It has been eighteen long, mostly wonderful (?) years but it is now time to send them off to college! You may be thrilled, or weepy, or both. But don’t forget they will still need you, possibly at a very critical time. If your child is over the age of 18, privacy laws in the US will deny you, the parent, access to your now-adult child’s medical records without their written permission.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) established national standards to protect individuals’ medical records and other personal health information and applies to most health plans and healthcare providers. Interestingly, university health facilities are not covered by HIPAA. Instead, college students’ health records fall under the Family Educational Rights and Privacy Act, which gives parents the right to inspect their children’s records at an educational institution.
So, which is it? Can you access your student’s health/medical records, or not? It may depend on where your child gets treated. Some schools just have a nursing/urgent care area for minor illnesses, but someone injured playing sports may have to go to a local emergency room. In that case, HIPAA would apply at the off-campus hospital and you would need your student’s authorization to access their records and/or to talk with their doctors, nurses, or other healthcare providers about their care.
The bottom line here – you may want to fill out a HIPAA privacy authorization form for medical providers and have your adult student complete and sign it to authorize you as parent(s) to be able to obtain medical information. At the least, discuss with your child the need for them to fill out an authorization form at each clinic or healthcare facility in order for you to have access to information about their healthcare.
In addition, some scenarios, while unlikely, might necessitate further action. What if your child is off snowboarding during spring break and breaks a leg? While inconvenient for everyone, if your child can verbally direct or sign a HIPAA authorization on-site, you should be able to get information from the doctors and hospitals.
Advance Healthcare Directive
But, consider the worst case scenario…they wipeout, hit their head, and lose consciousness. What happens if your child remains in coma or is declared brain dead? As awful and unthinkable as this is, preparing a signed medical directive with your child now will help you make decisions that will honor your child’s wishes and avoid additional bureaucracy such as needing to obtain a court order.
An advance healthcare directive (also known as a medical power of attorney or healthcare proxy) allows an adult to appoint a person they trust as their healthcare agent/surrogate to make medical decisions on their behalf if they lose the ability to do so. Consider having your majority-age child fill out a medical directive (and do so for yourself as well if you do not have one). In an emergency situation without a directive, one or two persons will be designated to make decisions; by having a signed medical directive, your student will choose that person (designated agent) and a backup in advance.
This is an opportunity for you to have an important discussion with your adult children. They may never have considered that life-prolonging/terminating decisions sometimes have to be made. Your grown children are now facing life decisions and responsibilities that they have never had before, so help them understand the importance of planning ahead. This is also a chance for you to convey and document your own wishes for your healthcare in worst case scenarios (and prepare your own healthcare directive if you haven’t done so). Plan for the worst but expect the best is as important at this age as establishing a guardian for your minor children was years ago – you hope that you will never need it, but it may be one of the most important actions you ever take.
You may have a healthcare advance directive prepared by an attorney as part of your estate planning process. For your student, you may want to obtain a state-specific standard medical directive form and follow its instructions for completion. You can access each state’s medical directives at www.caringinfo.org. While each state has its own form, they are similar – with areas to designate a healthcare power of attorney (in the case of your college student, this should most likely be you or another parent or guardian) and indicate preferences about life-prolonging care, treatment, services, and procedures.
While most states will honor other states’ directives, it is most prudent to fill out a medical directive for the state(s) your student will spend the most time in. Differences between states’ medical directives can include what is age of majority/a competent adult, number of witnesses required, how incapacity is determined, and/or a living will as a separate document from the healthcare power of attorney.
Now that we have covered medical records access, guess what? You aren’t allowed access to your college student’s education records either due to the FERPA (Family Educational Rights and Privacy Act) without written permission. So, don’t forget to get a grade/education record access waiver signed by your college student for their institution. But that’s another battle to wage.
Authored by fellow Alliance of Comprehensive Planner (ACP) member, Pamela Khinda, MBA. Alliance of Comprehensive Planners