Text of OH SB 274 (2025)

As Introduced 136th General Assembly Regular Session S. B. No. 274 2025-2026 Senators Cirino, Brenner To amend sections 2151.461, 3129.03, 3313.473, 3798.07, and 3798.12 and to repeal section 5122.04 of the Revised Code to prohibit the provision of mental health services to minors without parental consent. BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO: Section 1. That sections 2151.461, 3129.03, 3313.473, 3798.07, and 3798.12 of the Revised Code be amended to read as follows: Sec. 2151.461. (A) If a child is under the care and supervision of a residential facility and presents to an emergency department or is admitted to a hospital for an injury or mental health crisis, the emergency department or hospital shall do both of the following: (1) Communicate with the public children services agency or private child placing agency with custody of the child about the visit. Except for care that a child has consented to under section 2108.31, 2151.85, 2907.29, 3701.242, 3709.241, 3719.012, or 5120.172, or 5122.04 of the Revised Code, the emergency department or hospital shall discuss the child's medical treatment with and request authorization of care from the 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 S. B. No. 274 Page 2 As Introduced agency. (2) Notify the agency of the discharge of the child from the emergency department or hospital. (B) A public children services agency or private child placing agency with custody of a child who is under the care and supervision of a residential facility and presents to an emergency department or is admitted to a hospital for an injury or mental health crisis shall respond to the emergency department or hospital's communication regarding medical care for the child not later than four hours after initial contact. Sec. 3129.03. (A) Notwithstanding section 5122.04 of the Revised Code, no No mental health professional shall diagnose or treat a minor individual who presents for the diagnosis or treatment of a gender-related condition without first obtaining the consent of one of the following: (1) At least one parent of the minor individual; (2) At least one legal custodian of the minor individual; (3) The minor individual's guardian. (B) No mental health professional shall diagnose or treat a minor individual who presents for the diagnosis or treatment of a gender-related condition without screening the minor individual for both of the following during the course of diagnosis and treatment: (1) Other comorbidities that may be influencing the minor individual's gender-related condition, including depression, anxiety, attention deficit hyperactivity disorder, autism spectrum disorder, and other mental health conditions; (2) Physical, sexual, mental, and emotional abuse and 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 S. B. No. 274 Page 3 As Introduced other traumas. Sec. 3313.473. (A) The general assembly maintains that a parent has a fundamental right to make decisions concerning the upbringing, education, and care of the parent's child. (B) Not later than the first day of July following the effective date of this sectionApril 9, 2025, the board of education of each city, local, exempted village, and joint vocational school district shall develop and adopt a policy to promote parental involvement in the public school system. The policy shall require a school district to do all of the following: (1)(a) Ensure that any sexuality content is age- appropriate and developmentally appropriate for the age of the student receiving the instruction, regardless of the age or grade level of the student. (b) Prior to providing instruction that includes sexuality content or permitting a third party to provide such instruction on behalf of the district, provide parents the opportunity to review any instructional material that includes sexuality content. Upon request of the student's parent, a student shall be excused from instruction that includes sexuality content and be permitted to participate in an alternative assignment. (2) Promptly notify a student's parent of any substantial change in the student's services, including counseling services, or monitoring related to the student's mental, emotional, or physical health or well-being or the school's ability to provide a safe and supportive learning environment for the student. The policy shall specify in what manner a student's parent will be notified of any substantial change in the student's services. 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 S. B. No. 274 Page 4 As Introduced The policy shall specify that notice to parents shall reinforce the fundamental right of parents to make decisions regarding the upbringing and control of their children, and that the school district shall not inhibit parental access to the student's education and health records maintained by the school. (3) Prohibit school district personnel from directly or indirectly encouraging a student to withhold from a parent information concerning the student's mental, emotional, or physical health or well-being, or a change in related services or monitoring. The policy shall prohibit school district personnel from discouraging or prohibiting parental notification of and involvement in decisions affecting a student's mental, emotional, or physical health or well-being. (4) Adopt a procedure to obtain authorization from parents prior to providing any type of health care service to the student, including physical, mental, and behavioral health care services. Under the procedure, a parent may choose whether to authorize a district to provide a health care service to the parent's child. The procedure shall require the school district to do both of the following: (a) At the beginning of the school year, notify parents of each health care service offered at, or facilitated in cooperation with, their student's school and their option to withhold consent or decline any specified service. Parental consent to health care services does not waive the parent's right to access the parent's student's educational or health records or to be notified about a change in the student's services or monitoring as provided in this section. 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 S. B. No. 274 Page 5 As Introduced (b) Prior to providing a health care service to a student, notify a parent whether the service is required to be provided by the school district under state law and if other options for a student to access the service exist. This requirement may be satisfied by an annual notice to parents at the beginning of the school year. Division (B)(4) of this section does not apply to emergency situations, first aid, other unanticipated minor health care services, or health care services provided pursuant to a student's IEP or a school district's obligation under section 504 of the "Rehabilitation Act of 1973," 29 U.S.C. 794. (5) Permit a parent to file with a school principal or assistant principal a written concern regarding a topic addressed in this section. The policy shall establish a process for a principal or assistant principal to resolve such concerns within thirty days after their receipt. Under the policy, school districts shall notify parents of their right to file a written concern. A parent may appeal a principal's or assistant principal's decision to the superintendent of that district. If a parent appeals the principal's or assistant principal's decision, the superintendent, or a designee of the superintendent, shall conduct a hearing on the decision. Based on the findings of that hearing, the superintendent shall decide whether to affirm the principal's or assistant principal's decision. If the superintendent does not affirm the decision, the superintendent shall determine a resolution to the parent's concern. A parent may appeal the superintendent's decision to the board of education of the school district. The board shall review the superintendent's decision and, if the board determines it necessary, hold a hearing on the decision and, 107 108 109 110 111 112 113 114 115 116 117 118 119 120 121 122 123 124 125 126 127 128 129 130 131 132 133 134 135 136 S. B. No. 274 Page 6 As Introduced based on that hearing, either affirm the superintendent's decision or determine a new resolution to the parent's concern. Nothing in division (B)(5) of this section shall prevent a parent from contacting a member of a board of education regarding the parent's concerns with the operation of a school under the supervision of that board. (C) Each school district shall make its policy adopted under this section publicly available and post it prominently on its publicly accessible web site, if it has one. (D) This section does not prescribe all rights of parents or preempt or foreclose claims or remedies in support of parental rights that are available under the constitution, statutes, or common law of this state. (E) No school district or third party acting on behalf of a district shall provide instruction that includes sexuality content to students in grades kindergarten through three. (F)(1) Nothing in this section shall require disclosure or activity that is in conflict with or in violation of any of the following: (a) The HIPAA privacy rule; (b) Chapter 3798. of the Revised Code; (c) Section 2317.02, or 4732.19, or 5122.04 of the Revised Code; (d) The "Family Educational Rights and Privacy Act of 1974," 20 U.S.C. 1232g; (e) Ohio Constitution, Article I, Section 10a and any laws enacted to implement that section, including sections 2930.07 137 138 139 140 141 142 143 144 145 146 147 148 149 150 151 152 153 154 155 156 157 158 159 160 161 162 163 S. B. No. 274 Page 7 As Introduced and 2930.10 of the Revised Code. (2) Nothing in this section requires disclosure or activity in violation of any court order, including any of the following: (a) A condition of bond; (b) A protection order or consent agreement issued pursuant to section 2151.34, 2903.213, 2903.214, 2919.26, or 3113.31 of the Revised Code; (c) A condition of a community control sanction, post- release control sanction, or parole. (3) Nothing in this section requires disclosure or activity in violation of a specific request for nondisclosure made pursuant to a criminal investigation or grand jury subpoena in which the student is the victim and a parent is the alleged perpetrator. (4) Nothing in this section prohibits or prevents mandatory reporting under section 2151.421 of the Revised Code. (5) Nothing in this section prohibits or limits the career and academic mentoring and counseling between teachers and students in the regular course of the school day. (G) As used in this section: (1) "Biological sex" means the biological indication of male and female, including sex chromosomes, naturally occurring sex hormones, gonads, and unambiguous internal and external genitalia present at birth, without regard to an individual's psychological, chosen, or subjective experience of gender. (2) "HIPAA privacy rule" has the same meaning as in 164 165 166 167 168 169 170 171 172 173 174 175 176 177 178 179 180 181 182 183 184 185 186 187 188 189 190 S. B. No. 274 Page 8 As Introduced section 3798.01 of the Revised Code. (3) "IEP" has the same meaning as in section 3323.01 of the Revised Code. (4) "Parent" has the same meaning as in section 3313.98 of the Revised Code. (5) "Sexuality content" means any oral or written instruction, presentation, image, or description of sexual concepts or gender ideology provided in a classroom setting. "Sexuality content" does not mean any of the following: (a) Instruction or presentations in sexually transmitted infection education, child sexual abuse prevention, and sexual violence prevention education provided under division (A)(5) of section 3313.60 or section 3314.0310 or 3326.091 of the Revised Code; (b) Instruction or presentations in sexually transmitted infection education emphasizing abstinence provided under section 3313.6011 of the Revised Code; (c) Incidental references to sexual concepts or gender ideology occurring outside of formal instruction or presentations on such topics, including references made during class participation and in schoolwork. (6) "Student's mental, emotional, or physical health or well-being" includes, at a minimum, any of the following: (a) A student's academic performance; (b) Any significant sickness or physical injury, or any psychological trauma suffered by a student; (c) Any harassment, intimidation, or bullying, as defined 191 192 193 194 195 196 197 198 199 200 201 202 203 204 205 206 207 208 209 210 211 212 213 214 215 216 217 S. B. No. 274 Page 9 As Introduced in section 3313.666 of the Revised Code, by or against a student in violation of school district policy; (d) Any request by a student to identify as a gender that does not align with the student's biological sex; (e) Exhibition of suicidal ideation or persistent symptoms of depression, or severe anxiety, or other mental health issues. (7) "Age-appropriate" and "developmentally appropriate" content refers to activities or items that are generally accepted as suitable for children of the same chronological age or level of maturity or that are determined to be developmentally appropriate for a child, based on the development of cognitive, emotional, physical, and behavioral capacities that are typical for an age or age group. Sec. 3798.07. (A) A covered entity shall be subject to the following conditions when it discloses protected health information to a health information exchange: (1) The covered entity shall restrict disclosure consistent with all applicable federal laws governing the disclosure. (2) If the protected health information concerns a minor, the covered entity shall restrict disclosure in a manner that complies with laws of this state pertaining to the circumstances under which a minor may consent to the minor's own receipt of health care or make medical decisions on the minor's own behalf, including sections 2907.29, 3709.241, 3719.012, 5120.172, 5122.04, and 5126.043 of the Revised Code unless the minor authorizes the disclosure. (3) The covered entity shall restrict disclosure in a manner that is consistent with a written request from the 218 219 220 221 222 223 224 225 226 227 228 229 230 231 232 233 234 235 236 237 238 239 240 241 242 243 244 245 246 S. B. No. 274 Page 10 As Introduced individual or the individual's personal representative to restrict disclosure of all of the individual's protected health information. (B) The conditions in division (A) of this section on a covered entity's disclosure of protected health information to a health information exchange do not render unenforceable or restrict in any manner any of the following: (1) A provision of the Revised Code that on September 10, 2012, requires a person or governmental entity to disclose protected health information to a state agency, political subdivision, or other governmental entity; (2) The confidential status of proceedings and records within the scope of a peer review committee of a health care entity as described in section 2305.252 of the Revised Code; (3) The confidential status of quality assurance program activities and quality assurance records as described in section 5122.32 of the Revised Code; (4) The testimonial privilege established by division (B) of section 2317.02 of the Revised Code; (5) Any of the following items that govern the confidentiality, privacy, security, or privileged status of protected health information in the possession or custody of an agency as defined in section 111.15 of the Revised Code; govern the process for obtaining from a patient consent to the provision of health care or consent for participation in medical or other scientific research; govern the process for determining whether an adult has a physical or mental impairment or an adult's capacity to make health care decisions for purposes of Chapter 5126. of the Revised Code; or govern the process for 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 S. B. No. 274 Page 11 As Introduced determining whether a minor has been emancipated: (a) A section of the Revised Code that is not in this chapter; (b) A rule as defined in section 119.01 of the Revised Code; (c) An internal management rule as defined in section 111.15 of the Revised Code; (d) Guidance issued by an agency as defined in section 111.15 of the Revised Code; (e) Orders or regulations of a board of health of a city health district made under section 3709.20 of the Revised Code; (f) Orders or regulations of a board of health of a general health district made under section 3709.21 of the Revised Code; (g) An ordinance or resolution adopted by a political subdivision; (h) A professional code of ethics; (i) When a minor is authorized to consent to the minor's own receipt of health care or make medical decisions on the minor's own behalf, including the circumstances described in sections 2907.29, 3709.241, 3719.012, 5120.172, 5122.04, and 5126.043 of the Revised Code. Sec. 3798.12. As used in this section, "agency" has the same meaning as in section 111.15 of the Revised Code. (A) Except as provided in division (B) of this section, any of the following pertaining to the confidentiality, privacy, security, or privileged status of protected health information 276 277 278 279 280 281 282 283 284 285 286 287 288 289 290 291 292 293 294 295 296 297 298 299 300 301 302 S. B. No. 274 Page 12 As Introduced transacted, maintained in, or accessed through a health information exchange is unenforceable if it conflicts with this chapter: (1) A section of the Revised Code that is not in this chapter; (2) A rule as defined in section 119.01 of the Revised Code; (3) An internal management rule as defined in section 111.15 of the Revised Code; (4) Guidance issued by an agency; (5) Orders or regulations of a board of health of a city health district made under section 3709.20 of the Revised Code; (6) Orders or regulations of a board of health of a general health district made under section 3709.21 of the Revised Code; (7) An ordinance or resolution adopted by a political subdivision; (8) A professional code of ethics. (B) Division (A) of this section does not render unenforceable or restrict in any manner any of the following: (1) A provision of the Revised Code that on the effective date of this section September 10, 2012, requires a person or governmental entity to disclose protected health information to a state agency, political subdivision, or other governmental entity; (2) The confidential status of proceedings and records within the scope of a peer review committee of a health care 303 304 305 306 307 308 309 310 311 312 313 314 315 316 317 318 319 320 321 322 323 324 325 326 327 328 329 S. B. No. 274 Page 13 As Introduced entity as described in section 2305.252 of the Revised Code; (3) The confidential status of quality assurance program activities and quality assurance records as described in section 5122.32 of the Revised Code; (4) The testimonial privilege established by division (B) of section 2317.02 of the Revised Code; (5) An item described in divisions (A)(1) to (8) of this section that governs any of the following: (a) The confidentiality, privacy, security, or privileged status of protected health information in the possession or custody of an agency; (b) The process for obtaining from a patient consent to the provision of health care or consent for participation in medical or other scientific research; (c) The process for determining whether an adult has a physical or mental impairment or an adult's capacity to make health care decisions for purposes of Chapter 5126. of the Revised Code; (d) The process for determining whether a minor has been emancipated. (6) When a minor is authorized to consent to the minor's own receipt of health care or make medical decisions on the minor's own behalf, including the circumstances described in sections 2907.29, 3709.241, 3719.012, 5120.172, 5122.04, and 5126.043 of the Revised Code. Section 2. That existing sections 2151.461, 3129.03, 3313.473, 3798.07, and 3798.12 of the Revised Code are hereby repealed. 330 331 332 333 334 335 336 337 338 339 340 341 342 343 344 345 346 347 348 349 350 351 352 353 354 355 356 357 S. B. No. 274 Page 14 As Introduced Section 3. That section 5122.04 of the Revised Code is hereby repealed. 358 359