Privacy of Health Forms

[WisconsinMomma]

This may sound bad but just because an adult or youth turns in a medical form, it doesn't mean that they get read in detail.  Obviously, if someone has an important medical condition, they will also communicate that beyond the health form.  But I've never sat and read 40 people's detailed health histories. Why would I?  But if something happens and an ambulance comes, the paperwork can be grabbed and sent to the hospital with the patient. Or, in an emergency situation, the paperwork gets pulled out and referenced. Otherwise, I would stick the forms in a manila folder upon arrival and return them on departure. 

Does that make sense?  

Edited March 31, 2019 by WisconsinMomma

[eagle90]

I always looked at each medical form to make sure the right signatures were present.  It's unbelievable how many came in without parent's and scouts signatures.  I would also look for anything that stood out as a potential problem - allergies, medications needed, etc.  To me, that is what the form is for.  Always better to be forewarned.  Remember "Be Prepared"?

[CherokeeScouter]

Just do what I do. I treat the adults differently from the kids. The adults hand me their A&B forms in a sealed envelope and it stays sealed unless it's needed by medical personnel. At the end of the event, I give the envelopes back to the adults. Never had to open one in 6 years. 

Kids are handled more traditionally. I have them in a file box that stays in my tent. 

When we backpack, everyone carries their own - adult or kid. 

[Buggie]

Good idea on that backing packing point. Having it readily available is important. 

[awanatech]

I always glance over the medical forms to make sure I am aware of any pertinent information.  I want to know before heading out if I have a dad with a heart condition.  Or that Scout that has asthma, or another that has a peanut allergy.  These are all things that I've learned by glancing at the med forms, but had never been verbalized to me by either Scouts nor parents.  I had another incidence years ago when we were camping on an aircraft carrier.  A dad developed a medical condition at 3am where I ended up going with him to the ER.  He was conscious, but in & out of awareness.  The medics were there at the ship when it happened, so they were on the scene before another leader could go get the med form out of my bag.  Since I had looked over his med forms, I was able to tell them of his drug allergy before the med form was brought to me. 

[John-in-KC]

On 3/8/2019 at 8:54 PM, Eagle94-A1 said:

Health forms or no trips. Seriously it is a health and safety issue. I've been on a camp out where the binder with the forms did not come with us by accident. The SM was the only one with access, and he didn't go. Just happened that I had to take a Scout to the immediate care. Luckily  it was a local camp out, and we met mom there.

Never again.

As for disposing of out of date forms, I have access to a shredbox at work.

A to the men.  Being private with them is not difficult. Place each one in a large Manila envelope. envelope. Seal it. If a Scout or a Scouter gets injured or has some form of disease overcome them, take them to urgent care or the ER or the dark, and open the envelope. This is not difficult.

Ps:   This militates for registering all adults on a trip.

Edited April 8, 2019 by John-in-KC

[mrkstvns]

10 hours ago, awanatech said:

... Since I had looked over his med forms, I was able to tell them of his drug allergy before the med form was brought to me. 

Hmmmm.

You might think that's a "positive" outcome, but I'm very troubled that any adult is prowling through the medical forms, reading info about everyone in the troop. That is precisely the reason that health care providers are obligated to safeguard health info under HIPAA regulations --- because we, as a society, WANT to have the right to our health information staying "personal".

What you are doing argues strongly in FAVOR of extending HIPAA protections to organizations like BSA, because they clearly cannot be trusted to keep personal information "personal".

I certainly don't know the ideal way to handle personal health information, but I know it's not having you read everybody's health background.  It might be to adopt something like the sealed envelope approach that John-in-KC described. It can certainly be done better than today's practice of having binders of forms sitting around, readable by anyone with an inkling to snoop and gossip.

[willray]

9 minutes ago, mrkstvns said:

Hmmmm.

You might think that's a "positive" outcome, but I'm very troubled that any adult is prowling through the medical forms, reading info about everyone in the troop. That is precisely the reason that health care providers are obligated to safeguard health info under HIPAA regulations --- because we, as a society, WANT to have the right to our health information staying "personal".

What you are doing argues strongly in FAVOR of extending HIPAA protections to organizations like BSA, because they clearly cannot be trusted to keep personal information "personal".

I certainly don't know the ideal way to handle personal health information, but I know it's not having you read everybody's health background.  It might be to adopt something like the sealed envelope approach that John-in-KC described. It can certainly be done better than today's practice of having binders of forms sitting around, readable by anyone with an inkling to snoop and gossip.

Again, I believe someone without knowledge of what HIPAA actually is or does, is advocating for something they don't understand.

What you are advocating for, does not prevent what you want it to prevent:  assuming Awanatech is the cognizant individual with responsibility for the health information and medical-preparedness of the unit on an activity, he or she would be allowed by HIPAA to review the medical forms.

Personally, I kind of like the idea of having everyone carry their necessary medical information on their person, but I am not sure whether that addresses whatever legal requirements/regulations regarding camping, to which BSA feels they're required to adhere.

[mrkstvns]

3 hours ago, willray said:

Again, I believe someone without knowledge of what HIPAA actually is or does, is advocating for something they don't understand.

Be careful of what happens when you "assume"...

 

3 hours ago, willray said:

What you are advocating for, does not prevent what you want it to prevent:  assuming Awanatech is the cognizant individual with responsibility for the health information and medical-preparedness of the unit on an activity, he or she would be allowed by HIPAA to review the medical forms.

Not necessarily. There should be no assumption that Awanatech is a qualified medical professional, therefore, no assumption that ANYBODY in the unit is authorized to review health and medical information. A better approach to extending privacy laws would be for an organization to set health standards and only for a trained medical professional to assess an individual's ability to handle the stress or physical conditions. A simple "Qualified / Not Qualified" checkbox signed by the professional is all the organization really needs.

BSA's health / medical forms are problematic because they disrespect people's privacy. They can do better.

Honestly though, this problem isn't limited to BSA.  Schools often have athletic physicals that likewise, request information that could be sensitive and that really is not the business of school coaches, administrators, etc.

[MikeS72]

30 minutes ago, mrkstvns said:

no assumption that ANYBODY in the unit is authorized to review health and medical information.

I spent the weekend assisting with scenarios and skills practice for a WRFA class.  There were 3 medical doctors and a nurse teaching.

As each person checking in Saturday morning turned in their Part A & B forms they were asked if there were any issues we should be aware of, and the forms went straight into a folder, where they remained until they were returned Sunday afternoon.  No reason to read anything on them.

 

[willray]

29 minutes ago, mrkstvns said:

Be careful of what happens when you "assume"...

I certainly try to be!

30 minutes ago, mrkstvns said:

Not necessarily. There should be no assumption that Awanatech is a qualified medical professional, therefore, no assumption that ANYBODY in the unit is authorized to review health and medical information.

I've made no assumption that Awanatech is a qualified medical professional.  HIPAA contains no requirement that only qualified medical professionals have access to a person's medical data.  That's simply not what the law is about, what it does, or how it works.

Now, what HIPAA would do, is make it a finable offense subject to mandatory reporting to the federal government and a defined punishment and sanction program, if your child told a member of another patrol, that a member of his or her own patrol had a food allergy.

It's not clear to me how a "qualified/not-qualified" checkbox provides the information necessary for a unit to make well-informed decisions about how to deal with a person's medical status in the context of an activity, unless you're proposing that BSA bar anyone from participating in any activity unless a Dr. is willing to certify that there is no possibility that any medical conditions that person may suffer, will have zero effect on the activity.  People will encounter situations during activities where their medical conditions have bearing on their treatment.  That shouldn't bar them from the activity, but it would be exceptionally un-scout-like to insist that the unit should suffer the burden of trying to assist them in the absence of information that would be helpful in improving their care.

I certainly don't have a good answer to the problem, HIPAA certainly isn't it.  

[mrkstvns]

11 minutes ago, willray said:

It's not clear to me how a "qualified/not-qualified" checkbox provides the information necessary for a unit to make well-informed decisions about how to deal with a person's medical status in the context of an activity, unless you're proposing that BSA bar anyone from participating in any activity unless a Dr. is willing to certify that there is no possibility that any medical conditions that person may suffer, will have zero effect on the activity.  People will encounter situations during activities where their medical conditions have bearing on their treatment.  That shouldn't bar them from the activity, but it would be exceptionally un-scout-like to insist that the unit should suffer the burden of trying to assist them in the absence of information that would be helpful in improving their care.

It is not YOUR business whether somebody is fit or not fit. That is between them and their doctor. If the doctor has reviewed the demands/requirements and says "fit", then all you have to do is accept his professional opinion and you are absolved of liability. A waiver would be okay. A detailed medical history is not necessary, no matter how much you, BSA, or the busy-bodies in your troop may think it is. Pretending that there is some special "scout-like" obligation is simply nonsense. Medical info is none of your business. Nobody in the troop has a right to expect that it is.

11 minutes ago, willray said:

I certainly don't have a good answer to the problem, HIPAA certainly isn't it.  

Never said it was.  HIPAA though does set a responsibility on health care organizations to respect an individual's privacy and safeguard their information.

This is the ONLY point that I think should be extended to BSA, schools, camps, and ALL other organizations that ask for any health info: they should respect privacy, safeguard information, and penalties should be imposable for failures to do so. People should be allowed to keep private info private, and organizations that are cavalier about it should be fined, sued or otherwise face consequences. THAT is my point. Exactly how such a policy could be formulated is up to the legislature, but a need for such safeguards is apparent from this discussion.

[mrkstvns]

25 minutes ago, MikeS72 said:

I spent the weekend assisting with scenarios and skills practice for a WRFA class.  There were 3 medical doctors and a nurse teaching.

As each person checking in Saturday morning turned in their Part A & B forms they were asked if there were any issues we should be aware of, and the forms went straight into a folder, where they remained until they were returned Sunday afternoon.  No reason to read anything on them.

 

And you could very easily have  just asked the one relevant question without keeping any paper records that have the potential to be abused by people with zero "need to know"....

[MikeS72]

From HHS.gov

Who must comply with HIPAA privacy standards?

Answer:

As required by Congress in HIPAA, the Privacy Rule covers:

• Health plans
• Health care clearinghouses
• Health care providers who conduct certain financial and administrative transactions electronically. These electronic transactions are those for which standards have been adopted by the Secretary under HIPAA, such as electronic billing and fund transfers.

These entities (collectively called “covered entities”) are bound by the privacy standards even if they contract with others (called “business associates”) to perform some of their essential functions. The law does not give the Department of Health and Human Services (HHS) the authority to regulate other types of private businesses or public agencies through this regulation. For example, HHS does not have the authority to regulate employers, life insurance companies, or public agencies that deliver social security or welfare benefits. See our business associate section and the frequently asked questions about business associates for a more detailed discussion of the covered entities’ responsibilities when they engage others to perform essential functions or services for them.

 

While we do not fall into one of those categories, we should do our best to respect the privacy of all scouts and families.  I would hope however, that any parent would willingly make us aware of any potentially serious medical issues, particularly in regard to food allergies.

[willray]

34 minutes ago, mrkstvns said:

It is not YOUR business whether somebody is fit or not fit. That is between them and their doctor. If the doctor has reviewed the demands/requirements and says "fit", then all you have to do is accept his professional opinion and you are absolved of liability. A waiver would be okay. A detailed medical history is not necessary, no matter how much you, BSA, or the busy-bodies in your troop may think it is. Pretending that there is some special "scout-like" obligation is simply nonsense. Medical info is none of your business. Nobody in the troop has a right to expect that it is.

The medical history information is not about whether someone is fit or not.  It's about whether the unit is prepared for whatever medical complications the person may bring to the activity with them.

If you believe that it's fine for you to come on activities with my unit without informing us that you have a communicable disease that requires extra attention to personal-protective equipment if someone must assist you medically, while you are allergic to things that we need to know in advance for planning or for maintaining your safety during the activity, or any number of other medical issues that impact whether we can conduct a safe activity for everybody including you, then I'll invite you to not participate.

The medical information forms are for information that we need to know.  If we don't need to know it, because it can't affect your care, or our safety we don't need to know it. If it can affect your care, or our safety, then because we will be the ones administering first aid, we need to know it, and a doctor's permission slip is not adequate.