Abigail English, JD, of the Center for Adolescent Health & the Law, provides the following information. According to English (2019): Health care professionals are allowed to rely on a minor’s written statement that they are authorized to consent. Texas minor consent laws also relieve health care professionals of liability for non-negligent care for which a minor has consented. Even though minors can give consent in certain situations, their health information may still be accessed by parents, as English explains: Texas laws contain provisions that are specific to the confidentiality of minors’ health information, particularly with respect to parents’ access to that information. Confidentiality protections and consent requirements are closely linked but not perfectly matched. Generally, when minors may consent for their own health care they can expect confidentiality protection, but there are exceptions. The Texas laws that allow minors to consent for their own health care and counseling also allow the health care provider to inform the parents, with or without the consent of the minor for them to do so. The Texas laws that require mental health and substance abuse communications and records to be confidential also provide for disclosure based on consent of the patient, consent of the parent of a minor, or if the patient presents a threat of imminent danger to self or others. This subsection reminds the counselor that they must follow all state and federal laws. TAC rules defer to the HIPAA Privacy Act and FERPA that governs information disclosure in an educational setting which is reviewed in the ASCA section on confidentiality. One part of the Privacy Act, the Minimum Necessary Rule, is summarized as follows (HHS, 2013): The minimum necessary standard, a key protection of the HIPAA Privacy Rule, is derived from confidentiality codes and practices in common use today. It is based on sound current practice that protected health information should not be used or disclosed when it is not necessary to satisfy a particular purpose or carry out a function. The ACA Code of Ethics: Confidentiality According to the ACA Code of Ethics, “Confidentiality is the ethical duty of counselors to protect a client’s identity, identifying characteristics, and private communications.” (ACA, 2014). Here are the sections of the ACA Code of Ethics related to confidentiality: Section A: The counseling Relationship A.7. Roles and Relationships at Individual, Group, Institutional, and Societal Levels A.7.b. Confidentiality and Advocacy Counselors obtain client consent prior to engaging in advocacy efforts on be-half of an identifiable client to improve the provision of services and to work toward removal of systemic barriers or obstacles that inhibit client access, growth, and development. Section B: Confidentiality and Privacy Introduction: Counselors recognize that trust is a cornerstone of the counseling relationship. Counselors aspire to earn the trust
minimum necessary standard requires covered entities to evaluate their practices and enhance safeguards as needed to limit unnecessary or inappropriate access to and disclosure of protected health information. The Privacy Rule’s requirements for minimum necessary are designed to be sufficiently flexible to accommodate the various circumstances of any covered entity. The Privacy Rule generally requires covered entities to take reasonable steps to limit the use or disclosure of, and requests for, protected health information to the minimum necessary to accomplish the intended purpose. The minimum necessary standard does not apply to the following: ● Disclosures to or requests by a health care provider for treatment purposes. ● Disclosures to the individual who is the subject of the information. ● Uses or disclosures made pursuant to an individual’s authorization. ● Uses or disclosures required for compliance with the Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Rules. ● Disclosures to the Department of Health and Human Services (HHS) when disclosure of information is required under the Privacy Rule for enforcement purposes. The subchapter details the mandate of required reporting in cases of abuse or neglect. When mental healthcare providers, including licensed counselors, believe neglect or physical, mental, emotional, or sexual abuse or exploitation has occurred, they are required to make a report to the state agency of license or the Council. The subchapter lists the time frames, types of information to be gathered, and the format for reporting. Additional permitted disclosures of protected health information (PHI) will be covered in subsequent sections. The 500-page HIPAA document includes sections that apply to disclosure of protected information and the transmission of information that may be shared among agencies. Health providers should receive additional training on HIPPA regulations that apply to their practice.
CONFIDENTIALITY IN ASSOCIATION CODES OF ETHICS
of clients by creating an ongoing partnership, establishing, and upholding appropriate boundaries, and maintaining confidentiality. Counselors communicate the parameters of confidentiality in a culturally competent manner. B.1. Respecting Client Rights B.1.a. Multicultural/Diversity Considerations Counselors maintain awareness and sensitivity regarding cultural meanings of confidentiality and privacy. Counselors respect differing views toward disclosure of information. B.1.b. Respect for Privacy Counselors respect the privacy of prospective and current clients. Counselors request private information from clients only when it is beneficial to the counseling process. B.1.c. Respect for Confidentiality Counselors protect the confidential information of prospective and current clients. Counselors disclose information only with appropriate consent or with sound legal or ethical justification.
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Book Code: PCTX1325
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