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It may sound crazy to have you child think about an advanced healthcare directive. He or she JUST graduated high school. But, that means they are 18 or 19 – technically an adult.

Now, as fall approaches and your family and student starts to plan, narrow down your students options, go through the application process, take tours, make choices, pay tuition and fees, gather belongings, search for room mates, find housing, make schedules, ready for move-in day and finish up last minute packing . . .

Don’t forget these two very important Legal issues that happened when you weren’t looking and when your student turned 18.

girls on desk looking at notebook

Most states and our government operate on the premise that once a person turns 18, he or she can make ALL decisions for themselves. Even if they clearly cannot. Even if they are Developmentally or Intellectually Disabled – or just plain not ready.

What that means here is; once your child is 18, if they seek medical care, are admitted to a hospital, or require any medical attention. You, the parent (who likely still provides the healthcare coverage), will not be permitted access to those medical records, may not be informed about their condition or consulted regarding their care.

man in black and white polo shirt beside writing board

Legal issue number one:

EDUCATIONAL RECORDS: FERPA The Family Educational Rights and Privacy Act

Basically, you are no longer allowed access to your child’s educational records.

The FIX: almost all schools have a form students can fill out giving you permission to view their educational records.

clinic doctor health hospital
Photo by Pixabay on

Legal issue number two:

HEALTH INFORMATION: HIPAA The Health Insurance Portability and Accountability Act

HIPAA protects health information, but can also prevent colleges and hospitals from contacting parents. These laws require an ’emergency’ or an ‘imminent threat of harm’ before parents may be contacted and health information shared. Many people believe parents would be contacted in a serious situation. However, this is not always true. The interpretation of “emergency” or “imminent threat” varies. In assessing difficult situations, providers often choose to protect themselves and health information.

The only way for health care providers to legally share information without the risk of being sued is when the patient has already established a health care power of attorney and an advance medical directive, specifying whom the provider can legally contact, and the extent of medical care the patient wishes to receive.

The Fix: ALL require your child’s consent and authorization.

  • Option One – Have an attorney draw up documents and have your child sign them. You will pay the attorney a fee to do this work.
  • Option Two – Locate the documents for the state your child lives in, download them, get your child to sign and have the documents notarized. This is free. But be careful. Fill-able forms not be legal in some states.
  • Additional Option – The new AMD Card – a wallet-sized, notarized, identification card that gives legal permission for providers to call designated family or others during an emergency. There are accompanying electronic PDF versions that can be stored and shared. The cost ranges from $125 to $150 and can be accessed via
    Keep in mind that to be effective, legal documents must be discoverable and accessible to first responders and providers at the time of the emergency. This is a problem, because often, legal documents are put away for safekeeping once issued. Therefore, in an emergency doctors have no way of knowing these documents exist. An advantage of the AMD card is that your child can keep it with them.
    I am not recommending The AMD Card over other options. It is an additional option.

When the unthinkable happens – IF one happens – having the right documents in place can be very important.  And having them around may even grant some peace of mind at a time when little is to be had.

Post Author: Beth Freudenburg

I am lucky! I have been given the chance to both do work that I truly love and engage in that work on behalf of families who inspire me every day!
My best days are spent helping families learn how their money works, how to grow it, how to protect it, and how to position themselves to spend and enjoy more of it so they are happier now. As a retirement income specialist I help clients secure a retirement income stream they can never outlive and that takes healthcare into account. Clients learn how to preserve their wealth for generations to come.