Allows a minor under certain circumstances to consent to the provision of medical care and services or primary or preventive medical care and services. (SB2166 HD1)

A BILL FOR AN ACT

SECTION 1. The legislature finds that minors who are living on their own without parental support or guidance find it difficult, if not impossible, to obtain general medical care without consent from a parent or guardian. Minors living on their own who cannot obtain parental consent for medical treatment include runaway, homeless, and street youth, as well as young people from Micronesia and other Pacific Islands who have moved to Hawaii on their own. Licensed or registered health care practitioners or clinics that provide treatment to minors without parental consent face possible legal action. Without consent from a parent or guardian, this population of young people is left suffering when in need of medical treatment.

Currently in this state, youth aged fourteen and older may consent to family planning and contraceptive care, pregnancy-related care, and treatment for sexually transmitted diseases. Approximately forty-nine per cent of the fifty states and the District of Columbia allow minors some form of access to general medical care.

The purpose of this Act is to allow certain minors to consent to the provision of medical care and services if a licensed or registered health care practitioner determines that the minor has sufficient mental capacity to understand the nature and consequence of the proposed medical care and services and if the medical care and services are for the minor's benefit.

SECTION 2. Section 577A-1, Hawaii Revised Statutes, is amended as follows:

1. By adding three new definitions to be appropriately inserted and to read:

""Licensed or registered health care practitioner" means an individual licensed under chapter 453, 457, or 457A.

"Preventive medical care and services" means health services that include screening, counseling, immunizations, treatment, or medication determined to be effective in preventing or detecting disease.

"Primary medical care and services" means basic, entry-level health care provided by licensed or registered health care practitioners that is generally provided in an outpatient setting."

2. By amending the definition of "medical care and services" to read:

""Medical care and services" means the diagnosis, examination, and administration of medication in the treatment of venereal diseases, pregnancy, and family planning services. [It shall not include surgery or any treatment to induce abortion.]"

SECTION 3. Section 577A-2, Hawaii Revised Statutes, is amended to read as follows:

"§577A-2 Consent valid. [The consent] (a) A minor may:

(b) Any consent given under this section shall be valid and binding as if the minor had [achieved his or her] reached the age of majority [as the case may be; that is, a female minor who is, or professes to be pregnant, or a minor who is, or professes to be afflicted with a venereal disease, or a minor seeking family planning services] and the minor shall be deemed to have, and shall have the same legal capacity to act, and the same legal obligations with regard to the giving of [such] consent [to such hospitals and such clinics or medical care and services to be provided by a physician licensed to practice medicine,] as a person of full legal age and capacity, the infancy of the minor and any contrary provisions of law notwithstanding[, and such].

(c) The consent given under this section shall not be subject to later disaffirmance by reason of [such] the patient's minority[; and the].

(d) No consent of [no] any other person or persons, [(]including[, but not limited to] a spouse, parent, custodian, or guardian[)], shall be necessary [in order] to authorize [such] hospitals or [such] clinics or medical care and services provided by a [physician] licensed [to practice medicine,] or registered health care practitioner, to [such] a minor[.] under this section.

(e) Any licensed or registered health care practitioner who in good faith renders primary or preventive medical care and services to a minor in accordance with subsection (a)(2) shall have immunity from any civil or criminal liability based on that determination; provided that a person may be liable for any damages resulting from the person's negligence or wanton acts or omissions."

SECTION 4. Section 577A-3, Hawaii Revised Statutes, is amended to read as follows:

"§577A-3 Providing information. Public and private hospitals, or public and private clinics or [physicians] licensed [to practice medicine] or registered health care practitioners may, at the discretion of the treating [physician,] licensed or registered health care practitioner, inform the spouse, parent, custodian, or guardian of any minor patient of the provision of medical care and services, or primary or preventive medical care and services, to the minor or disclose any information pertaining to such care and services after consulting with the minor patient to whom such medical care and services, or primary or preventive medical care and services, have been provided under this chapter.

If the minor patient is not diagnosed as being pregnant or afflicted with venereal disease, such information as well as the application for diagnosis may be disclosed, at the discretion of the treating [physician] licensed or registered health care practitioner after consulting with the minor patient."

SECTION 5. Section 577A-4, Hawaii Revised Statutes, is amended to read as follows:

"§577A-4 Financial responsibility; counseling. (a) If a minor consents to receive medical care and services, or primary or preventive medical care and services, the spouse, parent, custodian, or guardian of the minor patient shall not be liable for the legal obligations resulting from the furnishing of medical care and services or primary or preventive medical care and services provided by the public and private hospital, or public and private clinic or [physician] licensed [to practice medicine.] or registered health care practitioner. A minor who consents to the provision of medical care and services, or primary or preventive medical care and services, under this [section] chapter shall assume financial responsibility for the costs of [such] the medical care and services. Any other law to the contrary notwithstanding, no spouse, parent, custodian, or guardian whose consent has not been obtained or who has no prior knowledge that the minor has consented to the provision of [such] medical care and services or primary or preventive medical care and services shall be liable for the costs incurred by virtue of the minor's consent.

(b) If a claim for medical care and services or primary or preventive medical care and services obtained under this chapter is filed with a managed care plan or health insurance plan under which a minor is enrolled, and the minor does not want the plan to disclose information regarding the claim to the spouse, parent, custodian, or guardian of the minor, the minor or, on behalf of the minor, the licensed or registered health care practitioner rendering the medical care and services or primary or preventive medical care and services shall notify the plan prior to the submission of the claim. The plan may require that a request for confidential communication be made in writing and contain a statement that disclosure of all or part of the information to which the request pertains could endanger the minor. The plan may accommodate requests by the minor or the licensed or registered health care practitioner to receive communications related to the medical care and services or primary or preventive medical care and services by alternative means or at alternative locations.

[(b)] (c) Medical care and services or primary or preventive medical care and services shall include individual counseling for each minor patient by a [physician] licensed [to practice medicine.] or registered health care practitioner. Such counseling shall seek to open the lines of communication between parent and child[.], when appropriate."

SECTION 6 Statutory material to be repealed is bracketed and stricken. New statutory material is underscored.

SECTION 7. This Act shall take effect upon its approval.