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What steps can a district take when a student enduring homelessness lacks the immunizations required for enrollment? The law provides an easy answer to this question—as long as a parent, custodial adult, or someone legally authorized to consent is available. But what can a school do when the student is an unaccompanied youth or a runaway and no one is readily available to consent to the required inoculations?
Section 32.101 of the Texas Family Code designates that—in addition to parents and adults who have legal custody of the child—a child’s guardian or a person authorized under the law of another state or a court order can consent to the immunization. However, if they are not available, the following agents can give consent:
- Grandparent
- Adult brother or sister
- Adult aunt or uncle
- Stepparent
- Educational institution in which the child is enrolled (with written authorization to consent from a parent, managing conservator, guardian, or other person who may consent for the child under the law of another state or a court order)
- Another adult who has actual care, control, and possession of the child (with written authorization to consent from a parent, managing conservator, guardian, or other person who may consent for the child under the law of another state or a court order)
- Court having jurisdiction of a suit affecting the parent-child relationship of which the minor is the subject
- Adult having actual care, control, and possession of the child under an order of a juvenile court or by commitment by a juvenile court to the care of an agency of the state or county
- Adult having actual care, control, and possession of the child as the child’s primary caregiver
However, these agents may not consent for the child if they have actual knowledge that a parent, managing conservator, guardian of the child, or other person who may consent for the child under the law of another state or a court order has expressly refused to give consent to the immunization, has been told not to consent for the child, or has withdrawn a prior written authorization to consent.
In addition, an agent authorized to consent to the immunization of a child must ensure that the consent, if given, is an informed consent. The person authorized to consent is not required to be present when the immunization of the child is requested as long as the individual has completed the proper consent form and submitted it to the health care provider.
Many school districts are concerned about how this law applies to students who are runaways or otherwise unaccompanied by parent or custodian. Section 32.003(a)(2)(A) and (B) of the Texas Family Code states that “A child may consent to medical, dental, psychological, and surgical treatment for the child by a licensed physician or dentist if the child is 16 years of age or older and resides separate and apart from the child’s parents, managing conservator, or guardian, with or without the consent of the parents, managing conservator, or guardian and regardless of the duration of the residence; and [the child is] managing the child’s own financial affairs, regardless of the source of the income.” According to this passage, runaways or unaccompanied youths who are 16 years of age or older are self-governing in matters that involve medical, dental, psychological, and surgical decisions. However, the Texas Family Code nowhere makes a similar statement about immunizations. Consequently, the law doesn’t directly state that immunizations are considered medical care or that a youth 16 years of age or older can consent to his or her own immunization.
Liaisons and school personnel can certainly enroll the youth in school, but only provisionally. An opinion issued 15 April 2005 by the Texas Attorney General1 upheld a homeless student’s right to attend school during a thirty-day period established for the student to be immunized, produce immunization records, or provide proof that he or she is not required to be immunized. A similar opinion is needed to clarify the issue of whether unaccompanied homeless youths or runaways can consent for their own immunization. The Texas Homeless Education Office plans to pursue this matter with appropriate authorities and will publish the results when an opinion has been rendered.
1 http://www.oag.state.tx.us/opinions/op50abbott/ga-0178.htm
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