Text of AL SB 101 (2025)

SB101 INTRODUCED Page 0 SB101 6DYU331-1 By Senators Stutts, Williams, Allen RFD: Children and Youth Health First Read: 05-Feb-25 1 2 3 4 5 6DYU331-1 01/27/2025 GP (L)lg 2025-175 Page 1 SYNOPSIS: Under existing law, a minor who is at least 14 years of age, who has graduated from high school, or who is married, divorced, or pregnant may give legal consent to medical, dental, and mental health services for himself or herself. Also under existing law, any minor may give legal consent to participate in school counseling services, to donate bone marrow, or to determine the presence of or treat pregnancy, sexually transmitted infections, and alcohol or drug dependency. This bill would require a minor to be at least 18 years of age to consent to medical, dental, and mental health services, including participation in school counseling services, receipt of a vaccine, and the donation of bone marrow, unless the minor is married, divorced, pregnant, emancipated, or living independently apart from his or her parents or legal guardian. This bill would allow any minor to consent to services to prevent or treat pregnancy, sexually transmitted infections, and alcohol or drug dependency. This bill would prohibit a health care provider or governmental entity from denying a parent access to his or her minor child's health information, unless a 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 SB101 INTRODUCED Page 2 court order prohibits the access or the parent is under investigation for a crime against the child. This bill would also provide that parents have a fundamental right to make decisions concerning the furnishing of health care services to their minor child. A BILL TO BE ENTITLED AN ACT Relating to consent to medical treatment; to amend Sections 16-22-16.2, 22-8-4, 22-8-6, 22-8-9, and 22-8-10, Code of Alabama 1975; to add Sections 22-8-12 and 22-8-13 to the Code of Alabama 1975; to raise the age at which a minor may give legal consent to medical, dental, and mental health services for himself or herself; to provide exceptions for certain minors and certain services; to prohibit health care providers and governmental entities from denying a parent access to his or her minor child's health information, with exceptions; and to provide that it is the fundamental right of a parent to make decisions concerning the health care of his or her child. BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: Section 1. Sections 16-22-16.2, 22-8-4, 22-8-6, 22-8-9, and 22-8-10, Code of Alabama 1975, are amended to read as follows: 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 SB101 INTRODUCED Page 3 "§16-22-16.2 (a) Subject to appropriations by the Legislature, commencing with the 2023-2024 school year, each local board of education in the state shall employ a mental health service coordinator. The coordinator shall be responsible for coordinating student mental health services throughout the local school system. (b) An individual hired as a coordinator shall possess at least one of the following qualifications: (1) Have a bachelor's degree in social work. (2) Satisfy State Department of Education qualifications for a school counselor. (3) Satisfy State Department of Education qualifications for a school nurse. (4) Have professional mental health experience, or have been licensed in a mental health occupation including, but not limited to, licensure as a licensed professional counselor or marriage and family therapist. (5) Other qualifications as determined by the Alabama Department of Mental Health and the State Department of Education. (c) Within one year after being hired as a mental health service coordinator, an individual shall earn a school-based mental health certificate by successfully completing a certification program developed by the Alabama Department of Mental Health. (d) On or before the last day of the 2021 fiscal year, and as requested thereafter, each local board of education 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 SB101 INTRODUCED Page 4 shall complete and submit to the Alabama Department of Mental Health a needs assessment and resource map for the schools under the jurisdiction of the board. The assessment shall document the status of mental health for the entire school system and allow the local board of education to engage in a quality improvement process to improve the provision of mental health resources to students within the school system. (e) The Alabama Department of Mental Health and the State Department of Education may adopt rules and policies as necessary for implementation of this section. (f) The administration of this section shall be subject to appropriations made by the Legislature. (g) As used in this section, the term "local board of education" and "school system" shall include the schools or school systems provided by Chapter 1 of Title 21; Chapters 26A, 26B, and 26D of this title; and Article 4 of Chapter 1 of Title 44. (h)(1) For the purposes of this section,: (i) "mental health services" includes services, treatment, surveys, or assessments relating to mental health, including, but not limited to, guidance counseling and any programming offered by an employee or independent contractor of a local board of education relating to mental health, suicide provention, or bullying prevention;, and (ii) "parent" includes a student's parent or legal guardian, as applicable. (2)a. Except as provided in paragraph b., no No student of a public K-12 school under the age of 14 18 years of age may be allowed to participate in ongoing school counseling 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 SB101 INTRODUCED Page 5 services including, but not limited to, mental health services, unless specific written instruction has been granted by the student's parent, unless there is an imminent threat to the health of the student or others. For the purposes of this section, this written permission is referred to as an opt-in opt in. b. No school counselor may be precluded from providing school counseling services due to: 1. An imminent threat to the health of the student or others; 2. Suspected abuse, neglect, or exploitation; or 3. When there is an immediate necessity for immediate grief counseling. (3) All local boards of education in this state shall adopt a policy concerning parent opt-in opt in for mental health services. At a minimum, each policy shall contain the following: a. A provision for written notification, at least annually, to parents about school provided or sponsored mental health services. The notification shall include the purpose and general description of each of the mental health services, information regarding ways parents may review materials to be used in guidance and counseling programs that are available to students, and information regarding ways parents may allow, limit, or prevent their student's participation in the programs. b. A provision requiring written permission by a parent for his or her student to participate in mental health 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 SB101 INTRODUCED Page 6 services. This written permission shall be specific as to any treatment and not broad in nature. This permission shall also be required annually and may be rescinded at any time by providing written notice to school administration. c. If a parent elects to opt-in opt in to mental health services for his or her student, the counselor providing the services shall keep the parent fully informed regarding diagnosis, recommended counseling, or treatments, and the parent shall have the authority to make final decisions regarding counseling and treatments. d. A provision requiring all records pertaining to mental health services to be treated as health care records and kept separately from academic records." "§22-8-4 (a) Any minor who is 14 years of age or older, or has graduated from high school, or is married, or having been married is divorced or is pregnantEach of the following individuals may give effective consent to any legally authorized medical, dental, health or mental health services for himself or herself, and the consent of no other person shall be necessary: (1) An individual who is 18 years of age or older. (2) A minor who has graduated from high school. (3) A minor who is married, or having been married is divorced. (4) A minor who is pregnant. (5) A minor who is emancipated. (6) A minor who is: (i) not dependent on a parent or 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 SB101 INTRODUCED Page 7 legal guardian for support; (ii) living apart from his or her parents or other individual in loco parentis; and (iii) managing his or her own financial affairs. (b) For the purposes of this section, the term "medical services" includes the receipt of a vaccine." "§22-8-6 (a) Any minor may give effective consent for any legally authorized medical, health or mental health services to determine: (1) Determine the presence of, or to treat, pregnancy, venereal disease sexually transmitted infections, drug dependency, or alcohol toxicity or any reportable disease, and the; and (2) Prevent or determine the presence of pregnancy. (b) The consent of no other person shall be deemed individual is necessary for a minor to receive any services under this section." "§22-8-9 Any minor who is 14 years of age or older, or has graduated from high school, or is married, or having been married is divorced or is pregnant,(a) Each of the following individuals may give effective consent to the donation of his or her bone marrow for the purpose of bone marrow transplantation: (1) An individual who is 18 years of age or older. (2) A minor who has graduated from high school. (3) A minor who is married, or having been married is divorced. 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 SB101 INTRODUCED Page 8 (4) A minor who is pregnant. (5) A minor who is emancipated. (6) A minor who is: (i) not dependent on a parent or legal guardian for support; (ii) living apart from his or her parents or other individual in loco parentis; and (iii) managing his or her own financial affairs. (b) A parent or legal guardian may consent to such bone marrow donation on behalf of any other minor who is not authorized to give his or her own effective consent to the donation of his or her bone marrow pursuant to subsection (a)." "§22-8-10 (a) Notwithstanding Section 22-8-4, no minor may receive medical treatment for any mental health services without the written consent of the minor's parent or legal guardian. (b) The parent or legal guardian of a minor who is at least 14 years of age and under 19 18 years of age may authorize medical treatment for any mental health services even if the minor has expressly refused such treatment services if the parent or legal guardian and a mental health professional determine that clinical intervention is necessary and appropriate. Access to the mental health records of the minor will follow the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Public Law 104-191." Section 2. Sections 22-8-12 and 22-8-13 are added to the Code of Alabama 1975, to read as follows: §22-8-12 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 SB101 INTRODUCED Page 9 (a) Except as provided in subsection (b), no health care provider or governmental entity may deny a parent or legal guardian access to his or her minor child's health information when: (1) The health information is in the control of the health care provider or governmental entity; and (2) The parent or legal guardian requests access to the health information. (b) A health care provider or governmental entity may deny a parent or legal guardian access to his or her minor child's health information if: (1) The access is prohibited by a court order; or (2) The parent or legal guardian is a subject of an investigation related to a crime against the minor child and a law enforcement officer has requested that the information not be released to the parent. §22-8-13 Parents have the fundamental right and duty to make decisions concerning the furnishing of health care services to their minor child. Section 3. This act shall become effective on October 1, 2025. 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246

SB101 ENROLLED Page 0 SB101 5V4NE3M-2 By Senators Stutts, Williams, Allen RFD: Children and Youth Health First Read: 05-Feb-25 1 2 3 4 5 SB101 Enrolled Page 1 Enrolled, An Act, Relating to consent to medical treatment; to amend Sections 16-22-16.2, 22-8-4, 22-8-6, 22-8-9, and 22-8-10, Code of Alabama 1975; to add Sections 22-8-12, 22-8-13, and 22-8-14 to the Code of Alabama 1975; to raise the age at which a minor may give legal consent to medical, dental, and mental health services for himself or herself; to provide exceptions for certain minors and certain services; to prohibit health care providers and governmental entities from denying a parent access to his or her minor child's health information, with exceptions; and to provide that it is the fundamental right of a parent to make decisions concerning the health care of his or her child. BE IT ENACTED BY THE LEGISLATURE OF ALABAMA: Section 1. Sections 16-22-16.2, 22-8-4, 22-8-6, 22-8-9, and 22-8-10, Code of Alabama 1975, are amended to read as follows: "§16-22-16.2 (a) Subject to appropriations by the Legislature, commencing with the 2023-2024 school year, each local board of education in the state shall employ a mental health service coordinator. The coordinator shall be responsible for coordinating student mental health services throughout the local school system. (b) An individual hired as a coordinator shall possess at least one of the following qualifications: (1) Have a bachelor's degree in social work. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 SB101 Enrolled Page 2 (2) Satisfy State Department of Education qualifications for a school counselor. (3) Satisfy State Department of Education qualifications for a school nurse. (4) Have professional mental health experience, or have been licensed in a mental health occupation including, but not limited to, licensure as a licensed professional counselor or marriage and family therapist. (5) Other qualifications as determined by the Alabama Department of Mental Health and the State Department of Education. (c) Within one year after being hired as a mental health service coordinator, an individual shall earn a school-based mental health certificate by successfully completing a certification program developed by the Alabama Department of Mental Health. (d) On or before the last day of the 2021 fiscal year, and as requested thereafter, each local board of education shall complete and submit to the Alabama Department of Mental Health a needs assessment and resource map for the schools under the jurisdiction of the board. The assessment shall document the status of mental health for the entire school system and allow the local board of education to engage in a quality improvement process to improve the provision of mental health resources to students within the school system. (e) The Alabama Department of Mental Health and the State Department of Education may adopt rules and policies as necessary for implementation of this section. 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 SB101 Enrolled Page 3 (f) The administration of this section shall be subject to appropriations made by the Legislature. (g) As used in this section, the term "local board of education" and "school system" shall include the schools or school systems provided by Chapter 1 of Title 21; Chapters 26A, 26B, and 26D of this title; and Article 4 of Chapter 1 of Title 44. (h)(1) For the purposes of this section,: (i) "mental health services" includes services, treatment, surveys, or assessments relating to mental health, including, but not limited to, guidance counseling and any programming offered by an employee or independent contractor of a local board of education relating to mental health, suicide counseling, or bullying counseling;, and (ii) "parent" includes a student's parent or legal guardian, as applicable; and (iii) "imminent threat" means a known or foreseeable danger that could occur in the immediate or near future. (2)a. Except as provided in paragraph b., no No student of a public K-12 school under the age of 14 16 years of age may be allowed to participate in ongoing school counseling services including, but not limited to, mental health services, unless specific written instruction has been granted by the student's parent, unless there is an imminent threat to the health of the student or others. For the purposes of this section, this written permission is referred to as an opt-in opt in. b. No school counselor or health care provider may be precluded from providing mental health services due to: 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 SB101 Enrolled Page 4 1. An imminent threat to the health of the student or others; 2. Suspected abuse, neglect, or exploitation; or 3. When there is an immediate necessity for immediate grief counseling. (3) All local boards of education in this state shall adopt a policy concerning parent opt-in opt in for mental health services. At a minimum, each policy shall contain the following: a. A provision for written notification, at least annually, to parents about school provided or sponsored mental health services. The notification shall include the purpose and general description of each of the mental health services, information regarding ways parents may review materials to be used in guidance and counseling programs that are available to students, and information regarding ways parents may allow, limit, or prevent their student's participation in the programs. b. A provision requiring written permission by a parent for his or her student to participate in mental health services. This written permission shall be specific as to any treatment and not broad in nature. This permission shall also be required annually and may be rescinded at any time by providing written notice to school administration. c. If a parent elects to opt-in opt in to mental health services for his or her student, the counselor providing the services shall keep the parent fully informed regarding diagnosis, recommended counseling, or treatments, and the 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 108 109 110 111 112 SB101 Enrolled Page 5 parent shall have the authority to make final decisions regarding counseling and treatments. d. A provision requiring all records pertaining to mental health services to be treated as health care records and kept separately from academic records. (i) Nothing in this section shall limit, preclude, or prevent the provision of any health care service to a minor when the health care provider providing the service has a good faith belief that one of the following conditions exist in regard to the minor: (1) An imminent threat, as defined in subsection (h). (2) Suspected abuse, neglect, or exploitation." "§22-8-4 (a) Any minor who is 14 years of age or older, or has graduated from high school, or is married, or having been married is divorced or is pregnantEach of the following individuals may give effective consent to any legally authorized medical, dental, health or mental health services for himself or herself, and the consent of no other person individual shall be necessary: (1) An individual who is 16 years of age or older. (2) A minor who has graduated from high school. (3) A minor who meets any of the criteria as set forth in Section 22-8-5. (4) A minor who is pregnant. (5) A minor who is emancipated. (6) A minor who is: (i) not dependent on a parent or legal guardian for support; and (ii) living apart from his or 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 137 138 139 140 SB101 Enrolled Page 6 her parents or other individual in loco parentis. (b) Notwithstanding any provision of law to the contrary, an individual who is 18 years of age or older may give effective consent to participate in any clinical trial, and the consent of no other individual shall be necessary. (c) For the purposes of this section, a minor who is the parent of a child as provided in Section 22-8-5 or is pregnant may consent to any legally authorized medical, dental, or mental health services for his or her own child, and the consent of no other individual shall be necessary." "§22-8-6 (a) Any minor may give effective consent for any legally authorized medical, health or mental health services to determine: (1) Determine the presence of, or to treat, pregnancy, venereal disease sexually transmitted infections, drug dependency, or alcohol toxicity or; (2) Determine the presence of any reportable disease, and the; and (3) Prevent or determine the presence of pregnancy. (b) The consent of no other person shall be deemed individual is necessary for a minor to receive any services under this section." "§22-8-9 Any minor who is 14 years of age or older, or has graduated from high school, or is married, or having been married is divorced or is pregnant,(a) Each of the following individuals may give effective consent to the donation of his 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 164 165 166 167 168 SB101 Enrolled Page 7 or her bone marrow for the purpose of bone marrow transplantation: (1) An individual who is 16 years of age or older. (2) A minor who has graduated from high school. (3) A minor who meets any criteria as set forth in Section 22-8-5. (4) A minor who is pregnant. (5) A minor who is emancipated. (6) A minor who is: (i) not dependent on a parent or legal guardian for support; and (ii) living apart from his or her parents or other individual in loco parentis. (b) A parent or legal guardian may consent to such bone marrow donation on behalf of any other minor who is not authorized to give his or her own effective consent to the donation of his or her bone marrow pursuant to subsection (a)." "§22-8-10 The parent or legal guardian of a minor who is at least 14 16 years of age and under 19 years of age may authorize medical treatment for any mental health services even if the minor has expressly refused such treatment services if the parent or legal guardian and a mental health professional determine that clinical intervention is necessary and appropriate. Access to the mental health records of the minor will follow the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Public Law 104-191." Section 2. Sections 22-8-12, 22-8-13, and 22-8-14 are added to the Code of Alabama 1975, to read as follows: 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 191 192 193 194 195 196 SB101 Enrolled Page 8 §22-8-12 (a) Except as provided in subsection (b), no health care provider or governmental entity may deny a parent or legal guardian access to his or her minor child's health information when: (1) The health information is in the control of the health care provider or governmental entity; and (2) The parent or legal guardian requests access to the health information. (b) A health care provider or governmental entity may deny a parent or legal guardian access to his or her minor child's health information if any of the following conditions exist: (1) The access is prohibited by a court order. (2) The parent or legal guardian is a subject of an investigation related to a crime against the minor child and a law enforcement officer has requested that the information not be released to the parent. (3) The health care provider has reported the minor child as a known or suspected victim of abuse or neglect pursuant to Chapter 14 of Title 26. (4) The provision of access to the parent or legal guardian would be in violation of any federal laws or rules protecting the confidentiality of participant health information in substance use disorder treatment programs. §22-8-13 Parents have the fundamental right and duty to make decisions concerning the furnishing of health care services to 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 218 219 220 221 222 223 224 SB101 Enrolled Page 9 their minor child, subject to the provisions of this chapter and Section 16-22-16.2. §22-8-14 Nothing in this chapter shall limit, preclude, or prevent the provision of any health care service to a minor when the health care provider providing the service has a good faith belief that one of the following conditions exist in regard to the minor: (1) An imminent threat, as defined in Section 16-22-16.2. (2) Suspected abuse, neglect, or exploitation. Section 3. This act shall become effective on October 1, 2025. 225 226 227 228 229 230 231 232 233 234 235 236 237 SB101 Enrolled Page 10 ________________________________________________ President and Presiding Officer of the Senate ________________________________________________ Speaker of the House of Representatives SB101 Senate 08-Apr-25 I hereby certify that the within Act originated in and passed the Senate, as amended. Patrick Harris, Secretary. House of Representatives Amended and passed: 07-May-25 Senate concurred in House amendment 14-May-25 By: Senator Stutts 238 239 240 241 242 243 244 245 246 247 248 249 250 251 252 253 254 255 256 257 258 259 260 261 262 263 264 265 266 267 268 269 270 271 272 273 274 275