Confidentiality at Medical Practitioners
Though minors may obtain some services without parental consent, confidentiality is not guaranteed in all circumstances.
- All Title X clinics are required to maintain confidentiality as part of their federal funding. At other providers, minors should ask about confidentiality policies prior to obtaining treatment.
- If the practitioner believes that a minor is being abused, they must contact the authorities.
- Note that a positive HIV test result may not be confidential for minors.
RSA 141-F:7, III states, "If the person with a serologic positive test result is less than 18 years of age, the physician or the person authorized by the physician may disclose the test results to a parent or legal guardian."
- One additional consideration is payment for services. If the visit is paid by insurance, it is likely that the parents would learn of the visit.
Senate bill 389 was passed by the NH senate in 2008 but did not pass the House. This bill would amend existing confidentiality laws relating to communication with treating physicians, mental health providers and nurses to explicitly extend to minors.
Confidentiality at Public School
FERPA gives parents of students who are less than 18 the right to view their child's educational record. The records maintained by the school health office are included. Therefore anything that is recorded in a minor's record by the school nurse may be viewed by the parents if requested. (The issue of who is able to access school health information is dealt with in a separate FERPA FAQ.)
If a student discloses a pregnancy to a nurse or other school staff member, the issue of whether to inform the student's parent(s) is to be determined on a case-by case basis at the local school level.
The nurse should provide a safe, non-judgmental place for the student to disclose important health information. The nurse can offer support and ensure that the student is currently in a safe situation (i.e. assess for depression or suicidality; assess the possibility of abuse or assault, etc.) If there is concern for the safety of the student, the nurse must enlist additional help as needed.
The nurse should offer to help the student discuss the issue with her parents. If the student continues to refuse to inform her parents, the nurse should seek guidance from the principal and perhaps the school's legal counsel. It is also appropriate for the nurse to seek this guidance if there are unusual circumstances that the nurse feels are beyond her ability to manage.
Laws Relating to Minors Consenting for Treatment
Minors who are at least 14 years of age may obtain testing and treatment for STD's from a licensed physician without parental consent. (RSA 141-C:18)
Minors who are at least 12 years of age may obtain treatment for drug or alcohol dependence without parental consent. (RSA 318-B:12-a)
There are no specific NH statutes relating to consent for pregnancy testing, birth control, or abortion. In 2007, the NH statute that required parental notification prior to minors obtaining abortion (RSA 132:28) was repealed.
There are no specific NH statutes relating to minors consenting for mental health services.