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A state commission approved new rules for the release of mental health records despite thousands of comments from the public urging them to reject the changes over questions about parental notification requirements.
The Independent Regulatory Review Commission voted 4-1 Thursday to approve changes proposed by the Department of Human Services in response to a 2022 state law dealing with who has access to minors' mental health records.
The bulk of the pushback against the new rules was triggered by the department's move to eliminate language spelling out that parents must be granted access to health records related to mental health treatment for children under age 14. Department of Human Services officials said at the meeting that the language was removed because it was outdated and unnecessary and that the guide rails governing release of minors' mental health records are set in other state laws, like Act 65 of 2020, Act 32 of 2022 and the federal Health Insurance Portability and Accountability Act.
Act 65 says that minors 14 and older can seek mental health services without obtaining parental permission or sharing their medical records with their parents, according to a summary of the legislation posted online by the Department of Human Services. If the teen is receiving outpatient mental health services, there is no requirement that the minor's parents be notified. If the teen is admitted for inpatient treatment, the parents would be notified but they would have no authority to stop the treatment other than to appeal the decision in court.
Ahead of the vote, commission member Murray Ufberg questioned whether under the regulations, parents might receive a bill for treatment services without being provided information on what that treatment entailed. Department officials acknowledged that could be the case.
In the two weeks ahead of Thursday's vote, the commission received 2,000 comments from people opposed to the regulation.
Commissioner John Soroko was the only member to vote against the regulations. Soroko said he thinks the language used by DHS in the new regulation is more confusing than the passages they were replacing.
Soroko said department officials had suggested that they would provide "technical assistance" if needed but that would be unlikely to be much use to a parent who is arguing with a mental health provider or whether or not he or she gets access to their child's healthcare records.
"You substituted what was a very clear direction with broad references to statutes that actually don’t say anything different, but the ambiguity will work against the interests of parents. And I think that’s unfortunate," Soroko said.
Many commentators raised issues similar to Soroko's objections.
"The regulation should clearly preserve lawful parental access to children's mental health information, protect meaningful informed consent, and provide understandable standards for families and providers," according to comments submitted by the Pennsylvania Coalition for Informed Consent. "Removing explicit protections can make those rights harder for families to understand and exercise. Parents should not have to navigate multiple statutes and federal regulations to determine whether they can obtain information necessary to care for their child."
The dust-up comes just weeks after the Department of Health withdrew a proposed regulation updating public health law related to immunizations over intense pushback from conservatives who asserted that the regulations would revive COVID-19 pandemic restrictions.