School-based health programs and providers bring a range of needed health care services to a school campus. These programs also provide an exciting opportunity to increase health care access for youth and improve care coordination and collaboration among providers and schools.

When developing school-based health programs, there are several legal considerations that the health provider(s) and education agencies should address early on. One of the most important is determining which confidentiality laws control access to and disclosure of the school-based health programs’ health care information. While there may be multiple laws to consider, the first question to address is whether the program’s information is subject to the federal Family Educational Rights and Privacy Act (FERPA) or the federal Health Insurance Portability and Accountability Act of
1996 (HIPAA).

Whether HIPAA or FERPA applies and how those laws interact with state confidentiality law will impact schoolbased health service operations in large and small ways:

  • from framing how school staff and health
    providers collaborate and share information;
  • to shaping policies about how to deal with
    suicide threats and other emergencies;
  • to determining the content of required notices and consent forms
    and other administrative issues.

This Primer provides an overview of HIPAA, FERPA, and California state law. The goal is to provide sufficient information for health care providers and schools to be able to start important conversations with legal counsel about which law applies to their services.

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