UNDERSTANDING CONFIDENTIALITY AND MINOR …

1 UNDERSTANDING CONFIDENTIALITYAND MINOR CONSENT IN CALIFORNIAAn Adolescent Provider ToolkitIllustrations by Jordan Zioni, 17 This toolkit can be downloaded from the following websites:Adolescent Health Working Group - Francisco Health Plan copies of the Toolkit may be requested via mail, telephone, fax or e-mailfrom:Adolescent Health Working Group323 Geary Street, Suite 418 San Francisco, CA 94102 Telephone: (415) 576-1170 x312 Fax: (415) 576-1286E-mail: Adolescent Health Working Group (AHWG) was formed in 1996 when adoles-cent health providers, administrators, and youth advocates in San Francisco becameconcerned about Medicaid managed care s impact on young people s access toyouth-sensitive, comprehensive health care.

2 Today, the mission of the AHWG is tosignificantly advance the health and well-being of San Francisco s youth by applyingthe collective wisdom, resources, and energy of individuals and agencies that carefor and support young people. The AHWG s activities include conducting commu-nity research, public policy advocacy, and training activities. Members of the collab-orative include representatives of youth development agencies; public and privateprimary care, behavioral health clinics and programs; academic institutions; healthplans; schools; social service and advocacy organizations; youth and Francisco Health Plan (SFHP) is a licensed community health plan providingaffordable health coverage to low and moderate-income families residing in SanFrancisco.

3 SFHP was designed for and by the residents it serves, many of whomwould not be able to otherwise obtain health care for themselves or their SFHP, members have access to a full spectrum of medical services, includ-ing preventive care, hospitalization, prescription drugs, family planning, and sub-stance abuse programs. SFHP's mission is to provide superior, affordable health carethat emphasizes prevention and promotes healthy living, with the goal of improvingthe quality of life for the people of San Francisco. M. Simmons, J. Shalwitz, S. Pollock (2002). UNDERSTANDING CONFIDENTIALITY andMinor Consent in California: An Adolescent Provider Toolkit.

4 San Francisco, CA:Adolescent Health Working Group, San Francisco Health TO OBTAIN A COPY OF THIS TOOLKITADOLESCENT HEALTH WORKING GROUPSUGGESTED CITATIONSAN FRANCISCO HEALTH PLANA dolescent Health Working GroupSan Francisco, CASan Francisco Health PlanSanFrancisco,CADear Colleagues:We are pleased to present you with UNDERSTANDING CONFIDENTIALITY and MINOR Consent inCalifornia: An Adolescent Provider is one chapter of a larger project, TheAdolescent Provider Toolkit, made possible through the generous support of TheCalifornia Endowment and our close collaboration with the San Francisco Health Plan(SFHP). The Toolkit contains resources to help health care providers better meet theneeds of adolescent list concerns about CONFIDENTIALITY as the number one reason they mightforgo medical care.

5 Ayoung person is more likely to disclose sensitive information if heor she is provided with confidential services and has time alone with the , providers indicate that they are mystified and confused by the various confi-dentiality and MINOR consent laws and about their reporting responsibilities. This toolkit,compiled by a multi-disciplinary group of lawyers, health care providers, and youthadvocates, strives to clarify these issues. Designed for busy providers, the Toolkit includes materials that you are free to copy anddistribute to your adolescent patients and their families or to hang in waiting and examrooms. In addition, we will soon have a link to an online CONFIDENTIALITY training on ourwebsite, which you will be able to access without would like to thank The California Family Health Council and the CaliforniaAdolescent Health Collaborative for their assistance with the printing and distribution ofthis you have questions regarding the Toolkit or its accompanying trainings and resources,please call the Adolescent Health Working Group at (415)

6 ,Marlo Simmons, MPH, Program CoordinatorAdolescent Health Working GroupJanet Shalwitz, MD, DirectorAdolescent Health Working GroupKaren Smith, MD, medical DirectorSan FranciscoHealth PlanWe would like to extend our sincerest thanks to members of the Toolkit AdvisoryCouncil for their time, energy, dedication and unwavering commitment to the health Brown, MSW New Generation Health CenterAmanda Goldberg San Francisco Unified School DistrictEric Hernandez, RD Child Health and Disability ProjectDavid Knopf, MSW MPH UCSF Division of Adolescent Medicine Nancy Lewis, FNP Huckleberry s Cole Street Clinic, SFDPHC aroline Miranda, LCSW New Generation Health Center Erica Monasterio, FNP UCSF Division of Adolescent MedicinePayal Patel SFGH Child and Adolescent Services, Department of PsychiatryPatricia Peretz Jewish Vocational ServicesMichelle Persha, MPH San Francisco Health Plan Naomi Schapiro, PNP Valencia Health ServicesAnita Shankar, MPH Health Initiatives For YouthKaren Smith, MD San Francisco Health PlanLisa Stone - SFGH Child and Adolescent Services, Department of PsychiatryKelly Wong, MD Pediatrician, Private PracticeWe would also like to thank the following individuals and organizations for contributionsof their experience, ideas.

7 And Allison Adolescent Health Working GroupRenee Cheney-Cohen Child Health and Disability Prevention ProgramNatalie CombsAbigail English, JD- Center for Adolescent Health and the LawRebecca Gudeman, JD, MPA National Center for Youth LawMary Isham, RNDan Leonard San Francisco HealthCorpsYoshiko OginoElizabeth Ozer, PhD UCSF Division of Adolescent MedicineJordon Zioni IllustrationsACKNOWLEDGEMENTSTHE ADOLESCENT PROVIDER TOOLKIT ADVISORY COUNCILThe Adolescent Health Working Group gratefully acknowledges The California Endowment forgenerously supporting the production of this TABLE OF CONTENTSC alifornia MINOR Consent Laws: Who Can Consent for What Services and Providers Obligations (Chart).

8 A-1 When am I Required to Report the Sexual Activity of Minorsto Children s Protective Services or Police in California? (Chart) ..A-2 CONFIDENTIALITY and MINOR Consent Q&A ..A-3 Mandated Reporting Q&A ..A-4 Checklist Is Your Office/Clinic CONFIDENTIALITY Conscious? ..A-5 Tips for Protecting Youth CONFIDENTIALITY in Your an Atraumatic Parentectomy ..A-7 Financing Sensitive Services: A Guide for Adolescent Health Care and CONFIDENTIALITY Tips for Teens ..A-9 Consent and CONFIDENTIALITY Letter from Providers to Parents and Guardians ..A-10 Caregiver s Authorization Affidavit Form ..A-11 Confidential Health Care for Adolescents: Position Paper of the Society for Adolescent Medicine.

9 A-12 Research on Providing Confidential Care to Adolescents (Summary)..A-13 Health information Portability and Accountability Act (Summary) Federal Policy Agenda: The HIPAA medical Privacy Regulations ..A-14 Internet Resources for Providers ..A-15 MODULEONE:Tips, Tricks,and ToolsResourcesAdolescent Provider Toolkit Adolescent Health Working Group, 2002** Please copy and distribute these handouts to teens and their caregivers. Spanish and Chinese versions are available online at or or by calling Health Working Group, 2002 Adolescent Provider ToolkitCALIFORNIA MINOR CONSENT LAWS Who Can Consent For What Services And Providers ObligationsMINORS OF ANY AGE MAY CONSENTLAWCONFIDENTIALITY AND/OR INFORMING OBLIGATION OF THE HEALTH CARE PROVIDERPREGNANCYCONTRACEPTIONABORTION A MINOR may consent to medical care relat-ed to the prevention or treatment of preg-nancy, except sterilization.

10 (Cal. FamilyCode 6925)A MINOR may receive birth control withoutparental consent. (Cal. Family Code 6925)A MINOR may consent to an abortion withoutparental consent and without court permis-sion. (American Academy of Pediatrics 16 307 (1997))A MINOR who has a condition or injurywhich is considered an emergency butwhose parent or guardian is unavailable togive consent is permitted to give consent formedical services. (Cal. Business andProfessions Code 2397)A MINOR who may have been sexuallyassaulted or raped may consent to medicalcare related to the diagnosis, treatment andthe collection of medical evidence. ( Code 6928) A physician and surgeon or dentist or theiragents.