parental status - ROI

  • 1.  parental status - ROI

    Posted 09-01-2020 05:46 PM
    Our speech and hearing clinic has recently had a number of incidents regarding parental status and custody issues and release of information rights. We are looking at adding a supplemental intake form to be filled out for minors so that staff can understand who they are permitted to speak to when girl/boyfriends of parents and stepparents bring in the child client and when custody battles are involved.

    The proposed supplemental content is below. One response is that it is too intrusive. I would like to hear opinions on this and if anyone has something similar.

    If client is a minor, who has legal custody of the minor?

    • Natural Parent(s) Mother: ________________________________  Father: _______________________________
    • Non-parental custodian
    • Foster parent
    • Other: ________________________________________________________________________________________


    Marital Status of Parents of the Minor:

    • Married
    • Widowed
    • Separated (complete section 1 below)
    • Divorced (complete section 2 below)
    • Never married (complete section 3 below)


    1. If separated, is there a parenting plan in place or a court order designating which parent has decision making authority for healthcare?
      ð No ð Yes   If yes, which parent has decision making authority of healthcare: _____________________________
      Do you have a copy of the parenting plan for us to keep on file?    ð  Yes    ð  No


    1. If divorced, the parenting plan gives decision making authority of healthcare to:
    • One parent. Name of parent: ____________________________ (written consent of this parent is required).
    • Both parents.

      Do you have a copy of the parenting plan for us to keep on file?  ð  Yes    ð  No


    1. If never married, name of natural mother: ______________________________
      Does the other parent have a court document granting decision making authority for health care? ð  Yes    ð  No
      Do you have a copy of the court document for us to keep on file?   ð  Yes    ð  No

    Supervision of Minor: Will there be another individual other than the child's parent/legal custodian, bringing them to appointments? 

    ð  Yes    ð  No

    If yes, what is their name and relationship?

    Name: ________________________________________ Relationship: _____________________________
    Name: ________________________________________ Relationship: _____________________________
    Note: Under state law, the clinic is limited on disclosing healthcare information to certain individuals without legal written authorization.

    Nicole Goodman
    University Compliance Manager/HIPAA Privacy Officer
    Western Washington University

  • 2.  RE: parental status - ROI

    Posted 09-02-2020 08:48 AM
    Edited by Anthony Ambrose 09-02-2020 11:33 AM
    Hi Nicole,

    You may look to state law. Act 147 in PA, which is specific to mental health services, conveys that whoever legally consents for the service is going to be the person that controls the record, from a privacy perspective.

    If a parent claims to have custody etc and they're not the parent that consented for the service, maybe that's when you begin to ask the type of questions that are in your form and/or collaborate with the consenting parent. As a parent of two school aged kids, I've never had to answer questions similar to those that are in your form for any of their many health related intakes.

    Anthony Ambrose, MBA, CHC, CHPC
    Compliance Officer
    Service Access and Management, Inc.
    Lewisburg, PA


  • 3.  RE: parental status - ROI

    Posted 09-02-2020 09:29 AM
    Need to clarify that it is not the individual who consents to services that controls the record. If you follow that as policy, you run the risk of getting in the middle of a nasty fight.

    The patient always controls their own record.  In the case of a minor or someone else without legal capacity, it is the individual(s) who have guardianship.  The default for minors is both of their parents unless a Court has stepped in and stripped one or both of them of such rights.

    Even if Parent 1 brings in the patient for the services, Parent 2 has full rights absent a Court Order saying otherwise.

    Scott Intner
    Chief Compliance Officer
    GW Medical Faculty Associates


  • 4.  RE: parental status - ROI

    Posted 09-02-2020 09:10 AM
    In general, it's not the custodial arrangement you are concerned with in determining which parent would have access to health information, or right to consent.
    It's whether either parent has had their parental rights terminated by the courts for some reason.  If neither parent has had parental rights terminated, then both parents have access to information and either parent could consent to services and treatment - barring some other type of restriction put in place by family services or the courts.

    Again, generally speaking, when there are terminations to parental rights, or restrictions on one parent, the other parent is typically quite forthcoming about that and will present documentation without being prompted.  In many cases, it's been an ongoing issue and the one with intact parental rights is wanting to protect their child.
    If a parent told us the other did not have a right to access or consent, we asked to see documentation.

    Amy Pendergast
    Sr. Compliance & Privacy Specialist


  • 5.  RE: parental status - ROI

    Posted 09-03-2020 10:05 AM
    When I have seen a form like this used in the past is for a step-parent or significant other to be able to bring the child to the doctor, have the office relay test results to the non-parent (for lack of a better word), and discuss the child's care/needs with the non-parent. It saved our clinics from getting caught in the middle of some nasty fights between the parents that might not want the step-parent/significant other having those rights. We would say the father/mother gave them permission to bring the child to the office, allow us to discuss the child's care/needs with them, etc., please take your objections to your ex.We would also ask if they had a court order that would prevent us from sharing this information with the other parent.
    The form helped to keep us out of the middle of family squabbles that didn't involve us. It allowed us to provide the best care to the child and speak with the person that brought the child in.

    [Deborah] [Dabbs] [MBA, CHC,CHPC, CHRC, MT(ASCP)SM]
    [Compliance/Privacy Officer]
    [Seminole Hospital District]