California’s Assembly Bill 665 lets any minor aged 12 or older consent to outpatient mental health treatment or residential shelter services as long as the treating provider finds them mature enough to participate intelligently in that care. The California AB 665 minor consent for mental health rule took operative effect on July 1, 2024, and it removed the old requirement that a young person be in crisis, suicidal, dangerous to others, or a victim of abuse before they could get confidential counseling. The maturity judgment is now the only gate.
What the Law Changed
Before AB 665, California Family Code Section 6924 set two conditions for a minor 12 or older to consent to outpatient mental health care on their own. A provider had to find the minor mature enough to participate, and the minor also had to be either at risk of serious harm to self or others or an alleged victim of incest or child abuse.1California State Board of Behavioral Sciences. Bill Analysis – AB 665 That second condition effectively required a crisis before a young person could get confidential help.
The restriction hit Medi-Cal enrollees hardest. Minors on private insurance already had broader access through Health and Safety Code Section 124260, which only required the maturity finding. Minors on Medi-Cal were routed through the stricter Family Code standard. AB 665 struck the crisis condition from Section 6924, giving every minor 12 or older the same single standard regardless of how they are insured.2California Legislative Information. California Family Code FAM 6924
Who Can Consent
A minor must be at least 12 years old. The attending provider must then conclude that the minor is mature enough to participate intelligently in the proposed services.2California Legislative Information. California Family Code FAM 6924 The statute does not define that standard. It is a clinical call about whether the young person understands the nature, risks, and benefits of the care, and two providers evaluating the same minor could reach different conclusions.
Children under 12 cannot use this pathway. Parental or guardian consent is still required for them.
What Treatment Is Covered
Section 6924 covers two things: outpatient mental health treatment or counseling, and residential shelter services. Outpatient treatment includes counseling delivered by a government agency, an agency under government contract, a community-funded agency, a runaway house or crisis resolution center, or an individual qualifying professional. Residential shelter services means temporary or emergency housing in a facility that serves only minors, such as a licensed community care facility or crisis resolution center.2California Legislative Information. California Family Code FAM 6924
Three interventions are off-limits to minor consent. A young person cannot consent on their own to convulsive therapy, psychosurgery, or psychotropic medication. Those still require a parent or guardian’s approval.3California Legislative Information. California Family Code FAM 6924 The practical consequence: a psychiatrist cannot prescribe medication based on the minor’s consent alone. Even when a minor begins therapy independently, a parent has to be brought in before medication can be started.
Qualifying Providers
The “professional person” who can treat a minor under this section is defined through Health and Safety Code Section 124260. The list includes mental health professionals designated in state regulations, marriage and family therapists, licensed educational psychologists, credentialed school psychologists, clinical psychologists, and licensed professional clinical counselors.4California Legislative Information. Today’s Law As Amended – AB 665 Supervised trainees and associates in those fields can also provide services under a supervisor’s oversight.5California Legislative Information. California Health and Safety Code HSC 124260
Where Parents Fit In
AB 665 does not cut parents out automatically. Section 6924 says treatment “shall include involvement of the minor’s parent or guardian” as the default. A provider skips that involvement only after consulting with the minor and determining that bringing a parent in would be inappropriate.2California Legislative Information. California Family Code FAM 6924 The statute does not define “inappropriate.” In practice, it might apply when a parent is the source of the minor’s distress, when disclosing treatment could put the minor’s safety at risk, or when it would undermine the therapeutic relationship.
Whichever way the provider decides, the record must show it. The clinical file has to document whether the provider attempted to contact the parent or guardian, whether that attempt succeeded, or why the provider believed contact would be inappropriate. For residential shelter services, the provider must make “best efforts” to notify the parent or guardian regardless of what the treatment-involvement decision was.2California Legislative Information. California Family Code FAM 6924
Who Pays
A parent or guardian is not financially responsible for care provided under this section unless the parent actually participates in the treatment, and even then only for the sessions they participate in. The same rule governs residential shelter services.2California Legislative Information. California Family Code FAM 6924
For Medi-Cal enrollees, the program covers the cost. For minors on a parent’s private plan, the question is trickier because filing a claim can trigger an Explanation of Benefits notice that reaches the subscribing parent.
Keeping Treatment Confidential on Insurance Paperwork
California law lets a minor block the paper trail. Civil Code Section 56.107 and Insurance Code Section 791.29 allow a minor to direct the health plan to send communications about “sensitive services,” including care under Family Code Section 6924, to the minor rather than to the parent who subscribes to the plan. For Medi-Cal managed care, the Department of Health Care Services has instructed plans and providers to put safeguards in place so appointment notices, benefit determinations, and similar communications are not routed to a parent when confidentiality applies, and to withhold information about minor-consent services absent the minor’s express permission.
HIPAA adds another layer. A provider may decline to treat a parent as the minor’s personal representative if the provider reasonably believes the minor has been or may be subjected to abuse or neglect by that parent, or if treating the parent as a representative could endanger the minor.6U.S. Department of Health and Human Services. Personal Representatives and Minors When the provider makes that call, the parent loses federal access to the minor’s treatment records.
When It Took Effect
AB 665’s substantive consent changes became operative on July 1, 2024.7LegiScan. Bill Text – CA AB665 2023-2024 Regular Session – Chaptered Any outpatient mental health visit or shelter intake on or after that date falls under the current maturity-only standard.