Controversy surrounds a healthcare provider’s decision to block parents from having access to their children’s prescription records.
Beginning on Nov. 1, parents of children ages 12-17 will no longer have access to their child’s prescriptions on CarolinaCARE, a home-delivery pharmacy service available to Atrium Health employees and their family members enrolled in the Atrium Health LiveWELL and Blue Ridge Healthcare health plans.
Atrium said in a letter to parents that they are making the change because they need to remain compliant with laws in all of the states that CarolinaCARE serves and that those states have varying laws regarding access to health information, including prescriptions.
The letter stated, “The laws are intended to allow minors to receive prescription medication for sensitive issues, without worrying about how their parents may react. This may include treatment for sexually transmitted diseases and other diseases that must be reported to the state; pregnancy, drug or alcohol abuse; and mental health. We protect the privacy of the minor and follow state law by limiting access to the child’s CarolinaCARE record.”
Atrium did say a parent or guardian can still call the doctor’s office to discuss any concerns about their child’s health.
That decision is not sitting well with many people, including Tami Fitzgerald, executive director of the NC Values Coalition. She said the reason that Atrium Health has adopted a policy to exclude parents is because North Carolina has what she says is “the most liberal law in the country,” General Statute 90-21.5a, that allows minors, in some cases, to consent to their own diagnosis, prevention, and treatment on certain medical issues, most of which involve things like pregnancy, substance abuse, and emotional disturbance.
“The North Carolina law, which has been around since the late 1970s, allows the minor to consent to their own treatment for those conditions, and that triggers the federal privacy laws that require a health plan to say we cannot grant parents access to medical records for these diseases or these services,” Fitzgerald said. “And so I think the reason Atrium Health has extended this to all healthcare records is because they don’t know how to segregate between the ones that are authorized by the very liberal North Carolina law. They don’t know how to distinguish between those and the rest of the medical treatments that minors might undergo.”
Fitzgerald, who is also a lawyer, said the law needs to be changed because it is a direct attack on parental rights. Still, she said Atrium is also at fault and taking the easy way out by not implementing a computer program to differentiate between the treatments.
“Atrium Health could spend money to go ahead and create some sort of software program to distinguish between those four categories of treatment and the rest, but they’re not willing to,” she said. “So, they’re saying we’re not going to give parents any access to medical records from age 12 to 17, and that’s just an arbitrary decision on their part that seeks to shut parents out. Ideologically, I think they probably just want to shut parents out anyway, but that gives them a good excuse.”
Atrium wrote in their letter that they’re working on system upgrades that they hope will make it easier for parents and their children to manage next year.
“The Parents’ Bill of Rights does require parental consent for treatment, but this deals with the disclosure of medical records,” Fitzgerald said. “I do believe that parental rights are a fundamental right, and parents have a fundamental right under our US Constitution, as well as the state constitution, to oversee the healthcare and education and upbringing of their children.”
Fitzgerald said the record of treatment would be different from the treatment itself, with treatment including the administration of drugs specifically, and admits that this is a gray area or a fine line between what can be revealed, according to the PBR, and what can’t.
“What you’re talking about here is the disclosure of the healthcare record, so it’s in a gray area in the technical legal sense,” she said. “If you wanted to cover this situation, that bill should have specifically covered it, but it doesn’t.”
Fitzgerald mentioned an interesting scenario involving HB 808, Gender Transition Minors, which passed in August, and this new action taken by Atrium. The bill makes it unlawful for a medical professional to perform a surgical gender transition procedure on a minor or to prescribe, provide, or dispense puberty-blocking drugs or cross-sex hormones to a minor without the consent of a parent, She said one of the best ways to check on that from the standpoint of being prescribed puberty blockers or cross-sex hormones is the medical record of the child.
“If the child is being treated by a physician for medical transitioning, the best way for the parent to know would be the medical records,” she said. “So, it just makes it easier for medical professionals to basically not follow the law that prohibits medical transitioning.”
If parents are concerned about this change, Fitzgerald says they could seek the advice of an attorney, but the best way would be to simply change providers.
“I would highly recommend that parents do that because Atrium is not going to make change unless they hear from parents on something like this,” she said. “Who would ever anticipate that the healthcare system would say they’re not going to give the medical records of a minor child to the parent? Obviously, Atrium is not parent-friendly.”
When Carolina Journal contacted Atrium Health seeking comment on the matter, a spokesperson emailed the following statement:
“In order to ensure compliance with North Carolina General Statutes §§ 90-21.4(b) and 90-21.5(a) pertaining to medical consent and privacy rights for teenagers, we recently notified subscribers to CarolinaCARE that enrolled minors would need to create their own, separate digital account. This pertains to prescription medications and mirrors what already exists for their medical records. Allowing unrestricted parental access to medications would be contrary to statutory prohibitions on parental notification in circumstances where the minor has sought and consented to their own care.”