Are You Kidding Me!!!!!

[Willow]

Just to clarify - genital herpes (H1) and oral herpes (H2) are two completely different things, contracted different ways, and would need to be addressed in entirely different ways.

[SunshineMama]

Just wondering- but if in fact the child did have that, are you obligated notify the other parents of the children in your care (without naming any particular children)?

[Willow]

Just wondering- but if in fact the child did have that, are you obligated notify the other parents of the children in your care (without naming any particular children)?

I'd say only if it's required reportable by licensing standards.

I would not breach confidentiality like that otherwise. If say a child contracted genital herpes through sexual abuse there is no way I'd be sharing that they did or how they got it if I didn't have to. No need to further traumatize the child or the family by disclosing something so incredibly personal.

[Solandia]

Just wondering- but if in fact the child did have that, are you obligated notify the other parents of the children in your care (without naming any particular children)?

Depends on the illness/disease lists by your state. Otherwise, the child's right to privacy trumps everyone else's desire to know.

For example, everyone wants to know if there is a cold/flu/Fifth's disease, pink eye, etc going around. That is okay to disclose in my daycare, since every family has given verbal permission to share that sort of information. In general, it is still protected medical informations BECAUSE in a small daycare setting it is next to impossible to maintain confidentiality of the "sick kid" AND it is not a requirement to disclose that info anyway.

Regulations state I have to post a notification in the daycare area if there is a non-immunized child attending. Even though I cannot maintain privacy b/c of the size of the daycare, it is still a licensing requirement. I have to report to the dept of health if there is a case of hepA. Herpes is NOT that list, neither is HIV or HepB. It is nobody's right to know if there is someone with those illnesses or conditions. Flu H1N1 was reportable when it was first an issue, it is no longer on the "list".

There is a reason why medical information is private....the actions/reactions on this thread alone are proof as to why.

[Unregistered]

Absolutely right! This is an older, resurrected thread but the information in it is evergreen. I am a pediatric NP and I have a specialized daycare. Not currently, but some time ago, we had a little girl with HIV. We could not disclose it to anyone. In fact, mom wasn't obligated to disclose to us even, except the little girl was on antivirals and received a dose daily while in our care.

Universal precautions should be taken for all children, regardless of whether they are deemed infectious or not. As child care providers, myself included, sometimes we become attached to these little people and our vigilance in PPE and other sanitizing measures may fall off a bit. I mean, we've had little Johnnie since he was 6 weeks, he's 5 now, and I have him more waking hours than mom does! We still must wear gloves if we have to help him wipe, and use antiviral/antibacterial disinfectant cleanser after every use of the restroom.

As for an outbreak of GENITAL herpes specifically, that is more likely related to a sexual assault rather than transmission via vaginal delivery. Statistically so. A child who is delivered to an infected mother is treated right away, and ALL children are given drops at birth for infectious diseases that may have been transmitted but never disclosed to health professionals. It is much more likely the outbreaks would occur on the head, torso or back. Herpes that are relegated solely to the groin are absolutely the result of sexual maltreatment.

[SunshineMama]

Depends on the illness/disease lists by your state. Otherwise, the child's right to privacy trumps everyone else's desire to know.

For example, everyone wants to know if there is a cold/flu/Fifth's disease, pink eye, etc going around. That is okay to disclose in my daycare, since every family has given verbal permission to share that sort of information. In general, it is still protected medical informations BECAUSE in a small daycare setting it is next to impossible to maintain confidentiality of the "sick kid" AND it is not a requirement to disclose that info anyway.

Regulations state I have to post a notification in the daycare area if there is a non-immunized child attending. Even though I cannot maintain privacy b/c of the size of the daycare, it is still a licensing requirement. I have to report to the dept of health if there is a case of hepA. Herpes is NOT that list, neither is HIV or HepB. It is nobody's right to know if there is someone with those illnesses or conditions. Flu H1N1 was reportable when it was first an issue, it is no longer on the "list".

There is a reason why medical information is private....the actions/reactions on this thread alone are proof as to why.

I understand HIPAA, but I thought that, for example, if a child came to daycare with Lice, it is the responsibility of the provider to let the parents know that lice has been around the daycare, without telling who the specific child was. Same with this instance, is it possible to say that this virus has been around the daycare, without exposing who the child was?

Not judging or wanting to call anyone out, but just wondering. I know that if I were sending my child to a daycare where a provider had to diaper another child with a STD, I would want to know. What if the provider didnt wash hands between diaper changes, or wipe down the diaper table between every child? (Again, not saying OP doesnt do those things- just thinking about the situation from a parent's eyes).

[Willow]

Daycare providers are not held to HIPPA laws as far as I'm aware.

You could blab away if you wanted to to whoever you wanted to. I've certainly never signed or had any of my parents sign anything about confidentiality clauses saying what I would or wouldn't discuss with others. I've also never seen that addressed via licensing. Wouldn't be good for business to air anyone's health status I also don't believe it's against the law.

Does anyone have any verification on this?



I do believe parents are required to notify at least licensed caregivers of any infectious illnesses/diseases outlined in state health statutes (which are typically required to be included in a providers policy/parent handbook). It would not be an option to withhold diagnosis information on those listed.

[SunshineMama]

This thread is making me wonder if I should have a section in my contract or policy that states whether or not the child has any known infectious diseases or health conditions. I am legally unlicensed, but it never ocurred to me to even ask if a child has AIDS, STD's etc. (Can licensed centers require this information)?

I can only think about 2 of my dcks, who have constant nose bleeds. If they had a communicable disease and I was not aware of it, that could jeapordize my saftey and the other kids.

I feel very sad for the child OP is talking about, however the issue does bring some interesting questions to light.

[Blackcat31]

Daycare providers are not held to HIPPA laws as far as I'm aware.

You could blab away if you wanted to to whoever you wanted to. I've certainly never signed or had any of my parents sign anything about confidentiality clauses saying what I would or wouldn't discuss with others. I've also never seen that addressed via licensing. Wouldn't be good for business to air anyone's health status I also don't believe it's against the law.

Does anyone have any verification on this?



I do believe parents are required to notify at least licensed caregivers of any infectious illnesses/diseases outlined in state health statutes (which are typically required to be included in a providers policy/parent handbook). It would not be an option to withhold diagnosis information on those listed.

9502.0345 AGENCY RECORDS
Subp. 2.

Data privacy.

The agency, department, and the authorized agent shall have access to provider records on children in care to determine compliance with parts 9502.0315 to 9502.0445. The provider shall not disclose any records on children in care to any persons other than the parents of the child, the agency, the department, the persons required by part 9502.0375, subpart 1, and medical or public safety persons if information is necessary to protect the health and safety of the child.

That's all I could find for our state.

[Willow]

9502.0345 AGENCY RECORDS
Subp. 2.

Data privacy.

The agency, department, and the authorized agent shall have access to provider records on children in care to determine compliance with parts 9502.0315 to 9502.0445. The provider shall not disclose any records on children in care to any persons other than the parents of the child, the agency, the department, the persons required by part 9502.0375, subpart 1, and medical or public safety persons if information is necessary to protect the health and safety of the child.

That's all I could find for our state.

I've read the entire book of statutes a handful of times and don't ever remember that part.

THANK YOU!

[Solandia]

This thread is making me wonder if I should have a section in my contract or policy that states whether or not the child has any known infectious diseases or health conditions. I am legally unlicensed, but it never ocurred to me to even ask if a child has AIDS, STD's etc. (Can licensed centers require this information)?

I can only think about 2 of my dcks, who have constant nose bleeds. If they had a communicable disease and I was not aware of it, that could jeapordize my saftey and the other kids.

I feel very sad for the child OP is talking about, however the issue does bring some interesting questions to light.

It depends on your state, but there are some health conditions (mainly HIV) where there are anti-discrimination laws in place. You can ask for medical information all you want, but the parents are NOT required to tell you, no matter how you word it in your contract. In the case of HIV, my state has - or used to have - a disclosure that is from the health department to notify the school that there is an HIV student enrolled, but the school may never know who that child is with HIV. (the parents notify the health dept, the health dept notifies the school...completely confidential).


In short, putting something in your contract is a false sense of security because generally, you have no right to that information. Not to mention that the parent may not know, either. As a foster parent, I may get a child with HIV, bipolar, FAS/FAE.... I do NOT have the right to disclose that info to anyone. AT ALL. And daycare/school has been determined to be in the "not required to know" category, unless it is shown to negatively impact the care of the child.

[Willow]

In short, putting something in your contract is a false sense of security because generally, you have no right to that information. Not to mention that the parent may not know, either. As a foster parent, I may get a child with HIV, bipolar, FAS/FAE.... I do NOT have the right to disclose that info to anyone. AT ALL.

You sign a confidentiality agreement between you and your state licensing agency though. You're not allowed to disclose that info or any for that matter.

I know I wasn't even allowed to disclose the names of some of the kids in my care, much less that they were foster children or the reasons they were with me. Those rules don't across the board apply to licensed daycare situations.





Here's where it gets fuzzy for me......if I'm watching a child who's obviously got some sort of upper respiratory infection, I'm going to require a doctors visit and subsequent diagnosis and treatment to re-admit that kiddo back into care.

On that same note - if I'm changing the diaper of a 1 year old, and they have oozing lesions on their genitals, I am going to require a doctors visit and subsequent diagnosis and treatment to re-admit that kiddo into care.

We require families tell us about the extent of a cold, but parents can legally withhold if their child has something like genital herpes? Why would it be ok to implement scenario number 1, which so many many of us have, but not scenario number 2? Why would the second scenario be protected by confidentiality statutes but not the first?


Do we have NO rights to a child's health information? I don't know how many times I've required documentation from the doctor directly stating a child is no longer contagious with this that or the other.....was I legally not allowed to do that?

[Oneluckymom]

Just to clarify - genital herpes (H1) and oral herpes (H2) are two completely different things, contracted different ways, and would need to be addressed in entirely different ways.

I was just going to point this out!

[Country Kids]

You sign a confidentiality agreement between you and your state licensing agency though. You're not allowed to disclose that info or any for that matter.

I know I wasn't even allowed to disclose the names of some of the kids in my care, much less that they were foster children or the reasons they were with me. Those rules don't across the board apply to licensed daycare situations.





Here's where it gets fuzzy for me......if I'm watching a child who's obviously got some sort of upper respiratory infection, I'm going to require a doctors visit and subsequent diagnosis and treatment to re-admit that kiddo back into care.

On that same note - if I'm changing the diaper of a 1 year old, and they have oozing lesions on their genitals, I am going to require a doctors visit and subsequent diagnosis and treatment to re-admit that kiddo into care.

We require families tell us about the extent of a cold, but parents can legally withhold if their child has something like genital herpes? Why would it be ok to implement scenario number 1, which so many many of us have, but not scenario number 2? Why would the second scenario be protected by confidentiality statutes but not the first?


Do we have NO rights to a child's health information? I don't know how many times I've required documentation from the doctor directly stating a child is no longer contagious with this that or the other.....was I legally not allowed to do that?

I believe you can ask if the child is contagious but can't ask what it is. You know they are sick/have a rash/etc. and can send them in. Dr. can diagnos and let you know if they can come back what ever time frame. Dr. can't tell you what they have-I believe.

[SunshineMama]

I wonder what the specific federal law is concerning this issue??

I remember hearing a case of a man who knew he had AIDS, and still had unprotected sex with multiple women over a period of years, knowingly infecting them. He was charged with first degree murder, with AIDS being the weapon. Obviously this is with ill intention, but the point is that, had he bothered to use protection with these women, they may have had a chance to live a full life. I relate this to a parent telling a provider, to prevent possible issues for other children involved.

If a parent were to knowingly bring a child with AIDS to care, and not at least tell the provider, with the understanding that the provider would keep it confidential (or even sign a legal confidentiality agreement to protect the child), could the parents of the child be liable if there was a preventable AIDS transmission to another child? I understand not-discriminating, but not even allowing the provider the opportunity to take extra precautions seems just as wrong to me. If the OP's dck did have genital herpes, and she was aware of the situation, she would be able to take extra precautions to protect herself and all of the other children. It just does not seem fair to me to put the provider and other children at risk for a lifetime illness when it can be so easily preventable through information.