My Pharmacist and Me: How California Pharmacists Can Help Protect Patient Privacy

As pharmacists prepare to step into the ring of providing sensitive family planning services to their patients, it is important to brush up on patient confidentiality strategies, especially as they pertain to teens.

But wait…isn’t that what HIPAA is for?

Well yes… but wait there’s more! Once the statewide protocol for pharmacy access to hormonal contraception gets approved in California, pharmacists are likely to see teens pursue this option as a confidential, convenient way to get effective birth control. As a pharmacist, you should know that in the State of California, minors are allowed to obtain birth control without parental consent. In fact, you legally cannot discuss any family planning issues with a minor’s parents without the patient’s written permission. While you should encourage teens to keep open communication lines with their parents, you need to respect their decision if they choose to keep their sexual health a private matter. Knowing that they can trust their pharmacist to keep their healthcare private is VERY important to teens and they would benefit from being assured that you will keep their information confidential.

How does the ACA affect patient privacy?

The Affordable Care Act not only expanded insurance coverage for young adults through their parent’s plan up to age 26, it also provided complete coverage for birth control for women. This brings up an important dilemma, patients may now have expanded coverage for birth control, but they may be afraid to access it because of privacy concerns. While you have provider-patient confidentiality laws to adhere to, the insurance companies do not have to keep it confidential. This means that if your patient uses her insurance to cover her birth control, but her parent or spouse is the policy holder, then the insurance company could send billing information that reveals services obtained to that policy holder.

keepitconfidential birth control pregnancy test STD teen insurance pharmacy pharmacist

How can I make sure my insurance company keeps my health information confidential?

In California, a law was passed that allows dependents to fill out a Confidential Communications Request form to prevent insurance companies from sending potentially revealing information to the policy holder. Instead information specified in the form will be sent directly to the patient by either email or an alternate mailing address as requested by the dependent. More information for patients and providers can be found at myhealthmyinfo.org.

How can pharmacists help?

This is an important counseling point for pharmacists to review with patients.  Cost can become a big barrier to access when patients do not feel comfortable using their insurance and have to resort to paying out of pocket.  Since this is a new law, pharmacists can help spread the word and direct patients to the website for more information and the form.  Pharmacists should always be aware of their state laws regarding serving minors and confidentiality.


Courtney HeadshotAbout the Author:  

Courtney Miller is in her second year of pharmacy school at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences. 

What California Teens Need to Know About Pharmacy Access to Birth Control

ProviderGuess what California! Having safe sex is about to get a whole lot easier for you in the next few months! We think that increasing access to highly effective forms of birth control is the best way to help prevent unplanned pregnancies and the lawmakers in California agree! A law was passed that is getting ready to rock how you get your birth control in a big way. Starting towards the end of 2015, your local pharmacist can start providing you with more effective forms of birth control in the pharmacy (the pill, the patch, the ring, and the shot)!

This means that you would be able to get your birth control without worrying about making a doctor’s appointment or clinic visit. (Side note: Getting checked out by a doctor regularly is really important! ESPECIALLY, if you are sexually active. It just shouldn’t prevent you from getting effective birth control!) Now if you need birth control you are going to have choices – the doctor’s office, your local family planning clinic, or your local pharmacy!

Who can get birth control at the pharmacy?

First of all, all you ladies out there can use it! Women of all ages — including teens — will be able to use this service. You also don’t need to have insurance or an ID card to get birth control. In California, minors can consent to medical care for the prevention or treatment of pregnancy without parental permission. In fact, legally the pharmacist cannot disclose any information to your parents without your written permission. Of course we know that your parents had sex at least once (hey, you’re here right?) so they probably know a thing or two about sex and birth control. So if you feel comfortable you can always chat with them about any questions you might have and they are welcome to come along to the pharmacy. We know teens like their privacy too; so just know if you don’t want to tell them, we won’t either!

How does pharmacy access to birth control work?

So here’s how it works. It is kind of like when you go get a flu shot from the pharmacist (if you don’t do that you totally should!). You fill out a health screening questionnaire and get your blood pressure taken to make sure that it is safe for the pharmacist to give you birth control and that’s it! The pharmacist will review your questionnaire and talk you about which methods of birth control would be safe for you to use. Then you can discuss how each method works and pick which you like best. The pharmacist will then provide you with birth control supplies just like you would get with a doctor’s prescription and you are good to go.

Keep in mind that not all pharmacies will be providing this service right away. It’s always a good idea to give the pharmacy a quick call to find out if they do before you go in.

How much will this cost me?

There will probably be a small service fee for the screening. This is different than the cost of the medication. If you do have insurance, you will most likely be able to get your prescription filled with no copay. (Thanks Obama!) If you are under your parents insurance, the insurance company might send your parents documents about what you got from the pharmacy. If this is something that you want to keep private, consider filling out a “confidential communication request” for your insurance company. See www.myhealthmyinfo.org for more information and a copy of the form.

What if I don’t live in California?

Basically, this new law is very exciting in the word of birth control. Hopefully once the other states see how much it has helped in California they will follow suit! So if you don’t live in California keep your eyes out changes to come!

What are some trusted sources for more info about birth control methods?

If this gets you excited about birth control, check out these helpful links to help you learn about different methods! These are really cool resources for teens and they break down all the pros and cons of each method. Bedsider includes videos from guys and girls talking about the experiences they’ve had with each method. On their website you can also sign up for text reminders for clinic appointments or to remind you to take your birth control pills, patch, ring, or shot. Planned Parenthood has an interactive quiz to let you know which methods might work best for you. They’ve even got info just for teens.

How can I get my questions answered?

Check out our new resource page just for teens!  If you have any other questions about your sexual health or anything pharmacy related you can submit your question anonymously. Your question will be answered by Dr. Sally Rafie, PharmD, who is a pharmacist and is very passionate about sexual health and how pharmacists can help!


Courtney HeadshotAbout the Author: Courtney Miller just finished her first year of pharmacy school at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences. She is from the central valley which has the highest rates of teen pregnancy in California so this topic is very close to her heart!

My Personal Journey from “Choose Life” to “Choose Control”

I am a pharmacy student at UCSD and if you would have told me one year ago that I would be spending my summer advocating for adolescent reproductive health I probably would have laughed.

My Conservative Background

You see, I was born and raised in the central valley in California, in a conservative community, in a conservative Christian home. I was raised to value human life, including the unborn. You could (and should) call me pro-life. However, during the winter quarter of my first year in pharmacy school, Dr. Sally Rafie, PharmD gave us a lecture about emergency contraception that really impacted me. She shared some staggering statistics. You see, in the United States over 50% of pregnancies are unplanned. Of those unplanned pregnancies, 40% are going to end in abortion. That’s about 20% of all pregnancies in the U.S. But it was her next comment that really struck me and got me interested in this topic, “if we are ever going to decrease the number of abortions, we have to decrease the number of unplanned pregnancies.” That was a lightbulb moment for me.

Courtney Light Bulb Birth Control Sally Rafie

Why I Care About Teens and Family Planning

This summer I have the privilege of doing a project with Dr. Rafie on pharmacists’ growing role in reproductive health services for adolescents. Teen pregnancy in the U.S. is at an all-time low of roughly 26 births per 1000 teens. Now this sounds like a pretty good statistic right?  Less than 3% of teens are actually having babies every year (of course even more are getting pregnant)!  Until you consider the fact that is one of the highest teen birth rates among developed countries and places like the Netherlands have only 5 births per 1000 teens. That means 5 times as many teens are having babies here in the United States. In the central valley where I grew up, our rates are well above the national average and some counties (like Tulare) nearly double it. Obviously what and how we are teaching our teens about and the access that they have to birth control services is not working.

Studies have repeatedly shown that increasing knowledge of and access to birth control methods and services does not increase the number of teens having sex or even how often or with how many people they have sex with. The only statistic that it affects is the number of teens having safe sex and the number of teen pregnancies and teen births. Studies have also revealed that abstinence-only education is ineffective in decreasing the number of teen pregnancies. When we as conservative Christians fight to implement abstinence-only educational programs in schools and limit teens’ access to information and birth control methods, we are contributing to the number of teen pregnancies, the number of abortions, and the number of teen parents and children in the foster system. That is not a statistic that I want to be a part of. Additionally, unless parents know for 100% sure that their child will be living a life of celibacy, family planning education will be valuable to them at some age even if they remain abstinent until marriage. It can also be helpful for teens to share information with their friends who could benefit from accurate knowledge about birth control.

What I’m Doing About It

A new law was passed in California that will allow pharmacists to provide hormonal birth control directly to patients in pharmacies regardless of age. My project this summer is focused on teen girls to see if this is a service that they are interested in and how pharmacies can serve them best. This project will be very important in helping pharmacists prepare to meet the needs of adolescents in their communities as this new program is rolled out.

If you have questions about any of the statistics I discussed or you just want to know more about my research please feel free to contact me. As you might have guessed, this is something that I feel very passionate about and I would love to discuss it with you more.


About the Author:  Courtney Miller just finished her first year of pharmacy school at the University of California San Diego Skaggs School of Pharmacy & Pharmaceutical Sciences. She is from the central valley which has the highest rates of teen pregnancy in California so this topic is very close to her heart!