Student Affairs administrators are rethinking their plans to begin notifying students' parents of alcohol-related hospital visits, citing a new federal law that protects the privacy of health information.
Designed to prevent the spread of health records without a patient's permission, the Health Insurance Portability and Accountability Act of 1996 will also prevent the University from knowing about students' visits, said Jim Clack, interim vice president for student affairs.
"The way the law is now, we would not be able to inform [parents]. We are taking action to try to influence the implementation of the law," he said.
Although HIPAA's regulations will not take effect until April 2003, plans for notifying parents are still unsettled for this year, Clack said, adding that he and his incoming successor, Larry Moneta, will decide soon.
Parental notification was one of the major facets of April's alcohol policy revision, and was supported nearly unanimously by student leaders. It would apply to alcohol-related judicial violations when the students' health or safety had been at risk. Although the University will still monitor campus violations, it may not always be aware of incidents when students' health is seriously threatened.
Clack said he is lobbying to add an exception for parental notification to the law's regulations, which were written by the U.S. Department of Health and Human Services and are still being interpreted. Notification is supported by some federal agencies. "We are being encouraged to [notify parents] by the Department of Education, but we are being discouraged by HHS," he said. "We've got to get the government on the same page."
Without such an exception, HIPAA could cause other troubling scenarios as well. Clack described a hypothetical situation where a student goes to the hospital without telling anyone and Student Affairs is not able to even locate the student because of medical privacy concerns.
David Kirby, information security officer for the Medical Center, called an exception possible but "very unlikely," adding that it would still have to comply with the law passed by Congress.
"The general idea is that adults have rights to privacy of health information. The notion that they're students doesn't have any relevance to the law," Kirby said.
He noted, however, that the University and other parties do have limited flexibility in obtaining students' medical records. A party could be notified if a student lost the ability to communicate and if health care providers believed that notifying would help the patient. Some medical procedures could also require parents' consent, Kirby said. But in all such cases, he said, "there must be some justification for the health of the student."
If possible, an exception for students' privacy rights should be made for the sake of their health, said Duke Student Government President C.J. Walsh.
"If it's going to endanger someone's health, the parents have a right to know. Smaller than that, they don't," Walsh said. "The good part about Dr. Clack's new policy is that the minor incidents are still a matter between the student and the University."
For those incidents where the hospital is involved, however, not notifying parents runs contrary to many parents and students' expectations of the role of the Medical Center, said Sue Wasiolek, assistant vice president for student affairs. "The irony is that many students and parents choose Duke because of the Medical Center, because they have a particular health need or just because its a good resource to have nearby," she said.
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