Use this SOP to protect a minor member's right to obtain confidential sensitive services and to ensure Besa Health team members use the correct consent, access, communication, and documentation practices. Sensitive services include care related to sexual assault, substance or alcohol abuse, pregnancy, family planning, contraception, and sexually transmitted diseases.
📚 Resources Needed
Authorization for Treatment form
The member's verified confidential telephone number, address, and communication preferences
In-plan and Medi-Cal out-of-network provider information for sensitive services
The member's medical record and Besa Health confidentiality procedures
✅ Before You Start
Minors 12 years of age and older may seek medical care without parental consent for sensitive services related to sexual assault, substance or alcohol abuse, pregnancy, family planning, contraception, and sexually transmitted diseases.
A minor who is 12 years of age or older may sign an Authorization for Treatment form for sensitive services without parental consent.
Parental or guardian consent is required for a minor under 12 years of age who seeks substance or alcohol abuse treatment or treatment of a sexually transmitted disease. The possibility of sexual abuse must also be raised.
The member's PCP should encourage use of in-plan services to improve coordination of care, but the member may access sensitive services through Medi-Cal out-of-network providers without prior authorization.
Access to sensitive services must be timely.
If a current law, regulation, or payer requirement differs from this protocol, contact the Besa Health Compliance team before restricting access, seeking parental consent, or releasing information.
🚀 Tips & Tricks
Speak with the minor privately when discussing sensitive services, consent, confidentiality, or communication preferences.
Confirm a safe contact method directly with the minor before placing calls, sending letters, or leaving messages.
Do not direct letters or telephone calls about sensitive services to the home without the minor's authorization.
Do not release medical records or treatment information specific to confidential sensitive services to a parent or guardian without the minor's consent.
📘 Instructions
Step 1: Identify The Sensitive Service
Determine whether the requested care relates to sexual assault, substance or alcohol abuse, pregnancy, family planning, contraception, or sexually transmitted diseases.
Treat the request as confidential and move the conversation to a private setting.
Do not delay the member's access while routing the request to the appropriate clinician or provider.
Step 2: Determine The Consent Requirement
For a minor 12 years of age or older, allow the minor to sign the Authorization for Treatment form for sensitive services without parental consent.
For a minor under 12 years of age who seeks substance or alcohol abuse treatment or treatment of a sexually transmitted disease, obtain parental or guardian consent as required by this protocol.
Raise the possibility of sexual abuse when the circumstances require it and follow Besa Health's child-abuse identification and reporting procedure.
When the consent requirement is uncertain, pause administrative disclosure or access restrictions and obtain guidance from the responsible clinician or Compliance team.
Step 3: Support Timely Access And Care Coordination
The member's PCP should encourage use of in-plan services to enhance coordination of care.
A member may access sensitive services through Medi-Cal out-of-network providers without prior authorization.
Do not refuse or postpone sensitive services solely because the member did not obtain parental authorization when the minor is permitted to consent.
Ensure that referrals, scheduling, and follow-up for sensitive services are completed timely.
Step 4: Provide Confidential Family Planning Access
Medi-Cal members have free access to confidential family planning services from any family planning provider or agency without prior authorization.
Family planning includes medical treatment and procedures defined as family planning services under the current Medi-Cal scope of benefits.
Family planning includes medical contraceptive services, including diagnosis, treatment, supplies, and follow-up.
Family planning includes informational and educational services.
Step 5: Protect Confidentiality And Communications
Treat services for sexually transmitted diseases and referrals for substance or alcohol abuse treatment as confidential.
Do not release records or information regarding treatment specific to confidential services to a parent or guardian without the minor's consent.
Record the minor's authorized contact method and any permission to communicate with a parent, guardian, or another person.
Take special precautions with letters and telephone calls. Do not send or direct them to the home without the minor's authorization.
Step 6: Document The Service And Consent
Document the member's age, the sensitive service requested, the consent authority used, and the signed Authorization for Treatment form when applicable.
Document the confidential contact instructions, the access or referral provided, and any disclosure authorized by the minor.
Place sensitive-service documentation in the medical record using the available confidentiality protections.
If possible sexual abuse is raised, document and complete required reporting under the Besa Health child-abuse procedure without adding unnecessary details to routine communications.
Step 7: Recognize Examples Of Covered Services
Routine pregnancy testing
Elective therapeutic abortions
Birth control pills
A prescription for the "Morning After Pill" to avoid pregnancy, approved by the FDA for emergency treatment only. Examples of an emergency include rape and incest.
Depo-Provera, a long-acting progesterone, as routine birth control
Norplant, including the device, insertion, and removal
An intrauterine device (IUD), including the device, insertion, and removal
A diaphragm
Contraceptive foam, male and female condoms, cervical caps, sponges, and related supplies
Elective tubal ligation, which may require parental consent
Elective vasectomy, which may require parental consent
Office visits for birth-control education and instruction, including the Symptom-Thermal method, Billings procedure, rhythm method, and instruction about the methods and devices listed above
STD screening, testing, diagnosis, education, and referrals for treatment
HIV screening, testing, diagnosis, education, and referrals for treatment
Step 8: Complete Confidential Follow Up
Provide the member with the agreed referral, education, supplies, or follow-up instructions.
Use only the confidential contact method authorized by the minor.
Before closing the encounter, verify that no automatic letter or telephone communication will be directed to the home without the minor's authorization.
🛠 Troubleshooting
A Minor Under Age 12 Requests Substance Abuse Or STD Treatment
Obtain parental or guardian consent as required by this protocol. Raise the possibility of sexual abuse, notify the responsible clinician, and follow Besa Health's child-abuse identification and reporting procedure when indicated.
A Parent Or Guardian Requests Records Or Visit Information
Do not release records or information specific to confidential sensitive services without the minor's consent. Route uncertain disclosure requests to the Besa Health Compliance team.
The Minor Does Not Have A Safe Home Contact Method
Do not send a letter or place a call to the home. Work directly with the minor and the responsible clinician to identify and document an authorized confidential contact method.
The Member Requests An Out Of Network Provider
Explain that the PCP may encourage in-plan services for care coordination, but Medi-Cal members may access sensitive services through out-of-network providers without prior authorization.
The Team Is Unsure Whether A Service Is Sensitive
Protect confidentiality while the question is reviewed. Contact the responsible clinician or Compliance team before denying access, requesting parental consent, or releasing information.
✅ Completion Check
The requested service was evaluated as a sensitive service.
The correct consent rule was applied based on the minor's age and requested service.
Possible sexual abuse was raised and handled through the required reporting procedure when applicable.
In-plan care was encouraged without blocking permitted out-of-network access.
Family planning access and scope were explained when applicable.
Sensitive-service access, referrals, and follow-up were timely.
Medical records and communications were protected from unauthorized parental or guardian disclosure.
The minor's authorized contact method and any permitted disclosure were documented.
The Authorization for Treatment form and medical-record documentation are complete.
References
Guidance: California Minor Consent And Confidentiality Resources • CalOptima Referenced Minor Consent And Confidentiality Chart
Source: CalOptima Provider FSR/MRR Binder, pages 137-138 • Revised Jun 17, 2020
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