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Law denies parents access to their children’s medical records

Lisa Bourne Lisa Bourne Follow Lisa

CORALVILLE, Iowa, January 29, 2019 (LifeSiteNews) — An Iowa father has been advised he no longer has access to his daughter’s medical records now that she has turned 12 years of age and the hospital policy – tied to federal law – has raised a red flag regarding parental rights.

“As a parent, I was really concerned,” Kevin Christians told the local ABC affiliate. “I really can’t understand why they would implement this policy.”

Christians received a letter from the University of Iowa Hospitals and Clinics (UIHC) informing him he was losing access to his daughter’s records and asked KCRG-TV to investigate.

"We believe that children at this age should take a more active role in their own health care and have a choice to keep some information private," the letter says.

What the letter doesn’t say is that the hospital’s practice of mandating medical privacy for adolescents, even from their parents, is actually in keeping with federal law, though implementation is largely left up to the individual states.

The law, enacted in 2002, derives from of the Health Insurance Portability and Accountability Act (HIPAA) passed by Congress in 1996.

According to the Department of Health and Human Services (HHS), the HIPAA 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.”

There are three scenarios where the parent would not be the minor’s personal representative under the Privacy Rule; when the minor consents to care and parental consent is not required by state law, when the minor is receiving court-ordered care,

and when the parent agrees to the minor and the health care provider having a confidential relationship.

Even given these exceptional situations, the Privacy Rule states, the parent may have access to the medical records where state law allows, but likewise the parent is blocked if state law denies parental access.

In cases where state or other applicable law is silent on a parent’s right of access, the health care provider can determine whether a parent is granted or denied access to their child’s medical information.

Medical providers can also choose not to treat a parent as a personal representative if they believe the child “has been or may be subjected to domestic violence, abuse or neglect, or that treating the parent as the child’s personal representative could endanger the child.”

The Iowa Department of Public Health offers guidelines, the KCRG report said, but neither those guidelines nor Iowa law stipulate the age when adolescence begins.

In addition to the University of Iowa Hospitals and Clinics in Iowa City, Mercy Medical Center and Unity Point’s St. Luke's Hospital in nearby Cedar Rapids have set the age where parents can be barred from their children’s records at 12, according to KCRG.

Another Iowa hospital, Mercy in Dubuque, has the age at 18, and the station found one medical provider in New York, the Institute for Family Health, that cuts parents off from medical their kids’ records as young as age 10.

A UIHC spokesman said that because of concerns expressed the policy is under review.

“We’ve listened to the concerns of parents and recognize that perhaps we need to perhaps make some changes,’ Tom Moore said.

As it stands right now, parents are still barred from access to most of their children’s records as of the child reaching age 12 even if the child consents to access.

“Less information about visits, fewer options for messages,” Moore said, listing some things for the news station, “and the billing history, though, remains the same.”

Moore upheld the essence of the UIHC’s current rule, saying one reason it’s warranted is that doctors want a child to be comfortable divulging whether they’re engaged in risky behavior, such as being sexually active, or using illegal drugs or alcohol.

“In some circumstances where there’s something of a sensitive nature that a patient wishes to discuss confidentially with their provider this provides an opportunity for those patients to have those conversations and know that they won’t be shared with others,” he said.

Moore told The Gazette the review is not finished yet, and UIHC plans to share a revised practice in the coming months.

The UIHC policy inhibiting parental access at age 12 has been in force since 2010, the Gazette report said, when UI Hospitals and Clinics implemented access to the online health management tool MyChart.

The tool lines up with state laws giving health care privacy to adolescents, according to Moore, who also said UIHC follows the American Academy of Pediatrics (AAP) recommendation about protecting adolescent patient confidentiality. 

The AAP supports contraception and abortifacients for adolescents, opposes parental consent laws on abortion, and has also said children as young as 14 can decide they are the wrong sex and consent to controversial sex reassignment treatments.

“University of Iowa Health Care takes very seriously ensuring that adolescents feel that they are able to have private conversations with their physicians and other health care providers,” Moore said, “especially those who seek certain sensitive services or types of care, such as substance abuse counseling, testing for sexually transmitted diseases, etc.”

Christians told KCRG that denying parents access to their children’s medical records makes parenting harder and shuts down communication between parents and kids, and he hopes Iowa legislators will act to give the situation more clarity.

“I think there should be dialogue,” he said, “and I think in this case they’re limiting that dialogue that I can have as a parent with my child.”

"If you get locked out of being able to see the health care records for your child that makes parenting even that much more difficult in my opinion," said Christians.

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