Confidentiality Protected
Youth-Friendly Practices
Protecting confidentiality is important, especially as adolescents feel concerned about the disclosure of sensitive health information, including sexual behavior.
Strategies
Implementation Tips
- Ensure compliance with federal and state confidentiality and consent laws
Tools & Resources
Sample confidentiality policy from a health center in Massachusetts; includes a letter describing the health center’s time alone policy in English and Spanish
Sample policy regarding the treatment of minors from a health center in Massachusetts
Implementation Tips
- Train all staff, including front desk and financial staff, on confidentiality for adolescents
- Ensure content includes the following topics:
- Federal and state laws related to confidentiality and minor’s rights to consent
- Common issues that may break confidentiality (e.g., billing, explanation of benefits) and strategies to address
- Strategies for talking with adolescents about confidentiality and the limits of confidentiality (e.g., cases of potential harm to self or others)
- Skills for providing confidential care while also encouraging communication with parents, when appropriate
Tools & Resources
Information on State Laws
Summary, by state and the District of Columbia, of minors’ rights to consent for contraceptive services
Summary, by state and the District of Columbia, of minors’ rights to consent for STI services
Summary, by state and the District of Columbia, of minors’ rights to consent for a variety of sexual and reproductive health services
List of provisions regarding billing and claims processing that several states have put in place to protect the confidentiality of individuals insured as dependents
Care Team Member Training
Recorded presentation on the basics of privacy rules, policies, and patient portals, which includes discussion on areas of concern and areas for opportunities; free registration required before being directed to video
E-learning on privacy and confidentiality for adolescent sexual and reproductive health care
Online training on minor consent laws for multiple (but not all) states and best practices for providing confidential care to adolescents
Online training to help health centers engage in discussion about how to handle the challenges of confidential care in their practice
Implementation Tips
- Use process mapping techniques and co-design to document current clinic workflow and identify opportunities when the care team can meet alone with the patient
Tools & Resources
Example clinic workflows for providing time alone for confidential risk screening on page 3
Implementation Tips
- Use features in the electronic health record to protect confidentiality, such as marking a record confidential and implementing security access controls on progress notes, to reduce the chance of information being disclosed through the patient portal, staff, claims, and patient statements
Implementation Tips
- Conduct periodic chart audits to identify gaps in care or concerns around confidentiality, as well as to identify who in the clinic needs additional training or education
Tools & Resources
Flowsheet demonstrating where to bill based on confidentiality concerns and insurance
Implementation tips
- Place posters and pamphlets in the waiting and exam rooms where adolescents can see them
- Include in education and information materials for adolescents and parents
- Mail or provide parents a standard letter about talking to adolescents 1-1 when patient reaches adolescence
- Be mindful and respectful of community norms and values with regard to time alone and consider potential parental mistrust of care team members and reluctance to leave children alone with them
Tools & Resources
Posters with state-specific privacy and confidentiality information to display in exam and waiting rooms; also available in Spanish for some states
Example caregiver letter for highlighting confidentiality in risk screening on page 4
Informational sheet for parents about time alone with care team members
Example time alone policy letters for parents; includes Spanish version
