Provides treatment for sexually transmissible diseases to minors without a parent's or guardian's consent

Summary of specific provisions

Section one amends subdivision 1 of section 2305 of the public health law 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 one also amends subdivision 2 of section 2305 of the public health law to provide that a health care practitioner may diagnose, treat or prescribe treatment for a sexually transmissible disease for a person under age eighteen without the consent or knowledge of his or her parents or guardians where such person is infected with a sexually . transmissible disease or has been exposed to infection with a sexually transmissible disease.

Subdivision 2 of section 2305 of the public health law is further amended to provide that a health care practitioner may provide health care related to the prevention of a sexually transmissible disease, including administering vaccines, to a person under age eighteen without the consent or knowledge of his or her parents or guardians, provided such person has capacity to consent to the care, without regard to the person's age, and the person consents, This subdivision is amended further to provide that 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.

In addition, section one amends subdivision 3 of section 2305 of the public health law 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 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 necessarily involves disclosing to parents that the teen has engaged in sexual 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 transmissible diseases, This can be particularly problematic in correctional settings where attempts to obtain parental consent are often unsuccessful.

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 confidential 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 sexually 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 two 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 transmissible 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 circulating 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 someone who thinks he or she is completely well. Persons who become chronically 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

Similar to A.9630, 2008 referred to health.

Fiscal implication

None to the state.

Effective date

Immediately.