Update of potential ringworm.

[coolconfidentme]

I heard back from my licensing agent about the return to daycare note of suspected ringworm. She turned it over to the Chief Nurse Consultant.

The reply read:

"Physician only needs to release and note not contagious. This is what was done. The note shows that the guardian received treatment/prevention instruction. Giving a diagnosis to persons unknown to the physician could be considered by some a HIPAA violation.

The photo shows an area that fits the description of Ringworm. However, lesions may continue to look this way even after treatment has begun for a while. The lesion is not on hands, arms or an area that could be easily touched by someone else; and according to the note is under treatment. The childcare should not exclude."

[hope]

So we are not allowed to request a diagnosis? Then how can we inform other parents of anything contagious?

[NightOwl]

THAT ^^^^ is an excellent question. I would ask this of the nurse, since notification is a requirement of anything potentially contagious. What do they want you to say?

Dcms,
This is to notify you that your child has been exposed to unknown cooties. If your child gets said cooties.....Good luck! Because no one knows what it is.

[coolconfidentme]

IDK..., I have a state inspection today & I will ask the inspector. Crazy btw.

[CraftyMom]

IDK..., I have a state inspection today & I will ask the inspector. Crazy btw.

Yes crazy. Keep us informed! I am very curious what the answer is!

Good luck with the inspection!

[Unregistered]

It sounds like one more instance where daycare provider's hands will be tied. Catch 22.

[Unregistered]

Also they would not be releasing info to a stranger. They would be releasing it to the parent to give to someone else.

http://www.urbandictionary.com/define.php?term=Catch+22

[Solandia]

LOL @ "could be a HIPAA vio by some". The parent voluntarily handing over a diagnosis/treatment plan (note) has nothing to do with HIPAA. A daycare provider informing parents of something contagious to look out for has nothing to do with HIPAA.

Once a note is given to the patient, it is not the dr's responsibility to maintain confidentiality of that piece of paper or worry about who might read it, that is on the patient/parent. Can you imagine, a lost rx or a lost physical form would be a HIPAA vio. If the dr had to be responsible that no one unauthorized would read a piece of paper given to the patient.

I think the Chief Nurse Consultant feels that the daycare child's right to privacy trumps your policy of having a dr note with a dx. And that is fine to feel that way, but it doesn't change the fact that you can require it for your daycare, the parents can chose another daycare that doesn't require that sort of transparency.

Ringworm is not a protected condition. HIV status is, FYI. A parent never needs to tell you about that, even if requested. That gets tricksy. But my experience in that has more to do in foster care & not daycare.

[SignMeUp]

Only a child care provider would be responsible for things that happened AFTER their watch ::

[Blackcat31]

LOL @ "could be a HIPAA vio by some". The parent voluntarily handing over a diagnosis/treatment plan (note) has nothing to do with HIPAA. A daycare provider informing parents of something contagious to look out for has nothing to do with HIPAA.

Once a note is given to the patient, it is not the dr's responsibility to maintain confidentiality of that piece of paper or worry about who might read it, that is on the patient/parent. Can you imagine, a lost rx or a lost physical form would be a HIPAA vio. If the dr had to be responsible that no one unauthorized would read a piece of paper given to the patient.

I think the Chief Nurse Consultant feels that the daycare child's right to privacy trumps your policy of having a dr note with a dx. And that is fine to feel that way, but it doesn't change the fact that you can require it for your daycare, the parents can chose another daycare that doesn't require that sort of transparency.

Ringworm is not a protected condition. HIV status is, FYI. A parent never needs to tell you about that, even if requested. That gets tricksy. But my experience in that has more to do in foster care & not daycare.

Yes! This^^

Licensing may not require you to have a diagnosis but you can still require one FROM parent.

That isnt protected under HIPAA.

[Heidi]

Yes! This^^

Licensing may not require you to have a diagnosis but you can still require one FROM parent.

That isnt protected under HIPAA.

[hope]

OP, what are you going to say to dcm? Will you show her the response from licensing or has she dropped it by now?

Maybe you can have a talk with her and let her know that licensing says only a note of contagious is needed but explain why you would need a diagnosis. I think a lot of us now communicate through text or email and its hard to explain certain things. Have her look at it from a different point of view like if another child had something that was no longer contagious but you still wanted to inform her so that she can look out for any symptoms. Explain that you were only looking out for the group.

[nannyde]

I would contact the nurse and have her send you information on the Hippa violation she is referring to. What part of Hippa does this relate to and where would the violation be that some would consider.

[coolconfidentme]

I would contact the nurse and have her send you information on the Hippa violation she is referring to. What part of Hippa does this relate to and where would the violation be that some would consider.

Funny you said that...., I asked licensing that same thing. (I just had my annual inspection today.) I also ask, "How can I tell the other parents their child may have been exposed something contagious without a diagnosis of what they were exposed to?" She said that was a very good question I need to ask the Chief Nurse. She thought it was odd as well. What the what???

I will first take a moment for myself, the inspections was nerve wracking. Thumbing though every paper & doing a chaotic fire drill with a bunch of shoeless 2 yr old, .

[Scribbles]

Did this ever get resolved? Did the nurse consultant get back to you about the wording of HIPAA? How about the parent? Did she have any further comment on this?