There are a number of states that provide the privilege in cases like this. And yes since the holder is the communicant then the clergy is bound by it. If the communicant wants to lift the privilege then the clergy member has no longer any privilege to keep it quiet. Again that is why in the Conti case Simmons ask Kendrick's Ex Wife and Step Daughter if they wanted the communication to be kept private, because he knew that the privilege would still apply unless they somehow can prove that they lifted the privilege.
And like you brought out what a ministers sees with their own eyes that is not privileged. Such as in the Fessler case, even though the father was an elder, he found out about the abuse as his role of a father not as an elder.