Disclosing a minor’s PHI involves careful consideration of both HIPAA regulations and state-specific laws. While parents generally have the right to access their child’s health information, exceptions exist that empower minors to make certain healthcare decisions and control access to their PHI.
Parental rights and access to PHI
In most cases, parents or legal guardians have the right to access their minor child’s PHI because they are typically responsible for their child’s healthcare decision-making. According to the HHS, “The Privacy Rule generally allows a parent to have access to the medical records about his or her child, as his or her minor child’s personal representative when such access is not inconsistent with State or other law.”
Read also: How does HIPAA apply to minor patients?
Exceptions to parental access to a minor’s PHI
Minor’s consent to care
Under certain conditions, minors may consent to specific types of medical treatment without the need for parental consent. When this occurs, the minor gains control over their health information and parental access may be restricted. Common scenarios where minors can independently consent to care include:
- Reproductive health services (e.g., contraception, pregnancy care, abortion)
- Mental health services
- Substance abuse treatment
The laws governing this consent vary by state. In some states, minors as young as 12 or 13 can seek specific medical treatments without their parent’s involvement. In these situations, healthcare providers may be required to protect the confidentiality of the minor’s PHI, and parents may be excluded from accessing these records unless the minor gives explicit permission.
Court-ordered or judicially appointed care
When a minor receives healthcare under a court order or through an individual appointed by the court (such as in cases of abuse or neglect), parental access to the minor’s PHI may be restricted. The court may determine the scope of access, and the healthcare provider must adhere to the court’s directive.
Confidential relationship between provider and minor
Parents may agree to allow a healthcare provider and their minor child to maintain a confidential relationship. This often happens when minors seek therapy, mental health counseling, or other sensitive services. If the parent agrees to the confidentiality arrangement, they forgo their right to access the child’s PHI in these situations.
Emancipated minors
Emancipated minors are those who have legally been granted adult status before the age of 18, either through marriage, military service, or a court order. Once emancipated, these minors are considered adults under HIPAA and have full control over their healthcare decisions and their PHI, just like any other adult.
Healthcare providers are required to treat emancipated minors as independent individuals and cannot disclose their PHI to parents or guardians unless the minor consents.
See also: HIPAA Compliant Email: The Definitive Guide
Balancing confidentiality with parental involvement
The balance between a minor’s right to privacy and a parent’s role in healthcare decisions is complex because it involves safeguarding the minor's confidentiality in sensitive situations, while also recognizing the parent's legal and ethical responsibilities in overseeing their child’s healthcare. Healthcare providers must be diligent in understanding when they are allowed to disclose PHI to a parent and when they must protect the minor’s confidentiality. To ensure compliance, providers should:
- Stay informed about federal HIPAA regulations and any applicable state laws.
- Document consent: When a minor consents to treatment or confidentiality, this should be documented clearly in their medical records.
- Communicate with patients and families: Open, clear communication can help families understand their rights and the legal obligations of healthcare providers.
FAQs
How do state laws influence the disclosure of a minor's PHI?
State laws can sometimes grant minors more rights over their health information than HIPAA does. For example, in some states, minors can consent to mental health or reproductive services without parental involvement, and these laws take precedence over HIPAA. Healthcare providers must follow the most stringent laws applicable.
Can a healthcare provider disclose a minor’s PHI to protect them from harm?
Healthcare providers may disclose a minor’s PHI without parental consent if it is necessary to prevent imminent harm to the minor or another individual. For instance, if a minor is at risk of self-harm or poses a danger to others, a provider can share relevant PHI to protect them.
How can healthcare providers ensure compliance with both HIPAA and state laws?
Healthcare providers should stay informed about both HIPAA and state-specific laws regarding minors’ PHI. They should document all cases where minors consent to services independently, consult legal advisors if needed, and ensure that policies are in place to handle cases involving minors’ confidentiality.
Tshedimoso Makhene
