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This gets a bit dicey. Most situations are a case by case basis, and it depends largely on why the child is being treated. It depends tremendously too on the state where it occurs.

For instance:

In Michigan, there are only two typical reasons a child, any patient for that matter, will be screened for drugs.

The first is if the child is brought into a trauma unit unconscious or clearly intoxicated. In this situation, the age of the child will be critical, but the doctor is bound by state law to contact social work, who contact CPS (Child Protective Service), who contact law enforcement, and likely as not it will be law enforcement or CPS who notify the parent or guardian.

The second is in the case of pregnancy and delivery. Again, in Michigan the hospital views the pregnant child as emancipated. However, if the mother tests positive for illegal substances or alcohol, the unit will contact social work, who calls CPS, who calls law enforcement, and the mother, not the mother's parents, will be notified--typically--that her child is being placed in foster care (potentially with a family member).

HIPPA is a difficult set of laws to sidestep, and in most cases the only way to do so is for criminal investigations. While the parents have an interest in their child, that interest does not mean much in the face of the state's jurisdiction or HIPPA.

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