BILL NUMBER:  S5611

 TITLE OF BILL :  An act to amend the public health law, in relation
to providing medical care to minors for sexually transmitted diseases
without a parent's or guardian's consent

 PURPOSE OR GENERAL IDEA OF BILL :

To ensure that the diagnosis, treatment, and prevention, including
immunization, of a sexually transmissible 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 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. 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 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 the State's 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
illnesses 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 99.79 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 males and females age 11 - 26, with recommended
vaccination of 11 & 12 year olds, is most effective when administered
before a person becomes sexually active. Generally, this means
administering the vaccine to persons under the age of eighteen.

Armed with this knowledge, young people 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
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
some- one 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.

 FISCAL IMPLICATION :

None to the State.

 EFFECTIVE DATE :
Immediately.