Confidentiality — Understanding the Basics
Confidentiality laws exist to protect your child’s private health information and to explain who can see, share, or release it. Knowing these rules helps families and providers communicate clearly while keeping care safe and respectful.
1. What HIPAA Means
HIPAA stands for the Health Insurance Portability and Accountability Act. It is a federal law that:
- Protects private health information (called PHI) such as a person’s name, birth date, address, diagnosis, or treatment.
- Requires written permission before a hospital or clinic can share PHI with anyone who is not directly involved in care.
- Gives patients the right to read and request copies of their own medical records.
If you want providers to talk with each other or with you about your child’s care, you’ll usually need a Release of Information (ROI) form.
2. Minor-Consent and Parent Rights in Oregon
Under ORS 109.640 – 109-675 (2023 update):
- Youth ages 14 and older can consent on their own to outpatient mental-health, drug, or alcohol treatment.
- Parents or guardians must be included before treatment ends, unless the provider believes that contact would seriously harm their youth.
- Youth may ask that certain information stay private, but providers can share details if needed for safety or medical reasons.
Providers must report suspected abuse, neglect, or serious danger to state authorities, even without permission.
3. What a Release of Information (ROI) Does
An ROI form lets your child or their legal guardian decide:
- What information can be shared (eg. diagnosis, medications, care plans).
- With whom it can be shared (doctor, therapist, school counselor, parent).
- For how long the release is valid (it can be canceled any time in writing).
Youth aged 14 and older may sign their own ROI. Parents of children under the age of 14 sign on their own behalf.
It’s a good idea to discuss together what information is helpful to share so that everyone can support safety and treatment goals.
4. Informed Consent for Treatment
Before starting care, you or your child should receive:
- A description of the treatment and its purpose.
- Possible risks and benefits.
- Other options that may be available.
Signing an informed-consent form shows you understand and agree to the plan.
5. Substance-Use Treatment Privacy (42 CFR Part 2)
This federal rule gives extra protection to people receiving care for alcohol or drug use in programs that receive federal funds.
Such programs cannot reveal that a person is or was in treatment without written permission—not even to confirm they are a patient.
6. When Providers Can Share Information Without Permissions
A doctor or therapist may disclose limited information if:
- There is an immediate risk of harm to the youth or someone else.
- The youth requires emergency medical care (such as surgery or hospital admission).
- Law requires reporting (suspected abuse, infectious disease, or court order).
These exceptions are meant to protect life and safety.
7. Tips for Families
- Talk with your child’s provider about how information will be shared.
- Keep a copy of any signed ROI forms.
- Ask for updates in plain language—you deserve to understand what’s happening.
- You do not need an ROI to give the provider background information about your child or to help develop a safety plan.
8. Learn More
- Minor Rights: Access and Consent to Health Care in Oregon (OHA 2023): https://sharedsystems.dhsoha.state.or.us/DHSForms/Served/le9541.pdf
- HIPPA and 42 CFR Part 2 Summaries (Office for Civil Rights): hhs.gov/hipaa
- Add OHA memo here
Frequently Asked Questions
What if my 14-year-old won’t sign an ROI for me at the ED? How do I advocate for my child if they don’t want me involved in their care?
In Oregon, youth age 14 and older can consent to some mental health services and control who gets information.
This can feel painful and confusing. You can still:
- Share safety concerns with the care team, even if they cannot share details back
- Ask general questions about diagnosis, next steps, and safety
- Tell staff: “I want to support my child and keep them safe.”
You are not doing anything wrong by asking to be involved.