Youth in Foster Care
Young people in foster care have the same rights to health care services as other minors. For example, you can still get sexual and reproductive health services without your parents’ consent. The foster care agency that is assigned to your case will generally be responsible for paying for and arranging your health care. Youth in foster care also have court-appointed attorneys who may be able to help you navigate questions about your care and speak to you confidentially about issues you are encountering.
In some cases, your parents may still have the right to consent to your other medical care. If you no longer have a legal relationship with your parents, your provider will need the consent from your foster care agency.
No matter who consents to treatment, if you are in foster care, there is a higher chance that your medical information will not be confidential. This is because any medical information relating to a minor that a foster care or adoption agency has must be released to potential foster or adoptive parents when the minor is adopted, placed in foster care, or placed with a relative or other legally responsible person. In other words, if your placement changes or you are adopted, and the agency has your medical records, it must share them with your new placement.
Unlike other minors whose HIV testing and/or treatment would be confidential, minors in foster care have less protection. Foster care agencies must release any HIV-related information to potential foster parents, adoptive parents, or other legally responsible people who are going to take on the responsibility of caring for the minor.
If you want to get an HIV test and want the results to remain confidential, it is best to ask for an anonymous HIV test. An anonymous HIV test is a way to test for HIV where your name and contact information is not written down. You are given a numbered testing code that only you know and that you must provide to get your result.
Any young person can request an anonymous HIV test. However, this can be particularly helpful for young people in foster care.
Reproductive Health Care
You have the same rights as other minors when it comes to reproductive health care. However, because any medical information that your foster care agency has about you has a higher chance of being shared, you might want to get care from a clinic that is separate from your foster care agency to protect your confidentiality.
Clara, who is 16, is in foster care and wants to see a gynecologist to begin annual reproductive care checkups. However, she doesn’t want her foster care agency or foster parents to know about the private medical information that her doctor will learn about her. How can she keep the information confidential?
Clara can seek treatment from an independent health care clinic or provider – such as Planned Parenthood (https://www.plannedparenthood.org/health-center), the Community Health Care Network (http://www.chnnyc.org/), or the Mount Sinai Adolescent Health Center (http://www.mountsinai.org/patient-care/service-areas/adolescent-health-center) – that is not associated with the foster care agency. Such clinics must keep her medical information confidential and cannot disclose it to foster care agencies without her consent. They also provide free and low-cost services. However, if Clara seeks HIV-related care, that information will be subject to disclosure, even if the health care provider is not affiliated with the foster care agency.
Transgender-Related Health Care
The same consent requirements apply for youth in foster care seeking transition-related care as apply to youth outside of the foster care system, but the relevant foster care agency may be able to provide consent if your parent is unwilling or unable to consent, cannot be contacted, or no longer have the right to consent on your behalf.
Medicaid, as well as the NYC Administration for Children’s Services, will often cover the cost of hormone therapy and/or gender affirming health care for foster youth.