Table 2

Highlights of Information Obtained Directly From the Legislators Who Crafted the Bills or From the Bills' Legislative Histories

State	Commentary
Arizona	The bill was sponsored by the late Douglas Holsclaw (R, Tucson) and former United States Supreme Court Associate Justice Sandra Day O’Connor (formerly R, Paradise Valley). In her reply letter, Justice O’Connor wrote “In response to your letter. … I have kept no records of my legislative activity in 1971 and have no information to offer in response to your question.”
California	The bill was introduced by Assemblywoman Leona Egeland in 1977 and was approved, with amendments, by the California House and Senate the same year. The legislative history indicates that 12 years was selected, to be “. … consistent with minor consent rights for other types of care in California.”
Colorado	One legislator involved in crafting the bill did not recall specific details. He proceeded to say, “If you ask me, we probably pulled the number out of thin air.” A member of the Behavioral Health Network that provides services to the State of Colorado stated, “Many treatment providers do have a policy that adolescents younger than 16 will only be admitted with parental consent. This is partially a clinical decision based on the belief that treatment cannot be successful for such individuals without family involvement, partially a concern for parental rights and potential liability, and partially due to licensing issues.”
Connecticut	The legislative history indicates that the statute was intended to establish an opportunity for minors to seek and enter into substance abuse treatment programs without parental consent, in an effort to remove barriers for young people to receive treatment.
Florida	The information available indicates that Florida does not have a consistent public policy governing health care for minors. An official with Florida's Department of Children and Families indicated, “In my many years with the system, each of these laws reflects decisions made at the time of passage over a span of many years. The decisions derive from political, financial, and precedent origins, not necessarily on the developmental needs or maturity level of a person to make such decisions.”
Idaho	Upon review of the legislative history, a member of the state librarian's office said, “In the original bill, the age was 18. In 1972 they tried to change it to 12 years old; it ended at 16 years old. The minutes don‘t really discuss why.”
Indiana	An attorney with the Indiana Family and Social Services Administration indicated that no legislative history was available for review, as “. … Indiana is not a legislative history state, in some jurisdictions the legislative hearings are recorded and carry some legal weight in interpreting statutes the way the legislators intended them. Indiana is not such a jurisdiction, and legislative history has absolutely no legal significance, and so it's not preserved except by memory of those involved.”
Kansas	Interpreting the legislative history, an attorney with the Kansas Department of Social and Rehabilitation Services indicated his recollection was that “… [14 years] was the age that legislators thought might show the most promise for treatment.”
Kentucky	An individual in the Attorney General's office indicated that the age was set at 16 for purposes of uniformity, given that in Kentucky “. … minors can consent to medical treatment, mental health services, and sex at age 16. … the age at which a minor can consent to sex was lowered to 16 in 1976.”
Maryland	After reviewing the legislative history, an individual with the Attorney General's office indicated that before 1981, the age was 18 years. Then, the Special Committee on Mental Health Laws began working on a revision that among other things would lower the age from 18 to 14. The change received support from the state's Department of Health and Mental Hygiene, as “lowering the age for voluntary admissions to 14 is in accordance with the developmental guidelines of when children reach adult-type abstract thinking capacity. According to developmental psychologists, this capacity is attained at age 14.” For unclear reasons, at the last minute the age was raised to 16 years, and the bill was signed into law.
New Hampshire	Interpretation of the bill's legislative history revealed that 12 years of age had been selected, as “. … the age of individuals involved with drugs [had been] decreasing and the legislators wanted children to be able to come forward and ask for help.”
New Mexico	In his reply, an attorney with Child Protective Services wrote, “In the mid-1990s, a task force was convened to do a major rewrite of the Children's Mental Health Code. I sat on that task force. We debated the age of consent for hours, possibly days. We looked at other states' laws. We looked at New Mexico laws that set ages for different processes (the age at which delinquents could be tried as adults, 14). There was psychological information that was presented about child development and brain development. Many on the task force wanted a younger age and some wanted an older age. In the end we compromised on the age 14.”
North Dakota	The legislative history revealed that “mental health professionals” advising the 1977 North Dakota Legislative Council testified that “. … there is a need to be able to treat juveniles in life-threatening situations. This help cannot now be given without the permission of the jiveniles' parents. … [J]uveniles are often in trouble and need the help precisely because they cannot or will not talk to their parents. … [M]ost adolescents who come in [for treatment] are in conflict with society, especially their family. … [T]hey do not trust adults. If we tell them that we will provide them with care and respect their need for confidentiality, this instills a trust within them for us.” ND representatives discussed using 14 as the age, then agreed to eliminate a specific age and insert the word “minors” in the bill. The next day, after a meeting with the state's Attorney General (AG) and the Legislative Research Council, the AG asked that 14 years be reinserted. The argument was that 14 years was a ‘“point of reference’ in federal and state law.”
Oregon	The legislative history of the bill revealed that its passage was not driven by access to substance abuse treatment as much as it was related to abused children who were seeking care. Treatment providers who received service requests from children were concerned about the confidentiality of adolescents who were victims of abuse or were afraid of parental retaliation if the children reported abusive behavior to others. Specific discussions regarding age were not found.
Tennessee	Tennessee's legislators selected this age to be consistent with federal laws that authorize 16-year-olds to consent to inpatient treatment without parental consent.
Utah	An attorney from the Utah Medical Association indicated that arguments are evaluated on a case-by-case basis. “. … [W]e tend to encourage people to look at the AMA code of ethics on the issue. … and to the extent we need to have legislative backing on that, we look to the provisions in Utah's professional licensing code. Finally, the state looks to nationally recognize[d] standards to fill in the blanks for whatever isn’t specifically regulated by the state.”
Virginia	An individual with the office of Mental Health Planning of the Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services indicated that “. … the age of 14 is consistent with the age [at which minors may consent] for several things: substance abuse treatment, seeking treatment for STDs, medical care for reproductive health (except for surgical sterilization), mental health services for outpatient mental health treatment, involuntary commitment proceedings, and with other states' laws.”
Washington	An individual in the office of the Director of Washington State's Division of Alcohol and Substance Abuse indicated that . … 14 was selected [initially] as the age, given that it was the age of the youngest kids who were seeking, or showing up, for treatment and seemed to have the maturity to follow through. Then later we decided to be consistent with mental health for no reason other than consistency and the age was lowered to 13 years.”
West Virginia	An individual in the Attorney General's office for the Bureau for Behavioral Health and Health Facilities stated, “. … I suspect that 12 years was selected based upon family and domestic laws, where a child 12 years or older must consent to various living arrangements, such as foster parents, group homes, etc.”