HIPPA & BSA

[T2Eagle]

In another thread I said that there are only minor exceptions to the idea that BSA can publish any information about you that you have given. I want to back away a little from that statement because one of the issues we're looking at in our troop is the application of HIPPA to BSA.

 

Does anyone know whether, how, and to what extent HIPAA applies to BSA.

 

We turn in Medical forms to our units every year. What legal obligations does that saddle a unit with.

 

Before I rejoined scouting I read a long legal analysis about HIPPA but I wasn't thinking at the time about scouting. We're not, at least with respect to volunteers, an employer, we're not a health care provider, we're not an insurer, we're not a reporting agency. Does it apply to us?

[The Blancmange]

You answered your own question in this line:

 

We're not, at least with respect to volunteers, an employer, we're not a health care provider, we're not an insurer, we're not a reporting agency. Does it apply to us?

In order for HPPA to apply, one must be a "covered entity" under the statute. Those are:

1. a health care provider that conducts certain transactions in electronic form (called here a "covered health care provider");

2. a health care clearinghouse; or

3. a health plan.

 

That's not to say there might not be state laws which restrict your disclosure of health info. in your possession, plus the fact that it is simply a good practice to keep the information confidential. But HIPPA has nothing to do with it.(This message has been edited by the blancmange)

[moxieman]

Blancmange, I wish it was that simple. I work for a University. We do not meet any one of your three criteria. However, since we do research and occasionally, it "involves" human subjects (as minor as blind, unidentifiable surveys), the university falls under HIPPA. I don't understand it fully as I'm just a low-level peon.

 

After reading some of the rules during a mandatory training on HIPPA, it seems to me that basically, posting an open position in the university and accepting applications for said position could be considered as falling under HIPPA:

 

You're collecting data on private information (SSN's, addresses, resumes, letters of reference, face-to-face interviews) on individuals. AND you are making decisions based on that information that will affect the lives of those you collected the data from (either they get the job or they don't).

 

It's a messy, slippery slope.

[The Blancmange]

Those aren't "my" categories, they come directly from the statute and regulations. A university certainly may be a covered entity to the extent it is providing healthcare. However, HIPPA regs only to information gathered in that context. I would disagree that the information collected in the context of a job application is covered as well. It isn't "protected health information" within the meaning of HIPPA. Whoever told you that is mistaken. Again, those things may be protected for other reasons (i.e. in the university context, the federal Family Educational Rights and Privacy Act) but now this is straying far off topic, so I'll stop there.

[Beavah]

Yah, T2Eagle, Blancmage has da right of it, eh? HIPAA (Health Insurance Portability and Accountability Act) rules do not apply to either the BSA in general or a BSA unit in particular. Period.

 

Moxieman, it's just hard to say what you're describin' at your university, eh? Generally speakin', human subjects research is under still a different set of laws and regulations. Not HIPAA, but usually somethin' called an IRB ("Institutional Review Board") is mandated, which serves as a local branch of da federal regulatory enterprise.

 

B

[John-in-KC]

Beavah,

 

Since you've been on camp visitation teams in the past, and I assume somewhere you have a copy of National Camp Standards, can you share what the NCS provisions are for health record privacy during a unit week at a Scout Reservation?

 

Thanks in advance.

[Eagle92]

Don't have the Summer camp standards, but I bet they are similar to CSDC standards

 

M11. A current (within 12 months) health history (Parts A and C of form 34605) for each camper, leader, and staff member is on file in camp during the camping period.

 

Now while the camp standards do not state who has access to the medical records, in NCS they state that only the CHO (camp health officer)will have access to those records.

 

Now according to the CHO Training ppt I have, "The camp director and unit leaders are informed about campers with limitations so that the appropriate staff members can be alerted." and "information is shared only with the camp staff members who need to know, and they are instructed to handle this important information in a discrete and proper manner."

[T2Eagle]

Beavah and Blancmange,

 

Thanks. That's what I thought. Interestingly, right on the BSA Medical form they tell you that if you have any questions about HIPAA to go to that website. You have to wonder why they put that there when it's just going to make people think they're related.

[PhillyScout]

The BSA is not regulated by HIPPA however, in a resident camp setting, medical information is distributed only on a need to know basis to unit leaders and select staff members.

 

Standard M20 reads: "The camp director and unit leaders are informed of campers with limitations so that the appropriate staff members are alerted"

 

As a former waterfront director and current COPE director, information about scouts with asthma, sting allergies, and other relevant conditions is generally made available to me by the health officer at the start of each week.

[evmori]

HIPPA does not now nor has it ever applied to the BSA.

[RememberSchiff]

"...Interestingly, right on the BSA Medical form they tell you that if you have any questions about HIPAA to go to that website. You have to wonder why they put that there when it's just going to make people think they're related."

 

Pass the buck and CYA. That's because you will NOT find any answers regarding HIPAA in the Guide to Safe Scouting Medical Information section or the National website - not even in the Scouting Safely section. I think the professionals at National/Council owe us volunteers a clear written statement on HIPAA rather than leaving it as yet another figure-it-out-yourselves exercise.

 

Another policy issue is the return or destruction of health forms from summer camp or other council/district activities. Can't get an answer for that either.

 

My $0.02,

 

 

 

[dScouter15]

HIPPA stands for the "Health Insurance Privacy and Portability Act" -- It mainly has to do with accessibility and portability of health care coverage when loosing/changing jobs, setting up unique identification numbers for health care providers, and protecting against insurance fraud. Only a small section of the law refers to privacy, and that section refers only to the insurance industry, and health care providers that engage in specific types of electronic transactions. This last category generally refers to procedures for securing electronic storage and transmission of health care information.

 

So, unless your troop is electronically billing health insurance companies for some reason, it seems clear that HIPPA does not apply in any way to the day-to-day operations of your troop, which is probably why the BSA hasn't offered any training on the subject - there's nothing to train about, it doesn't apply to you.

 

I work in the health care field, in areas that are both covered and not covered by HIPPA laws. A point that I'd like to emphasize is that "privacy" and "HIPPA" are not the same thing. For instance, for a while I was working with a volunteer EMS squad, that did not bill for any services rendered, and did not store any electronic health information about our patients. Even though we were not regulated by HIPPA, we still to patient privacy seriously, in terms of physically securing our paper patient care reports, not releasing names or identifying information about our patients, etc.

 

So, even though HIPPA is not really relevant to your BSA unit, I'm glad to see that you're thinking about the privacy of your unit's scouts and scouters. I would encourage that your unit adopt its own "privacy policy" type guidelines. For example, this might be a starting point:

 

1) BSA Medical Record forms will be kept in a secure area, only accessible to specific adult leaders tasked with that responsibility, and other health care providers in emergency situations.

2) Identifying information about scouts and scouters will be released only to the council and the Chartered Organization, as is required for registration purposes. Release of personal information for other reasons must be approved by the scouter or scout's parent.

3) Adult leaders will refrain for sharing or discussing any personal information they encounter, unless necessary to maintain health and safety.

 

Keep it short and sweet. It doesn't have to be full of "legal-ese," but should give adult leaders a sense of what is expected of them when dealing with personal information about scouts and scouters.

[Brian85]

"HIPPA does not now nor has it ever applied to the BSA."

 

Not...nor...ever is very firm. The original Health Insurance Portability and Accountability Act of 1996 did not originally apply, but amendments to that law have made some changes to the original act. The biggest change that everyone is the disclosure clause incuded in the Protected Health Information clause of 2003. The BSA Medical Form is a legal document that can be used as evidence in insurance claims cases. The BSA uses the medical form to mitigate issues and limit liability exposure for all the activities that units perform. The GTSS has the list of what is and is not allowed. If a unit violates the GTSS then they are not covered by the group insurance provided by the BSA. The gray area occurs during an event that is allowed by the GTSS. If the medical form provided by the participant does not match the form on record with the health insurance provider, guess what?

 

So, does HIPAA apply? Yes. The protected health information clause is very applicable. The prescription drugs taken by your youths is PHI. Have any of you been given medications to provide to youths by the parents? We are not legal guardians, and most are not licensed medical people, able to retain medications for distribution. Imagine if you got arrested for possession of controlled prescription drugs for one of your Scouts. Another great headline...

[Brian85]

Almost forgot...The ARRA of 2009 expanded the applicability of HIPAA statutes to all business entities irt PHI. It could be very easily argued that BSA is a business entity that uses the PHI provided in its medical forms to protect its exposure to liability litigation.

 

[T2Eagle]

Brian85,

 

I am not disagreeing with you I just want to understand things correctly. Let me ask some questions for clarification.

 

Do you have citations for what you said?

 

"The BSA Medical Form is a legal document that can be used as evidence in insurance claims cases"

 

All documents, including probably this post, can be legal documents that can be used as evidence in insurance claims cases. Whats different about the medical form?

 

"If a unit violates the GTSS then they are not covered by the group insurance provided by the BSA"

 

Are you sure thats true? Thats not how most insurance works. My auto insurance and Homeowners insurance are in place precisely to protect me from stupid and dangerous stuff I do. If the BSA policy is different where can I get a definitive list of exclusions and coverages.

 

"If the medical form provided by the participant does not match the form on record with the health insurance provider, guess what?"

 

What? I cant think of anyway this makes a difference. If I get hurt on a scout trip my health care provider has to pay. If later they can find someone whose negligence caused my injury they can, on my behalf, sue that person to recoup their costs. This is what happens if Im in a car accident that is someone elses fault.

 

"The protected health information clause is very applicable. The prescription drugs taken by your youths is PHI."

 

Protected by who, from who. If I tell voluntarily tell my neighbor Im taking Viagra he can tell anyone he likes, I cant sue him or stop him. Similarly parents are voluntarily telling us about their kids medication. Who would we LEGALLY be prohibited from telling that?

 

"Imagine if you got arrested for possession of controlled prescription drugs for one of your Scouts."

 

This I can definitively say is not true. Carrying someone elses medications is not a crime unless your intent is to be committing a crime.

 

But I am curious how other troops handle scouts medication. This is an issue we are actively looking at.