Town Pediatrics is committed to ensuring the highest quality of care for all of our patients.  When it comes to adolescent care, we are particularly mindful of their special needs as they transition to adulthood.  It is at this stage of their lives that we create an environment in which confidentiality becomes an important part of their care.  

Why does confidentiality matter?

According to research:

• Adolescents are more likely to discuss high-risk behaviors if they believe their care is confidential.
• Adolescents answer confidential screenings more honestly.
• State and national laws allow minor to receive confidential care related to sexual health, mental health, and substance abuse.

Policies & Best Practices:

In order to abide by state/federal law and to respect the rights of our adolescent population, Town Pediatrics has put in place Protocols and Workflow, based on state/federal laws and guidelines by prestigious associations like American Academy of Pediatrics and Society for Adolescent Medicine.   

Our protocols also stress the importance of not only setting up a relationship with teens but with parents as well.  

Laws:

• Minor consent laws allow adolescents to consent to specific health services without parental involvement.
• Vary by state.
• According to Virginia law, adolescents have the right to confidentiality around the following issues:  Birth control/contraceptives, family planning, pregnancy testing, prenatal care and pregnancy services.  Testing and treatment for STI or any infectious or contagious disease that the State Board of Health requires to be reported.  Medical or health services needed in the case of outpatient care, treatment, or rehabilitation for substance abuse.  Finally, medical or health services needed in the case of outpatient care, treatment or rehabilitation for mental illness or emotional disturbance.  You have the right to review and access your health records as it relates to the above.   

Policies:

• Set by health centers or institutions (Town Pediatrics has policy in place.)

Best practices:

• Based on research, studies show that when teens are assured of confidentiality, they seek health care more often and are more honest with their provider.
• Allows to the discretion of provider and/or staff.

Parents as Partners; A shared framework of Understanding:

• Parents/guardians can have a valuable role in their child’s experience as an independent health care consumer.
• Parents/guardians are experiencing their own adjustment to their child’s adolescence.
• We have an opportunity to educate parents about the value of confidentiality in the provider-patient encounter.
• How do we Talk to Parents?  A sample script: “As teens begin to develop into adults and take responsibility for their lives, we always ask parents/guardians to wait outside for part of the visit to encourage the teen to discuss their own view of their health.”

How do we talk to teens?

Best practice: Rights and Limitations

• Inform adolescent patients about their rights and limitations regarding confidentiality laws and procedures.
• Many teens do not know that they have the right to access “certain” services without a parent/guardian’s consent.
• Adolescents are more likely to disclose sensitive information if they have an assurance of confidentiality from their provider.
• The adolescent should be informed that confidentiality does not apply if:  the provider suspects that that an adult or other adolescent is hurting you.  They tell the provider that they want to hurt themselves.  They tell the provider they want to hurt someone else.  In other words, if they are a danger to themselves or others or if they are in eminent harm from someone else.  The provider always has the right to use discretion.    

Best practice: Insurance and Confidentiality

• Inform adolescent patients that if their insurance is billed for a service, that an Explanation of Benefits (EOB) may be mailed to their parent/guardian.
• Provide referral information for free or sliding scale clinics to adolescent patients who do not want to use their parent/guardian’s insurance.

Town Pediatrics Protocol/Workflow:  

• Town Pediatrics Protocols/Workflow is based on State/Federal Law along with guidelines from AAP and best practices noted above
• We require all providers and staff to view a 60-minute video training session on pediatric and adolescent patient HIPAA rights/violations.  
• Town Pediatrics has displayed a brief explanation of the Adolescent Confidentiality Policy on our website.
• During the 12-year-old Well child exam, the provider will introduce the policy of Adolescent Confidentiality with the parent/patient and provide a copy of the policy.   This will allow time for  the provider to answer questions and ensure understanding of protocol for future well child exams.  

• At the 17-year-old Well Child exam, the adolescent will be educated to their rights for release of information/confidentiality at 18 years. They will be told that an authorization/release of information form will need to be completed and turned into Town Pediatrics for any information to be released to anyone other than themselves.  *Town Pediatrics has a dedicated form to be completed.