(C) Tennessee Lookout
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Bill limiting DCS ability to seek vaccinations for juvenile justice, foster kids draws alarm – Tennessee Lookout [1]
['Anita Wadhwani', 'More From Author', '- April']
Date: 2023-04-11
The Tennessee Legislature is poised to pass legislation that would stop the Department of Children’s Services from giving any vaccine to a child in custody without written permission of a parent or guardian — a measure that could have “unintended consequences” such as an inability to act swiftly in an outbreak of meningitis at a juvenile facility, public health professionals said.
The measure, HB1380/SB111, by Rep. John Ragan, R-Oak Ridge and Sen. Janice Bowling, R-Tullahoma, would effectively end Tennessee’s so-called “Mature Minor” doctrine giving physicians discretion to give older teens vaccines without explicit parental permission and putting in check the state’s child welfare agency’s control over the healthcare decisions for children in its care. As applied to DCS, the bill would end the agency’s current ability to provide vaccines to kids of all ages.
The prospect has alarmed some local pediatricians who say that the measure’s requirement of written parental consent for vaccinations provided to teens is contrary to standard practice and an “unwelcome government intrusion” into the doctor-patient relationship.
Ragan said the bill would restore parental rights in their children’s healthcare decisions.
The bill follows GOP backlash at the height of the COVID-19 pandemic, when the state’s former vaccine chief, Dr. Michelle Fiscus, sent a memo to healthcare providers outlining the Mature Minor doctrine. The memo infuriated Republican leaders and eventually led to Dr. Fiscus’ firing.
The state Senate on Monday voted in favor of the bill; it has yet to reach the floor of the House. A spokesperson for DCS did not respond to questions Monday about the agency’s position on the bill.
Children may come into state custody behind on their childhood vaccinations as a result of parental neglect, or need vaccines to be enrolled in a school or to be placed in foster homes with other children.
In those instances, routine immunizations for chicken pox, measles or other diseases are critical, advocates for kids in state care said. Currently DCS is responsible for obtaining all necessary healthcare for kids who come into its custody, including vaccines.
“We don’t take a position on whether that (the Mature Minor doctrine) is a good or bad thing,” said Brian Haile, CEO of Neighborhood Health, which provides healthcare at clinics serving low-income patients in Middle Tennessee. “The truth is teenagers aren’t lining up to get vaccines of any type,” with the exception of routine ‘flu shots, he said.
“What we’re really worried about is the foster care kids and the kids in the juvenile justice system,” Haile said. “Where there’s a potential meningitis outbreak, time is of the essence and at least as we understand this, those kids could not be vaccinated.”
In some instances, parents may have abandoned children; in others they may resist complying with DCS requests for their permission, a result of the neglect that may have led to their children being taken into custody. Parents may also resist providing permission as a result of the mistrust they develop with DCS after their children are taken away. And in the case of disease outbreaks in group settings, Haile said that swift medical intervention is critical.
What we’re really worried about is the foster care kids and the kids in the juvenile justice system. Where there’s a potential meningitis outbreak, time is of the essence and at least as we understand this, those kids could not be vaccinated.” – Brian Haile, CEO, Neighborhood Health
The proposed new law would allow DCS to petition a judge for permission to vaccinate a child, but — in addition to their efforts to get signed, written vaccine permission — a legal petition for a vaccine would add yet another administrative burden to caseworkers who are already overburdened, child advocates said.
Pediatricians said the policy would upend standard practice for their patients — those in state custody and those who are not.
“Treating older minors without parental consent has been a standard part of medical practice at least since the 1980s Tennessee court decision that supported older minors having capacity to make their own medical decisions,” said Nashville area pediatrician Dr. Vidya Bansal.
The bill has received limited public debate since its introduction into the legislature. Pediatricians say they have not had the opportunity to make public comments.
“As physicians, we have tried to make public comments advocating for vaccinations, and we have been denied this opportunity,” said Dr. Amy Gordon Bono, a primary care physician. “We continue to see this legislative body silence voices who speak politically inconvenient truth.”
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https://tennesseelookout.com/2023/04/11/bill-limiting-dcs-ability-to-seek-vaccinations-for-juvenile-justice-foster-kids-draws-alarm/
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