The Adoption Medical History Registry, AMHR, was created in 1997 so Pennsylvania birth parents and adoptees could register medical information for family members who requested it. Because Act 101 required the creation of a social history registry as well, the AMHR was expanded to include the additional medical requirements as well as the social history requirements and is now known as the Pennsylvania Adoption Information Registry, PAIR. Act 101 expanded who could register and access information from adoption records. Before Act 101, only an adoptee could request information from the court record. Act 101 opened up who can request or search for birth parents and birth relatives.
Because Act 101 requires DHS to collect and maintain medical and social history information on all adoptions finalized or registered in Pennsylvania, all adoptees adopted on or after the effective date of the OCYF bulletin are now able to obtain much more information about their birth family than was previously allowed.
In addition to the medical records of the AMHR, PAIR also contains the social history information required by Act 101. The database is managed by the Pennsylvania Adoption Exchange, PAE, and is set up to receive, file and retain medical and social history information for all adoptions finalized or registered in Pennsylvania.
PAIR collects medical records and other information about an adoptee or an adoptee’s birth family that is relevant to current or future health care or medical treatment. This includes previously confidential or privileged information about a potential hereditary or congenital medical problem. Adoptees and family members control if the information released includes identifying information or is limited to non-identifying information.
PAIR also collects economic, cultural and ethnic information about the adoptee and his or her birth relatives. A developmental history of the adoptee that will now be available includes:
- Social experiences: Child abuse and neglect history, out-of-home placement or care and patterns of interpersonal relationships.
- Educational experiences of the adoptee including the names of schools attended, dates attended, academic performance, extracurricular activities and special interests.
- Current functioning of the adoptee including behavioral patterns and relationships.
- Circumstances surrounding the adoption.
- Summary of the original birth record that consists only of the names and ages of the birth parents, the date and county of the child’s birth and the name given at birth.
All public and private child welfare agencies and individuals licensed by DHS to provide adoption services must submit this medical and social history information on all children whose adoptions are finalized or registered in Pennsylvania. The information is uploaded in a PDF file to PAIR at www.pagov-pair.org. Copies of the signed consent to release information must be maintained in the child’s file and included in the medical history that is uploaded to the PAIR.
Some medical information may only be shared if a signed consent to release information is first obtained. Additionally, some agency records may contain medical records or information obtained from providers that expressly prohibited sharing that information. Agencies and individuals should follow their established policies and procedures about sharing such medical information and should not upload information they are forbidden by statute to provide.
Medical information that may be submitted as part of the medical history are medical and agency records such as birth information, immunizations, dental care, serious illness information, surgeries, hospitalizations, handicaps, allergies, medications and information about the birth parents that could include potentially hereditary or congenital medical problems.
Social history information about the adoptee and birth relatives includes their economic, cultural and ethnic information; a developmental history about the circumstances at birth and early development; the social experiences including abuse and neglect history, placement history, patterns of relationships and educational history that would be in a child’s Child Profile if one exists.
Agencies that are not Pennsylvania Statewide Adoption and Permanency Network, SWAN, affiliates can find a Child Profile outline on SWAN’s website at www.diakon-swan.org or may develop a format of their own as long as it contains all of the required information. Free online training about completing a Child Profile is available at www.swan-online.org. A Child Profile uploaded to PAIR must be current at the time of finalization and may also include an updated Child Profile or social summary.
Responsibilities of PAIR in Releasing Information
Non-identifying information requested to PAIR will be provided to the requester within 30 calendar days. Before releasing the information, PAIR will redact any identifying information (names, aliases, addresses, former addresses, etc.).
Requests for identifying information will only be released if an authorization to release identifying information was filed by the adoptee or birth parent. Identifying information will be provided to the requester within 30 calendar days of the request.
Requests for contact with the birth family or adoptees’ identifying information, including contact information, will be provided if an authorization to release identifying information is on file. If there is no authorization to release identifying information, the person who requested the information will be notified in writing within 30 days and will be asked to submit a Birth Parent or Adoptee Authorization to Release Information and Registration Form, which is available online at http://www.adoptpakids.org/Forms.aspx.
Medical and Social History Information:
Medical and social history information may be filed in:
- The court that terminated parental rights
- The court that finalized the adoption
- The agency that coordinated the adoption
- The PAIR
If medical history and social history information is filed in the court that terminated the parental rights, a copy must be forwarded to the court that finalized the adoption and the PAIR. Courts may submit information as a PDF file to the PAIR at www.pagov-pair.org.
To reduce duplication, courts and agencies should collaborate to determine who will upload information to the PAIR on their behalf. The PAIR will provide written acknowledgement it received the uploaded information within 30 calendar days.
Agencies should retain PAIR’s acknowledgement in the child’s record to verify the information was submitted and received. If a county agency delegates this responsibility to a SWAN affiliate agency or private provider, that agency should provide a copy of the acknowledgement from PAIR to the county agency as their verification that the required information was submitted.
The OCYF regional offices will ensure that licensed adoption agencies complete the requirements for handling medical and social history information requests during their annual licensing inspection. Documentation in agency case records will be required to determine requests were answered within the required time.
The following individuals may file, update and request a statement about medical and social history information at any time:
- An adoptee who is 18 or older
- An adoptive parent or legal guardian of an adoptee who is under 18 or adjudicated incapacitated
- A descendant of a deceased adoptee
- A birth parent
- A legal guardian of an adjudicated incapacitated birth parent
- A survivor of a deceased birth parent
Within 30 days of filing medical or social history information, the court, agency or PAIR must notify the person who filed the statement that it was received. Within 120 days after the information is filed, the court, agency or PAIR must notify a person who is at least 21 and who the information is intended to benefit, if known or identified in its records, that information was submitted.
When the court or agency receives a written request for medical and social history information and the required fee from a requester, they must notify them within 120 days if they possess any medical and social history information about the adoption. If medical and social history information is found, the court or agency must, within 120 days:
- For non-identifying information, review and furnish to the requester medical and social history information that will not compromise the confidentiality of the relationship between the adoptee and the adoptee’s birth parent
- For identifying information, if an authorization form is on file with the court, agency or PAIR, furnish to the requester the available identifying information in its records.
- If no information or authorization form is on file, the court or agency will contact the subject of the request and ask him or her to provide non-identifying information for the requester and to file an authorization form. If the subject of the request can not be located from the information contained in the court records, the court or agency will appoint an authorized representative to use reasonable efforts to locate the subject. Reasonable fees may be charged by courts and agencies for search activities.
- If non-identifying information is provided by the subject of the request, the court or agency will provide the non-identifying information to the requester and
- If an authorization form is filed, identifying information may also be provided.
- Any information on file about a deceased birth parent may be disclosed if the requester is an adoptee seeking information about the birth parent.
Access to Information
Information released to and submitted by allowed individuals may be information that identifies the birth family or adoptees or it may be non-identifying information. Act 101 of 2010 allows the following individuals to file a written request with the court that finalized the adoption, the agency that coordinated the adoption or the successor agency for identifying or non-identifying information or contact:
- An adoptee at least 18 years of age
- An adoptive parent of an adoptee who is under 18, or adjudicated incapacitated and is 18 or older, or who is deceased
- A legal guardian of an adoptee who is under 18 or adjudicated incapacitated
- A descendant of a deceased adoptee
- A birth parent of an adoptee 21 or older
- A parent of a birth parent of an adoptee 21 or older if the birth parent consents, is incapacitated or is deceased
- A birth sibling of an adoptee if both are 21 or older and meet the following criteria:
- The birth sibling remained in the custody of a birth parent and that birth parent consents, is deceased or is incapacitated
- The birth sibling and the adoptee were both adopted out of the same birth family
- The birth sibling was not adopted out of the birth family and did not remain in the custody of the birth parent
These listed individuals listed may also file a written request for information or contact with the following individuals (these are those individuals who may be subject of a request for information).
- An adoptee 21 or older
- A birth parent of an adoptee
- A parent of the birth parent of an adoptee who is 21 or older if the birth parent consents, is incapacitated or deceased
- A birth sibling of an adoptee if both the sibling and adoptee are 21 or older and the following criteria exist:
- The birth sibling remained in the custody of a birth parent and that birth parent consents to the release of information or contact, is deceased or is incapacitated
- The birth sibling and the adoptee were both adopted out of the same birth family
- The birth sibling was not adopted out of the birth family and did not remain in the custody of the birth parent
Requests for Non-Identifying Information is information that does not reveal identity or contact information of a family member. According to the bulletin, the term includes but is not limited to the following types of information:
- The date, time and location of the adoptee’s birth
- The adoptee’s birth weight and other physical characteristics
- Where the birth parents of the adoptee were born
- The age of the birth parents when the adoptee was born
- The marital status of the birth parents when the adoptee was born
- The facts and circumstances about the nature and reason for the adoption
- The nationality, ethnic background, race, tribal affiliation and religious preference of the birth parents of the adoptee
- The educational level, course of study, general occupation, talents and hobbies of the birth parents of the adoptee
- A general physical description of the birth parents and other birth relatives of the adoptee, including, height, weight, color of hair, color of eyes, complexion and other similar information
- Whether a birth parent of the adoptee had other children and, if so, available non-identifying information about these children
- Information about the birth grandparents of the adoptee
- The name of the agency involved in the adoption
- The length of time the adoptee was in the custody of an adoptive parent.
- Whether the adoptee was ever placed in foster care, and if so, the number of foster care placements, the beginning and end dates of each foster placement and anything significant that occurred in each foster care placement
- Available health history of the adoptee and birth relatives of the adoptee, including psychological and psychiatric information that may have an effect on the mental or physical health of the adoptee
Act 101 of 2010 allows the court or agency to charge reasonable fees for non-identifying information. The court or agency must notify the requester within 30 days of receiving the request for information, and this notification must include the required fee, if applicable. The court or agency will redact any identifying information such as the name, aliases, address or former addresses before releasing any information on file.
The court or agency must review its records and within 120 days furnish to the qualified requester any information about the adoption that will not compromise the confidentiality of the relationship between the adoptee and the adoptee’s birth parent.
The OCYF regional offices will ensure that licensed adoption agencies have completed the requirements for handling requests for non-identifying information during the annual licensing inspection process. Documentation in agency case records will be required to determine that the requirements were met within the specified time frames required.
Requests for Identifying Information. Agency and courts also may charge reasonable fees for identifying information. After a request for identifying information and the fee are received, the court or agency will, within 120 days do all of the following:
- Determine whether it has in its possession any records relating to the adoptee;
- Conduct a good faith search for identifying information by an authorized representative appointed by one of the following:
- The court in which the adoption was finalized;
- The agency that coordinated the adoption;
- A successor, by merger or acquisition, of the agency that coordinated the adoption; or if neither the agency or successor exists, by an agency authorized by the court.
The Role of the Authorized Representative in Search
Public and private adoption agencies and courts often receive requests for information about adoptions. The requests most often come from adoptees who are seeking information about the circumstances of their birth, their family members or medical information. Some adoptees are interested in pursuing contact with their birth family. Birth parents also frequently contact agencies and courts seeking contact with their birth children who were adopted.
The authorized representative reviews the court and agency record for identifying information about the birth or adoptive family and determines whether an authorization form was filed with the court or agency. The authorized representative will:
- Notify any other court or agency listed in its records of the request for identifying information
- Ask any other court or agency listed in its records to advise if an authorization form was filed
- Contact the PAIR about the request for identifying information and ask whether an authorization form was filed with the registry
- Notify the requesting individual of its findings
Courts or agencies may adapt Appendices I, J and L from the Implementation of Act 101 OCYF bulletin. If an applicable authorization form is not located, all of the following apply:
The authorized representative must use reasonable efforts to locate the subject of the search. The search process may include:
- Review of records for background information about the birth family or adoptive family, including last known address, names of family members, social security numbers, occupations, addresses of employment, military services, names of schools attended and dates and places of marriages and deaths
- Review of the SWAN LSI Diligent Search Packet available at http://www.diakon-swan.org for a step by step process and resources to use when looking for people
- Search of public databases
- Review of any available county records, including those held by the voter’s registration offices, the recorder of deeds, the register of deeds, the register of wills and the marriage license bureau
If the subject of the search is located, the authorized representative obtains their written authorization before any identifying information is released or contact between the parties is made. If the requester is an adoptee seeking the identity of a birth parent, the identity of a deceased birth parent may be disclosed. If the requester is an adoptee seeking the identity of both birth parents and only one birth parent agrees to the disclosure, only the information relating to that birth parent can be disclosed.
Any adoptee or birth relative may withdraw or change their authorization form at any time by completing Appendix L to the Implementation of Act 101, OCYF bulletin filed with the court or agency where the authorization to release information was previously filed.
Confidentiality
In conducting a search, the court or agency will ensure that no individual other than a birth parent is informed of the adoptee’s existence and relationship to the birth parent of the adoptee.
Refusal to Search
An agency can decline to conduct a search to determine if an individual will authorize disclosing identifying information or contact information if the agency is satisfied the request could cause physical or emotional harm to the requesting individual or others. An agency that declines to conduct a search must refer the request to the court that finalized the adoption and inform it why they declined the search request. The agency will notify the requester and identify which court the was notified of the refusal.
If a court is satisfied that a request could cause physical or emotional harm to the requesting individual or others, the court may also decline to perform a search. A court that declines to conduct a search must inform the requesting individual of its decision in writing and of the procedures for appeal of that decision.
An agency may also decline to conduct a search if the requester fails to pay the reasonable costs associated with the search.
Original Birth Record
No disclosure of information will be made by a court, agency, the Department of Health, DOH, or any other Commonwealth agency about an adoptee’s original birth record or the documents or proof on which an amended certificate of birth is based or in any way about the birth parents unless the disclosure is made pursuant to the provisions of Act 101.
When their parental rights are terminated or at any time thereafter, the birth parents may place on file with the court or DOH a consent form (Appendix O of the Implementation of Act 101 OCYF Bulletin) granting permission for the court or DOH to issue a copy of the summary of the adoptee’s original birth record that discloses the identity of the birth parents at any time after the adoptee turns 18, or if less than 18 to the adoptive parent or legal guardian. If only one birth parent has filed consent, a copy of the summary of the original birth record naming only the consenting parent shall be issued.
The consent of a birth parent may be withdrawn at any time by filing a withdrawal of consent form with the court and DOH. Birth parents must file their consent and withdrawal of consent separately with both the DOH and local court that will have their own local processes in place.
Search and Reunion
Authorized representatives will be working with adopted persons who have come from a variety of birth family experiences. Some adoptees search to find a historical context for their memories. They may need the assistance of a professional capable of helping them address painful memories of their past. The facts about what happened to them will be essential. Looking to the historical context of an adoptee’s circumstances is part of the healing process. As an authorized representative who is assisting an adoptee in the search process, your role is to not save them from the pain of reality but rather to help them cope with it.
As an authorized representative, your efforts will be aimed at helping individuals make sense of their lives through:
- Understanding their past
- Correcting misperceptions
- Opening up choices for the future
- Holding them responsible for their actions
Situations may arise where establishing contact is indicated only with support of therapy. In some situations opening an adoption or establishing contact may not be warranted. These situations may include:
- Concerns about safety
- Mental illness or criminal history
- Hidden agendas
- Birth parent is focused on reclaiming the child
Searching or opening an adoption is not a magic cure all. It does however, offer an opportunity to address important developmental issues over time and begin the adoptee on a journey of healing.