School social workers must be knowledgeable of the ethical principles and codes of professional conduct described in the National Association of Social Work’s Code of Ethics. In addition, because the CSDE certifies school social workers as educators, they are also bound to the State of Connecticut’s Code of Professional Responsibility for Teachers (appendix D). Finally, as school employees, school social workers must comply with the Family Educational Rights and Privacy Act (FERPA) and the Health Insurance Portability and Accountability Act (HIPAA). Due to the obligations these professional conduct codes, statutes and regulations impose, a school social worker must balance the systemic needs of the school with the privacy needs of students served. Ethical codes may be broad and may not pertain to all situations, leaving social workers with the responsibility of using their professional judgment in keeping with the standards of the profession. In this section addressing ethical issues confronting school social workers, particular attention will be paid to matters of privacy and confidentiality. Due to the nature of collaborative communication present among school staff and the necessity to meet the varied needs of a school’s student body, school social workers will often be confronted with conflicting needs arising from a student’s disclosure. Striking a balance between protecting student privacy and confidentiality, while remaining an important source of contextual information for other school staff, is a necessary responsibility for school social workers.
It is illegal to disclose strictly confidential information without specific written request. Such information includes a diagnosed learning disability, previous status as a special education student, any other type of diagnosed physical or mental disability, a diagnosed medical condition, use of prescription drugs, history of drug/alcohol abuse and/or treatment, HIV/AIDS status, and official transcripts, including GED scores.
Confidentiality of student information is based on legal and ethical precepts derived from constitutional law, federal and state mandates related to health and education, and social work ethical standards. See NASW, Code of Ethics, 1996; NASW Position Statement: The School Social Worker and Confidentiality, 1991. The general rules addressing disclosure of student information include:
- The right to privacy
The right to privacy is founded on federal and state constitutional law, statutes, common law principles, and the belief that personal information belongs to the individual who has the right to decide whether that information should be disclosed to others.
Family and student privacy: Student health information that any school personnel have recorded and health information that outside health care providers have provided to the school are considered “education records” within the protection of FERPA.
- FERPA, a federal law, protects the privacy of students and parents by restricting access to, and protecting the confidentiality of, education records. FERPA defines specific rights of parents and students who are 18 years or older regarding their access to, and the confidentiality of, education records. FERPA applies to public schools and other education agencies that receive federal funds.
- HIPAA privacy rule. The HIPAA privacy rule governs how health care providers use and disclose “protected health information.”
As FERPA protects health information in a public school education record, HIPAA’s privacy rule specifically exempts it. Even though HIPAA generally does not govern public school health records, school social workers need to be aware of HIPAA regulations and how the privacy rule affects their ability to obtain protected health information from outside providers for their students. Such disclosures generally require proper authorization to release the information to schools.¹ Only the parent or guardian of a student or students themselves if they are 18 or older can provide such authorization. Urgent or emergency situations allow sharing of essential information with emergency responders assisting the student in question. Depending on the level of care emergency responders need to provide, this might include information such as current medications, ongoing or recent treatment, and other necessary medical or psychiatric information that privacy and confidentiality laws might otherwise protect.
- Provider-client confidentiality
A confidential communication to a school social worker made in the context of a client relationship should not be revealed without the consent of the client (i.e., student), unless required by law. The belief that a client is more likely to disclose all the relevant information necessary for proper diagnosis and treatment if he or she knows that private facts will be held in confidence was derived from practice in the medical profession. This concept guides the practice of maintaining confidentiality of verbal communications and forms the basis for the client-confidentiality standards incorporated into:
- the social work ethical codes of practice;
- standards for health care institutions and agencies;
- relevant state mandates, including a minor’s right to seek treatment for certain conditions, and common law principles; and
- relevant federal statutes and regulations regarding treatment, counseling or assessment and referral law principles of persons, including students, who are receiving alcohol and drug abuse services.
In the course of their responsibilities, school social workers have access to confidential student and family information. They have a responsibility to ensure that such information is maintained according to the ethical and legal standards of confidentiality. As certified personnel, school social workers’ requirements to adhere to confidentiality are governed by the same codes of professional conduct as are teachers and school administrators (State of Connecticut’s Regulations Concerning State Educator Certificates, Permits and Authorizations, Sections 10-145d-400a and 10-145d-400b). In addition, there are state and federal laws that restrict the disclosure of specific information, such as the HIV or substance-abuse status of a student.
- Privileged Communications
Although certification is the only requirement to practice in schools, many social workers are also licensed as clinical social workers (LCSW) by the Department of Public Health (DPH). Established through specific state statutes, privileged communication is the right of the client in a judicial proceeding to exclude from evidence confidential communications made to a social worker in the course of diagnosis or treatment. In Connecticut, statute prohibits LCSWs from disclosing confidential communications without the explicit consent of the client, except in specific circumstances (Connecticut General Statutes (C.G.S.) Section 52-146f [see appendix J]).
Confidentiality Practices Within Schools
Under FERPA, school officials may disclose personally identifiable information from an education record to other school personnel who have a “legitimate educational interest.” FERPA includes many requirements for safeguarding student information. Nondirectory information about students may only be disclosed — unless otherwise prohibited by law — to other school personnel who have a legitimate educational interest. School officials may only disclose or re-disclose information that is necessary to provide appropriate services to a student. Information about one student may not be disclosed to another student or another student’s parent unless such disclosure is necessary to protect the health and safety of others. Finally, the school district must provide its policy regarding confidentiality of student information to students and parents each school year.
Although not explicit in FERPA, school personnel should employ the following practices regarding confidential student information:
- Discussions concerning confidential information should take place in secure locations.
- Confidential written documentation or notes of oral confidential communications should be marked “confidential” and stored in secure locations. When in use, such documentation should be shielded from the view of others and should not be left unattended.
- Confidential information should not be left as a message with a secretary, on a voice mail or on an electronic mail system.
- Confidential information that must be mailed or carried should be placed in an envelope marked “Confidential.”
- Confidential information to be discarded should be shredded or otherwise disposed of securely.
Confidentiality Practices Among Agencies
Appropriate practices related to confidentiality between school personnel and another institution, such as a school-based health center or community mental health center include, but are not limited to, the following:
- School officials must obtain prior written consent of the parent or, where applicable, the student, before requesting from or disclosing to representatives of outside institutions or third parties any student or family information unless otherwise allowed by law.
- It is acceptable to discuss the situation of a particular student with outside professionals, (e.g., professional development, LCSW supervision and case consultation) if this communication is conducted in a manner that protects the identity of the student and the family (e.g., by withholding the student’s name, address, birth date, and other identifying data). In other words, relevant information must be presented in a manner that is reasonably calculated to ensure that the identity of the student cannot be determined. Furthermore, information should be disclosed only to the extent necessary to fulfill the purpose of the professional consultation.
- Confidential information received by the school that was not requested or is not needed should not be made part of the student’s record, and should be returned to the sender or shredded. The school district should notify the parent if this occurs.
An outside party, such as a private health care provider, must obtain proper authorization to disclose protected health information to schools. Such authorization must contain the core elements specified in the HIPAA privacy rule.
Exceptions to the General Rules Prohibiting Disclosure
School social workers are faced with ethical dilemmas when ethical principles and the laws converge, when the needs of their client systems (school, student and families) diverge, or when colleagues are unaware of the ethics and practice standards of the social work profession. The particulars of a situation may require expert clinical judgment to determine whether or to what extent, confidentiality should be maintained. To minimize such potential conflicts, social workers are encouraged to work collaboratively with school administrators to develop written policies and procedures concerning confidentiality, as well as professional development opportunities, so that all building staff members are kept informed. Furthermore, it is important to educate students and their parent or legal guardians about their confidentiality rights and the limitations of such rights.
There are instances when maintaining confidentiality is not appropriate:
- Written consent: Confidential information may be disclosed to designated individuals when informed, prior written consent is obtained from the parent, legal guardian, surrogate parent or when appropriate, from the student. The consent may limit the information to be disclosed and the time to which it is applicable.
- Health or safety emergency: Confidential student information may be disclosed without consent when a student is, or others are, in danger of imminent harm. If the school district determines that there is a clear and significant threat to the health and safety of others, it may disclose information from education records to any person whose knowledge is necessary to protect others. A health or safety emergency generally refers to the high probability of suicide, homicide or risk of a life-threatening injury, condition or illness.
- Abuse: Pursuant to C.G.S. Section 17a-101, school social workers are mandated reporters of suspected child abuse. Instances of suspected child abuse and neglect or imminent danger of abuse must be reported as required by law.
Personal Notes and Confidentiality
Social workers may maintain personal notes on students separate from the official student record as a personal memory aid when the following conditions are met:
- the notes are in the sole possession of the social worker; and
- the notes are not accessible nor the content revealed to any other person.
If the content of the notes is discussed with others, the notes lose their “sole possession” status and they become part of the student’s permanent record. As with all confidential materials, personal notes should be kept in a secure location.
1. HIPAA includes provisions for allowable disclosures by health care providers under certain circumstances, including, but not limited to, treatment, public health, state law, and child abuse.