Provides treatment for sexually transmitted diseases to minors without a parent's or guardian's consent; provides definition for health care practitioner.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A497A
SPONSOR: Paulin (MS) TITLE OF BILL: An act to amend the public health law, in relation to
providing medical care to minors for sexually transmitted diseases with-
out a parent's or guardian's consent
PURPOSE OR GENERAL IDEA OF BILL: To ensure that the diagnosis, treat-
ment, and prevention, including immunization, of a sexually transmissi-
ble disease are available when most effective
SUMMARY OF SPECIFIC PROVISIONS: Section one amends the heading and
subdivisions 1, 2 and 3 of section 2305 of the public health law. The
section amends subdivision 1 to provide that no person other than a
health care practitioner shall diagnose, treat or prescribe for a person
who is infected with a sexually transmissible disease, or who has been
exposed to infection with a sexually transmissible disease, or dispense
or sell a drug, medicine or remedy for the treatment of such person
except on prescription of a health care practitioner. This section
amends subdivision 2 to provide that a health care practitioner may
provide health care related to the prevention of a sexually transmissi-
ble disease, including administering vaccines, to a person under age
eighteen without the consent or knowledge of his or her parents or guar-
dians provided such person has capacity to consent to the care, without
regard to the person's age, and the person consents. Any release of
patient information regarding vaccines provided under this section shall
be consistent with sections 17 and 18 of the public health law and other
applicable laws and regulations. This section one amends subdivision 3
by adding the definition of "health care practitioner."
Section two provides the effective date.
JUSTIFICATION: Section 2305 of the public health law currently permits
a licensed physician or a staff physician in a hospital to diagnose or
treat persons under age 21 infected with a sexually transmissible
disease or exposed to infection with a sexually transmissible disease
without the consent or knowledge of the parents or guardians of such
persons. Yet current law does not allow young people the same access to
care to prevent sexually transmissible diseases. The Legislature has
recognized that it is critical to protecting the health of young people
to allow them to seek treatment of sexually transmitted diseases without
the consent of their parents or guardians because we know that teens
often do not seek parental consent because a request for consent neces-
sarily involves disclosing to parents that the teen has engaged in sexu-
al activity. The Legislature is aware that if teens are not permitted to
seek care and treatment of sexually transmissible diseases, sexually
transmissible diseases among many of our teens would go untreated,
severely impeding our ability to control the spread of sexually tran-
smissible diseases. This can be particularly problematic in correctional
settings where attempts to obtain parental consent are often unsuccess-
ful.
Regardless of setting, teens should not be limited to access to care on
a confidential basis after the fact, or after infection or contraction
of a sexually transmissible disease. Teens should have access to confi-
dential care before infection or contracting the sexually transmissible
disease, to prevent disease or life-threatening illness such as cervical
cancer and liver cancer.
This is particularly evident when we possess safe and effective means,
such as the human papillomavirus (HPV) and hepatitis B vaccines, to
prevent our teens from becoming infected with the viruses that cause
such cancers.
Approximately 99.7% of all cervical cancer cases are linked to certain
types of the HPV virus. According to the American Cancer Society,
approximately 3,700 people die from cervical cancer in the United States
every year. African American women and Hispanic women in the U.S. are
disproportionately impacted by cervical cancer. The HPV vaccine, which
has been approved by the U. S. Food and Drug Administration for girls
and women age 11 - 26, with routine vaccination of 11 & 12 year old
girls, is most effective when administered before a person becomes sexu-
ally active. Generally, this means administering the vaccine to persons
under the age of eighteen. Moreover, the vaccine is more effective if
it is obtained before a woman becomes sexually active.
Armed with this knowledge, young women have sought to be immunized with
the HPV vaccine. Planned Parenthood and several community health centers
testified at a Senate hearing a few years ago that young women were
coming into clinics and centers requesting the HPV vaccine. Yet even
though teens may receive family planning counseling and birth control,
terminate a pregnancy, and receive treatment for a sexually transmissi-
ble disease, in each case without the consent of a parent or guardian,
those very teens cannot obtain the HPV vaccine without parental consent.
Similarly, a teen cannot obtain the hepatitis B vaccine without parental
consent. The hepatitis B virus (HBV), a major cause of liver disease,
ranking as a substantial cause of cirrhosis and cancer of the liver, is
sexually transmitted. Persons with HBV infection have the virus circu-
lating in their blood, much like HIV, (HBV is approximately 100 times
more contagious than HIV.) HBV infected persons either recover from
their infection in several months or they may remain chronically
infected for most of their life.
Although HBV is a common infection, it often goes unnoticed. Chronic
infection with HBV often goes undetected for 20 to 40 years until the
resulting liver disease makes the person ill. HBV can effectively
destroy the liver or stimulate the development of liver cancer in some-
one who thinks he or she is completely well. Persons who become chron-
ically infected with HBV as adolescents or adults have a 15% chance of
dying from liver disease and are at high risk of death from liver
cancer, 4,000 to 5,000 people die in the United States each year from
hepatitis B.
It is imperative that we promote protection against often fatal diseases
to those who will most benefit from that protection. By allowing health
care professionals to administer immunization against HPV, hepatitis B,
and other sexually transmitted diseases to persons under the age of
eighteen without the consent or knowledge of a parent or guardian, this
legislation promotes the health and well being of persons at a most
critical juncture in their lives: prior to being sexually active and
prior to exposure to viruses we know are linked to deadly diseases.
With this legislation, we can ensure that every person, regardless of
age, may receive the full range of reproductive and sexual health care
services, including prevention care, and where the person is under the
age of eighteen, if he or she has the capacity to consent and consents.
PRIOR LEGISLATIVE HISTORY: A.343, 2011 and 2012 referred to health.
Same as S.384, 2011 and 2012 referred to health. A.6702C, 2009 amended
on third reading and 2010 referred to health. Same as S.97798, 2009 and
2010 referred to health. Similar to A9630, 2008 referred to health.
FISCAL IMPLICATION: None to the state.
EFFECTIVE DATE: Immediately.
