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“Please be informed that access to your child’s account has been revoked.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.
Shockwaves continue to ripple through Arizona’s beleaguered healthcare industry after Tuesday’s emailed announcement by Banner Health CEO Peter Fine that employees could lose their jobs if they fail to provide proof of a COVID-19 vaccination by Nov. 1.
Fine’s companywide email touted uncited “overwhelming evidence” and “vaccine data” which purportedly proves the “safety and efficacy” of the three current vaccines. Employees will have the option to undergo an unspecified “exemption request process,” in hopes of retaining their job without being vaccinated but the between-the-lines message to Banner Health employees is that terminations are possible for refusing to subject themselves to the risks of an emergency-use-only vaccine.
Banner Health is also putting up $100,000 to award 10 fully-vaccinated employees with $10,000 each in a companywide drawing this summer.
“We care for some of the most vulnerable people in our communities and we owe it to them to take every measure possible to ensure the safest care environment,” Fine wrote, adding that mandatory vaccinations will reduce risk “for our patients, their families, visitors and each other.”
The problem, according to many in the healthcare industry, is that Arizona is already experiencing a shortage of workers in a high demand market. An exodus of qualified workers to other hospital systems or into smaller healthcare companies could leave Banner Health without enough medical professionals to adequately serve its patients.
Studies show the majority of healthcare workers who have declined so far to be vaccinated for COVID-19 are under the age of 40. Many have expressed concern about the lack of data about long-term impacts on fertility and overall health.
In April, Gov. Doug Ducey issued an Executive Order banning proof of vaccinations, also known as vaccine passports, and preventing state and local governments from requiring anyone to disclose their COVID-19 vaccination status to receive service or enter a public area.
The Order, however, allowed health care institutions to require COVID-19 vaccination status documentation of a patient, resident, employee, or visitor.
Protecting all Arizonans from being coerced into obtaining a COVID-19 vaccination was a priority for Rep. Bret Roberts throughout the recent legislative session. Roberts (R-LD11) advocated strongly for passage of a state law to prevent government and private employers from interfering with anyone’s freedom of choice when it came to being vaccinated.
Eventually the language of Roberts’ bill was watered down to protect those doing business with government entities, as well as customers and clients of private employers. Employees of private companies -particularly those working in the healthcare industry- would have had no protection.
The bill never made it to Ducey’s, but the governor did sign legislation which ensures any person “may refuse a vaccination…based on the person’s personal beliefs” during a public health emergency.
Roberts spoke out Tuesday against Banner Health’s mandate, expressing concern about the unknown risks associated with the current COVID-19 vaccines.
“Force and coercion, in my opinion, are not routes that should be taken,” he said. “Adults should be able to weigh the risks involved and decide for themselves.”
One of those who opposed freedom of choice protections for employees of private companies was State Sen. T.J. Shope (R-LD8). Shope bragged earlier this month about protecting Arizonans -including legislative staffers- from government required proof of vaccinations, but refused to support the same protections for most employees across the state.
To date, Banner is the largest private employer in Arizona to announced forced vaccinations as a condition of new or continued employment. However, earlier this year the U.S. Chamber of Commerce provided tips to its members on how to persuade employees and customers to receive the COVID-19 vaccine.
“Vaccination is a personal decision, so it’s logical that when employers show a personal willingness to be vaccinated, they are more likely to increase the willingness of their employees—across all demographic groups – to follow their lead and get the shot,” according to the chamber’s website.
The website also provides guidance for employers on talking to employees about getting vaccinated and includes advice on conducting business-sponsored “get vaccinated” events.
