Q1: Is the reproductive and sexual health information of youth in foster care protected by confidentiality law?
Youth in foster care(1) have reproductive and sexual health care rights that allow them to consent to medical services, without obtaining consent from their parent or guardian, and any information regarding those services remains confidential between them and their provider to the extent required by law.(2) These services include:
●prevention or treatment of pregnancy(including contraception, pregnancy testing, prenatal care,or abortion) at any age,
●health care due to a rape or sexual assault at any age, and
●prevention or treatment of a sexually transmitted infection or HIV prevention at age 12 or older. As such, a medical provider cannot share a youth’s protected health information with a third-party such as the youth’s child welfare social worker(SW) or probation officer(PO) without the written consent of the youth or through a court order. A foster youth has the right to authorize or deny disclosure of their health information, or portions thereof,with persons specifically selected by the youth. When a SW or PO obtains protected health information from a medical provider, that information cannot be shared with others except as allowed by applicable confidentiality and privilege laws.When a youth chooses to voluntarily disclose their health information to their SW or PO outside of the medical setting, this information is subject to a general right of privacy. As such, local child welfare and juvenile probation departments should determine and follow their established policies and procedures on confidentiality and information sharing. Placing agencies should have clear policies which stipulate whose responsibility it is to ensure that protected information is appropriately flagged and redacted from juvenile case files. Placing agencies should consult with their county counsel when necessary.For further information related to the juvenile case file, refer to question 3.
Q2: How does honoring privacy requests encourage youth to disclose to their SW/PO?
Private information about reproductive and sexual health, sexuality, gender identity are essential elements of one’s well being. These foundations reflect who we are and how we interact with others. A youth may or may not feel ready or comfortable to disclose personal information about their reproductive or sexual health. However, there may be times when the youth may feel comfortable sharing some portions of information, but not all information, with only certain individuals. When child welfare and juvenile probation professionals explain confidentiality and the limits of confidentiality in a manner that is age and developmentally appropriate to the youth in an open and honest manner this trustworthiness will most likely lead to more disclosure. Youth are more comfortable to share information about their reproductive and sexual health, as well as their needs and concerns when they feel supported and know what to expect.Open and honest discussions presents a great opportunity for the SW/PO and the youth to engage, build trust, discuss life skills and further good health outcomes.
1 Foster care means the provision of 24-hour care and supervision to a child, youth, or non minor dependent consistent with Welfare and Institution Code (WIC) section 11400(f).
2 Information on the reproductive and sexual health care rights of youth in foster care is found in All County Letter No 16-82.