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Virginia Minors & Confidentiality

Integrating Ethical Standards & Laws

Ethics Codes have some important things to say about minors’ confidentiality rights, but how do those fit together with the legal provisions in Virginia statutes? Because Virginia law gives minors of any age the right to consent to outpatient treatment, HIPAA regulations therefore give Virginia minors almost the same rights as adults; but what are the legal limitations of those rights (e.g., Virginia’s statute granting parents access to minors’ records)? How does all this legal information fit together with our ethical standards?  This workshop represents our best attempt to integrate all these ethical and legal mandates.

OUTLINE:

I. Ethical Standards

Informed Consent vs. Informed Assent

Confidentiality

Ethical/Legal Conflicts

Other

II. Legal Issues

Virginia Statutory Law & Case Law

Legal PROTECTIONS of a Minor’s Confidentiality

Virginia Health Record Privacy Statute – §32.1-127.1:03

Minors Obtain Outpatient M.H. Tx w/o Parent Consent – §54.1-2969

Therapist-Patient Privilege in Civil Cases – §8.01-399; §8.01-400.2

Special Protections Re: Records as Evidence… §32.1-127.1:03

Schwartz v. Schwartz (2005) [Child Therapist and §20-124.3:1]

Fairfax Hospital v. Patricia Curtis (1997) [Non-Disclosure]

Legal LIMITATIONS of a Minor’s Confidentiality

Parent Access to Treatment Records of Minor Child – §20-124.6

CSB Access w/o Consent – Commitment of Minors – §16.1-342

Statutory Exceptions to Privilege in Civil Court Cases

Abuse/Neglect Cases – §63.2-1519; §8.01-400.2

“Judicial Discretion” Exception – §8.01-399; §8.01-400.2

Mental Condition at Issue in Case…§8.01-399; §8.01-400.2

GAL (Guardian Ad Litem) – Access in Court Cases §16.1-266G

CASA (Court-Appointed Special Advocate) – §9.1-156

[Repeal of §20-124.3:1 that provided privilege for parent information]

Virginia Regulatory Law

Licensing Board Standards of Practice

State Mental Health Agency/Institution Regulations

Federal Statutory Law (Substance Abuse) – (P.L. 92-255)

Federal Regulations – HIPAA Privacy Rule

III. Integrating Ethical & Legal Responsibilities

IV. Implications

Educational Goals :
1. Describe Ethical Standards relevant to confidentiality for minors in clinical relationships;
2. Describe the Virginia and Federal laws and regulations that affect confidentiality for minors;
3. Integrate these into a coherent policy that can be explained to minors and parents;
4. Recognize the practical implications of this policy for clinical relationships with minors.