Parental Access to Minor Patients' Medical Records

A895 establishes a clear, affirmative duty for two categories of providers. Under new Section 5, every health care facility licensed under P.L.1971, c.136 must provide the parent or guardian of an unemancipated patient younger than 18 years of age access to any of the patient's medical records that are in the facility's custody, without requiring the patient's authorization. Under new Section 6, every health care professional licensed under Title 45 of the Revised Statutes faces the identical obligation with respect to records in that professional's custody. The American Council supports this bill because parents bear legal, moral, and spiritual responsibility for their children's wellbeing, and that responsibility cannot be exercised in the dark. We urge every legislator to vote yes.

Both the facility duty and the professional duty carry the same carefully bounded exception: the obligation does not apply where care falls under subsections a. or b. of section 1 of P.L.1968, c.230 (C.9:17A-4). Subsection a. covers minors treated for sexually transmitted infections, HIV/AIDS, or apparent sexual assault; subsection b. covers minors treated for substance use disorders, alcohol use disorders, or -- for minors 16 and older -- temporary outpatient behavioral health services. Outside those carve-outs, the duty to provide access is unqualified by the bill's text.

To encourage compliance and remove provider hesitation, both new sections grant immunity. Except in cases of gross negligence or willful misconduct, a health care facility is immune from any civil or criminal liability and any adverse administrative or licensure action for providing parental access under Section 5. The parallel immunity in Section 6 shields health care professionals from any civil or criminal liability and any adverse administrative or professional disciplinary action. The gross-negligence and willful-misconduct exceptions apply in both sections; providers are not insulated from every consequence, but the ordinary risk of compliance is removed. We believe this immunity provision is essential: without it, cautious providers would default to restriction even where the law clearly requires access.

Section 4 amends C.9:17A-4 directly by adding a new subsection c. That subsection has two operative sentences that work differently and must be read separately. The first sentence states that, except as provided in subsections a. and b. of that section, and to the extent authorized under federal law, parents or guardians of unemancipated patients younger than 18 shall be provided access to medical records without the patient's authorization. The second sentence addresses HIPAA directly: it states that, for purposes of the federal health privacy rule at 45 CFR Parts 160 and 164, nothing in C.9:17A-4 shall be construed to preclude a parent or guardian of an unemancipated minor from accessing medical records pertaining to care or treatment provided under subsection a. -- that is, the STI, HIV/AIDS, and sexual-assault care that the first sentence and Sections 5 and 6 otherwise treat as shielded from the parental access duty. The single named exception to that HIPAA sentence is where care is provided to a minor who appears to have been sexually assaulted and the treating healthcare professional believes it is in the best interests of the patient not to provide notice to the minor's parent or guardian. In plain terms: for HIPAA classification purposes, this bill affirmatively opens subsection a. care records -- including STI and HIV/AIDS records -- to parental access, with only the sexual-assault best-interests situation excepted. Supporters should be clear with legislators' offices that the bill does not preserve confidentiality of STI and HIV/AIDS records from parents under HIPAA; it removes that barrier, except in the narrowly defined sexual-assault circumstance. The bill's judgment call to place that decision with the treating professional is one the Council finds reasonable, and we support the provision as written.

Section 3 amends C.9:17A-1, the statute governing consent by married or pregnant minors, to add a HIPAA-facing sentence: for purposes of 45 CFR Parts 160 and 164, nothing in that section shall be construed to preclude a parent or guardian of a minor who consents to care or treatment pursuant to that section from being provided access to the medical records pertaining to that care or treatment. The operative reach of C.9:17A-1 includes care consented to by a married minor on their own behalf or on behalf of their children, and care consented to by an unmarried pregnant minor that is related to her pregnancy or her child. Section 3 contains no carve-out for any of that reproductive care: the HIPAA-access sentence applies to all records pertaining to care consented to under that section. Constituents should understand that when they tell a legislator's office this bill restores parental access for care under C.9:17A-1, they are accurately describing a provision that includes pregnancy- and childbirth-related care consented to by an unmarried pregnant minor.

Sections 1 and 2 amend the two operative provisions of P.L.2022, c.51, which govern reproductive health records confidentiality (C.2A:84A-22.18) and the prohibition on state resources being used in certain interstate investigations (C.2A:84A-22.19). To each, the bill adds identical language: nothing in that section shall be construed to impede the lawful sharing of medical records as permitted by State or federal law or the Rules of Court, including as authorized under C.9:17A-1, C.9:17A-4, and new Sections 5 and 6 of this bill. These amendments ensure that the 2022 confidentiality statute cannot be read as a barrier to the parental access this bill establishes. The Council views this as a necessary alignment: a parent's right to their child's records should not be quietly nullified by a separate statute aimed at a different purpose.

Section 7 directs the Commissioner of Health and the Director of the Division of Consumer Affairs in the Department of Law and Public Safety to promulgate rules and regulations pursuant to the Administrative Procedure Act, P.L.1968, c.410, as necessary to implement the act. Section 8 sets the effective date as immediate upon enactment. Rulemaking will be needed to give providers practical guidance, and the Council will monitor that process to ensure implementation reflects the bill's plain intent to restore parental access as the default.

One drafting note worth flagging: new subsection c. of C.9:17A-4 states that parental access applies "to the extent authorized under federal law." This phrase conditions the new right on federal authorization, which introduces interpretive uncertainty at the margin -- particularly given ongoing changes to federal HIPAA guidance. As drafted, it is unclear whether this qualifier would allow a federal regulatory reversal to silently contract the state-law right. The Council reads the phrase as a federalism acknowledgment rather than a self-defeating limit, but a court could read it more narrowly. We note this not to oppose the bill -- we support it strongly -- but because constituents deserve an honest account of what the text says.