Parental Access of School Health Records

History
While nursing standards for documenting client care in health care settings are clear, application of these standards in school settings can present complex challenges.

Rules for access to student information, including health information in the school setting are governed by FERPA (Family Educational Rights to Privacy Act). Educational records generated or maintained within a school system are exempt from HIPPA.

Description of Issue
FERPA does not differentiate health records from other educational records. Even if stored separately, health records are still defined by FERPA as part of the educational record.

Rationale
FERPA guarantees parents/legal guardians access to their own minor child's educational records (which includes student health records). Students age 18 or who are emancipated also have a right to view their own records, at which point parental access rights are terminated.

Every LEA should respect this right and establish its own policy and procedures regarding this issue. The school nurse should become familiar with the procedures for parental access and be able to guide the parents appropriately.

Conclusion
It is the position of the School Nurse Association of North Carolina (SNANC) that school nurses support the LEA policy and procedures for parental access to their student's educational records. The policy should include health records generated and maintained by the school system.

1. Role of the School Nurse in Parental Access
   • Be familiar with the LEA policy and procedure governing parental access
   • Guide the parent appropriately when the parent requests access
   • Ensure privacy and confidentiality of information
   • School nurse may serve as the LEA liaison and be available to interpret information in the health record
2. Sole Possession Notes
   • Documentation of all nursing contacts with students should be in keeping with the nursing process of assessment, planning, implementation and evaluation. FERPA exempts sole possession notes from parental access; however, the definition of sole possession notes is narrowly defined.

Definition of Sole Possession Notes

According to the U.S. Department of Education, any notes (handwritten or typed) that are kept in the sole possession of the maker (school nurse, teacher, supervisor, school counselor or school administrator) can be used only as a personal memory aid. The following do not meet the definition of sole possession notes.

• Notes used to make decisions about a student
• Notes containing information received directly from the student
• Information obtained through counseling or testing
• Information revealed to any person other than a temporary substitute or other replacement person [34 CRF Section99.3].

Example of a Sole Possession Note

Example: A note written by a school health staff member reminding them to make contact with a student to address a student concern. The results of that visit should be officially recorded in the student's health record, and would not be considered sole possession notes.

The reminder note would be the only part of the example that qualifies as a sole possession note. After use, it should be destroyed, as it is no longer needed.

References

Information about FERPA from the United States Department of Education is available at http://www.ed.gov/policy/gen/guid/fpco/ferpa/index.html

All North Carolina statutes are available at http://www.ncleg.net/gascripts/Statutes/statutestoc.pl

Protecting and Disclosing Student Health Information: How to Develop School District Policies and Procedures, American School Health Association, (2005). Kent, Ohio.

Legal Issues in School Health Services: A Resource for School Attorneys, School Administrators, School Nurses. Schwab, N. and Gelfman, M., 2001. Sunrise River Press, North Branch, MN.

NC School Health Program Manual. NC Department of Health and Human Services & Public Schools of North Carolina, 2005. Raleigh, NC.

Records Retention and Disposition Schedule: Local Education Agencies. NC Dept. of Cultural Resources, Records Services Branch, Feb. 1999.

Created by: Professional Practice and Standards Committee, May 2007 Adopted by: School Nurse Association of North Carolina, September 21, 2007