TPC Journal-Vol 10- Issue 1

The Professional Counselor | Volume 10, Issue 1 111 and other institutions where a student may be transferring. If a counseling student is dismissed for causing harm to clients, it is within the bounds of FERPA for program faculty to share that information with faculty where the student is applying for admission. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) It is important for online counselor educators to be fully informed on HIPAA regulations as they relate to technology. These regulations provide protections for confidential and protected health information and are commonly referenced in the modern health care lexicon. With relation to training, online counselor education students and faculty frequently use various forms of software or other communication technology to communicate about client issues in practicum or internship classes and supervision sessions. It is not within the scope of this article to cover every aspect of technology and client personal health information (PHI) as defined by HIPAA. This section will focus specifically on the utilization of videoconferencing software (e.g., FaceTime, Skype, Zoom) to hold class and supervision sessions, which are often the primary ways distance faculty, supervisors, and students meet. First, a key principle to understand in any discussion of HIPAA is that the user (e.g., faculty, supervisor, student counselor) is responsible to maintain compliance with HIPAA regulations. Videoconference software companies that counselor educators and supervisors choose to use could be considered business associates. Business associates are contractors who handle PHI of clients and have agreed to uphold HIPAA regulations. There is no clear guidance on the need for business associate agreements for videoconferencing software. Some researchers have said that it is necessary for videoconferencing providers to have business agreements (Rousmaniere et al., 2016). Others have suggested that videoconferencing software falls under the HIPAA conduit exception (Caldwell, 2019). The conduit exception allows service providers to transmit or transport PHI without entering into a business agreement (Office for Civil Rights, 2016). To be eligible as a conduit, software providers must not store the data and may only transmit it (Taylor, 2015). Generally, videoconferencing software companies do not store any transmissions on their servers (Caldwell, 2019). FaceTime, Skype, and Zoom, for example, provide end-to-end encryption to create a peer-to-peer connection. It is not possible for them to decrypt the data as it goes from the device of the supervisor to the student. Therefore, given that no data from a supervision session or class is being recorded, the argument has been made that a business associate agreement is not necessary to use these platforms (Caldwell, 2019; Taylor, 2015). Recordings of supervision sessions or classes should not be saved to cloud services unless there is a business agreement in place, as now the company will be potentially storing PHI. As a reminder, it is still up to the faculty and student to be HIPAA-compliant when they use technological tools. Talking about a client over Facetime while in a coffee shop is still not considered HIPAA-compliant. Technology moves swiftly. For example, Amazon has recently equipped their Alexa devices to handle PHI and has begun signing business agreements with select health care providers (Jiang, 2019). But there is little in terms of policy, law, or ethics to address anecdotal reports that the Amazon Alexa device is recording conversations in homes and therefore likely in offices where it is used. For the online educator and student, that could mean that a piece of technology intended to make home life easier creates a HIPAA or FERPA violation if portions of classes or client sessions are recorded. We anticipate this technology, and thus the policies, laws, and ethics that govern its use, will continue to develop. At this point, it is recommended that these devices not be in homes or offices where counselor education or supervision occurs.