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Consent to Health Care: A Kinship Giver’s Guide

Authored By: Columbia Legal Services

A kinship caregiver is a relative of a child who is not the child’s parent, but who is taking care of a child. Some kinship caregivers have a court order that lets them consent to health care for the child. Many more do not. Often, caregivers who do not have court orders have problems when they try to get health care for the child. #5940EN

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Who is a Kinship Caregiver?

A kinship caregiver is a relative of a child who is not the child's parent, but who is taking care of a child.  Examples are:

  • Grandparents

  • Aunts or uncles

  • Adult sisters or brothers

  • Other adult relatives

Some kinship caregivers have a court order that lets them consent to health care for the child. Many more do not. Often, caregivers who do not have court orders have problems when they try to get health care for the child.

I am a kinship caregiver. I do not have a court order.  Can I consent to health care on behalf of a child in my care?

Yes.  Under state law, you can consent to health care for a child when any of these is true:

  • You have a signed authorization from the child's parent to make health care decisions for the child

  • You represent yourself to be a relative responsible for the child's health care

  • You are a relative caregiver who has signed and dated a declaration that you are an adult relative responsible for the child's health care.  RCW 7.70.065

Who is a "relative"?

The law does not explain this.

I am not a relative. Can I consent to health care for the child?

The law lets nonrelatives consent to health care if the child's parent has given you written authorization and in some cases if you provide a declaration describing your relationship to the child.

What is a declaration?

It is a written statement you sign saying the information in the statement is true. You date and sign a declaration "under the penalty of perjury under the laws of the state of Washington." Signing a declaration that is false is a serious felony. 

The law does not always require a signed declaration for a relative to consent to health care for a child. Health care providers might ask for a declaration.

We have two examples here of a declaration you can use. One is for a family member. It is the "Kinship Caregiver's Declaration of Responsibility for a Minor's Health Care." The other is a declaration for a non-family member. You can use one of these or make your own.

How long is the declaration good for?

It is only good for six months from the date you signed it. 

What should I do if it expires?

After six months, you should fill out another declaration.    

I signed a declaration. Does it give me legal custody?

No.  It only lets you consent to health care for the child. It has no effect on legal custody, or the parents' legal rights.

What care can I consent to?

Under state law, you can consent to any care, service, or procedure provided by a health care provider

  • To diagnose, treat, or maintain a physical or mental condition

  • Affecting the structure or any function of the human body

Based on other definitions, this law also covers dental care.

What if a doctor or other health care provider asks for proof that I am a relative responsible for the child's health care?

The law says a provider can ask you for proof that you are the relative caregiver responsible for the child's health care. If this happens, these might help:

  • A will listing your relationship to the child

  • A letter from a social worker, school staff, lawyer, religious leader, or licensed medical, mental health, or behavioral professional showing your relationship to the child

  • Records from a school, hospital, clinic, or other public health or social service agency showing your relationship to the child

  • Proof that you get a public benefit, such as TANF, SSI, medical coupons, food stamps, or free or reduced school lunch for the child

  • Records from the Department of Social and Health Services (DSHS) showing you are the contact for the child

  • Proof that a child lives in your home and/or is related to you

  • Insurance for you or the child that states your relationship

  • Your Federal Income Tax return listing the child

  • Any other documents showing your relationship with the child and that you are the child's caregiver

Can the child consent to health care services themselves?

Under state law, yes, some. They include:

  • Non-emergency medical services, if the child can understand the consequences of the medical procedure under the Mature Minor Doctrine.  Health care providers will evaluate the child's age, intelligence, maturity, training, experience, economic independence, general conduct as an adult and freedom from the control of parents (Smith v. Seibly, 72 Wn.2d 16 (1967)

  • Outpatient and inpatient mental health treatment, if the child is 13 or older (RCW 71.34.530 & .500(1))

  • Testing or treatment for sexually transmitted diseases if they are 14 or older (RCW 70.24.110), or any age in King County

  • Abortion services (RCW 9.02.100(2)) (State v. Koome, 84 Wn.2d 901 (1975))

  • Birth control services (RCW 9.02.100(1))

  • Prenatal care services (State v. Koome, 84 Wn.2d 901 (1975))

  • Inpatient or outpatient substance abuse treatment if the child is 13 or older (RCW 70.96A.095)

Can a child get emergency health care without parental consent?

Yes. A health care provider can provide a child with required treatment in a recognized health care emergency without parental consent. RCW 7.70.050(4).

How can I get medical help?

For most medical programs, including insurance and subsidies, you can apply online at www.wahealthplanfinder.org, by calling 1-855-923-4633 (1-855-WAFINDER), or by asking for a paper application from Healthplanfinder or from your local DSHS office. If you go online, make sure you go to the right website (www.wahealthplanfinder.org).

 

This publication provides general information concerning your rights and responsibilities.  It is not intended as a substitute for specific legal advice. 
This information is current as of October 2019.
© 2019 Columbia Legal Services

 

(Permission for copying and distribution granted to the Alliance for Equal Justice and to individuals for non-commercial use only.)

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Last Review and Update: Oct 08, 2019
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