In general, minors (individuals under the age of 18 years) require a parent or legal guardian to consent for medical care and treatment. However, there are a few exceptions that allow minors* to provide their own consent for certain types of medical care.
These exceptions are related to reproductive issues (birth control, pregnancy, abortion, sexual assault, and sexually transmitted diseases), outpatient mental health treatment, and drug or alcohol abuse. Making it even more confusing for medical offices, each exception has its own set of rules and exceptions.
California law authorizes a physician to see a minor for the care and treatment of these allowed exceptions. Further, if the minor is the one providing consent, any information related to their care and treatment should not be released to anyone else, including a parent or legal guardian, without the authorization of the minor.
A parent or legal guardian is not responsible for payment of services that result from the minor providing their own consent under these exceptions. In order to follow California law, protect the privacy of the minors, and preserve the relationship with the minor and parents, the physician should discuss payment with the minor prior to the appointment. The physician and minor should agree who is paying for the services and who the physician can release information to regarding payment. Without this agreement, the minor may not realize that their private information may be sent to their parents insurance company and ultimately their parents.
Understandably so, parents become very angry to learn that they are being billed for a service they know nothing about. Further, the physician and office staff may violate the minor's federal and state privacy rights by releasing the minor's protected health information to the insurance company and parents for payment. Therefore, when a minor requests treatment for one of the exceptions permitted under California law, it is in the best interest of all involved for the physician to discuss payment and authorization to release information prior to the service. If the minor insists that their privacy be protected and they do not have a means for payment, they may have to seek treatment at a clinic providing these services at a reduced cost.
Attached is CAP's information sheet on Consent for Minors.
Submitted by Kimberly Danebrock, RN, JD
CAP Senior Risk Management and Patient Safety Specialist
If you have questions about this article, please contact us. This information should not be considered legal advice applicable to a specific situation. Legal guidance for individual matters should be obtained from a retained attorney.