Choices for Minors

The Minor Opt-Out Process

Minor Opt-Out is a narrowly-tailored process that supplements the NC HIEA’s Standard Opt-Out process that applies to adult patients and when parents/guardians direct that their child be opted out of NC HealthConnex.

Only patients younger than 18 can complete the Minor Opt-Out form – and then only when treatment is provided for certain medical “Opt-Out Events” identified in N.C. Gen. Stat. § 90-21.5. Under that law a patient under 18 may independently consent to receive medical services for prevention, diagnosis, and treatment of certain conditions without permission from a parent or guardian. These “Opt-Out Events” include patient encounters concerning:

          (i) venereal disease and other diseases reportable under G.S. 130A-135,

          (ii) pregnancy,

          (iii) abuse of controlled substances or alcohol, and/or

          (iv) emotional disturbance.

The circumstances contemplated by N.C. Gen. Stat. § 90-21.5 are a statutory exception to the general rule that an unemancipated minor may not receive medical treatment without the consent of the minor’s parent, legal guardian, or a person acting in loco parentis.

Further, pursuant to N.C. Gen. Stat. § 90-21.4(b), medical providers are also prohibited from notifying the minor’s parent or legal guardian about the medical services given to the minor for the conditions set out in N.C.G.S. § 90-21.5, unless the attending physician determines that notifying the parent or legal guardian is essential to the life or health of the minor.

To allow a minor to exercise their right to protect these services from being shared among providers, the NC HIEA, in collaboration with our vendor partner SAS Institute, NC Department of Health and Human Services and the local health department pilot participants, have developed a Minor Opt-Out process.

Importantly, the Minor Opt-Out Process is encounter-based. That means each time a minor patient seeks to exercise their opt-out right for treatment records related to care provided under N.C. Gen. Stat. § 90-21.5, they must complete the Minor Opt-Out Form.

The process involves the following steps for health care facilities:

  • The practice enrolls in the NC HealthConnex Minor Out-Out solution by emailing the NC HIEA at hiea@nc.gov. Implementation will be tested and approved by the NC HIEA before proceeding.
  • The provider obtains a Minor Opt-Out form from the minor patient during their visit, which does not require permission from parent or guardian. Details on what this means for the patient are outlined below.
  • The provider sends the patient’s Minor Opt-Out form to the NC HIEA via Direct Secure Messaging (DSM) within two days of the encounter. To request a DSM account, contact the Participant Account Administrator (PAA) for your facility.
  • The NC HIEA staff will acknowledge receipt via DSM to the provider.
  • Minor data will be withheld from NC HealthConnex for six calendar days in order to account for processing time in receipt of the Minor Opt-Out form.
  • If the completed Minor Opt-Out form is received via DSM during the six-day window, no data associated with that encounter will be sent to the health information exchange platform. If the provider does not timely relay the Minor Opt-Out form to the NC HIEA via DSM, then the minor’s data from that encounter will be released in the health information exchange platform and be viewable upon a patient search.

With the help of providers, unemancipated minor patients receiving certain medical treatments identified by state law can complete an NC HealthConnex Minor Opt-Out Form to keep those encounters from being shared through NC HealthConnex. It’s important to educate minor patients of what submitting an opt-out form means:

  • The treating health care provider or designee will assist the minor with completing the appropriate form or forms and submit them on the patient’s behalf.
  • Any minor can opt out of sharing specific services including treatments for some contagious diseases, family planning/pregnancy, emotional issues, and drug or alcohol use.
  • The Minor Opt-Out solution is for a date-specific encounter and only applicable when a confidential treatment is provided.
  • Only that specific visit will be suppressed from being shared in NC HealthConnex. This form will need to be filled out for each Minor Opt-Out event the minor does not want shared in NC HealthConnex.
  • Once a patient turns 18, they may exercise their statutory right to opt out of NC HealthConnex using the Standard Opt-Out form.
  • North Carolina law requires providers to notify their parent or legal guardian if they determine information is essential to their well-being.