Consent for Routine Medical Care
0600-501.10 | Revision Date: 05/25/16
This policy guide provides information on who can consent to medical, surgical dental or remedial medical care for a child/youth.
TABLE OF CONTENTS
Parent/Legal Guardian Consent
Licensed Foster Parent Consent
Relative Caregiver/NREFM Consent
Youth Over 18 and Nonminor Dependents Consent
Parent's/Guardian's Rights to be Notified and Present for Medical Examinations
Consent for Routine Medical Care
Notifying Parents/Guardians of Medical Exams
Court Authorized Medical Treatment
ER/Case-Carrying CSW Responsibilities <![CDATA[ ]]>
Approvals <![CDATA[ ]]>
Helpful Links <![CDATA[ ]]>
Referenced Policy Guides <![CDATA[ ]]>
Statutes <![CDATA[ ]]>
This policy guide was updated from the 07/01/14 version to remove emergency medical consent and HIV testing from this policy as the information exist in their own separate policies. The name of the policy was changed to reflect the current information. Also, a new section regarding parent's/guardian's rights was added.
In most cases, a child’s parent or legal guardian has legal authority to consent to medical and psychiatric treatment for a child, unless the child can consent for themselves. However, parents cannot provide consent if:
A parent whose parental rights have not been terminated by the Juvenile Court cannot consent to medical treatment in the following situations:
A legal guardian, appointed by the Juvenile Court or Probate Court cannot consent to the same medical and dental procedures as a parent in the following circumstances:
In cases where parents or legal guardians cannot, or will not give consent, DCFS can authorize medical treatment of a child with a court order.
Per California minor consent laws, any youth may consent to their own treatment without parental consent, or DCFS approval in the case of dependent youth, in the following circumstances:
Youth, eighteen (18) and older who are dependents of the court, including Nonminor Dependents can consent to their own medical care without court authorization, unless there is a court order that does not allow them to do so (e.g. conservatorship). If the youth refuses medical treatment and that places them in serious harm, or at risk of death, County Counsel must be contacted to discuss next steps, as a court order may be required.
Parents/guardians have a right to be given notice of medical exams and procedures their children are scheduled to undergo, as well as the right to be with their children while they are receiving medical exams and procedures, or to be in a waiting room or other nearby area if there is a valid reason for excluding them while all or a part of the medical procedure is being conducted. Therefore officials (CSWs, law enforcement, etc.) cannot exclude parents from the room where their child is receiving medical attention unless there is either parental consent, a valid reason for exclusion, or an emergency requiring immediate medical attention.
A valid reason to exclude a parent from the room where their child is receiving medical attention may include circumstances where authorities have reasonable cause to believe that the parent is abusive or will interfere in the examination in a significant way, or where the non-abusive parent is so emotionally distraught that they would disrupt the examination.
If there is a valid reason to exclude family members from the examination room, a parent’s right to be present in the examination room may be limited to being near the examination (e.g. in the waiting room or another nearby area).
Parents must be notified in all instances when their child is to receive medical attention, including instances where parental consent is not obtained. Efforts to notify the parents of the medical examination or procedure should be documented.
If a CSW determines that he/she needs to exclude a parent/guardian from the medical examination, even if that medical examination was ordered by the court, the CSW should consult with his/her SCSW for guidance. The SCSW will consult with the Warrant Liaison or County Counsel as needed. Any decision to exclude a parent/guardian from the examination must be documented by the CSW in the case contact notebook.
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Reportable Communicable Diseases
DCFS 179, Parental Consent and Authorization for Medical Care
DCFS 179-MH, Parental Consent for Child’s Mental Health/Developmental Assessment and Participation in Mental Health/Developmental ServicesServices provided by the Regional Centers, which include diagnostic evaluation, coordination or resources such as education, health, welfare, rehabilitation and recreation for persons with developmental disabilities. Additional services include program planning, admission to and discharge from state hospitals, court-ordered evaluations and consultation to other agencies.
DCFS 179-PHI, Authorization for Disclosure of Child’s Protected Health Information (includes a Revocation of Authorization)
DCFS 450, Parent’s/Guardian’s Consent for HIV Test
DCFS 451, Child’s Consent for HIV Test
DCFS 1688-1 , DCFS Worker’s Report to the Juvenile Court of Death, Injury, or Illness
DCFS 4158, Authorization for General Medical Care for a Child Placed by an Order of the Juvenile Court
DCFS 4158-A, Authorization for Emergency Medical Care for a Child Pursuant to WIC 369
DCFS 4158-2, Physician’s Questionnaire
DCFS 4158-2, Physician’s Questionnaire (type-fillable template)
DCFS 4225, Report of Children’s Social Worker with Recommendation of Authorization for Medical Care
DCFS 4225, Report of Children’s Social Worker with Recommendation of Authorization for Medical Care (type-fillable template)
DCFS 4334, Court Medical Consent-Medical Emergency Worksheet
DCFS 5402, Notice to Child’s Attorney Re: Child’s Case Status
0600-501.15, Consent for Emergency Medical Care
0070-548.20, Taking Children into Temporary CustodyThe removal of a child from the home of a parent or legal guardian and placement or facilitation of placement of the child in the home of a non-offending parent, relative, foster caregiver; group home or institutional setting.Temporary custody also includes: placing hospital holds on children; situations in which the CSW interrupts an established Family Law Court custody or visitation orders when the CSW believes that if the order is carried out, the child would be placed in immediate risk of abuse, neglect or exploitation and the child is allowed to remain in the home of the non-offending parent; situations in which DCFS requests that law enforcement remove a child from the home of his or her parent/legal guardian and the CSW places the child with a relative or unrelated caregiver; and situations in which the child is living with a relative or an unrelated caregiver and all of the following conditions exist: child’s parent is asking for the child to be returned home, CSW believes that the return of the child to his or her parent would place the child at risk of abuse, neglect or exploitation, CSW does not allow the child to be returned to his or her parent; and, the child remains in the home of the relative or is placed in out-of-home care.
0600-501.09, Consent for Mental Health Treatment
0600-502.20, HIV/AIDS Testing and Disclosure of HIV/AIDS Information
0600-507.10, Youth Development Reproductive Health
0600-514.10, Psychotropic MedicationMedications used as tools for producing certain chemical and physiological effects in the central nervous system. They are usually classified according to the types of disorders they are primarily used to treat.: Authorization, Review, and Monitoring for DCFS Supervised Child
0600-505.20, Hospitalization of and Discharge Planning for DCFS-Supervised Children
California Supreme Court Decisions, American Academy of Pediatrics vs. Lungren 1997 – States that girls as young as twelve (12) can obtain abortions without their parent’s knowledge or consent.
Family Code (FC) Section 6550(a) – States that a relative caregiver who meets the criteria in the caregiver’s authorization affidavit can consent to medical and dental treatment, with some exceptions.
FC Section 6922(a) – States that a minor can consent to their medical or dental care if they are fifteen (15) or older, living apart from their parents/legal guardian, and managing their own financial affairs.
FC Section 6925(a) – States that a minor can consent to medical care related to prevention or treatment of a pregnancy. This section does not authorize a minor to be sterilized without consent of their parent or legal guardian.
FC Section 6926(a) – States that a minor, twelve (12) or older can consent to medical care related to the diagnosis or treatment of a disease if the disease or condition is one that is required by law or regulation to be reported to the local health officer or is a related sexually transmitted disease, as determined by the State Director of Health Services.
FC Section 6927 – States that a minor, twelve (12) or older who is alleged to have been raped can consent to medical care related to the diagnosis or treatment of the condition and the collection of medical evidence with regard to the alleged rape.
FC Section 6928(b) – States that a minor, alleged to have been sexually assaulted can consent to medical care related to the diagnosis or treatment of the condition and the collection of medical evidence with regard to the alleged sexual assault.
FC Section 6929 – States that a minor, twelve (12) or older can consent to medical care and counseling relating to the diagnosis and treatment of a drug or alcohol related problem.
Health and Safety Code Section 1530.6 – States that persons licensed to provide residential foster care to a child placed with them by order of juvenile court or voluntarily placed with them by persons, who have legal custody of the child, can give consent for ordinary medical and dental treatment for the child.
Welfare and Institutions Code (WIC) Section 362(a) – States that when a child is adjudged a dependent child of the court, per Section 300, the court may make any and all reasonable orders for the care, supervision, custody, conduct, maintenance, and support of the child, including medical treatment.
WIC Section 369(a) and 369(b) – States that whenever a person is taken into temporary custody and is need of medical, surgical, dental, or other remedial care, the social worker may authorize this care upon the recommendation of the physician, surgeon, or dentist. The social worker must notify the parent/legal guardian/person standing in loco parentis of the care needed before the care is provided to the child. If they object, the care can only be given with a court order.
WIC Section 369(c) – States that when a dependent child of the juvenile court is placed by order of the court within the care and custody under the supervision of a social worker in the county in which the child resides, and it appears that there is no parent/legal guardian/person capable or willing to authorize treatment for the child, the court can, after providing notice to the parent/legal guardian/person standing in loco parentis, order that the social worker can authorize medical, surgical, dental, or other remedial care, as needed.
WIC Section 369(d) – States in part that when a child requires immediate emergency medical, surgical, dental, or other remedial care, in an emergency situation, the care can be provided by a licensed physician, surgeon, or dentist, without a court order, and upon authorization of the social worker.
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