SB 41
Department of Legislative Services
Maryland General Assembly
2021 Session
FISCAL AND POLICY NOTE
Third Reader
Senate Bill 41 (Senator Augustine)
Finance Health and Government Operations
Health – Mental and Emotional Disorders – Consent (Mental Health Access
Initiative)
This bill lowers the age for a minor to give informed consent in certain situations.
Specifically, the bill establishes that a minor who is at least age 12 and is determined by a
health care provider to be mature and capable of giving informed consent has the same
capacity as an adult to consent to consultation, diagnosis, and treatment of a mental or
emotional disorder by the health care provider or a clinic. The capacity of any minor to
refuse consultation, diagnosis, treatment for a mental or emotional disorder for which a
parent, guardian, or custodian of the minor has given consent remains unchanged. Also,
except as otherwise provided, a minor younger than age 16 may not consent to the use of
prescription medications to treat a mental or emotional disorder. The bill also authorizes a
health care provider to decide to provide specified information to a parent, guardian, or
custodian of a minor unless the health care provider believes that the disclosure will lead
to harm to the minor or deter the minor from seeking care.
Fiscal Summary
State Effect: To the extent service utilization by eligible minors increases under the bill,
general and federal fund expenditures for the Behavioral Health Administration and
Medicaid may increase by an indeterminate amount. Federal fund revenues increase
accordingly.
Local Effect: To the extent utilization increases for eligible students receiving mental
health services at public schools, expenditures may increase for local school systems by an
indeterminate amount. Local health departments may experience an increase in utilization
as well. Revenues are not materially affected.
Small Business Effect: Potential meaningful.
 Analysis
Current Law:
Minor’s Capacity to Consent Regarding a Mental or Emotional Disorder
A minor who is at least age 16 has the same capacity as an adult to consent to consultation,
diagnosis, and treatment of a mental or emotional disorder by a health care provider or a
clinic. The capacity of a minor to consent does not include the capacity to refuse
consultation, diagnosis, or treatment for a mental or emotional disorder for which a parent,
guardian, or custodian of the minor has given consent.
Except under certain circumstances, without the consent of or over the express objection
of a minor, the health care provider or, on advice or direction of the health care provider, a
member of the medical staff of a hospital or public clinic may give a parent, guardian, or
custodian of the minor or the spouse of the parent information about treatment needed by
the minor or provided to the minor.
If a health care provider is on a treatment team for a minor that is headed by a physician,
the physician heading the treatment team must decide whether a parent, guardian, or
custodian of the minor or the spouse of the parent should receive information about
treatment needed by the minor or provided to the minor.
Unless the parent, guardian, or custodian of a minor consents to consultation, diagnosis, or
treatment of the minor, the parent, guardian, or custodian is not liable for any costs of the
consultation, diagnosis, or treatment of the minor.
Minor’s Capacity to Consent to Medical Treatment
A minor has the same capacity as an adult to consent to medical or dental treatment if the
minor is (1) married; (2) the parent of a child; or (3) living separate and apart from the
minor’s parent(s) or guardian and self-supporting.
A minor has the same capacity as an adult to consent to (1) treatment for or advice about
venereal disease, pregnancy, contraception other than sterilization, drug abuse, and
alcoholism; (2) physical examination and treatment of injuries from, or to obtain evidence
of, an alleged rape or sexual offense; (3) initial medical screening and physical examination
on and after admission of the minor into a detention center; and (4) treatment for the
prevention of HIV.
SB 41/ Page 2
A minor also has the same capacity as an adult to consent to medical treatment if, in the
judgment of the attending physician, the life or health of the minor would be affected
adversely by a delay of treatment to obtain another individual’s consent.
Small Business Effect: Small businesses that provide consultation, diagnosis, and
treatment of mental or emotional disorders may provide additional care to eligible minors.
Additional Information
Prior Introductions: SB 611 of 2020, as amended, passed in the Senate but received no
further action from the House Health and Government Operations Committee. Its
cross file, HB 782, received a hearing in the House Health and Government Operations
Committee, but no further action was taken.
Designated Cross File: HB 132 (Delegate Bagnall) - Health and Government Operations.
Information Source(s): Judiciary (Administrative Office of the Courts); Maryland State
Department of Education; Maryland School for the Deaf; Maryland Department of Health;
Department of Human Services; Department of Juvenile Services; Department of
Legislative Services
Fiscal Note History: First Reader - January 28, 2021
rh/jc Third Reader - February 19, 2021
Analysis by: Amber R. Gundlach Direct Inquiries to:
(410) 946-5510
(301) 970-5510
SB 41/ Page 3


Statutes affected:
Text - First - Health – Mental and Emotional Disorders – Consent (Mental Health Access Initiative): 20-104 Health General
Text - Third - Health – Mental and Emotional Disorders – Consent (Mental Health Access Initiative): 20-104 Health General