DEFENSE HEALTH AGENCY7700 ARLINGTON BOULEVARD, SUITE 5101
FALLS CHURCH, VIRGINIA 22042-5101

DHA-Policy Memorandum 23-010
October 5, 2023
MEMORANDUM FOR: SEE DISTRIBUTIONSUBJECT: Parental Access to Protected Health Information of Unemancipated Minors
Reference: (a) DoD 5400.11-R, “Department of Defense Privacy Program,” May 14, 2007(b) DoD Instruction 6025.18, “Health Insurance Portability and Accountability Act(HIPAA) Privacy Rule Compliance in DoD Health Care Programs,” March 13,2019(c) DoD Manual 6025.18, “Implementation of the Health Insurance Portability andAccountability Act (HIPAA) Privacy Rule in DoD Health Care Programs,”March 13, 2019(d) Assistant Director for Health Care Operations Memorandum, “Minors andReproductive Health Care Services (Overseas),” March 12, 2023
This Defense Health Agency (DHA)-Policy Memorandum, based on the authorities ofreferences (a), (b), (c), and (d) provides guidance on disclosure of protected health information(PHI) of unemancipated minors to their legal personal representative(s) by staff at DHA military
medical treatment facilities (MTFs).
The Department of Defense (DoD) complies with federal law governing healthinformation privacy to include the release of protected health information (PHI) per the Health
Insurance Portability and Accountability Act (HIPAA) (as implemented in DoD Instruction
6025.18, “Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule
Compliance in DoD Health Care Programs,” March 13, 2019, and DoD Manual 6025.18,“Implementation of the Health Insurance Portability and Accountability Act (HIPAA) Privacy
Rule in DoD Health Care Programs,” March 13, 2019) and the Privacy Act (as implemented inDoD 5400.11-R, “Department of Defense Privacy Program,” May 14, 2007).
In general, when a parent or guardian or other person acting in loco parentis (i.e., an adultwith authority to act in place of the parents) has authority to act on behalf of an unemancipatedminor in making decisions related to health care, they are considered the personal representative
for receipt of the minor’s PHI. In those instances (e.g., mental health care, pregnancy, care forsexually transmitted diseases) where a minor is recognized as being able to provide informed
consent for their own care, typically when they become adolescents, state and federal law under
HIPAA protects their privacy interests.

DHA-Policy Memorandum 23-010
October 5, 2023
Access to PHI via the online patient portal is dependent on credentials managed by theDefense Manpower Data Center and subject to technical procedures implemented to safeguard thePHI of unemancipated minors within the electronic health record. Patient portal online access forparents, guardians, and others acting in loco parentis for adolescents would be limited to viewing
online appointments, messaging, immunizations, and allergies. Parents have full online access toPHI of unemancipated minors (ages 12 and under) unless limited by other applicable law orregulation. Because of this, DoD may not be able to provide full online access to parents,guardians, or other persons acting in loco parentis for adolescents (ages 13 to 17). Parents,guardians, and others acting in loco parentis may still obtain medical records through the Military
Medical Treatment Facility Outpatient Medical Records Department consistent with HIPAA foradolescents when the encounter was not one for which the adolescent provided their own consent
or when they authorized in writing another’s access to their PHI for encounters for which theyconsented.
DHA MTFs, also known as covered entities under HIPAA, are required to implement
policies and procedures designed to comply with the standards, implementation specifications, orother requirements of reference (b). DHA MTFs must incorporate into the MTF’s HIPAA
policies and procedures applicable international agreements, international laws, federal laws andregulations, and state laws when not in conflict with federal laws and regulations pertaining to apersonal representative who may have the authority to act on behalf of an unemancipated minor inmaking health care decisions. MTF Directors must ensure the workforce is trained on the MTF’s
HIPAA policies and procedures.
MTFs will provide information on access to PHI of minors via local websites, forums, andawareness products (e.g., posters, flyers, newspapers) for beneficiaries to understand theprocedures to request and receive PHI, as applicable. The standard enterprise-wide information
flyer provided by DHA Strategic Communications will be used to provide beneficiaries
information on options to receive PHI of their minor children.
This DHA-Policy Memorandum is cleared for public release and available on the Internet
from the Health.mil site at: https://health.mil/Reference-Center/Policies and is also available toauthorized users from the DHA SharePoint site at: https://info.health.mil/cos/admin/pubs/.
Please address questions regarding this DHA-Policy Memorandum to the DHA Privacy
and Civil Liberties Office at dha.ncr.pcl.mbx.hipaa-compliance-inquiries@health.mil.

TELITA CROSLAND
LTG, US ARMY
Director2

DHA-Policy Memorandum 23-010
October 5, 2023
Attachments:
DHA Strategic Communications Information Flyer

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DHA-Policy Memorandum 23-010
October 5, 2023

DISTRIBUTION:Defense Health Agency Assistant Directors, Deputy Assistant Directors, and Special StaffDirector, Alaska MarketDirector, Augusta MarketDirector, Central North Carolina MarketDirector, Central Texas MarketDirector, Coastal Mississippi MarketDirector, Coastal North Carolina MarketDirector, Colorado MarketDirector, El Paso Market
Director, Florida Panhandle Market
Director, Jacksonville MarketDirector, Low Country MarketDirector, National Capital Region MarketDirector, Puget Sound MarketDirector, Sacramento Market
Director, San Antonio Market
Director, San Diego MarketDirector, Southwest Georgia MarketDirector, Southwest Kentucky MarketDirector, Tidewater MarketDirector, Small Market and Stand-Alone Military Medical Treatment Facility Organization
Director, Defense Health Agency Region-Europe
Director, Defense Health Agency Region-IndoPacificDirectors, Defense Health Agency Small Markets
Directors, Defense Health Agency Military Medical Treatment Facilities
Directors, Defense Health Agency Dental Treatment Facilities

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Patient Portal Eligibility
IMPORTANT INFORMATION REGARDING PATIENTPORTAL ELIGIBILITY AND ADULT PROXIES• Access to Patient Portal information is dependent on
DMDC DS Logon permissions.
• Beneficiaries may grant permission to family members foraccess to medical information, by going to Managing
Relationships in DS Logon via
https://www.dmdc.osd.mil/identitymanagement/app/login• The Department of Defense allows proxy access forsituations where the beneficiary cannot access or provide
consent for access. Legal documentation is required. Seethe DS Logon Frequently Asked Questions for additional
information.
ACCESSING MEDICAL RECORDS• Beneficiaries may access their and their family members’
medical records via the Patient Portal, subject to DS
Logon permissions.
• Beneficiaries may visit their military hospital or clinic andrequest the records in person.
• Beneficiaries may coordinate with their military hospital orclinic to submit a request via postal mail or email.
FOR FURTHER ASSISTANCE PLEASE CONTACT:PATIENT PORTAL PERMISSIONSAges 18+: If eligible, may create their own DS Logonaccount and be able to access the Patient Portal.
Ages 0-12: Only sponsors, parents, or guardians (Proxies)
are granted access to a child’s records.
Ages 13-17: Only sponsors, parents, or guardians aregranted access to a limited set of the teenager’s records
such as appointments, secure messages, immunizations,and allergy information. Sensitive clinical information isrestricted from view in accordance with State Laws and theHealth Insurance Portability and Accountability Act (HIPAA).
Beneficiaries with special health care needs: Proxies may be
granted access in accordance with DOD guidelines.
Active Duty/National Guard/Reserve: May access thePatient Portal with a valid DS Logon account.
Retirees: May access the Patient Portal with a valid DS
Logon account.
Veterans with a continuing affiliation to the DOD: May
access the Patient Portal with a valid DS Logon account.

Last updated on November 2023

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