National Association for the Education of Homeless Children and Youth




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National Association
for the Education of Homeless Children
and Youth





National Association
for the Education of Homeless Children
and Youth


Executive Board

Tom Gray,


Immediate Past
President
Minnesota Department of Children, Families, and Learning

Barbara James,


President
University of Texas - Austin
Charles A. Dana Center

Gary Dickirson,


Vice-President
Illinois State Board of
Education

Linda Geiger,


Secretary
Kansas State Department of Education

Walter Varner,


Treasurer
Maryland Department of Education

Standing
Committee Chairs


Advocacy and
Legislation

Barbara Duffield
National Coalition for the Homeless

Education
Diana Bowman
National Center for
Homeless Education

External Communications / Public
Relations

Dona Horine Bolt
Oregon State Department of Education
Jim Winship
University of WisconsinWhitewater

General Operations
Gary Dickirson
Illinois State Board of Education

Advisory Members

Mary C. Herrington


Richmond Public Schools (VA)

Joanne Miro


Delaware Department of Education (DE)

Kerry Tintera


Portland Public Schools (OR)

National Association
for the Education of Homeless Children
and Youth


Executive Board

Tom Gray,


Immediate Past
President
Minnesota Department of Children, Families, and Learning

Barbara James,


President
University of Texas - Austin
Charles A. Dana Center

Gary Dickirson,


Vice-President
Illinois State Board of
Education

Linda Geiger,


Secretary
Kansas State Department of Education

Walter Varner,


Treasurer
Maryland Department of Education

Standing
Committee Chairs


Advocacy and
Legislation

Barbara Duffield
National Coalition for the Homeless

Education
Diana Bowman
National Center for
Homeless Education

External Communications / Public
Relations

Dona Horine Bolt
Oregon State Department of Education
Jim Winship
University of WisconsinWhitewater

General Operations
Gary Dickirson
Illinois State Board of Education

Advisory Members

Mary C. Herrington


Richmond Public Schools (VA)

Joanne Miro


Delaware Department of Education (DE)

Kerry Tintera


Portland Public Schools (OR)


Building Futures Through Education







Unaccompanied Youth Toolkit for Financial Aid Administrators
Unaccompanied Youth’s Rights to Consent for Medical Treatment

Q: What does the law say about youth consenting for their own health care?

A: Generally, only persons age 18 and over can give consent to their own routine medical and dental care. Youth under 18 need the consent of a parent or legal guardian to receive medical care. There are some exceptional circumstances in which youth under 18 can be treated without parental consent. For example, most states allow minors to consent to treatment in limited circumstances, such as:

  • Emergency treatment of life-threatening conditions;

  • Diagnosis and treatment of sexually transmitted diseases (minors above a certain age);

  • Treatment related to a pregnancy;

  • Drug or alcohol treatment (minors above a certain age); and

  • Mental health treatment (minors above a certain age).


Q: How do these laws affect unaccompanied youth?

A: Unaccompanied youth are not in the physical custody of a parent or legal guardian. Many do not know where their parents are or have no contact with their parents. As a result, many unaccompanied youth under age 18 cannot access routine medical and dental care. They cannot access preventive health care, which is critical to basic safety and welfare. Routine infections and illnesses go untreated. Without this basic health treatment, relatively minor conditions worsen until they become emergencies. At that point, physicians can treat the condition. However, the youth has missed school and work and placed his or her basic health and safety at grave risk, in addition to creating an overall public health hazard.
Q: Are there laws that help unaccompanied youth under 18 access health care?

A: Yes. Thirty states have addressed this issue already, using a variety of approaches to ensure that youth on their own can obtain basic medical care.i For example:

  • Alabama allows youth age 14 or over to consent to any legally authorized medical, dental, health or mental health services.ii Kansas has a similar law.iii

  • Alaska allows youth living apart from their parents or legal guardian and managing their own financial affairs to consent for medical and dental services.iv Texas, California, Colorado, Indiana, Maine, Massachusetts, Minnesota, Missouri, Montana, Nevada, New Mexico, Oklahoma and Wyoming have similar laws.v

  • Arizona allows any homeless youth to consent to hospital, medical and surgical care.vi

  • Idaho and Arkansas have put the “mature minor doctrine” into their laws, which has also been adopted by many state courts. Generally, the doctrine states that any person of ordinary intelligence and awareness sufficient to comprehend the need for, nature of and risks involved in medical care is competent to consent on his or her own.vii

  • Oregon allows youth age 15 or over to consent to hospital care and medical, dental surgical diagnosis or treatment without the consent of a parent or guardian.viii Louisiana and South Carolina have similar laws.ix


Q: When youth under age 18 need routine medical or dental health care, what are some strategies to get that care?

A: First, check to see what your state law says about consent by youth under 18. A chart with every state’s law is available at: http://naehcy.org/dl/memo_uy_med.doc. If the state law allows youth to consent, it may help to bring a copy of the law, or the memo provided at the link, to the clinic. Some health care professionals may not be familiar with the law and may deny health care unless the youth can explain the law and show it to the health care provider.

If your state law does not provide a way for youth under 18 to consent for health care, there are a few strategies that have been effective:



  • Have a parent sign a health care power of attorney: This document gives another adult, or possibly even the youth, the power to make health care decisions. It is the best solution for youth under 18 with a parent willing to sign. It does not affect any of the parent’s rights, but it allows the youth to seek health care independently of the parent. The specific wording of powers of attorney can vary by state, but sample forms are available from many court systems and legal aid offices. A good place to start would be to do a web search for your state and “parental power of attorney.”

  • Adult advocacy and support: Some health care providers will treat a youth without parental consent if another adult is present, such as a mentor, caregiver, McKinney-Vento liaison, school counselor or case manager. Some McKinney-Vento liaisons have found that providing the youth with a letter stating that the school has deemed the youth to be an unaccompanied homeless youth has empowered the youth to obtain health care by showing the letter to medical staff.

  • Ask the child welfare agency for help: Many unaccompanied youth meet the criteria for involvement in the child welfare system. While they may not want to enter foster care or state custody, the child welfare agency may be able to assist in getting the parent to sign a health care power of attorney or finding another way for the youth to access health care.

  • Phone consent of parent: If the youth is able to contact a parent by phone, some health care providers will provide treatment based on consent over the phone.

  • Emergencies: if the health issue can be framed as an emergency, health care providers will treat the youth.

  • Health Care for the Homeless providers: a list of these providers is available at http://www.nhchc.org/HCHdirectory.html. Since they specialize in serving homeless people, they often are able to assist homeless youth.

  • Mature Minor Doctrine: Many state courts follow this rule, even though it is not written into the state’s laws. Youth can explain their situation to health care providers and show that their situation, intelligence and awareness warrant them consenting to their own health care. The advocacy of an adult, such as a mentor, school counselor, McKinney-Vento liaison, case manager or legal services attorney, is likely to be helpful.



i In addition, medical professionals, including the American Academy of Pediatrics, have endorsed the idea of minors making their own medical decisions in certain circumstances, as well as federal legislation to support that right. See, e.g., Rhonda Gay Hartman, “Coming of Age: Devising Legislation for Adolescent Medical Decision-Making.” Am. Journal of Law & Medicine (December 2002): “Federal legislation would establish a unified, national policy regarding adolescent decision-making capability. By recognizing decision-making ability of adolescents, the policy would be responsive to the reality of adolescent cognitive development and to the particular needs of adolescents, separate and apart from younger children.”

ii Alabama Stat. §§22-8-4; 22-8-7 (2011).

iii Kan. Stat. Ann. §38-123b (2011).

iv Alaska Stat. §25.20.025.

v Tex. Fam. Code §32.003 (2011); Cal Fam Code §6922 (2011); Colo. Rev. Stat. 13-22-103 (2011); Burns Ind. Code Ann. §16-36-1-3 (2011); 22 Me. Rev. Stat. §1503 (2011); Mass. Gen. Law ch. 112, §12F (2011); Minn. Stat. §144.341 (2011); R.S. Mo. §431.056 (2011); Mont. Code Ann. §41-1-402 (2011); Nev. Rev. Stat. Ann. § 129.030 (2011); N.M. Stat. §24-7A-6.2 (2011); 63 Okl. St. §2602 (2011); Wyo. Stat. §14-1-101 (2011).

vi Ariz. Rev. Stat. §44-132 (2011).

vii Idaho Stat. §39-4503 (2011); Ark. Code Ann. §20-9-602(7) (2011).

viii Or. Rev. Stat. §109.640 (2011).

ix La. R.S. §40:1095 (2011); S.C. Code Ann. §63-5-350 (2011).
Nov. 2011


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