Share what kind of health records in schools are
& are not patient health care (PHC) records
Distinguish how PHC records must be treated
differently than other pupil records
Share conflicts between state & federal law
Share some strategies to help make it easier to
manage PHC records in your schools
Time for questions
1. Progress
2. Behavioral
3. Patient health care
See handout Categories of Pupil Records.
Progress records include student’s grades,
courses taken, attendance records,
extracurricular activities, & immunization
& lead screening records.
Wis. Stat. sec. 118.125(1)(c)
Behavioral records include psychological tests,
personality evaluations, records of
conversations, any written statement relating
specifically to an individual pupil's behavior,
tests relating specifically to achievement or
measurement of ability, the pupil's physical
health records (other than his or her
immunization records or any lead screening
records), law enforcement records, & any other
pupil records that are not progress records.
Wis. Stat. sec. 118.125(1)(a)
Except as provided in par. (b), any pupil record
that relates to a pupil's physical health & that is
not a pupil physical health record shall be
treated as a patient health care record under ss.
146.81 to 146.84.
Wis. Stat. sec. 118.125(2m)(a)
Any pupil record that concerns the results of an
HIV test, as defined in s. 252.01 (2m), shall be
treated as provided under s. 252.15.
Wis. Stat. sec. 118.125(2m)(b)
"Patient health care records" means all
records related to the health of a patient
prepared by or under the supervision of a
health care provider
Wis. Stat. sec. 146.81(4)
Note: It is the content of a record that determines its
category (i.e., progress, behavioral, or PHC), not the title
of the record. A medical opinion, diagnosis or judgment
within an IEP or 504 plan makes that portion of that
plan a PHC record.
School nurse
Physical therapist
Dietician
Athletic trainer
Occupational therapist
Occupational therapy
assistant
Speech-language
pathologist
Professional counselor,
psychologist, & social
worker licensed or
certified by Dept. of
Safety & Professional
Services (formerly
DRL)
Pupil physical health records include
immunization records, an emergency
medical card, a log of first aid & medicine
administered, an athletic permit card, a
record concerning ability to participate in an
education program, lead screening records,
results of routine screening test (hearing,
vision or scoliosis & any follow-up to such
test).
Wis. Stat. sec. 118.125(1)(cm)
Governed by Wis. Stat. Ch. 146, as well as Wis.
Stat. sec. 118.125 & FERPA
Security provisions of HIPAA apply if school is
directly billing Medicaid
Higher level of confidentiality & more
requirements
Schools must limit access to PHC records that are
not relevant to provision of instruction & services
Record of access by anyone must be kept
Parents must be given written statement of who
has access to their child’s PHC records
Maintenance of records
Custodian of PHC records should be health care provider
No specific guidelines for maintenance following graduation
(5-7 years recommended)
Note: Immunization records must be maintained for a
minimum of 5 years after a student graduates or leaves
school
Significant penalties in the law for unauthorized
disclosures
Fines for unintentional disclosures
Discipline & termination of employment
Transfer of records
Should always transfer PHC records that
originate in the school – Wis. Stat. 118.125(4)
OK to transfer community mental health &
AOD treatment records – Wis. Stat. 51.30(4)
See handout Confidentiality of Mental Health Treatment.
Get informed consent to transfer PHC records
that originate outside the school
More restrictive interpretation is not to forward these
records
Release forms
Consent to release PHC records must include
more information than for behavioral &
progress records
Types of health care providers making the
disclosure
Date on which the consent is signed
Time period during which the disclosure is
effective
State law authorizes these disclosures
Immunization records to DHS
Lead screening records to state & local health
officials
Wis. Stat. sec. 118.125(2)(h), (hm)
FERPA does not allow these disclosures without
consent
Both state & federal law do allow disclosures
without consent to protect health & safety in an
emergency
Wis. Stat. sec. 118.125(2)(p); 34 CFR 99.31(a)(10), 99.36
1. Create a single release form that includes all of
the necessary information to release PHC
records & use that form for all pupil records
(Question #8 – Student Records & Confidentiality)
2. Obtain copies of community health care
systems’ (e.g., clinics, hospitals, treatment
facilities) release forms & use them when you
want to obtain PHC records from these systems
3. When obtaining PHC records from health care
providers, be sure the release form specifies
disclosure to all necessary educators, whether
they are health care providers or not (e.g., IEP
Team, staff involved in evaluation and/or
program development/implementation)
Note: Patient health care records may be redisclosed without
additional parental consent, if the redisclosure is limited to the
same purpose for which the patient health care record was
initially received [Wis. Stat. sec. 146.82(5)(c)3.]
4. View PHC records in the medical records
department of the health care institution as an
alternative to obtaining copies
• This strategy may help reluctant parents
5. Ensure that all reports/records created within
your schools that contain PHC information only
include information that is necessary to
provide instruction & services
6. Develop a local policy to determine if PHC
records that originate outside of the school
will:
Be transferred to the next school district with
informed consent of the parent/guardian or adult
student, or
Not be transferred to the next school district
If the school district is not transferring, good practice is
to notify parent/guardian/adult student in order for the
family to provide consent for the original health care
provider to release the records to the next school district
7. Store PHC records that include information that
is not necessary for instruction & services
separate from other pupil records & in the
custody of a health care provider
• You may destroy pupil records no longer needed
• Need to notify parents first if SPED records
8. When pupil records are transferred to another
school district, you may wish to maintain a
copy of the PHC records for liability purposes
9. Record access by staff & parents to all pupil
records, rather than just PHC records
10.Provide training to staff on access to the
different kinds of pupil records
• Required for staff handling SPED records
34 CFR 300.623(c)
• Provide more intensive training for gatekeepers
11.Use gatekeepers to prevent inappropriate
access to more sensitive records
What other questions do you have
about health care records in
schools?
