A new law prohibiting restrictions to parental access of children’s records will take effect at the end of this month, on September 23. Even so, health care facilities are maintaining policies upholding their minor patients’ confidentiality. HB2161 will upend decades of common practice for Arizona health care providers.
The history of confidentiality in health care for minors leads back to the inception of the Title X family planning program in 1970 and the ensuing controversy over confidential reproductive health care services for minors. Beginning with the Clinton administration in 2000, the federal government issued privacy protections for medical records that extended to minors.
For many minors, getting permission from their parents to get an abortion is simply not an option. So why do 44 states require parental involvement in a minor's abortion? Instead of restricting their rights, we need to trust & provide support to minors seeking reproductive care.
— Center for Reproductive Rights (@ReproRights) May 1, 2019
Since then, federal precedent has informed and shaped Arizona’s health care system. One of the most recent examples of this occurred in late June, when HonorHealth implemented a policy allowing its 12 to 17-year-old patients to shield their medical records from parental view. According to the Arizona Daily Independent, parents don’t have full access to their child’s online medical records.
Meanwhile, Banner Health precludes parental access to all of their 12- to 17-year old child’s records without the child’s consent. One Arizona mother, Jacquie Wedding, felt the effects of this policy recently. In a viral Tiktok video, Wedding shared the following email sent to her by Banner Health shortly after her children’s 12th birthday:
“Please be informed that access to your child’s account has been revoked. The reason for this is because the child is now between the ages of 12 and 17. Based on state law, a minor child may consent to certain treatments without parental consent. Records of those treatments are protected and may not be released to a parent without the minor patient’s consent. As Banner Health is not able to separate those records, we do not provide proxy access to MyBanner for minor patients between the ages of 12 and 17.”
Banner Health and HonorHealth are both part of the Health System Alliance of Arizona (HSAA), an advocacy organization that also includes Dignity Health and Tenet Healthcare Corporation.
These HSAA members align with Arizona Medical Association (AMA) standards on confidentiality for adolescent treatment. AMA advised health care providers to limit parental access to their child’s records.
“Providing confidential care to teenagers for certain personal issues is essential to providing appropriate health care and helping them develop autonomy by encouraging them to be responsible for their own health care,” stated the guide. “In addition, by providing confidential care, the clinician can develop a trusting relationship with the teen.”
One of the AMA guide authors was Veenod Chulani: the doctor who founded and currently leads the Phoenix Children’s Hospital (PCH) Gender Support Program, one of the only comprehensive gender transition programs for minors in the state.
PCH allows minors aged 12 to 17 to grant or prohibit parental access to their records.
Corinne Murdock is a reporter for AZ Free News. Follow her latest on Twitter, or email tips to corinne@azfreenews.com.
As the government continues to struggle retaining a totalitarian grasp on all things related to the pandemic, including Americans’ health care options, Arizonans should be aware that their skin color will determine their ability to access life-saving treatment. One Phoenix man shared with AZ Free News how his decision to identify himself as “white” because of his skin tone, rather than Hispanic, nearly cost him his life, in the hopes that his experience will spread awareness and serve as a cautionary tale to fellow Arizonans.
Michael Myers explained that he made the mistake of marking his race as “white” on medical intake paperwork rather than “Hispanic” — in part due to his complexion, mixed with the fact that he was raised to not think of himself as Hispanic.
“Had I put that I was Hispanic they probably would’ve gave [the monoclonal antibodies] to me,” said Myers. “I lost four days [of treatment] getting sicker and sicker. I put down ‘white’ even though I was sicker than a dog.”
Even though race doesn’t weigh heavily on Myers’ mind, it does for the government. AZ Free News inquired with the health system that treated Myers, HonorHealth, about their adherence to any federal or state guidelines that limit or prohibit COVID-19 treatments based on high-risk categories that factor race or ethnicity. They explained that they “follow CDC guidelines when it comes to COVID-19 treatments.” The CDC cites the FDA as the reference for guidelines on treatments for individuals with “high risk of disease progression.”
In supplemental information on their emergency use authorization (EUA) of monoclonal antibodies, the FDA acknowledged that race and ethnicity “may also place individual patients at high risk for progression to severe COVID-19,” therefore rendering them valid determinations of eligibility for monoclonal antibody treatments. That’s a conclusion that the state of Minnesota drew explicitly in their “Ethical Framework for Allocation of Monoclonal Antibodies during the COVID-19 Pandemic” published last month.
Last summer, the Department of Health and Human Services (DHHS) lauded Michigan and Maryland for incorporating equity in their decisions to administer monoclonal antibody treatments.
Also last month, the CDC published a report suggesting that “equitable” use of treatments factoring race was critical in combating the disproportionate numbers of certain races being adversely affected by COVID-19. The CDC also has a page which argues for equitable approaches to health care because COVID-19 impacts minorities disproportionately.
Equity looked like health care providers ignoring the entirety of Myers’ condition and focusing on one characteristic: his reported race.
Myers was diagnosed with COVID-19 exactly two weeks before Christmas Day. Based on Myers’ condition, his health care providers at HonorHealth gave him the option to either receive monoclonal antibodies at their FastPace emergency room nearby or wait for their Scottsdale infusion center’s next available appointment. Myers told AZ Free News that he was so sick that he opted for the emergency room.
After waiting over two and a half hours, Myers was admitted to a room. Just as the IV was placed in Myers’ arm, a pharmacist intervened. The pharmacist informed Myers that he “didn’t qualify” for the monoclonal antibody treatment because he wasn’t “high-risk” enough. Confused and upset, Myers left.
He said he was shocked when, on Monday morning, HonorHealth called him for his appointment to receive monoclonal antibodies. When Myers informed the nurse that he’d been disqualified by their FastPace center, the nurse was dismayed and insisted that he receive the treatment based on his deteriorating condition. By that point, Myers had begun to cough up blood. The infusion center’s earliest available appointment was on Wednesday; Myers said he barely made the drive from Glendale to Scottsdale safely because his coughing had worsened and he nearly didn’t have the strength to steer the wheel.
“Within 24 hours I felt I was getting better. It took me a week and a half to get back to some normal,” said Myers.
Weeks later, Myers told AZ Free News that he received a $1,500 bill from FastPace — even though they refused to treat him. Myers said his entire ordeal was entirely unnecessary, relaying frustrations at how he believed politics got in the way of his health care.
“It’s political b******t really. I got sicker when I could’ve recovered faster, and it cost me thousands of dollars in medical bills and me being off of work,” said Myers.
Corinne Murdock is a reporter for AZ Free News. Follow her latest on Twitter, or email tips to corinne@azfreenews.com.
There has been much media coverage in recent months about Arizona’s nursing shortage. This summer, Phoenix-based Banner Health confirmed it was down nearly 1,400 nursing professionals at its 30 hospitals and associated medical offices across the country.
But even the prestigious Mayo Clinic—recognized as the top hospital in the United States for 2020-2021 by U.S. News & World Report—has learned that staffing issues extend far beyond the nursing ranks and into nearly every department.
As of Sunday, more than 375 jobs were advertised on the Mayo Clinic’s website. And those are only the company’s open positions in Arizona.
The reality of employment challenges facing Arizona’s medical community is forcing changes in how to attract medical professionals who may be looking to change jobs. And one hospital in Cochise County has found a creative way to garner the attention of prospective employees.
Canyon Vista Medica Center in Sierra Vista opened in 2015 as Cochise County’s only Level 3 trauma medical facility. Last week it released a recruitment video touting the wonderful work environment, although much of the video is spent showcasing Sierra Vista and Cochise County.
The video available on Facebook and LinkedIn draws attention to “the wonderful sceneries and opportunities” the region has to offer, according to CVMC spokeswoman Alexis Ramanjulu.
“Like all industries we have to be creative in how we attract new employees,” Ramanjulu explained to AZ Free News. “We hope by showcasing the place our business and healthcare heroes call home will attract medical professionals to our hospital and our part of the country.”
Such efforts are necessary despite the fact Gov. Doug Ducey announced $25 million to bolster hospital frontline staffing in November 2020, followed a few weeks later by another $60 million to address nursing shortages. The December funding pledge was matched by Ducey last month, but it could take weeks, if not months, to get that money into the hands of hospital administrators.
In the meantime, some smaller healthcare providers and medical offices have begun targeting workers at those larger companies in Arizona that are threatening to suspend or even fire medical professional for noncompliance of stringent COVID-19 vaccination mandates.
Yet hiring efforts across the state are not coming close to addressing the widespread staffing shortage. Part of the problem, according to one hospital administrator, is that such outreach efforts are often conducted by trained recruiters, which are also in short supply in Arizona.
Among those recently advertising for experienced recruiters in Arizona, are St. Luke’s Hospital (Tempe), Northwest Healthcare (Tucson), and Banner Health, which is Arizona’s largest employer.
Other companies with recruiter openings are Yavapai Regional Medical Center (Prescott), Envita Medical Center (Scottsdale), Mountain Vista Medical Center (Mesa), Northern Arizona Healthcare Corp. (Flagstaff), SpringBoard Healthcare (Phoenix), Havasu Regional Medical Center (Sacate), Tenet Healthcare (Phoenix), LifePoint Health (Lake Havasu City), Steward Health Care (Arizona City), and IASIS Healthcare (Mesa).
Banner Health, one of the largest health care companies in the United States, is exempting pregnant nurses from their COVID-19 vaccine mandate. Banner Health hasn’t announced these exemptions publicly.
This exemption was outlined in an email from a Banner Health nursing director, obtained by AZ Free News. The email also noted that Banner Health’s human resources may extend that exemption to women who are breastfeeding, of childbearing age, and more. The email didn’t clarify why pregnancy was considered an exemption by the health care company, nor did it elaborate why it was considering exemptions for women who are breastfeeding or of childbearing age.
“I learned today that pregnancy will be an approved exemption,” wrote the official. “The HR team is also working other automatic exemptions (breast feeding, child bearing age, etc). I will keep you all posted as I learn more.”
The CDC still recommends that pregnant women, breastfeeding women, and women of childbearing age get the COVID-19 vaccine (the CDC calls breastfeeding women “lactating people”).
Banner Health announced last month that it would require all employees to be vaccinated by November 1. The mandate didn’t bode well with the company’s employees.
This past week, hundreds of nurses protested against the vaccine mandate. Nurses say they oppose the mandate because the safety and efficacy of the vaccine isn’t proven, and they would like a choice in their own health care decisions.
