AB469: Bill Text

LRB-0264/2

DAK:kaf:arm

1997 - 1998 LEGISLATURE

1997 Assembly BILL 469

August 12, 1997 - Introduced by Representatives R. Young, Notestein, Murat, Springer and L. Young, cosponsored by Senator Risser. Referred to Committee on Health.

AB469,1,9 An Act to renumber and amend 51.47 (1) and 51.61 (6); to amend 46.10 (2m), 51.13 (1) (c), 51.14 (3) (a), 51.14 (3) (f), (g) and (h) (intro.), 51.14 (4) (a) and (c), 51.30 (4) (b) 20. (intro.), 51.30 (5) (a), 51.30 (5) (b) 1., 51.47 (title), 51.47 (2) (intro.), 51.47 (2) (b), 51.47 (3), 51.47 (4) and 938.505 (2) (a) (intro.) and 1.; and to create 51.30 (4) (b) 13m. and 51.47 (1) of the statutes; relating to: permitting certain minors to obtain certain mental health services without parental consent, permitting certain minors to refuse access by their parents to certain treatment records and notifying parents of the provision to minors of certain mental health services.

Analysis by the Legislative Reference Bureau

Under current law, a physician or health care facility may provide preventive, diagnostic, assessment, evaluation or treatment services for alcohol or other drug abuse to a minor aged 12 or older without obtaining the consent of or notifying the minor's parent or guardian. Consent of a parent or guardian must be obtained, however, before performing nonemergency surgical procedures, administering certain controlled substances or admitting a minor to an inpatient treatment facility unless the admission is for a period of detoxification that is less than 72 hours. In addition, the physician or health care facility must notify the minor's parent or guardian as soon as practicable about any services that have been provided. Lastly, if the care-giving situation is not one for which consent of the parent or guardian is required, the physician or health care facility must obtain the minor's consent before billing a 3rd party; if the minor refuses to consent, he or she is solely liable for payment.

This bill expands the types of services that may be rendered to consenting minors aged at least 12 without obtaining parental or guardian consent to include outpatient mental health services, except that the bill requires that parental or guardian consent be obtained before administering prescription drugs to a minor as a part of the services. The bill adds an outpatient treatment program (as defined in the bill) to the kinds of treatment providers that need not obtain consent of a parent or guardian before rendering outpatient mental health or alcohol and other drug abuse services to minors aged 12 or older.

Under current law, a minor aged at least 14 has access, within certain limitations, to his or her own treatment records for services for mental illness, developmental disability, alcoholism or drug dependence. A minor under age 14 has access, within certain limitations, to these treatment records only in the presence of his or her parent, guardian, counsel or guardian ad litem or the staff member of a treatment facility. The parent, guardian or person in place of a parent of a minor has the same right of access to treatment records of the minor for services for mental illness, developmental disability or alcohol or drug dependence as does the minor himself or herself, except that a developmentally disabled minor aged 14 or older may deny this access by filing a written objection with the record custodian. However, if the parent, guardian or person in the place of a parent is directly involved in providing care to or monitoring treatment of the minor, that parent, guardian or person may, under certain conditions, obtain access to certain of the minor's treatment records.

This bill permits a minor who is not developmentally disabled and who is aged at least 14 to deny access by a parent, guardian or person in the place of a parent to the minor's treatment records by filing with the record custodian a written objection to that access. However, the parent, guardian or person in place of a parent of such minors who directly provides care to or monitors treatment for the minor may have the same access to records as is currently provided to like parents, guardians or persons in place of a parent of objecting minors who are developmentally disabled. In addition, the parent, guardian or person in the place of a parent of a minor who is permitted to object to records access and who has received certain mental health treatment or services may have access, without the minor's consent, to notice that the minor is or has been a patient of a physician, health care facility or outpatient program that provided mental health treatment or services to the minor. Lastly, the bill requires a physician, health care facility or outpatient treatment program that provides alcohol and other drug abuse or mental health treatment to minors without parental consent to notify the minor's parent or guardian of the fact that 2 sessions of outpatient treatment have been rendered and that additional treatment is proposed unless the parent, health care facility or outpatient treatment program determines that the notification would be seriously detrimental to the minor's well-being or is unable, after making a good-faith effort, to contact the parent or guardian and documents the determination or inability in the minor's record. The physician, health care facility or outpatient treatment program must immediately notify, however, if the physician, health care facility or outpatient program later determines that the notification would not be detrimental; in such a case, the physician, health care facility or outpatient program must inform the minor that notification will be made.

For further information see the state and local fiscal estimate, which will be printed as an appendix to this bill.

The people of the state of Wisconsin, represented in senate and assembly, do enact as follows:

AB469, s. 1 Section 1. 46.10 (2m) of the statutes is amended to read:

AB469,3,7 46.10 (2m) The liability specified in sub. (2) shall not apply to tuberculosis patients receiving care, maintenance, services and supplies under ss. 58.06 and 252.07 to 252.10, to persons 18 and older receiving care, maintenance, services and supplies provided by prisons named in s. 302.01 or to parents of a minor who receives care for alcohol or other drug abuse or mental health services under s. 51.47 (1) (1m) without consent of the minor's parent or guardian.

AB469, s. 2 Section 2. 51.13 (1) (c) of the statutes is amended to read:

AB469,4,6 51.13 (1) (c) If a minor 14 years of age or older wishes to be admitted to an approved inpatient treatment facility but a parent with legal custody or the guardian refuses to execute the application for admission or cannot be found contacted, or if there is no parent with legal custody, the minor or a person acting on the minor's behalf may petition the court assigned to exercise jurisdiction under chs. 48 and 938 in the county of residence of the parent or guardian for approval of the admission. A copy of the petition and a notice of hearing shall be served upon the parent or guardian at his or her last-known address. If, after hearing, the court determines that the parent or guardian's consent is unreasonably withheld or that the parent or guardian cannot be found contacted or that there is no parent with legal custody, and that the admission is proper under the standards prescribed in sub. (4) (d), it shall approve the minor's admission without the parent or guardian's consent. The court may, at the minor's request, temporarily approve the admission pending hearing on the petition. If a hearing is held under this subsection, no review or hearing under sub. (4) is required.

AB469, s. 3 Section 3. 51.14 (3) (a) of the statutes is amended to read:

AB469,4,13 51.14 (3) (a) Either a minor 14 under 12 years of age or older or his or her the parent or guardian of a minor aged at least 12 may petition the mental health review officer in the county in which the parent or guardian has residence for a review of a refusal of either the minor or his or her the parent or guardian to provide the informed consent for outpatient mental health treatment for the minor as required under s. 51.61 (6).

AB469, s. 4 Section 4. 51.14 (3) (f), (g) and (h) (intro.) of the statutes are amended to read:

AB469,4,19 51.14 (3) (f) If prior to a hearing under par. (g) either the minor under age 12 or his or her the parent or guardian of the minor aged at least 12 requests and the mental health review officer determines that the best interests of the minor would be served, a petition may be filed for court review under sub. (4) without further review under this subsection.

AB469,5,2 (g) Within 21 days after the filing of a petition under this subsection, the mental health review officer shall hold a hearing on the refusal of the minor or the minor's parent or guardian to provide informed consent for outpatient treatment. The mental health review officer shall provide notice of the date, time and place of the hearing to the minor under age 12 and the minor's his or her parent or guardian or to the minor aged at least 12 and his or her parent or guardian at least 96 hours prior to the hearing.

AB469,5,11 (h) (intro.) If following the hearing under par. (g) and after taking into consideration the recommendations, if any, of the county department under s. 51.42 or 51.437 made under par. (e), the mental health review officer finds all of the following, he or she shall issue a written order that, notwithstanding the written, informed consent requirement of s. 51.61 (6), the written, informed consent of the minor aged at least 12, if the minor is refusing to provide consent, or the written, informed consent of the minor's parent or guardian of a minor under age 12, if the parent or guardian is refusing to provide consent, is not required for outpatient mental health treatment for the minor:

AB469, s. 5 Section 5. 51.14 (4) (a) and (c) of the statutes are amended to read:

AB469,5,20 51.14 (4) (a) Within 21 days after the issuance of the order by the mental health review officer under sub. (3) or if the requirements of sub. (3) (f) are satisfied, the minor under age 12 or his or her parent or guardian or the minor aged at least 12 or his or her parent or guardian may petition a court assigned to exercise jurisdiction under ch. 48 in the county of residence of the minor's parent or guardian for a review of the refusal of either the minor aged at least 12 or his or her the parent or guardian of a minor under age 12 to provide the informed consent for outpatient mental health treatment required under s. 51.61 (6).

AB469,6,2 (c) If a notation of a minor's refusal to provide informed consent to outpatient mental health treatment appears on the petition, the court shall, at least 7 days prior to the time scheduled for the hearing, appoint counsel to represent the minor if the minor is unrepresented. If the a minor's parent or guardian has refused to provide informed consent and the minor is unrepresented, the court shall appoint counsel to represent the minor, if requested by the minor or determined by the court to be in the best interests of the minor.

AB469, s. 6 Section 6. 51.30 (4) (b) 13m. of the statutes is created to read:

AB469,6,8 51.30 (4) (b) 13m. To the parent, guardian or person in the place of a parent of a minor who is receiving or has received mental health preventive, diagnostic, assessment, evaluation or treatment services without parental or guardian consent under s. 51.47 (1m). Information released under this subdivision is limited to that which is required to be provided under s. 51.47 (3).

AB469, s. 7 Section 7. 51.30 (4) (b) 20. (intro.) of the statutes is amended to read:

AB469,7,2 51.30 (4) (b) 20. (intro.) Except with respect to the treatment records of a subject individual who is receiving or has received services for alcoholism or drug dependence, to the spouse, parent, guardian, person in the place of a parent, adult child or sibling of a subject individual, if the spouse, parent, guardian, person in the place of a parent, adult child or sibling is directly involved in providing care to or monitoring the treatment of the subject individual and if the involvement is verified by the subject individual's physician, psychologist or by a person other than the spouse, parent, guardian, person in the place of a parent, adult child or sibling who is responsible for providing treatment to the subject individual, in order to assist in the provision of care or monitoring of treatment. Except in an emergency as determined by the person verifying the involvement of the spouse, parent, guardian, person in the place of a parent, adult child or sibling, the request for treatment records under this subdivision shall be in writing, by the requester. Unless the subject individual has been adjudged incompetent under ch. 880, the person verifying the involvement of the spouse, parent, guardian, person in the place of a parent, adult child or sibling shall notify the subject individual about the release of his or her treatment records under this subdivision. Treatment records released under this subdivision are limited to the following:

AB469, s. 8 Section 8. 51.30 (5) (a) of the statutes is amended to read:

AB469,7,10 51.30 (5) (a) Consent for release of information. The parent, guardian, or person in the place of a parent of a minor under age 14 or the guardian of an adult adjudged incompetent under ch. 880 may consent to the release of confidential information in court or treatment records. A minor who is aged 14 or more may consent to the release of confidential information in court or treatment records without the consent of the minor's parent, guardian or person in the place of a parent. Consent under this paragraph must conform to the requirements of sub. (2).

AB469, s. 9 Section 9. 51.30 (5) (b) 1. of the statutes is amended to read:

AB469,7,23 51.30 (5) (b) 1. The guardian of an individual who is adjudged incompetent under ch. 880 shall have access to the individual's court and treatment records at all times. The parent, guardian or person in the place of a parent of a developmentally disabled minor shall have access to the minor's court and treatment records at all times except in the case of a developmentally disabled minor aged 14 or older who files a written objection to such the access with the custodian of the records. The parent, guardian or person in the place of a parent of other minors a minor who is not developmentally disabled shall have the same rights of access as provided to a subject individuals individual under this section unless the minor, if aged 14 or older, files a written objection to the access with the custodian of the records. If a minor files an objection under this subdivision, the parent, guardian or person in the place of a parent may obtain access only as specified under sub. (4) (b) 13m. and 20.

AB469, s. 10 Section 10. 51.47 (title) of the statutes is amended to read:

AB469,8,2 51.47 (title) Alcohol and other drug abuse treatment and mental health services for minors.

AB469, s. 11 Section 11. 51.47 (1) of the statutes is renumbered 51.47 (1m) and amended to read:

AB469,8,19 51.47 (1m) Except as provided in subs. (2) and (3), any physician or, health care facility or outpatient treatment program licensed, approved or certified by the state for the provision of health or mental health services may render outpatient alcohol and other drug abuse or mental health preventive, diagnostic, assessment, evaluation or treatment services for the abuse of alcohol or other drugs to a an informed, consenting minor aged 12 years of age or over older who is in need of the services without obtaining the consent of or notifying the minor's parent or guardian, but shall render those services on an inpatient basis under the consent and notification requirements under s. 51.13. Unless consent of the minor's parent or guardian is required under sub. (2) or s. 51.13, the physician or, health care facility or outpatient treatment program shall obtain the minor's consent prior to billing a 3rd party for outpatient services under this section. If the minor does not consent to billing a 3rd party, the minor shall be solely responsible for paying for the outpatient services, which the department shall bill to the minor under s. 46.03 (18) (b).

AB469, s. 12 Section 12. 51.47 (1) of the statutes is created to read:

AB469,8,23 51.47 (1) In this section, "outpatient treatment program" means any publicly or privately operated program providing treatment on an outpatient basis to persons for alcohol abuse, other drug dependency, mental illness or developmental disability.

AB469, s. 13 Section 13. 51.47 (2) (intro.) of the statutes is amended to read:

AB469,9,3 51.47 (2) (intro.) The physician or , health care facility or outpatient treatment program shall obtain the consent of the minor's parent or guardian in each of the following circumstances:

AB469, s. 14 Section 14. 51.47 (2) (b) of the statutes is amended to read:

AB469,9,6 51.47 (2) (b) Before administering any prescription drugs or controlled substances to the minor, except to detoxify the minor under par. (c).

AB469, s. 15 Section 15. 51.47 (3) of the statutes is amended to read:

AB469,9,23 51.47 (3) The Except as provided in s. 51.30 (4) (c) and before providing a 3rd session of outpatient treatment to a minor under this section, the physician or, health care facility or outpatient treatment program shall notify the minor's parent or guardian of any services the fact that 2 sessions of outpatient treatment have been rendered under this section as soon as practicable and that additional treatment is proposed to be rendered, unless the physician, health care facility or outpatient treatment program determines that notification would be seriously detrimental to the minor's well-being or, after making a good-faith effort, is unable to contact the parent or guardian and documents this determination or inability in the minor's treatment records. If the physician, health care facility or outpatient treatment program later determines that notification would not be seriously detrimental to the minor's well-being, the physician, health care facility or outpatient treatment program shall immediately notify the parent or guardian that services have been rendered under this section. Before notifying the parent or guardian, the physician, health care facility or outpatient treatment program shall inform the minor that notification will be given to the parent or guardian.

AB469, s. 16 Section 16. 51.47 (4) of the statutes is amended to read:

AB469,10,3 51.47 (4) No physician or, health care facility rendering or outpatient treatment program that renders services under sub. (1) (1m) is liable solely because of the lack of consent or notification of the minor's parent or guardian.

AB469, s. 17 Section 17. 51.61 (6) of the statutes is renumbered 51.61 (6) (intro.) and amended to read: