HIPPA violation??

[RFRN]

Working in a clinic, this may not be something that everyone else deals with but what would you do if you had a minor teenager come in for their annual exam and the MD did a GC/Chlamydia and pregnancy test on the patient then the parent calls for test results? What I have heard from other nurses is that you cannot tell the parent these results but I have never heard of a HIPPA regulation for specific test results. If they are the patient's legal guardian, do they have a right to these results? Anyone have any thoughts?

I have also been told by other nurses that once a teenager becomes pregnant, that patient is legally emancipated, which I'm not so sure is true. Let's say you have a pregnant 16 year old - can you discuss any test results with their parent?

[blondy2061h, MSN, RN]

Pretty sure you mean emancipated and not emaciated. If they are medically emaciated they have other issues and likely can not become pregnant.

Lol, I just came back to this page to fix it realizing what I had typed. Of course someone had to catch it and quote it before I fixed it!

[Hospice Nurse LPN, BSN, RN]

Lol, I just came back to this page to fix it realizing what I had typed. Of course someone had to catch it and quote it before I fixed it!

Scott is just to fast!

[edrnbailey]

"This varies state to state ... and the only answer that matters to the OP is the one that applies to his/her state. Ask someone in your department if you are unsure."

This does vary from state to state. It is more than just a HIPAA violation or the possibility of one. The state I currently practice in addresses this in the code of laws for the state. It is actually illegal to render certain types of medical care without parental consent to a minor, which is defined as anyone under the age of 18. If you are uncertain of what the laws and regulations are in your state then contact your BON or you can search the state's code of laws regarding medical care and treatment for minor patients..

Hope this helps !!!!!!!!

[AgentBeast, MSN, RN]

Scott is just to fast!

That's what she said!

Damn I shouldn't do that too myself!

[sparklie.lady]

It might be a not be a HIPPA violation, but in my state, telling the parents would definitely be a crime under HIPAA :)

[Esme12, ASN, BSN, RN]

that's what she said!

damn i shouldn't do that too myself!

i'm gald you're back..... i had previously done something for my ed. the best advice is to check with your state as nuaces vary from state to state.

the area of medical treatment of minors is still controversial, especially as it relates to certain procedures and conditions such as abortion and sexually transmitted diseases. many states grant minors broad leeway to determine the course of their medical treatment, and others grant them very few rights. there is little agreement by either medical professionals or state lawmakers as to how far minor rights should go regarding medical treatment.

what is at issue in the debate over minor rights to medical treatment is a tension between the parental responsibilities toward the child, the immaturity and vulnerability of children, and the child's right to be emancipated from the decision of the parent. this tension has produced a patchwork of laws and makes it difficult to make any overriding statements about minor and parental rights in regard to medical treatment.

the general rule is virtually always the case regarding any sort of medical treatment before the minor enters their teenage years—no state or court has ever authorized minors younger than 12 to make any sort of medical decision for themselves. but after the minor becomes a teenager, states begin to digress in terms of the responsibility the minor can take for medical decisions. exceptions have been carved out for various medical procedures that allow teenage minors to make their own healthcare decisions.

informed consent

the crux of the debate over the treatment of minors is the doctrine of [color=#2393bd]informed consent. a person must offer informed consent to any medical treatment given to them, or the physicians involved can risk legal liability. informed consent has always been a crucial part of the doctor-patient relationship, and has been viewed by courts as a fundamental right.

but in the case of children, the question is, can they offer informed consent, or does that informed consent have to be provided by their parents, who may be seen as more capable of making a knowledgeable decision on a subject as important as medical care. beyond this simple question are an important set of underlying questions, pertaining for example to the age at which a child may become capable of informed consent, and whether there are certain procedures in which informed consent is more important than others.

states that require consent before a minor may have an abortion include alabama, indiana, kentucky, louisiana, massachusetts, michigan, mississippi, missouri, north carolina, north dakota, pennsylvania, rhode island, south carolina, tennessee, wisconsin and wyoming. states requiring notification before a minor's abortion include arkansas, delaware, georgia, idaho, iowa, kansas, maryland, minnesota, nebraska, ohio, south dakota, texas, utah, virginia and west virginia.

also, because the supreme court rulings, states that do not explicitly allow minors to obtain contraceptive and prenatal care services without parental consent still must permit this to happen in practice, as the court has ruled that these are services that are covered by the minors' right to privacy. however, states can still impose limitations on minors' ability to obtain these services, based on factors such as age, marriage status, medical condition or who referred the minors for treatment. in addition, two states—utah and texas—prohibit the use of state funds to provide contraceptive services to minors without parental consent.

emergency

all states allow parental consent for treatment of a minor to be waived in the event of a medical emergency. the circumstances that should be present in order for such an emergency include the patient being incapacitated to the point of being unable to give an informed choice, the circumstances are life-threatening or serious enough that immediate treatment is required, and it would be impossible or imprudent to try to get consent from someone regarding the patient. in these cases, consent of the parent is presumed, since otherwise the minor would suffer avoidable injury.

sexually transmitted diseases

every state currently allows minors over the age of 12 to receive testing for sexually transmitted diseases, including hiv, without parental consent. most of these states allow minors to receive treatment for all sexually transmitted diseases without parental consent; however, three states—california, new mexico, and ohio—as of 2002 do not allow minors to receive treatment for hiv without parental consent. one state, iowa, requires that parents be notified in the event of a positive hiv test. many states allow doctors to notify the parents of the results of tests and treatment for sexually transmitted diseases, though they do not require the doctor to get a consent.

status

in addition to making exceptions to the general rule requiring informed consent for specific medical treatments, states will often allow minors to consent to medical treatment on the basis of their status— whether they are considered emancipated from their parents. most states determine a child has reached the age of majority and is emancipated from his or her parents upon reaching the age of 18, although in alabama and nebraska, 19 is considered the age of majority, and in pennsylvania it is 21. mississippi has the age of majority at 21, but 18 as the age of consent for health care decisions.

beyond age, courts can declare a minor emancipated from their parents and thus able to issue consent, if they meet certain conditions, including self-sufficiency, living separate and apart from the parents, receiving money from a business activity not related to the parents, and proven capability of managing their own affairs. married and divorced minors are often considered automatically emancipated, as are minors on active duty with the armed forces. in addition, minor parents are allowed to make medical decisions for their children. in 29 states and the district of columbia, this consent is explicitly authorized.

the mature minor doctrine

the "mature minor" doctrine provides for minors to give consent to medical procedures if they can show that they are mature enough to make a decision on their own. it is a relatively new legal concept, and as of 2002 only a few states such as arkansas and nevada have enacted the doctrine into statute. in several other states, including pennsylvania, tennessee, illinois, maine and massachusetts, state high courts have adopted the doctrine as law.

in the states where it exists, the mature minor doctrine takes into account the age and situation of the minor to determine maturity, in addition to factors and conduct that can prove maturity. the arkansas statute states, "any unemancipated minor of sufficient intelligence to understand and appreciate the consequences of the proposed surgical or medical treatment or procedures, for himself [may offer consent]." the standard is typical of the requirements of the mature minor doctrine.

the mature minor doctrine has been consistently applied in cases where the minor is sixteen years or older, understands the medical procedure in question, and the procedure is not serious. application of the doctrine in other circumstances is more questionable. outside reproductive rights, the u.s. supreme court has never ruled on its applicability to medical procedures.

confidentiality of medical records

states that allow minors to consent to certain medical procedures often provide for confidentiality from parents in regard to those medical procedures. however, this is not always the case. many states allow the doctor to inform parents of medical procedures, and some states require parental notifications about specific medical procedures done on minors even when the minor has given consent.

the health insurance portability and accountability act (hipaa) of 1996 (p.l.104-191)

[tainted1972, ASN, RN]

I am in Ohio. My experience comes from being a mother of teenage girls... oh the horror!

anyway, I took my daughter to planned parenthood to get on birth control, I signed all of the forms, gave them my insurance info etc... I also told my daughter that she could utilize their service without me and I encouraged her to do so.

My daughter(16) went through a period where she was running away to be with a boy she felt was the "one". I was able to get a message to her to remind her that she was due for her depo shot and that she needed to go to the clinic.

She told me that she had an appointment on such and such day/time. I called the clinic to verify what she had told me because I had very good reason to believe she was lying to me. The clinic would not give me any information whatsoever regarding my daughter. All I wanted was a confirmation that she had an appointment. They spouted of HIPAA policy so I asked some questions. Basically I was told that I have absolutely no say so when it comes to her sexual health and I cannot be told anything. I also learned that if she were to become pregnant it would be my responsibility to take care of her, but I could not "know" anything. It is very frustrating as a parent to not be able to be involved in health care of your teenager.

BTW.. my daughter dumped her boyfriend, kept her appointment and is no longer running away. end rant :)

Anyway, the parents of the teenager cannot and will not know the results of those tests unless their daughter tells them.

[rjflyn, ASN, RN]

Its really weird when you get a minor with a child it the ER, some states automatically emancipate them but others dont. So you get instances where you have a minor consenting for treatment for a minor ie their baby, then their parent is consenting for treatment for them as they are seeking care for something not related to sexual or pregnant health.

[NeoPediRN]

Nope, parents do not have the right to information regarding their underage child's pregnancy.

[CAPPYBARA BREAKFAST]

In Georgia, pregnancy does not equal emancipation. The parents are still in control of medical care of the minor. The pregnant minor only has control of decisions about care associated with her pregnancy and unborn child.

[mamabaer439]

While I understand the reason behind the HIPAA laws, it frustrates me that they have taken parents out of their children's health care. I don't think that this was part of the original intent.

On another note about HIPAA, I was recently released from a job for a "HIPAA" violation because I handed one patient a phone number from another patient, with the second patient's consent. Who would have thought? And is a phone number really part of a patient's protected health information? They were just looking for an excuse, I think.

[sunshine1216]

I currently work in Labor and Delivery full time and a Pediatricians office per diem. In the peds office when we test for any STD no we can not give parents results. We get the girls cell numbers usually and give them the results. Once I called a 16 year old girl to inform her she had chlamydia and her mom answered her phone. She could see it was the dr on the caller ID. She was very upset that I could not tell her why I was calling. And yes once girls have a baby they are emancipated.