School staff and school health personnel are responsible for maintaining patient confidentiality as guided by two major federal laws, HIPPA (the Health Insurance Portability and Accountability Act) and FERPA (the Family Educational Rights and Privacy Act). Also, because most users of school health services are not yet 18 years old, providers must understand and follow California’s minor consent laws, which allow adolescents aged 12 and over to consent to certain services without parent or guardian involvement. Below, you will find information and resources to help SBHCs and other school health providers meet these complex, and very important, legal obligations.
This toolkit is a resource guide on navigating the complex interactions of HIPAA and FERPA in school health programs, including school health centers, school-based mental health programs, school nursing services, and other types of health services delivered on school campuses. This toolkit was developed for us by the National Center for Youth Law. It includes a summary of HIPAA and FERPA, guidelines for determining whether a school health program is subject to HIPAA or FERPA, and detailed information on disclosing and exchanging information under HIPAA and FERPA. The toolkit also includes sample consent and release of information forms and related instructions for school health programs. Note that forms are provided for reference purposes only. (Updated 2018)
Guidance on the Application of FERPA & HIPAA to Student Health Records
In this guidance document, the US Departments of Education and Health and Human Services explain the relationship between FERPA and the HIPAA Privacy Rule, and address confusion on the part of school administrators, health care professionals, and others as to how these two laws apply to records maintained on students. It also addresses certain disclosures that are allowed without consent or authorization under both laws, especially those related to health and safety emergency situations.
Minor Consent Reproductive Health Rights in California (AB 499)
Assembly Bill 499, signed by the Governor in October 2011, created a new minor consent health right in California. Previously, the law allowed minors to consent to diagnosis and treatment of sexually transmitted diseases, but did not allow them to consent to services that would prevent sexually transmitted diseases. Under AB 499, adolescents aged 12 and over can give their own consent for services that prevent sexually transmitted diseases, including both the HPV vaccine and post-exposure HIV prophylaxis. AB 499 amended section 6296 of the Family Code.
Minor Consent Mental Health Rights in California (SB 543)
Senate Bill 543, signed by the Governor in October 2010, created a new minor consent mental health right in California. This table describes Health and Safety Code 124260, the minor consent law created by SB 543, and highlights the differences between Health and Safety 124260 and Family Code 6924, the previous minor consent mental health statute. Please note that “Section 124260 of the Health and Safety Code shall not apply to the receipt of benefits under the Medi-Cal program.” This means that if the minor’s mental health services are/will be covered under EPSDT, the provider must get parent/guardian consent. To learn more, visit National Center for Youth Law.
Minor Consent Rights in California
A revised edition of Understanding Confidentiality and Minor Consent in California was completed in 2010 by the Adolescent Health Working Group and the California Adolescent Health Collaborative. Designed for busy providers, the new module includes materials that you are free to copy and distribute. Updates and additions in this new edition include: updated legal information; added resources for youth; a new section for parents/guardians; information addressing issues of HIPAA and FERPA.
Print copies of this publication can be ordered from the Adolescent Health Working Group website, which also offers other related resources, such as pocket cards and posters. If you have questions regarding the toolkit or its accompanying training and resources, please call the Adolescent Health Working Group at (415) 554-8429 or the California Adolescent Health Collaborative at (510) 285-5712.
National Center for Youth Law
National Center for Youth Law (NCYL) website has a plethora of up-to-date national and local news concerning youth law. NCYL is a private, non-profit law office serving the legal needs of children and their families. A key resource for navigating minor consent and providers’ reporting requirements was prepared by Rebecca Gudeman of NCYL:
Minor Consent, Confidentiality, and Child Abuse Reporting in California.
New! Confidential Medical Release: Frequently Asked Questions from Schools & Districts provides guidance to schools on excusing students from school to attend confidential medical appointments.
NCYL also has a website designed to help California adolescent health care providers understand the many laws that impact their work, with a focus on reproductive health. The NCYL site contains informaiton produced by NCYL as well as other organizations specializing in adolescent health care.
Teen Health Rights
The National Center for Youth Law’s Teen Health Rights Initiative was established to provide resources and information to health care providers about California laws pertaining to minor consent, confidentiality, child abuse reporting, and other adolescent health concerns. Based on provider requests for information, the initiative’s staff research and create manuals, forms, and other resources to facilitate health care delivery to adolescents. Staff also respond to requests for technical assistance, education and training.