Prohibit mental health service to minors without parental consent

As Introduced

136th
General Assembly

Regular
Session
H. B. No. 172

2025-2026

Representative Newman

Cosponsors: Representatives Click,
Dean, Lear, John, Klopfenstein, Ritter, Ferguson, Mullins, Mathews,
T., Creech, Miller, M., Workman, Salvo, Fowler Arthur, Williams

To
amend sections 2151.461, 3129.03, 3313.473, 3798.07, and 3798.12 and
to repeal section 5122.04 of the Revised Code
to
prohibit the provision of mental health services to minors without
parental consent.

BE
IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:

Section
1.
That
sections 2151.461, 3129.03, 3313.473, 3798.07, and 3798.12 of the
Revised Code be amended to read as follows:

Sec.
2151.461.
(A)
If a child is under the care and supervision of a residential
facility and presents to an emergency department or is admitted to a
hospital for an injury or mental health crisis, the emergency
department or hospital shall do both of the following:

(1)
Communicate with the public children services agency or private child
placing agency with custody of the child about the visit. Except for
care that a child has consented to under section 2108.31, 2151.85,
2907.29, 3701.242, 3709.241, 3719.012,
or

5120.172
,
or 5122.04

of the Revised Code, the emergency department or hospital shall
discuss the child's medical treatment with and request authorization
of care from the agency.

(2)
Notify the agency of the discharge of the child from the emergency
department or hospital.

(B)
A public children services agency or private child placing agency
with custody of a child who is under the care and supervision of a
residential facility and presents to an emergency department or is
admitted to a hospital for an injury or mental health crisis shall
respond to the emergency department or hospital's communication
regarding medical care for the child not later than four hours after
initial contact.

Sec.
3129.03.
(A)

Notwithstanding
section 5122.04 of the Revised Code, no
No

mental
health professional shall diagnose or treat a minor individual who
presents for the diagnosis or treatment of a gender-related condition
without first obtaining the consent of one of the following:

(1)
At least one parent of the minor individual;

(2)
At least one legal custodian of the minor individual;

(3)
The minor individual's guardian.

(B)
No mental health professional shall diagnose or treat a minor
individual who presents for the diagnosis or treatment of a
gender-related condition without screening the minor individual for
both of the following during the course of diagnosis and treatment:

(1)
Other comorbidities that may be influencing the minor individual's
gender-related condition, including depression, anxiety, attention
deficit hyperactivity disorder, autism spectrum disorder, and other
mental health conditions;

(2)
Physical, sexual, mental, and emotional abuse and other traumas.

Sec.
3313.473.
(A)
The general assembly maintains that a parent has a fundamental right
to make decisions concerning the upbringing, education, and care of
the parent's child.

(B)
Not later than the first day of July following
the
effective date of this section
April
9, 2025
,
the board of education of each city, local, exempted village, and
joint vocational school district shall develop and adopt a policy to
promote parental involvement in the public school system. The policy
shall require a school district to do all of the following:

(1)(a)
Ensure that any sexuality content is age-appropriate and
developmentally appropriate for the age of the student receiving the
instruction, regardless of the age or grade level of the student.

(b)
Prior to providing instruction that includes sexuality content or
permitting a third party to provide such instruction on behalf of the
district, provide parents the opportunity to review any instructional
material that includes sexuality content. Upon request of the
student's parent, a student shall be excused from instruction that
includes sexuality content and be permitted to participate in an
alternative assignment.

(2)
Promptly notify a student's parent of any substantial change in the
student's services, including counseling services, or monitoring
related to the student's mental, emotional, or physical health or
well-being or the school's ability to provide a safe and supportive
learning environment for the student. The policy shall specify in
what manner a student's parent will be notified of any substantial
change in the student's services.

The
policy shall specify that notice to parents shall reinforce the
fundamental right of parents to make decisions regarding the
upbringing and control of their children, and that the school
district shall not inhibit parental access to the student's education
and health records maintained by the school.

(3)
Prohibit school district personnel from directly or indirectly
encouraging a student to withhold from a parent information
concerning the student's mental, emotional, or physical health or
well-being, or a change in related services or monitoring.

The
policy shall prohibit school district personnel from discouraging or
prohibiting parental notification of and involvement in decisions
affecting a student's mental, emotional, or physical health or
well-being.

(4)
Adopt a procedure to obtain authorization from parents prior to
providing any type of health care service to the student, including
physical, mental, and behavioral health care services. Under the
procedure, a parent may choose whether to authorize a district to
provide a health care service to the parent's child. The procedure
shall require the school district to do both of the following:

(a)
At the beginning of the school year, notify parents of each health
care service offered at, or facilitated in cooperation with, their
student's school and their option to withhold consent or decline any
specified service. Parental consent to health care services does not
waive the parent's right to access the parent's student's educational
or health records or to be notified about a change in the student's
services or monitoring as provided in this section.

(b)
Prior to providing a health care service to a student, notify a
parent whether the service is required to be provided by the school
district under state law and if other options for a student to access
the service exist. This requirement may be satisfied by an annual
notice to parents at the beginning of the school year.

Division
(B)(4) of this section does not apply to emergency situations, first
aid, other unanticipated minor health care services, or health care
services provided pursuant to a student's IEP or a school district's
obligation under section 504 of the "Rehabilitation Act of
1973," 29 U.S.C. 794.

(5)
Permit a parent to file with a school principal or assistant
principal a written concern regarding a topic addressed in this
section. The policy shall establish a process for a principal or
assistant principal to resolve such concerns within thirty days after
their receipt. Under the policy, school districts shall notify
parents of their right to file a written concern. A parent may appeal
a principal's or assistant principal's decision to the superintendent
of that district.

If
a parent appeals the principal's or assistant principal's decision,
the superintendent, or a designee of the superintendent, shall
conduct a hearing on the decision. Based on the findings of that
hearing, the superintendent shall decide whether to affirm the
principal's or assistant principal's decision. If the superintendent
does not affirm the decision, the superintendent shall determine a
resolution to the parent's concern. A parent may appeal the
superintendent's decision to the board of education of the school
district. The board shall review the superintendent's decision and,
if the board determines it necessary, hold a hearing on the decision
and, based on that hearing, either affirm the superintendent's
decision or determine a new resolution to the parent's concern.

Nothing
in division (B)(5) of this section shall prevent a parent from
contacting a member of a board of education regarding the parent's
concerns with the operation of a school under the supervision of that
board.

(C)
Each school district shall make its policy adopted under this section
publicly available and post it prominently on its publicly accessible
web site, if it has one.

(D)
This section does not prescribe all rights of parents or preempt or
foreclose claims or remedies in support of parental rights that are
available under the constitution, statutes, or common law of this
state.

(E)
No school district or third party acting on behalf of a district
shall provide instruction that includes sexuality content to students
in grades kindergarten through three.

(F)(1)
Nothing in this section shall require disclosure or activity that is
in conflict with or in violation of any of the following:

(a)
The HIPAA privacy rule;

(b)
Chapter 3798. of the Revised Code;

(c)
Section 2317.02
,

or

4732.19
,
or 5122.04

of the Revised Code;

(d)
The "Family Educational Rights and Privacy Act of 1974," 20
U.S.C. 1232g;

(e)
Ohio Constitution, Article I, Section 10a and any laws enacted to
implement that section, including sections 2930.07 and 2930.10 of the
Revised Code.

(2)
Nothing in this section requires disclosure or activity in violation
of any court order, including any of the following:

(a)
A condition of bond;

(b)
A protection order or consent agreement issued pursuant to section
2151.34, 2903.213, 2903.214, 2919.26, or 3113.31 of the Revised Code;

(c)
A condition of a community control sanction, post-release control
sanction, or parole.

(3)
Nothing in this section requires disclosure or activity in violation
of a specific request for nondisclosure made pursuant to a criminal
investigation or grand jury subpoena in which the student is the
victim and a parent is the alleged perpetrator.

(4)
Nothing in this section prohibits or prevents mandatory reporting
under section 2151.421 of the Revised Code.

(5)
Nothing in this section prohibits or limits the career and academic
mentoring and counseling between teachers and students in the regular
course of the school day.

(G)
As used in this section:

(1)
"Biological sex" means the biological indication of male
and female, including sex chromosomes, naturally occurring sex
hormones, gonads, and unambiguous internal and external genitalia
present at birth, without regard to an individual's psychological,
chosen, or subjective experience of gender.

(2)
"HIPAA privacy rule" has the same meaning as in section
3798.01 of the Revised Code.

(3)
"IEP" has the same meaning as in section 3323.01 of the
Revised Code.

(4)
"Parent" has the same meaning as in section 3313.98 of the
Revised Code.

(5)
"Sexuality content" means any oral or written instruction,
presentation, image, or description of sexual concepts or gender
ideology provided in a classroom setting.

"Sexuality
content" does not mean any of the following:

(a)
Instruction or presentations in sexually transmitted infection
education, child sexual abuse prevention, and sexual violence
prevention education provided under division (A)(5) of section
3313.60 or section 3314.0310 or 3326.091 of the Revised Code;

(b)
Instruction or presentations in sexually transmitted infection
education emphasizing abstinence provided under section 3313.6011 of
the Revised Code;

(c)
Incidental references to sexual concepts or gender ideology occurring
outside of formal instruction or presentations on such topics,
including references made during class participation and in
schoolwork.

(6)
"Student's mental, emotional, or physical health or well-being"
includes, at a minimum, any of the following:

(a)
A student's academic performance;

(b)
Any significant sickness or physical injury, or any psychological
trauma suffered by a student;

(c)
Any harassment, intimidation, or bullying, as defined in section
3313.666 of the Revised Code, by or against a student in violation of
school district policy;

(d)
Any request by a student to identify as a gender that does not align
with the student's biological sex;

(e)
Exhibition of suicidal ideation or persistent symptoms of depression,
or severe anxiety, or other mental health issues.

(7)
"Age-appropriate" and "developmentally appropriate"
content refers to activities or items that are generally accepted as
suitable for children of the same chronological age or level of
maturity or that are determined to be developmentally appropriate for
a child, based on the development of cognitive, emotional, physical,
and behavioral capacities that are typical for an age or age group.

Sec.
3798.07.
(A)
A covered entity shall be subject to the following conditions when it
discloses protected health information to a health information
exchange:

(1)
The covered entity shall restrict disclosure consistent with all
applicable federal laws governing the disclosure.

(2)
If the protected health information concerns a minor, the covered
entity shall restrict disclosure in a manner that complies with laws
of this state pertaining to the circumstances under which a minor may
consent to the minor's own receipt of health care or make medical
decisions on the minor's own behalf, including sections 2907.29,
3709.241, 3719.012, 5120.172,
5122.04,

and
5126.043 of the Revised Code unless the minor authorizes the
disclosure.

(3)
The covered entity shall restrict disclosure in a manner that is
consistent with a written request from the individual or the
individual's personal representative to restrict disclosure of all of
the individual's protected health information.

(B)
The conditions in division (A) of this section on a covered entity's
disclosure of protected health information to a health information
exchange do not render unenforceable or restrict in any manner any of
the following:

(1)
A provision of the Revised Code that on September 10, 2012, requires
a person or governmental entity to disclose protected health
information to a state agency, political subdivision, or other
governmental entity;

(2)
The confidential status of proceedings and records within the scope
of a peer review committee of a health care entity as described in
section 2305.252 of the Revised Code;

(3)
The confidential status of quality assurance program activities and
quality assurance records as described in section 5122.32 of the
Revised Code;

(4)
The testimonial privilege established by division (B) of section
2317.02 of the Revised Code;

(5)
Any of the following items that govern the confidentiality, privacy,
security, or privileged status of protected health information in the
possession or custody of an agency as defined in section 111.15 of
the Revised Code; govern the process for obtaining from a patient
consent to the provision of health care or consent for participation
in medical or other scientific research; govern the process for
determining whether an adult has a physical or mental impairment or
an adult's capacity to make health care decisions for purposes of
Chapter 5126. of the Revised Code; or govern the process for
determining whether a minor has been emancipated:

(a)
A section of the Revised Code that is not in this chapter;

(b)
A rule as defined in section 119.01 of the Revised Code;

(c)
An internal management rule as defined in section 111.15 of the
Revised Code;

(d)
Guidance issued by an agency as defined in section 111.15 of the
Revised Code;

(e)
Orders or regulations of a board of health of a city health district
made under section 3709.20 of the Revised Code;

(f)
Orders or regulations of a board of health of a general health
district made under section 3709.21 of the Revised Code;

(g)
An ordinance or resolution adopted by a political subdivision;

(h)
A professional code of ethics;

(i)
When a minor is authorized to consent to the minor's own receipt of
health care or make medical decisions on the minor's own behalf,
including the circumstances described in sections 2907.29, 3709.241,
3719.012, 5120.172,
5122.04,

and
5126.043 of the Revised Code.

Sec.
3798.12.
As
used in this section, "agency" has the same meaning as in
section 111.15 of the Revised Code.

(A)
Except as provided in division (B) of this section, any of the
following pertaining to the confidentiality, privacy, security, or
privileged status of protected health information transacted,
maintained in, or accessed through a health information exchange is
unenforceable if it conflicts with this chapter:

(1)
A section of the Revised Code that is not in this chapter;

(2)
A rule as defined in section 119.01 of the Revised Code;

(3)
An internal management rule as defined in section 111.15 of the
Revised Code;

(4)
Guidance issued by an agency;

(5)
Orders or regulations of a board of health of a city health district
made under section 3709.20 of the Revised Code;

(6)
Orders or regulations of a board of health of a general health
district made under section 3709.21 of the Revised Code;

(7)
An ordinance or resolution adopted by a political subdivision;

(8)
A professional code of ethics.

(B)
Division (A) of this section does not render unenforceable or
restrict in any manner any of the following:

(1)
A provision of the Revised Code that on

the effective date of this section

September 10, 2012,

requires a person or governmental entity to disclose protected health
information to a state agency, political subdivision, or other
governmental entity;

(2)
The confidential status of proceedings and records within the scope
of a peer review committee of a health care entity as described in
section 2305.252 of the Revised Code;

(3)
The confidential status of quality assurance program activities and
quality assurance records as described in section 5122.32 of the
Revised Code;

(4)
The testimonial privilege established by division (B) of section
2317.02 of the Revised Code;

(5)
An item described in divisions (A)(1) to (8) of this section that
governs any of the following:

(a)
The confidentiality, privacy, security, or privileged status of
protected health information in the possession or custody of an
agency;

(b)
The process for obtaining from a patient consent to the provision of
health care or consent for participation in medical or other
scientific research;

(c)
The process for determining whether an adult has a physical or mental
impairment or an adult's capacity to make health care decisions for
purposes of Chapter 5126. of the Revised Code;

(d)
The process for determining whether a minor has been emancipated.

(6)
When a minor is authorized to consent to the minor's own receipt of
health care or make medical decisions on the minor's own behalf,
including the circumstances described in sections 2907.29, 3709.241,
3719.012, 5120.172,
5122.04,

and
5126.043 of the Revised Code.

Section
2.
That
existing sections 2151.461, 3129.03, 3313.473, 3798.07, and 3798.12
of the Revised Code are hereby repealed.

Section
3.
That
section 5122.04 of the Revised Code is hereby repealed.