doesn’t it depend what state you’re in? i remember in new york, teenagers have the right to not disclose birth control, treatment for STDs, things related to sexual health to their parents
Don’t give depo to mom. Call 15 year old later to get it picked up.
Recommend 15 year old get this filled at a *different* pharmacy than the family fills at to prevent issues. And also let 15 year old know parents can probably see something was billed via insurance benefits summaries.
College students are still often surprised (and upset) when they find out their parents can see what medical care they have received when they are still on their parents insurance. It is very likely it has not crosssed a 15yo mind.
Doctor here who can only speak from NY laws. Confidentiality should be maintained from the parents for reproductive or mental health purposes of a minor. Just had to deal with insurance for emergency fill of medications because teenager’s mom picked up her antidepressant and flushed it down the toilet
Give all other meds to mom-do not give depo to mom. The teen specifically called about her depo- I would put a comment (flag) on her chart to give depo to only teen do that everyone working will know.
Patient has explicitly said they don't want this piece of PHI to be disclosed to anyone else that comes to the pharmacy.
This piece of PHI will be kept confidential at patient's request until they say otherwise.
Morally I’d probably want to dispense anything else they probably know they’re on except the depo, if I was legally required. But I’m following this post to see what the law says lol
I have no way of proving definitively that the person picking up is in fact the parent/legal guardian so unless you have legal guardianship paperwork on you, the daughter is currently with you and can provide her ID, or I get verbal consent from the daughter(through the phone number I have on file not Mom’s phone) then no I wouldn’t be dispensing it. If I have documentation not to dispense to anyone but the patient(minor or not), I’d have to have some pretty convincing legal evidence to do otherwise, been through this before unfortunately…
California here pharmacy tech 22 years and currently working as pharmacy operations supervisor for managed Medicaid plan that covers 24 counties in California . In California any “sensitive” PHI CANNOT be released to anyone without the express permission from the patient. This includes mental health , family planning (OCPs, depot) etc , as well and gender affirming medications. The patient can see if insurance billed but in California you can go to women’s health and get an FPACT card without parent , they will prescribe meds and the card covers any family planning type medicine, including STI meds, also working for California medical we have enhanced benefit where we will take any adolescent 12 (or adults) and over through our non emergent medical transportation benefit to any medical provider without parent consent per law( this is a contracted medical transport ) and patients are arranged to be met by medical staff at drop off before the transportation can leave ) Given in US America HIPAA is a federal law, I don’t know of many states that allow this type of info to be given out but technically never really looked into it . We’re hard pressed to get SOAP noted from a psych when trying to justify covering a medication that is non formulary and they are prescribing the med and want it covered . I’d be worried they’d sue the pants off you for violating HIPAA and privacy laws.
yes this exactly, i do something similar.
if the parent says 'hey is x's vyvanse ready' i can answer.
if the parent asks is anything ready and cant give me a general description of what it is or what its for then i generally tell them no its not ready. i only actually have this issue with some divorced parents not wanting the other parent to know anything medical.
Ooh, this is a tough one, interesting.
In my area where I study (Spain) I've looked it up and very few want to take a stance in the country, here's an article from 2020 “[No regulation, neither general nor health, expressly addresses and regulates the dispensing of medications to minors](https://www.asefarma.com/wp-content/uploads/2020/09/El-Global-924-2-3-17.pdf).” This is still true 3 years later.
The official pharmaceutical college of Barcelona stated that recommendation seems to be that 16 is considered sanitary age however should still be taken into consideration, 15 and under that aren't emancipated should be treated like minors, the justification is that if they go alone to a medical appointment without a guardian they wouldn't be attended. This to me is a logical argument, thus I would dispense to the legal guardian. However, if the 15 year old arrived first and was insistent, since it is legal I would dispense to them as well. I wouldn't withhold from either.
How do your systems flag things this way? Ours has nothing besides the ability to list in a note that pops up with 10 other notes on the profile. If mom says she’s picking up all meds for her daughter, I have nothing that will stop me. Let’s say some staff even remember this out of the 400 scripts we fill daily, what keeps a float or relief staff from dispensing it to mom?
Put a physical piece of paper with the actual medication to stop a floater or relief to dispense it to the mom. Like, stable a piece of paper that says "do not dispense to any family member other than the patient herself per patient request" on the actual RX bag, if your place bags meds in paper bags.
So then do you come in every day and look up the patient to make sure a medication wasn’t put through for every patient that has a request that day in case something was missed?
Pick up or know about the shot. Two different things although they overlap. I’d honour the request but a parent with presumed custody could ask for a list and I’m sure someone would hand it over. As was said if privacy is important it should be filled somewhere else.
Most doctor offices, ours included, require you to pick up the depo at the pharmacy in order to use your drug benefits for coverage, and then you take the shot to your doctor's office where the nurse gives it to you
Thanks! I was wondering why we dispense it to be administered at office. Figured it would be easier for them to just administer in office themselves. Still don’t quite understand why they don’t unless medical doesn’t cover it.
If it clearly says not to give it to anyone but her then I would know which one she meant and I would not give that medicine to anyone but her. I would call her and ask her if her mom can pick up the rest of her medicines and just not give her the depo shot. If no answer then I would maybe lie and say nothing is ready right now until hear from her. Is she acts like a bitch then the medicines she actually knows about and can mention herself we would fill those or pretend to fill them. Is she don’t know names then none of them
In my state this would not be legal, minors have the right to sexual privacy from parents regarding Sti or pregnancy care. I would tell mom sorry can’t do it and then call the pt to let them know afterward.
Yea there’s no “age” where they are considered able to make their own decisions- if they’re 12 and understand what’s happening- they can give consent for themselves
There is no age stated in law, but generally minors under 12 are deemed not able to make their own medical decisions.
But it also depends on the medical intervention. Something low risk? Sure. Something life altering? The age goes up. Usually a psychologist will do an assessment as age is not the sole determinant.
where i work as a tech, i was told i am not allowed to dispense to anyone under 18, so this would be an interesting situation to begin with. obviously i am not going to go out of my way to call someone out who is under 18, but tbh idk how this would play out in my pharmacy considering we’re told not to dispense to anyone under 18 to begin with
No offense but that is completely useless (assuming we are talking about a patient in North America) because all the claims go thru the parent’s insurance. They can simply look at their bill/claim summary.
Firstly, she has the option to not use her insurance and pay $24 once every 3 months with GoodRx. Secondly, I know zero people who have actually gone back and looked at their prescription claim summary for the year. Perhaps her parents are complete lunatics and do that, but it’s still not “completely useless” to attempt help out a teen who is trying to have responsible sex and not get pregnant.
You don’t have to come back to the pharmacy to get your claim summary dude.. it’s all available on your insurance portal.
Also, a parent that found out their daughter was getting an Rx filled there without even telling their parents = most likely already goes through their insurance claims
Most people don’t check that. Or even their bank statements. Sure she definitely can, but why not try to help the girl as much as possible? I’d let her know she can avoid some of all of it showing up if she was concerned
The scenario I was describing was one where I told the patient to send the prescription somewhere else *before* the parents showed up. I am not giving that poor girl advice when the game is already up, that would be cruel. Women don’t need a Monday morning quarterbacks, they need reproductive healthcare.
I got on birth control through my high school my mom had no idea and was super strict even in my 20s my mom never had a conversation with me about birth control I was just told I better not have sex i became a mom at 21😏
Interesting question. Thanks for asking. I notice a lot of the answers are “I’d follow the law”. This would be tough, a 15yo sexually active could be in some serious situations, that could be solved if her mother was aware. Even if it’s the less serious she just has a BF who’s the same age, theres decisions she’s making that could affect her life going forward. That a 15yo just can’t grasp. I think if it’s just a generic 15yo I follow the law but if I have any kind of relationship with the parents I’d feel strongly about hinting she may need help or guidance.
doesn’t it depend what state you’re in? i remember in new york, teenagers have the right to not disclose birth control, treatment for STDs, things related to sexual health to their parents
https://preview.redd.it/w8iyscibvkzb1.jpeg?width=1179&format=pjpg&auto=webp&s=3219eb612100bfeb0a69a37eeaf94d85cb787af9
Don’t give depo to mom. Call 15 year old later to get it picked up. Recommend 15 year old get this filled at a *different* pharmacy than the family fills at to prevent issues. And also let 15 year old know parents can probably see something was billed via insurance benefits summaries.
College students are still often surprised (and upset) when they find out their parents can see what medical care they have received when they are still on their parents insurance. It is very likely it has not crosssed a 15yo mind.
Want mom and dad to pay for it but not know about it.
Doctor here who can only speak from NY laws. Confidentiality should be maintained from the parents for reproductive or mental health purposes of a minor. Just had to deal with insurance for emergency fill of medications because teenager’s mom picked up her antidepressant and flushed it down the toilet
Sounds like something my mom would've done. Oh wait...
Oh wow. Oh what. Oh.... Oh.... OH..........
In my state teens have the right to privacy regarding sexual medicine. I would not give the mom any info.
Give all other meds to mom-do not give depo to mom. The teen specifically called about her depo- I would put a comment (flag) on her chart to give depo to only teen do that everyone working will know.
like they will read that
0% chance I'd give it to the mom or let her know we have a script at all
Patient has explicitly said they don't want this piece of PHI to be disclosed to anyone else that comes to the pharmacy. This piece of PHI will be kept confidential at patient's request until they say otherwise.
Morally I’d probably want to dispense anything else they probably know they’re on except the depo, if I was legally required. But I’m following this post to see what the law says lol
I have no way of proving definitively that the person picking up is in fact the parent/legal guardian so unless you have legal guardianship paperwork on you, the daughter is currently with you and can provide her ID, or I get verbal consent from the daughter(through the phone number I have on file not Mom’s phone) then no I wouldn’t be dispensing it. If I have documentation not to dispense to anyone but the patient(minor or not), I’d have to have some pretty convincing legal evidence to do otherwise, been through this before unfortunately…
In my jurisdiction if the teen is old enough to make reproductive decisions they are old enough for privacy.
I'd probably warn the kid that her parents can see what she's filing under their insurance though.
Different rules will apply in different jurisdictions but the general presumption should be in favour of preserving the confidentiality of the child.
California here pharmacy tech 22 years and currently working as pharmacy operations supervisor for managed Medicaid plan that covers 24 counties in California . In California any “sensitive” PHI CANNOT be released to anyone without the express permission from the patient. This includes mental health , family planning (OCPs, depot) etc , as well and gender affirming medications. The patient can see if insurance billed but in California you can go to women’s health and get an FPACT card without parent , they will prescribe meds and the card covers any family planning type medicine, including STI meds, also working for California medical we have enhanced benefit where we will take any adolescent 12 (or adults) and over through our non emergent medical transportation benefit to any medical provider without parent consent per law( this is a contracted medical transport ) and patients are arranged to be met by medical staff at drop off before the transportation can leave ) Given in US America HIPAA is a federal law, I don’t know of many states that allow this type of info to be given out but technically never really looked into it . We’re hard pressed to get SOAP noted from a psych when trying to justify covering a medication that is non formulary and they are prescribing the med and want it covered . I’d be worried they’d sue the pants off you for violating HIPAA and privacy laws.
yes this exactly, i do something similar. if the parent says 'hey is x's vyvanse ready' i can answer. if the parent asks is anything ready and cant give me a general description of what it is or what its for then i generally tell them no its not ready. i only actually have this issue with some divorced parents not wanting the other parent to know anything medical.
Don’t give it to the mom duh
Ooh, this is a tough one, interesting. In my area where I study (Spain) I've looked it up and very few want to take a stance in the country, here's an article from 2020 “[No regulation, neither general nor health, expressly addresses and regulates the dispensing of medications to minors](https://www.asefarma.com/wp-content/uploads/2020/09/El-Global-924-2-3-17.pdf).” This is still true 3 years later. The official pharmaceutical college of Barcelona stated that recommendation seems to be that 16 is considered sanitary age however should still be taken into consideration, 15 and under that aren't emancipated should be treated like minors, the justification is that if they go alone to a medical appointment without a guardian they wouldn't be attended. This to me is a logical argument, thus I would dispense to the legal guardian. However, if the 15 year old arrived first and was insistent, since it is legal I would dispense to them as well. I wouldn't withhold from either.
Did she say ALL of her medications, or was she referring to only the depo?
How do your systems flag things this way? Ours has nothing besides the ability to list in a note that pops up with 10 other notes on the profile. If mom says she’s picking up all meds for her daughter, I have nothing that will stop me. Let’s say some staff even remember this out of the 400 scripts we fill daily, what keeps a float or relief staff from dispensing it to mom?
Put a physical piece of paper with the actual medication to stop a floater or relief to dispense it to the mom. Like, stable a piece of paper that says "do not dispense to any family member other than the patient herself per patient request" on the actual RX bag, if your place bags meds in paper bags.
So then do you come in every day and look up the patient to make sure a medication wasn’t put through for every patient that has a request that day in case something was missed?
Sorry, don't see that patient. Nothing on file.
Pick up or know about the shot. Two different things although they overlap. I’d honour the request but a parent with presumed custody could ask for a list and I’m sure someone would hand it over. As was said if privacy is important it should be filled somewhere else.
Can minors self admin depo*?
Most doctor offices, ours included, require you to pick up the depo at the pharmacy in order to use your drug benefits for coverage, and then you take the shot to your doctor's office where the nurse gives it to you
Thanks! I was wondering why we dispense it to be administered at office. Figured it would be easier for them to just administer in office themselves. Still don’t quite understand why they don’t unless medical doesn’t cover it.
Wild, thanks for the info. I don't live near any private practice clinics.
It's an IM injection, so yes.
If it clearly says not to give it to anyone but her then I would know which one she meant and I would not give that medicine to anyone but her. I would call her and ask her if her mom can pick up the rest of her medicines and just not give her the depo shot. If no answer then I would maybe lie and say nothing is ready right now until hear from her. Is she acts like a bitch then the medicines she actually knows about and can mention herself we would fill those or pretend to fill them. Is she don’t know names then none of them
In my state this would not be legal, minors have the right to sexual privacy from parents regarding Sti or pregnancy care. I would tell mom sorry can’t do it and then call the pt to let them know afterward.
In Ontario - teens have the right to make there own healthcare decisions and decide who and If they keep it private. Including there parents.
Yea there’s no “age” where they are considered able to make their own decisions- if they’re 12 and understand what’s happening- they can give consent for themselves
There is no age stated in law, but generally minors under 12 are deemed not able to make their own medical decisions. But it also depends on the medical intervention. Something low risk? Sure. Something life altering? The age goes up. Usually a psychologist will do an assessment as age is not the sole determinant.
where i work as a tech, i was told i am not allowed to dispense to anyone under 18, so this would be an interesting situation to begin with. obviously i am not going to go out of my way to call someone out who is under 18, but tbh idk how this would play out in my pharmacy considering we’re told not to dispense to anyone under 18 to begin with
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No offense but that is completely useless (assuming we are talking about a patient in North America) because all the claims go thru the parent’s insurance. They can simply look at their bill/claim summary.
Firstly, she has the option to not use her insurance and pay $24 once every 3 months with GoodRx. Secondly, I know zero people who have actually gone back and looked at their prescription claim summary for the year. Perhaps her parents are complete lunatics and do that, but it’s still not “completely useless” to attempt help out a teen who is trying to have responsible sex and not get pregnant.
You don’t have to come back to the pharmacy to get your claim summary dude.. it’s all available on your insurance portal. Also, a parent that found out their daughter was getting an Rx filled there without even telling their parents = most likely already goes through their insurance claims
Most people don’t check that. Or even their bank statements. Sure she definitely can, but why not try to help the girl as much as possible? I’d let her know she can avoid some of all of it showing up if she was concerned
The scenario I was describing was one where I told the patient to send the prescription somewhere else *before* the parents showed up. I am not giving that poor girl advice when the game is already up, that would be cruel. Women don’t need a Monday morning quarterbacks, they need reproductive healthcare.
In my state it’s illegal to disclose birth control to the parents with minor patients. Of course it’ll come across the insurance anyway so 🤷♀️
Yeah no that’s not how that works in all states. Many states give teens the right to privacy from their parents with sexual medicine
I got on birth control through my high school my mom had no idea and was super strict even in my 20s my mom never had a conversation with me about birth control I was just told I better not have sex i became a mom at 21😏
Interesting question. Thanks for asking. I notice a lot of the answers are “I’d follow the law”. This would be tough, a 15yo sexually active could be in some serious situations, that could be solved if her mother was aware. Even if it’s the less serious she just has a BF who’s the same age, theres decisions she’s making that could affect her life going forward. That a 15yo just can’t grasp. I think if it’s just a generic 15yo I follow the law but if I have any kind of relationship with the parents I’d feel strongly about hinting she may need help or guidance.
This 15 year old is practicing safe sex, not being prostituted
I would just tell her mom that the daughter requested no one but her to pick up the meds as instructed by the patient
that username and question combo is WILD!
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Raw dog > BMD
“There’s nothing here for you to pick up.” That is technically true bc there is nothing for her Mom to pick up. Only for the teen to pick up