?

[J_9]

What I am getting from your story is that the Dean went to the clinic regarding a complaint that a student/patient was selling their medications. This is appropriate and acceptable. What we don't know is what was discussed behind those closed doors.

HIPAA applies whether it is a small college campus clinic or a large university advanced medical hospital. There is no difference. Heck, if I knew my neighbor were selling the morphine patches she is on, and I reported it to her doctor, her doctor could refuse further treatment. This is not HIPAA.

[dontknownuthin]

She was part of the group who decided to terminate medical treatment, which indicates they confirmed to her the student was a patient there. There was an element of gossip to it as well because she did this after police were brought in and determined no drugs had been sold. The dean sent a letter to the student stating that though the allegations were found not to be credible or substantiated, she preferred such meds not be on campus and "convened a meeting" with medical staff to discuss the student's care. That is what started the parents being pissed off and I had to agree this was heavy handed at best. Sounds like a personal bias against ADHD as well.

[J_9]

She was part of the group who decided to terminate medical treatment, which indicates they confirmed to her the student was a patient there.

That is not a violation unless the patient tells the clinic that she wants to be a No Pub (No Publicity) meaning that the clinic/doctor/hospital are not allowed to tell anyone that they are a patient there, not the parents, not the police, NO ONE.

While I see what you are trying to get at here, it is my professional opinion there was no violation. Now, even if there were, neither the student nor her parents will have anything to gain from this. There are no monetary awards given to the people who are "violated," rather the staff/clinic, etc. are usually just given a verbal warning. If it is a blatant disregard of HIPAA a possible fine and/or termination of the violater in question.

Again, any doctor or facility has the right to "fire" their patients at their discretion. That sounds like what happened here. They can fight this, but they won't get anything out of it of any monetary value. Since the neither the parents nor the student was there to actually hear what happened in this "convened meeting," it's only speculation on there part.

[joypulv]

I still believe that the terms of being a student (contract between parents and school, or student and school, or both) trump those of HIPAA laws about privacy, and that HIPAA would agree if a claim were filed. A school is liable for all students. That means any aspect of 1 student's life that remotely applies to the well being of the campus and other students.

[dontknownuthin]

So, I don't know if this is definitive or not but the parents saw an attorney who specializes in ADA and HIPAA laws and to my understanding this is what he told them:

- campus medical facilities are under the same HIPAA rules as off-campus facilities and medical information is restricted to the medical staff. They should have not engaged in a discussion with the Dean about a specific student, but it would be appropriate for them to talk to the dean generally about students as a class of people, such as participating in discussions about campus health initiatives. The meeting probably was a clear violation per the attorney.
- As some of you pointed out, people cannot presently sue for damages for HIPAA violations but the medical providers can be fined for them or, if severe enough or repeated, shut down.
- The clinic might be able to argue that they only received information and didn't give any, but would likely not be successful because they admit to having had a formal meeting with the dean about a particular student. It might be hard to make an argument that they had a meeting and didn't offer any feedback or response at all to specific comments about the student.
- This could be a violation of ADA law, as the dean was representing the college as an institution and it could be seen as more than say, if the roommate called and reported that she thought her roommate was abusing medication. The College has leverage and authority over the clinic beyond a private citizen and the medical staff could feel coerced or pressured or ordered to follow their directives, which would be an obstruction of the student's access to medical care for her ADHD. Damages could be sought for that obstruction.
- If the Dean represented the allegations as anything more than unsubstantiated allegations, there might also be a case for slander against the Dean but the attorney thought courts would be hesitant to go very far with that even if there was a clear case for it because of repercussions it could have for college generally.
- He also said that it's probably not worth pursuing very far but worth a letter.