NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A6761
SPONSOR: Reyes TITLE OF BILL:
An act to amend the public health law, the mental hygiene law, the
social services law, and the insurance law, in relation to allowing
certain youth to give effective consent to medical, dental, health,
and/or hospital services and immunizations
PURPOSE OR GENERAL IDEA OF BILL:
To enable decisionally-capable minors to consent to their medical,
dental, health, and hospital care.
SUMMARY OF PROVISIONS:
Section 1 amends Public Health Law (PHL) section 2504 subdivision 1 to
add that a minor who comprehends the need for, the nature of, and the
reasonably foreseeable risks and benefits involved in a health service,
as well as alternatives, may consent to the service on their own.
§ 2 amends Mental Hygiene Law (MHL) § 9.13 subdivision (a) to allow
minors meeting the requirements under PHL 2504 to consent to inpatient
mental health care.
§ 3 amends MHL § 22.11 to allow minors meeting the requirements under
PHL 2504 to consent to inpatient, residential, or outpatient chemical
dependence treatment, and allows qualified health professionals other
than solely physicians to provide such treatment.
§ 4 amends MHL § 33.21 to allow minors meeting the requirements under
PHL 2504 to consent to outpatient mental health care.
§ 5 amends PHL § 2305 to allow minors meeting the requirements under PHL
2504 to consent to diagnosis and treatment of sexually transmitted
infections and allows qualified health professionals other than solely
physicians to provide such treatment.
§ 6 amends Social Services Law (SSL) § 372 subdivision 8 to protect the
confidentiality of health care information related to services a minor
had consented to themselves under PHL 2504 in instances when the minor
is being placed into kinship care.
§ 7 amends SSL § 373-a to protect the confidentiality of health care
information related to services a minor had consented to themselves
under PHL 2504 in instances when the minor is being placed into adoptive
or foster care.
§ 8 creates a new SSL § 373-b to require social services districts and
agencies to offer and provide, if requested, information about reproduc-
tive and sexual health care services to all foster parents and youth.
§ 9 amends SSL § 366 to provide that a minor who consents to care under
PHL 2504 and has no other source of health insurance shall be eligible
for Medicaid coverage of the specific services they consented to.
§ 10 amends PHL § 17 to protect the confidentiality of health records of
a minor who consented to care under PHL 2504 and to make clear that such
a minor may request their own medical records.
§ 11 amends PHL § 18 to protect the confidentiality of health records of
a minor who consented to care under PHL 2504 and make clear that such a
minor may authorize disclosure of such information and release of their
records if they so choose.
§ 12 amends MHL 33.16 to protect the confidentiality of mental health
records of a minor who consented to care under PHL 2504 and make clear
that such a minor may authorize disclosure of such information and
release Of their records if they so choose.
§ 13 amends Insurance Law 3244 to protect the confidentiality of a minor
who consented to care under PHL 2504 by enabling the minor to re-direct
an explanation of benefits form for that care to an address (or email
address) of their choosing and to suppress that information from any
online portal their parent(s) or guardian(s) may use to access explana-
tions of benefits.
§ 14 amends PHL § 2168 to protect the confidentiality of immunization
records for an immunization that a minor consented to themself.
§ 15 is the effective date: 180 days after it becomes a law.
JUSTIFICATION:
Timely treatment and preventative care are critical for young people's
health and wellbeing, enabling them to excel in school and beyond.
Current law generally requires parental consent for minors to receive
health care unless the minor is married, has a child, serves in the
armed forces, or is emancipated or incarcerated, but the need for
parental consent can be a huge barrier to accessing needed health care.
This bill will enable minors capable of making certain health care deci-
sions to consent to such health care services.
Involving parents and guardians in a young person's health care deci-
sions is ideal, and, indeed, parent and family support is a primary
predictor of a young person's wellbeing. At the same time, not all young
people have healthy, safe family relationships. In many cases, and
particularly for sensitive or highly personal care, young people will
not seek health care if they are required to involve a parent or have
their confidentiality compromised.
Recognizing the importance of young people's access to health care, New
York State currently permits a narrow subset of young people to consent
to all of their health care and permits all young people to consent to
certain types of confidential health care, such as reproductive health
care. However, this patchwork of laws leaves some young people without a
path to receive needed care.
In 1990, the only court in New York to consider whether a mature young
person could consent to their own health care recognized the gaps in New
York law and recommended "that the legislature or the appellate courts
take a hard look at the 'mature minor' doctrine
the doctrine that
allows decisionallycapable young people to consent to their own health
care and make it either statutory or decisional law in New York State."
In re Application of Long Island Jewish Med. Ctr., 557 N.Y.S.2d 239, 243
(Sup. Ct. Queens Cty. 1990). In adopting such a law, New York would join
more than 20 states that, either through statute or judicial decision,
allow at least some young people to consent to their own health care.
This comprehensive legislation would fill New York's legal gaps and
allow decisionally-capable young people meaning young people who are
mature enough to understand the need for, the nature of, and the reason-
ably foreseeable risks and benefits involved in the contemplated health
care, as well as any alternatives to that care - to consent to their own
health care. The bill also removes related barriers to young people's
access to health care and expands confidentiality protections for young
people who consent to their own care. It also sets up a payment mech-
anism that allows young people who do not have health insurance or who
cannot use their parents' health insurance to enroll in Medicaid for the
health care they consent to themselves without having to withdraw from
their parents' health insurance for other types of care.
Parents will - and should - continue to be involved in the vast majority
of young people's health care decisions. This bill, however, sets up an
important safety-net to allow those young people who have unsafe family
relationships or who are unable to involve their families to seek and
receive necessary health care.
PRIOR LEGISLATIVE HISTORY:
New bill
FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS:
None.
EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth day after it
shall have become a law. Effective immediately, the addition, amendment
and/or repeal of any rule or regulation necessary for the implementation
of this act on its effective date are authorized to be made and
completed on or before such effective date.
