Medical records systems and practices

¶ … obligations regarding reporting of the alleged abuse under federal and CA state laws? Who are mandated reporters and what is their legal obligation?

Under federal law pursuant to Child Abuse Prevention and Treatment Act, certain professionals such as teachers and those who provide healthcare have a mandatory obligation to report alleged child abuse (Smith, 2007). This act clearly defines child abuse including sexual abuse. In addition to the federal standards and definitions, California laws and the laws of the other 49 states have some sort of mandate concerning the reporting of child abuse.

As it pertains to section 11165.7 (a) of the penal code of California there are certain individuals that are mandated to report child abuse and/or neglect if they suspect that is has occurred or if a child reports such abuses to them. This mandate includes physicians. Other people who are mandated to report abuse include: teachers and teacher's aids, youth center employees, day care center administrators and employees, summer camp employees, employees of the Department of education if they are in contact with students, social workers, school counselors, clergy, district attorneys, EMT and a host of others. Basically anyone who works with children in their capacity as a professional is mandated to report abuse or suspected abuse in the state of California.

What do you say to Mrs. Anderson about her access to records? What laws regulate the access or disclosure of medical records/information of a minor (receiving reproductive care/treatment)?

As the parent of the Minor child Mrs. Anderson would be classified as the "patients representative" or representative under the Health and Safety Code section 123105. Under normal circumstances she would be given access to the records. However, these circumstances are not normal because there is alleged sexual abuse, the minor child is pregnant, and the mother is asserting that she wants to alter the medical records.

With these things understood, Mrs. Anderson would not have the right to view the records in accordance with California State Law under the Health and Safety Code section 123115. This section states that the representative of a minor does not have the right to look at or obtain copies of the health records of the minor patient under the following circumstances, the health care provider determines that access to the patient records requested by the representative would have a detrimental effect on the provider's professional relationship with the minor patient or the minor's physical safety or psychological well-being. The decision of the health care provider as to whether or not a minor's records are available for inspection or copying under this section shall not attach any liability to the provider, unless the decision is found to be in bad faith (Health and Safety Code)."

In this particular case the daughter is alleging abuse and the mother has expressed a desire to change the medical records on the grounds of religious beliefs. Though freedom of religion exists, this freedom does not allow people to break the law. In this particular turning the records over to the mother may endanger the safety of the child. In addition the hospital could be held liable if they turn the records over and something happens to the child because it would be considered a decision that was made in bad faith.

There are also federal laws that protect minors as it pertains to matters of reproductive health. These laws are part of the Health Insurance Portability and Accountability Act (HIPAA. Laws containted in this act are designed to allow girls under the age of 18 to have control of their sexual and reproductive health. Under this law teenage girls can receive treatment for STD's and abortions without the consent of their parents. Although this is a federal statute, indivudal states have the right to determine whether or not paretns should be notofied in the aforementioned instances. In some states minors under the age of 16 or 17 must have parental consent as it pertains to abortions. In addiition in some states parents have the right to notified if their child is found to be pregnant by a healthcare provider including school nurses.

In the scenario presented in this case, the mother is already made aware of the abuse and the pregnancy. Her contention is that she have a right to not only see the medical records but to alter them. Clearly this is in violation of both state and federal laws.

As it pertains to the aspect of the law regarding reproductive health What practical recommendations do you have to avoid similar problems in the future?