Health Care Consent Laws
About half the states have some form of medical consent law: Arkansas, California (includes consent for mental health treatment), Delaware, Florida, Georgia, Hawaii, Idaho, Indiana, Kentucky, Louisiana, Maryland, Mississippi, Missouri, Montana, New Mexico, New York, North Dakota, Ohio (includes consent for psychological treatment), Oregon, South Carolina, South Dakota, Texas (includes consent for psychological treatment), Utah, Virginia, Washington. and West Virginia (includes consent for mental health care).
These laws differ in various ways:
- whether the caregiver can complete the form without the parent’s signature
- whether oral consent is sufficient
- what types of treatment are covered
California has had a medical consent law since 1994 and the parents’ signatures are not required if they cannot be found.  This is an important feature for many grandfamilies.
A few of the consent laws do not require an affidavit or other writing. For example, in 2005, Washington State passed a law that allows for consent to be given orally: a "competent adult representing himself or herself to be responsible for the health care" of a child can provide informed consent for the health care of that child.  This law provides immunity to health care providers and facilities for relying on such a representation, provided they do not have actual knowledge that it is false. The health care provider or facility may, but is not required to, ask for documents proving the person's claim of responsibility.
Some laws only include immunizations or physical health care, whereas others, like the laws in California, Ohio, Texas, and Washington include mental health care. The inclusion of consent for this type of care is important and is a hurdle that many caregivers have faced. Anecdotally, the omission of mental health seems to be nothing more than an oversight and some legislators have expressed interest in amending their laws to include that coverage.
Another unintentional omission may be developmental screenings, which only Delaware's law appears to include. Since many of the children in these families have special needs due to the circumstances leading to the forming of their grandfamily, screenings and treatment for developmental delays can be particularly important.
Power of Attorney Laws
The majority of states and the District of Columbia have explicitly codified power of attorney laws so parents can bestow relatives with the power of attorney for the care of their children: Alabama, Alaska, Arizona, Arkansas, Colorado, District of Columbia, Georgia, Hawaii, Idaho, Kentucky, Maine, Massachusetts, Michigan, Minnesota, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oregon, Pennsylvania, Tennessee, Utah, and Washington.
These states typically allow the power of attorney:
- to be designated for six months to a year, so it may not be the best option for long term caregivers
- to confer all powers over the care of a child, with the notable exceptions of the powers to consent to marriage or adoption
Once the designation is complete, caregivers should be able to consent to health care treatment for a child.
Caveats for Both Types of Laws
It is important to note that medical consent documents and power of attorneys can be easily revoked by the parents. Furthermore, institutions, such as clinics and hospitals, may not accept them despite a law stating they should.