1. A Parental Notification of Health-Related Care (see Appendix C) must be sent to the parent/guardian whenever a youth has a chronic mental or physical health condition and a licensed healthcare practitioner has determined that a significant change has occurred in the chronic health condition of that youth. This shall not include those limited conditions to which, by statute, a youth can legally consent to screening, evaluation and/or treatment without the parent/guardian’s knowledge or consent (and which are to be
protected from disclosure to the parent/guardian). See section D, below, for a
discussion of these conditions/treatments.
2. A Parental Notification of Health-Related Care must be sent to the parent/guardian whenever a youth complains of the same complaint three (3) or more times during a two- week period. Mailing of a Parental Notification of Health-Related Care for multiple sick call visits is not required in the following situations:
a. Youth who return for on-site follow-up of a sick call complaint at the instruction/direction by a physician, osteopathic physician, advanced registered nurse practitioner or physicians’ assistant; and
b. Youth who report to sick call for complaints which are of such a nature that they are statutorily protected from disclosure to parents/guardians (e.g., evaluation/treatment of sexually transmitted illnesses/diseases).
3. A Parental Notification of Health-Related Care must be sent to the parent/guardian on any occasion in which the oral temperature equals or exceeds 103 orally. An attempt should also be made to notify the parent by telephone.
4. A Parental Notification of Health-Related Care must be sent to the parent/guardian whenever a youth is taken off-site for healthcare, except when the type of care for which the youth is taken off is statutorily protected from disclosure to the parent. This includes assessment and treatment for sexually transmitted diseases, assessment and treatment for HIV positivity or AIDS, pregnancy and/or family planning care, including gynecological services that, in the opinion of the health care provider, are necessary for the health and well-being of the youth. (For the types of mental health treatment which a youth may consent to without parental consent, please see section III of this chapter.
5. A Parental Notification of Health-Related Care must be sent via certified mail to the parent/guardian if the parent/guardian has specifically prohibited certain types of care, or requested that they be notified prior to certain types of care to be administered.
a. Written permission from the parent/guardian must be obtained prior to the initiation of a treatment which the parent has previously specifically prohibited This may be in the form of a letter obtained from the parent/guardian, or facility staff may check the box on the bottom of the Parental Notification form, indicating that the parent is to sign the form
and return it to the facility if the parent/guardian agrees to the care. Telephone consent should be attempted and documented as well and the Department’s regional general counsel should be notified.
b. A copy of the Parental Notification of Health-Related Care that was sent to the parent/guardian and the returned form with the parent’s signature must be filed in the Individual Healthcare Record, in the section reserved for parental notices, directly behind the Authority for Evaluation and Treatment, in reverse chronological order (most recent Parental Notification on top in that section).
6. A Parental Notification of Health-Related Care must be sent to the parent/guardian whenever the youth is taken off-site for medical treatment (for example, to an emergency room or hospital, doctor’s office, dentist’s office). Exceptions include situations in which the reason for the transfer and treatment are related to the conditions which, by statute, a youth may consent to without parental knowledge or consent (assessment and treatment for sexually transmitted diseases, assessment/treatment for HIV/AIDs, pregnancy and/or family planning services and those gynecological services that, in the opinion of the health care provider, are necessary for the health and well-being of the youth. In these situations, the youth must provide consent for the Department to notify the parent.
a. Telephone notification is required as soon as feasible. If possible, telephone notification and mailing of the Parental Notification should be done ahead of time (for example, if there is a pending dental appointment).
b. The written notice shall be sent regardless of the telephone notification.
7. Written parental notification is required for the administration of over-the-counter medications (OTCs) administered per approved protocols or an order (unless the parent has prohibited the administration of OTCs on the Authority for Evaluation and Treatment in which case over-the-counter medications will not be administered). See Chapter 4 of the Revised Health Services Manual for further information regarding parental notification requirements for over-the-counter medications.
8. Written parental notification is not required for treatment or services which are court-ordered.
NOTE: (When Parental Notification of Health-Related Care Cannot Be Accomplished By
Telephone or Mail)
When parental notification cannot be accomplished through telephone contact or by mail, the DJJ facility superintendent, program director or his/her designee must contact the youth’s juvenile probation officer (JPO) and request that the JPO visit the parent or legal guardian for the purpose of providing the necessary parental notification. The JPO must document all efforts to provide parental notification to the parent or legal guardian.
NOTE: (Parent Notification When the Youth’s Illness or Injury Requires Emergency Medical Services or is Life Threatening)
When the youth’s illness or injury requires emergency medical services or is life threatening (after necessary medical treatment is obtained for the youth) the facility superintendent or
program director must make every effort to immediately notify the parent/legal guardian.
If the parent or legal guardian cannot be contacted, the following steps must be taken:
1) Use alternative contact methods as documented in the youth’s record. Such alternative methods may include, but are not limited to, contact via the parent’s or legal guardian’s work address, pager/cell phone or electronic notification or contact via a relative or neighbor.
2) Contact the youth’s juvenile probation officer to request assistance with notification. In the case where the youth’s family lives in close proximity to the JPO’s work location or area, request that the JPO drive by the parent’s or legal guardian’s home, place of work, school or other known location outside of the home.
3) Contact law enforcement to request assistance in locating the parent or legal guardian.
The facility superintendent or program director must document all efforts to contact the parent or legal guardian.
D. INSTANCES WHEN ADDITIONAL WRITTEN CONSENT OF THE PARENT OR LEGAL
GUARDIAN IS REQUIRED:
Additional, written parental consent is required in certain circumstances. The form to be used shall be the form used by the healthcare provider that is providing the services. Examples of the types of care requiring additional, procedure-specific, written, informed parental consent include the following:
1. Any time it is recommended that the youth be hospitalized;
2. Any surgical procedure (except those to which a minor may consent without parental knowledge or consent as allowed under Chapter 743, Chapter 390 and Chapter 384, Florida Statutes);
3. Dental services other than evaluation and routine prophylaxis (for example, dental extractions, endodontic services and periodontal services require additional, written consent);
4. Any procedure or service of an invasive nature for which one would reasonably assume that a parent would want to be informed and personally involved in the decision to provide such treatment (with the exception of those types of services to which a youth may consent without parental knowledge);
5. Any procedure where there is uncertainty as to the benefits to the child (apart from the normal uncertainty that accompanies any medical or mental health practice or procedure); and,
6. Any procedure or service which the parent/guardian has specifically prohibited.
E. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT (HIPAA):
With regard to the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, in most cases under the HIPAA Rule, the parent or legal guardian is the “personal representative” of the minor child and can exercise the minor’s rights with respect to protected health information, because the parent usually has the authority to make health care decisions about his or her minor child. Regardless of whether a parent is the personal representative, the Privacy Rule permits a covered entity to disclose to a parent, or provide the parent with access to, a minor child’s protected health information when and to the extent it is expressly permitted or required by State or other laws (including relevant case law). Likewise, the Privacy Rule prohibits a covered entity from disclosing a minor child’s protected health information to a parent, or providing to a parent, or providing a parent access to, such information when and to the extent it is expressly prohibited under State or other laws (including relevant case law). Thus, State or other applicable law governs when such law explicitly requires, permits, or