California’s AB 665: Minor Consent for Mental Health Care

California’s AB 665 lets a minor aged 12 or older consent to their own outpatient mental health treatment or residential shelter services without a parent’s permission, as long as the treating professional finds the minor mature enough to participate intelligently in the care. The change took effect on July 1, 2024, and it applies whether the minor has private insurance or Medi-Cal.¹

What Changed on July 1, 2024

Before AB 665, Family Code section 6924 treated minors differently depending on their coverage. A privately insured 12-year-old could already self-consent to outpatient mental health care if a provider found them mature enough. A minor on Medi-Cal had to clear a higher bar: they also had to present a danger of serious physical or mental harm to themselves or others, or be an alleged victim of incest or child abuse.²

That crisis prerequisite is gone. Now a single standard applies to both tracks. The only question is whether the treating professional believes the minor can participate intelligently in the services being offered.¹

Who Qualifies

The consent right runs to any minor who is 12 years of age or older. Age alone is not enough. The attending professional must also form an opinion that the minor is mature enough to participate intelligently in the services, and that judgment goes into the client record.¹ There is no standard checklist. The statute places the maturity determination in the treating professional’s clinical judgment.

AB 665 also widened who can serve as that professional. Registered psychologists, registered psychological assistants, psychological trainees, associate clinical social workers, social work interns, clinical counselor trainees working under licensed supervision, and board-certified psychiatrists were all added to the definition of “professional person,” alongside the chief administrator of any qualifying agency listed in the statute.²

What Services Are Covered

Family Code 6924 covers two categories a minor can authorize independently:

Outpatient mental health treatment or counseling provided by a government agency, an agency under contract with the government, a community-funded agency, a runaway house or crisis center, or a licensed professional.
Residential shelter services, meaning temporary or emergency residential care in a facility that serves only minors, operated by a government agency, contracted provider, community-funded agency, or licensed community care facility.¹

The law does not extend the minor’s consent right to inpatient psychiatric hospitalization, psychotropic medications, or procedures like electroconvulsive therapy. Those still require parental or guardian consent.³

How Parents Fit In

Self-consent means treatment can start without a parent’s signature. It does not mean parents are automatically shut out. Under Family Code 6924(d), the treating professional must involve the minor’s parent or guardian in the treatment unless, after consulting with the minor, the provider determines that involvement would be inappropriate. The provider has to document in the client record whether and when they attempted to contact the parent, whether the attempt succeeded, and, if they decided against contact, the reason.¹

The consultation step matters. A provider cannot decide unilaterally to exclude a parent. They have to discuss the question with the minor first, working through whether family involvement is safe, whether it could interfere with treatment, and how the minor wants communication handled at home.

Residential shelter services carry a stricter notification duty. Even if the provider decides parental involvement in the care itself would be inappropriate, they must still make their best efforts to notify the parent or guardian that services are being provided.¹ That extra duty applies only to shelter services, not to outpatient therapy.

Confidentiality and Its Limits

A minor who consents to their own outpatient therapy generally controls what a parent learns about it. That confidentiality is not absolute. California’s mandatory reporting laws still apply. A treating professional with reasonable suspicion that a minor is being abused or neglected must report to child protective services or law enforcement. Providers also break confidentiality when a minor presents an imminent danger to themselves or others. These are longstanding duties under the Child Abuse and Neglect Reporting Act and related law, not something AB 665 created. A minor entering therapy under self-consent should expect the provider to explain these limits at the first session.

Access to Records

Under HIPAA, a parent is generally treated as a child’s personal representative and can access the child’s health information. There is an exception: when a child consents to their own care and state law does not require parental consent, the parent is not the personal representative for records tied to that care.⁴ Because AB 665 authorizes self-consent, that exception applies to the therapy records the minor independently authorized. Records for care the parent consented to on the child’s behalf remain accessible to the parent.

A provider can also refuse to treat a parent as personal representative if the provider reasonably believes the child has been or may be subjected to abuse or neglect, and that granting access could endanger the child. That determination is individualized and clinical.⁴

Insurance Paperwork

Private insurance creates a practical confidentiality risk that Medi-Cal does not. Health plans routinely mail an Explanation of Benefits to the subscriber, usually a parent, and that document would reveal that the minor received mental health services. California Civil Code section 56.107 and Insurance Code section 791.29 require health plans to suppress EOBs, appointment notifications, and other communications that would disclose a minor’s receipt of services under their own consent. The minor can direct the insurer to send communications about these sensitive services to the minor instead of the subscriber, and network providers and their subcontractors are barred from disclosing information about minor consent services without the minor’s express permission.

The system depends on the claim being flagged correctly. A minor using a parent’s plan should ask the provider or the insurer to set up a confidential communication request before billing goes out.

Who Pays

Family Code 6924(e) says a parent or guardian is not liable for the cost of mental health treatment or counseling provided under minor consent unless the parent actually participates in the treatment, and even then only for the services rendered with their participation.¹ The same rule applies to residential shelter services. If the provider determines that parental involvement would be inappropriate and never contacts the parent, the parent owes nothing for the care.

For minors already enrolled in full-scope Medi-Cal, no separate application is needed. Providers bill Medi-Cal directly, and outpatient mental health services can be covered for up to six months on the treating professional’s recommendation. All Medi-Cal minor consent cases are treated as confidential, and no communication about the services is directed to parents or guardians.³

1
California Legislative Information. California Family Code FAM 6924
2
LegiScan. California Assembly Bill 665 – Minors: Consent to Mental Health Services
3
DHCS. 4V – Minor Consent Services
4
U.S. Department of Health & Human Services. The HIPAA Privacy Rule and Parental Access to Minor Children’s Medical Records