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california legislation > AB 499

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Bill No: AB 499
Author: Atkins (D), et al.
Amended: As introduced
Vote: 21

AYES: Evans, Corbett, Leno
NOES: Harman

: 6-3, 8/25/11
AYES: Kehoe, Alquist, Lieu, Pavley, Price, Steinberg
NOES: Walters, Emmerson, Runner

: 50-25, 5/12/11 - See last page for vote

SUBJECT : Minors: medical care: consent

SOURCE : American Congress of Obstetricians and
District IX
California STD Controllers Association
Health Officers Association of California

DIGEST : This bill authorizes a minor, who is 12 years of
age or older, to consent to medical care related to the
prevention of a sexually transmitted disease.

ANALYSIS : Existing law provides that a minor who is 12
years of age or older who might have come into contact with

AB 499

a contagious, infectious, or
communicable disease may consent to medical care related to
the diagnosis or treatment of that disease if the disease
or condition is one that is required by law to be reported
to the local health officer, or is a sexually transmitted
disease as determined by the Director of the Department of
Health Services. (Family Code Section 6926 (a))

Existing law provides that the parents of a minor who has
consented to medical treatment for a communicable or
sexually transmitted disease are not liable for payment for
that care. (Family Code Section 6926 (b))

Existing law provides that a minor may consent to medical
care related to the prevention or treatment of pregnancy.
(Family Code Section 6925 (a))

Existing law provides that a minor's consent under minor
consent statutes cannot be subject to disaffirmance because
of minority. (Family Code Section 6921)

Existing law provides that a minor who is 12 years old or
older who is alleged to have been raped may consent to
diagnosis and treatment of that condition. (Family Code
Section 6927)

Existing law allows a minor alleged to have been sexually
assaulted to consent to medical care related to the
diagnosis and treatment of that condition. (Family Code
Section 6928 (b))

Existing law allows a minor to consent to medical care
related to the diagnosis or treatment of a drug or
alcohol-related problem. (Family Code Section 6929 (b))

Existing law provides that a minor may consent to medical
or dental care if that minor is over the age of 15, living
separate and apart from his or her parents whether with or
without his/her parents' consent, and managing his or her
own financial affairs. (Family Code Section 6922 (c))

This bill authorizes a minor, who is 12 years of age or
older, to consent to medical care related to the prevention
of a sexually transmitted disease.


AB 499

FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No

According to the Senate Appropriations Committee:

Fiscal Impact (in thousands)

Major Provisions 2011-12 2012-13
2013-14 Fund

Medi-Cal vaccination$1,200-$2,500 per 5 to
10% of Federal/
administrative fee eligible cases

Post-exposure Unknown; potentially
prophylactic HIV costs of $750 to $1,550
per 1,000 General*
treatment cases

Healthy Families Unknown; potential cost
pressure Federal/
Program impact on plan rates

Preventive services Potential future cost
savings inFederal/
diagnosis and treatment

* Costs shared 50 percent General Fund, 50 percent
federal funds

SUPPORT : (Verified 8/25/11)

American Congress of Obstetricians and Gynecologists,
District IX (co-source)
California STD Controllers Association (co-source)
Health Officers Association of California (co-source)
ACCESS Women's Health Justice
ACT for Women and Girls
American Civil Liberties Union


AB 499

American Association of University Women
Asian Communities for Reproductive Justice
California Adolescent Health Committee
California Coalition for Youth
California Commission on the Status of Women
California Communities United Institute
California Family Health Council
California Medical Association
California National Organization of Women
California Nurses Association
California Primary Care Association
California School Health Centers Association
Children's Law Center of Los Angeles
County of Los Angeles Board of Supervisors
Having Our Say
Kaiser Permanente
Los Angeles Gay and Lesbian Center
Maternal and Child Health Access
Mental Health Association in California
National Center for Youth Law
National Association of Social Workers-California Chapter
NARAL-Pro-Choice California
National Council of Jewish Women
Nevada County Citizens for Choice
Planned Parenthood Affiliates of California
Planned Parenthood Advocacy Project Los Angeles County
Planned Parenthood Mar Monte
Reproductive Justice Coalition of Los Angeles
Women's Health Specialists

OPPOSITION : (Verified 8/25/11)

California Catholic Conference
California Right to Life Committee
Capitol Resource Family Impact
Capitol Resource Institute

ARGUMENTS IN SUPPORT : The author writes:

"There is a gap in the law relative to prevention of
sexually transmitted diseases (STDs). Existing law only
specifies the ability to consent to diagnosis and
treatment. This omission creates a barrier to
time-critical preventive services. At the time the law


AB 499

was passed, the preventive options we have today did not

"We now have time-critical prevention services for
sexually transmitted diseases. Examples include the
hepatitis B vaccines, prophylactic post-exposure HIV
medications (which must be given within 72 hours of
exposure) and HPV vaccine which, if given before
exposure, can significantly reduce the risk of certain
cancers and abnormal, precancerous cervical cell changes
and genital warts. In addition to these diseases being
sexually transmitted, they also have in common that they
can be life-long and are only treatable, not curable.
The treatments can be costly in both financial terms and
quality of life.

"These services are ? time-sensitive, and there are
long-term health implications if there is a failure to
obtain the services. All of these therapies need to be
provided in a timely fashion to prevent significant harm.
Some adolescents, from difficult family situations, will
either delay or simply fail to obtain services if
confronted with a legal requirement of parental consent."

The co-sponsor of the bill, the Executive Committee of the
California STD Controllers Association writes, "While most
teens involve their parents in medical decisions, even
those involving sensitive subjects, we need to allow for
those minors who can't or won't include their parents. The
current requirement that minors obtain parental consent for
STD prevention services has resulted in missed and denied
opportunities for minors to receive vital and
time-sensitive medical care. The need to provide
prevention services to this population is essential."

The Health Officers Association of California, the
co-sponsor of this bill states, "Prevention of communicable
disease is a primary goal of public health. Prevention
allows physicians to stop diseases before they start,
avoiding unnecessary pain, disability, and medical costs.
Preventive measures for STDs include counseling,
age-appropriate education, distribution of prophylaxis, and
vaccination against Hepatitis B and HPV. Prevention is a
vital part of comprehensive care. Provision of


AB 499

confidential prevention services will help California's
physicians protect the health of our young people."

Also co-sponsoring the bill, the American Congress of
Obstetricians and Gynecologists, District IX (ACOG-IX)
writes: "The reality is that teens have the highest rate
of sexual violence, with 1 in 6 women and 1 in 33 men
reporting sexual assault in their lifetimes. Among victims
of Ýsexual] violence, the highest rate exists for those 25
years of age and below. Thus, teens are at particular
risk. What is of utmost concern to ACOG-IX is teen health
and safety. Previous legislatures, in passing current
minor consent laws, have also taken this position. ACOG
policy is to encourage minors to include their parents in
medical decisions. However for some teens, good family
communication is not possible and actually may be
dangerous. The California Supreme Court in a 1997 opinion
concluded that forcing parent communication about sensitive
health care can actually endanger teens physically and
emotionally and 'exacerbate the instability and
dysfunctional nature of the family relationship.'"

ARGUMENTS IN OPPOSITION : The California Catholic
Conference, Inc. argues that "most parents are involved in
the lives of their minor children and want and need to know
if they are seeking medical care-regardless of whether the
care is preventative or curative. Of course there are
occasions when parents do not adequately care for the
welfare of their minor child, but it is certainly not the
usual case." The California Catholic Conference continues
with "this bill is dangerous because it expands a faulty
law which assumes that children know better than their
parents and because it will allow minors access to HPV
vaccines which may cause them permanent harm."

ASSEMBLY FLOOR : 50-25, 5/12/11
AYES: Alejo, Allen, Ammiano, Atkins, Beall, Block,
Blumenfield, Bonilla, Bradford, Brownley, Buchanan,
Butler, Charles Calderon, Campos, Carter, Chesbro, Davis,
Dickinson, Eng, Feuer, Fletcher, Fong, Fuentes, Furutani,
Galgiani, Gatto, Gordon, Hall, Hayashi, Roger Hernández,
Hill, Huber, Hueso, Huffman, Lara, Bonnie Lowenthal, Ma,
Mendoza, Mitchell, Monning, Pan, Perea, V. Manuel Pérez,


AB 499

Skinner, Solorio, Swanson, Wieckowski, Williams, Yamada,
John A. Pérez
NOES: Achadjian, Bill Berryhill, Conway, Cook, Donnelly,
Beth Gaines, Grove, Hagman, Halderman, Harkey, Jeffries,
Jones, Knight, Logue, Mansoor, Miller, Morrell, Nestande,
Nielsen, Norby, Olsen, Silva, Smyth, Valadao, Wagner
NO VOTE RECORDED: Cedillo, Garrick, Gorell, Portantino,

RJG:mw 8/26/11 Senate Floor Analyses


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