A Kentucky lawmaker’s attempt to give parents or guardians legal access to a minor’s medical records is drawing fire from state reproductive health and mental health advocates.
Rep. Rebecca Raymer (R-Morgantown) sponsored the proposal in House Bill 174, passing the House Health Services committee last Thursday. The bill would give parents of someone under age 18 or a “personal representative” of the minor access to the minor’s medical records — even if a minor is allowed by law to consent to care alone. But reproductive health advocates say that access would have a “chilling” effect by exposing someone’s private decision to use birth control or seek treatment for a sexually transmitted infection, among other types of care.
Giving parents access to that information could even cause some minors to go without reproductive care, they say. Mental health professionals are raising their own concerns.
Current Kentucky law allows persons under age 18 to consent to reproductive care and treatment (except for abortion and “sterilization”) and substance use disorder treatment without notification of their parent or guardian. Anyone in Kentucky who is age 16 or older is allowed to seek outpatient mental health counseling without parental approval.
In emergencies, existing state law gives health care providers the authority to treat “minors of any age without the consent of a parent or legal guardian” if the physician or other provider believes waiting for consent would put the child at risk.
Raymer said in her committee testimony last week that HB 174 is “just a clarification so that a parent can maintain access to a minor’s medical records.” She says her bill wouldn’t take away a minor’s ability to consent to “certain things” like reproductive care (except for abortion, now almost totally banned in the state) or outpatient mental health treatment under current law.
But Planned Parenthood Alliance Advocates Kentucky director Tamarra Wieder told LINK nky that giving parents or others statutory access to a minor’s personal health records could have “unintended consequences” for minor care. Individuals may be less likely to seek treatment if their parents know the type of care they are seeking, she said.
Young people need a “safe place to talk to their provider” about their reproductive health, especially when they may not have a healthy relationship with their parent or guardian, said Wieder.
“If their parents are then going to access those records that can set a very chilling precedent that can stop care for minors,” she said.
Before the House Health Services committee voted 11-1 (with three Democrats passing on the vote) to approve HB 174 last week, committee chair Rep. Kimberly Poore Moser (R-Taylor Mill) said that Raymer has “been really careful” to maintain minor consent for reproductive and outpatient mental health under current law. “This bill will not supersede that,” said Moser.
The bill does include a provision that limits access to a minor’s health information if “prohibited under the federal Health Insurance Portability and Accountability Act of 1996 or any other federal or state law.” So-called “HIPAA laws” were traditionally designed to protect the privacy of a patient’s health information. According to Wieder, HB 174 “is not we believe, as written, shielded,” meaning a minor’s reproductive records would not be private.
Also signaling concerns about the bill is Dr. Laurie Grimes, a licensed psychologist and lobbyist for the Kentucky Psychological Association. Grimes told LINK nky in an email that her organization is concerned HB 174 could discourage minors from seeking necessary mental health treatment.
“The Kentucky Psychological Association is concerned that HB 174 in its current form could jeopardize the provisions set forth in Kentucky statute outlining specific services that minors can consent for – including mental health and chemical dependency services. As HB 174 was presented with the assurance that the proposed bill intends to uphold these provisions, KPA advocates for the language to be amended to make it clear how Kentucky consent laws and federal HIPAA laws will operate in these specific situations to protect minor healthcare and records access,” said Grimes.
In her testimony on Thursday, Raymer said reproductive and mental health records would be “unaffected” by her bill. She said that she filed HB 174 after learning parents are losing access to their child’s medical records, specifically in instances where a child is unable to physically consent to shared access.
Raymer read a letter from Kentucky parents who are struggling to access medical records for their 13-year-old son with immunodeficiencies and fine motor skill delays. The parents say they lost legal access to their son’s medical records when he turned 13 because he is unable to physically consent to give them access — something they described as “a must in our situation,” the lawmaker said.
“This isn’t stopping anyone from seeking treatment,” Raymer said. “Mental health is carved out in statute, reproductive health is carved out.”
Rep. Lisa Willner (D-Louisville) was one of the three Democrats that passed on the committee vote on the bill. She said she wants “to do a little more reading” on the bill before she votes on it. Willner said she specifically wants to know more about how HB 174 might affect minors who seek care on their own.
“I’m always concerned about unintended consequences of a bill,” Willner told the committee. “I think we all are as policymakers.” Also passing on the vote were Reps. Rachel Roarx (D-Louisville) and Lindsey Burke (D-Lexington).
Rep. Adrielle Camuel (D-Lexington) voted against the bill in committee.
As for Wieder, she said minors need to know their consent for health care is safe. Wieder told LINK nky her organization is sympathetic to cases where parents need to access records of a minor child who cannot care for themselves, citing the example shared by Raymer.
“We are by no means trying to impede parents from helping navigate the medical system for their children,” said Wieder. “What to me is deeply troubling is when we chip away at your confidential medical record access, where does that stop?
