Confidentiality has always been a key component of rehabilitative services. The HIPAA law (Health Insurance Portability and Accountability Act, signed by Bill Clinton in 1996), guarantees medical privacy, even for minors in many cases. But does it apply to rehabilitation for minors? Can a minor receive substance abuse rehabilitation without their parents finding out?
The short answer? Maybe. By HIPAA, minors are allowed to make their own informed consent decisions about health care without parental supervision, guidance, or involvement. However, there is a statute in HIPAA that states each state may make their own decisions and enact their own rules. This has led to a dizzying patchwork of regulations and rules from state to state.
Below is a table that identifies each state’s specific action toward both drug treatment and mental health treatment.
| State | Drug Treatment | Mental Health Treatment | ||
| Inpatient | Outpatient | Inpatient | Outpatient | |
| Alabama | Minor | Minor | Minor (≥ 14) | Minor (≥ 14) |
| Alaska | No Specific Law | No Specific Law | No Specific Law | No Specific Law |
| Arizona | Either (≥12) | Either (≥12) | Parent | Parent |
| Arkansas | No Specific Law | No Specific Law | No Specific Law | No Specific Law |
| California | Either (≥12) | Either (≥12) | Minor (≥12) | Minor (≥ 12) |
| Colorado | Minor | Minor | Minor (≥15) | Minor (≥ 15) |
| Connecticut | Either | Either | Either(≥14)a | Minor |
| Delaware | Parent | Either (≥14) | Parent | Parent |
| DC | Minor | Minor | Parent | Minor |
| Florida | Either | Minor | Parent | Minor (≥ 13) |
| Georgia | Either (≥12) b | Minor | Parent | Either (≥ 12) |
| Hawaii | Minor | Minor | Parent | Minor |
| Idaho | Either | Either | Either (≥14)a | Either |
| Illinois | Minor (≥12) | Minor (≥12) | Either (≥ 16)a | Minor (≥ 12) |
| Indiana | Minor | Minor | Minor | Minor |
| Iowa | Either | Either | Minor/Bothc | Minord |
| Kansas | Minor | Minor | Either (≥14) | Either (≥ 14) |
| Kentucky | Either | Minor | Minor (≥ 16) | Minor (≥ 16) |
| Louisiana | Minor | Minor | Minor | Minor |
| Maine | Bothb | Minor | Minor | Minor |
| Maryland | Either | Minor | Either (≥ 16) | Either (≥ 16) |
| Massachusetts | Minor (≥ 12) | Minor (≥ 12) | Either (≥ 16)a | Either (≥ 16) |
| Michigan | Either (≥ 14)f | Either (≥ 14) | Either (≥ 14) | Minor (≥ 14) |
| Minnesota | Minor (≥ 16) | Minor(≥ 16) | Minor (≥ 16) | Minor (≥ 16) |
| Mississippi | Parent | Minor (≥ 15) | Parent | No Specific Law |
| Missouri | Either | Either | Parent | Parent |
| Montana | Minor | Minor | Either (≥ 16) | Either (≥ 16) |
| Nebraska | Either | Either | Either | Either |
| Nevada | Minor | Minor | Parent | Parent |
| New Hampshire | Minor (≥ 12) | Minor (≥ 12) | Either | Either |
| New Jersey | Minor | Minor | Parent | Parent |
| New Mexico | Minor(≥ 14) | Minor (≥ 14) | Minor (≥ 14) | Minor (≥ 14) |
| New York | Either | Either | Either (≥ 16) | Either |
| North Carolina | Parent | Minor | Parent | Minor |
| North Dakota | Minor (≥ 14) | Minor (≥ 14) | Parent | Parent |
| Ohio | Minor | Minor | Parent | Minor (≥ 14) |
| Oklahoma | Minor (≥ 16) | Minor | Minor (≥ 16) | No Specific Law |
| Oregon | Minora | Minor (≥ 14) | Parent | Minor (≥ 14) |
| Pennsylvania | Either | Either | Either (≥ 14) | Either (≥ 14) |
| Rhode Island | Either | Either | Both | Both |
| South Carolina | Minor (≥ 16) | Minor (≥ 16) | Minor (≥ 16) | Minor (≥ 16) |
| South Dakota | Either | Either | Both (≥ 16) | Both (≥ 16) |
| Tennessee | Either (≥ 16) | Either(≥ 16) | Minor (≥ 16) | Minor (≥ 16) |
| Texas | Either (≥ 16) | Either (≥ 16) | Either (≥ 16) | No Specific Law |
| Utah | Parent | Parent | NoSpecific Law | No Specific Law |
| Vermont | Minor (≥ 12) | Minor (≥ 12) | Minor (≥ 14) | Minor (≥ 14) |
| Virginia | Both (≥ 14) | Minor | Both (≥ 14) | Minor |
| Washington | Parent | Minor (≥ 13) | Minor (≥ 13) | Minor (≥ 13) |
| West Virginia | Minor | Minor | Both (≥ 12) | Both (≥ 12) |
| Wisconsin | Parent | Either (≥ 12) b | Both (≥ 14)g | Both (≥ 14) |
| Wyoming | No Specific Law | No Specific Law | No Specific Law | No Specific Law |
Note. Parent = Parental consent only required; Minor = Minor consent only required; Either = Either parental or minor consent; Both = Both parental and minor consent required; No Law Found = No specific law was found addressing that particular form of treatment. If a state specified an age at which a minor was considered mature, it is indicated in parentheses after the type of consent required.
Again, a wildly varying and confusing array of laws. Let’s break them down to understand what’s being said here.
We have two columns. One labeled “Drug Treatment” and the other “Mental Health Treatment”. Let’s analyze the state of Virginia.
In Virginia, inpatient therapy (rehab) for addiction-related issues requires both the consent of the parent and the child (as long as the child is above 14) are required. The same applies to inpatient therapy with the minor being at or above the age of 14.
However, outpatient therapy for both substance abuse and mental health issues remains solely the domain of the child in question. There is no consent or notification of the parent or guardian required.
In the state of Rhode Island, the minor or guardian may send the minor to rehab (there is no age floor). However, to send the minor to mental health treatment of any kind) requires the consent of both the guardian and the minor.
In New Hampshire, only the minor can decide to go to rehab. Both the minor and the guardian may make the decision to go to mental health, be it, inpatient or outpatient.
In Utah, the parent has exclusive rights over the minor with regard to drug and alcohol rehabilitation. However, there is no actual law on the books regarding mental health aid; it is presumed that the minor may attend without parental supervision or guidance.
For the sake of ease of use, I have divided the entire US into two basic categories - Private and Non-Private.
Private states include all states listing minors as being the sole decision-maker under both fields (inpatient and outpatient) of drug rehabilitation. Most of them have separate rules regarding mental health. Please refer to the table above, if you have any questions.
These are the states of Alabama (over the age of 14), Arizona, (over the age of 12), , Colorado (over the age of 15), Connecticut, Florida, Washington DC, Georgia (over the age of 12), Hawaii, Idaho, Illinois (over the age of 12), Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts (over the age of 12), Michigan (over the age of 14), Minnesota (over the age of 16), Missouri, Montana, Nebraska, Nevada, New Hampshire (over the age of 12), New Jersey, New Mexico (over the age of 14), New York, South Dakota (over the age of 14), North Dakota (over the age of 14), Ohio, Oklahoma (over the age of 16), Oregon (over the age of 14), Pennsylvania, South Carolina (over the age of 16), South Dakota, Tennessee (over the age of 16), Texas (over the age of 16), and finally Vermont (over the age of 12). These states are all private for minors seeking rehab.
Rhode Island and Maine are fringe cases. They require parental consent unless the doctor evaluates that informing the parents about the rehab activity would terribly harm the recovery process.
Delaware requires parental consent for inpatient, but not outpatient care. Mississippi, North Carolina, Virginia, Washington, and Wisconsin all require parental permission for inpatient treatment.
Alaska and Wyoming do not have specific laws on the books, and so, therefore, should refer to following federal HIPAA law on the subject.
Unfortunately, this law and its state applications are only the tip of the iceberg. There are still more considerations. For example, if there is a charge or a bill associated with the services, the guardian may discover what has transpired. Correspondence, phone calls, & other methods of communication may be intercepted and used to pressure or otherwise identify the minor.
The best advice is to consult a doctor or addiction recovery professional and follow their advice. Though the framework for an independent addiction recovery journey is there, it differs greatly from state to state and in each circumstance
