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S.B. 83

             1     

MEDICAL DECISIONS OF A PARENT OR

             2     
GUARDIAN

             3     
2005 GENERAL SESSION

             4     
STATE OF UTAH

             5     
Sponsor: David L. Thomas

             6     
             7      LONG TITLE
             8      General Description:
             9          This bill modifies provisions of Child and Family Services, the Utah Criminal Code,
             10      and the Judicial Code regarding child abuse and neglect. This bill also modifies the
             11      Judicial Code regarding malpractice actions against health care providers.
             12      Highlighted Provisions:
             13          This bill:
             14          .    modifies provisions of Child and Family Services to provide that:
             15              *    a health care decision made by a child's parent or guardian does not constitute
             16      neglect unless the state or other party to the proceeding shows, by clear and
             17      convincing evidence, that the decision is not reasonable and prudent; and
             18              *    a parent or guardian has the right to a second medical opinion;
             19          .    modifies the Licensing Information System portion of Child and Family Services to
             20      provide that:
             21              *    a health care decision made by a child's parent or guardian does not constitute
             22      severe child abuse or neglect unless the state or other party to the proceeding
             23      shows, by clear and convincing evidence, that the decision is not reasonable and
             24      prudent; and    
             25              *    a parent or guardian retains the right to a second medical opinion;
             26          .    provides that a parent or guardian is not guilty of child abuse for selecting a
             27      treatment option for the medical condition of the parent's or guardian's child, if the


             28      treatment option is one that a reasonable parent or guardian would believe to be in the best
             29      interest of the child;
             30          .    provides that a parent or guardian is not guilty of abuse or neglect of a disabled
             31      child for selecting a treatment option for the medical condition of the parent's or
             32      guardian's disabled child, if the treatment option is one that a reasonable parent or
             33      guardian would believe to be in the best interest of the child;
             34          .    modifies the definition of a neglected child under the Juvenile Court Act of 1996 to
             35      provide that a health care decision made by a child's parent or guardian does not
             36      constitute neglect unless the state or other party to the proceeding can show, by
             37      clear and convincing evidence, that the decision was not reasonable and prudent;
             38          .    modifies the Juvenile Court Act of 1996 to provide that a parent or guardian has the
             39      right to a second medical opinion;    
             40          .    modifies the Termination of Parental Rights Act to provide that:
             41              *    a health care decision made by a child's parent does not constitute neglect
             42      unless the state or other party to the proceeding shows, by clear and convincing
             43      evidence, that the decision is not reasonable and prudent; and
             44              *    a parent has the right to a second medical opinion;
             45          .    modifies the Judicial Code to provide that a malpractice action may not be brought
             46      against a health care provider on the basis of the consequences resulting from the
             47      refusal of a child's parent or guardian to consent to health care recommended by the
             48      health care provider when the parent or guardian is provided with sufficient
             49      information to make an informed decision and the consent of the parent or guardian
             50      is required by law, unless the health care provider fails to comply with the child
             51      abuse or neglect reporting requirements;
             52          .    clarifies the scope of the malpractice action provision contained in this bill;
             53          .    enacts an uncodified expression of legislative intent; and
             54          .    makes technical changes.
             55      Monies Appropriated in this Bill:
             56          None
             57      Other Special Clauses:
             58          None


             59      Utah Code Sections Affected:
             60      AMENDS:
             61          62A-4a-101, as last amended by Chapter 356, Laws of Utah 2004
             62          62A-4a-116.1, as last amended by Chapter 210, Laws of Utah 2003
             63          62A-4a-116.4, as enacted by Chapter 283, Laws of Utah 2002
             64          76-5-109, as last amended by Chapter 125, Laws of Utah 2000
             65          76-5-110, as last amended by Chapter 303, Laws of Utah 1997
             66          78-3a-103, as last amended by Chapter 171, Laws of Utah 2003
             67          78-3a-408, as last amended by Chapter 274, Laws of Utah 1998
             68      ENACTS:
             69          78-14-5.5, Utah Code Annotated 1953
             70      Uncodified Material Affected:
             71      ENACTS UNCODIFIED MATERIAL
             72     
             73      Be it enacted by the Legislature of the state of Utah:
             74          Section 1. Section 62A-4a-101 is amended to read:
             75           62A-4a-101. Definitions.
             76          As used in this chapter:
             77          (1) "Abuse" means:
             78          (a) actual or threatened nonaccidental physical or mental harm;
             79          (b) negligent treatment;
             80          (c) sexual exploitation; or
             81          (d) any sexual abuse.
             82          (2) "Adoption services" means:
             83          (a) placing children for adoption[,];
             84          (b) subsidizing adoptions under Section 62A-4a-105 [,];
             85          (c) supervising adoption placements until the adoption is finalized by the court[,];
             86          (d) conducting adoption studies[,];
             87          (e) preparing adoption reports upon request of the court[,]; and
             88          (f) providing postadoptive placement services, upon request of a family, for the
             89      purpose of stabilizing a possible disruptive placement.


             90          (3) "Board" means the Board of Child and Family Services established in accordance
             91      with Sections 62A-1-105 , 62A-1-107 , and 62A-4a-102 .
             92          (4) "Child" has the same meaning as "minor," as defined in this section.
             93          (5) "Consumer" means a person who receives services offered by the division in
             94      accordance with this chapter.
             95          (6) "Chronic physical abuse" means repeated or patterned physical abuse.
             96          (7) "Chronic neglect" means a repeated or patterned failure or refusal by a parent,
             97      guardian, or custodian to provide necessary care for a minor's safety, morals, or well-being.
             98          (8) "Chronic emotional abuse" means repeated or patterned emotional abuse.
             99          (9) "Custody," with regard to the division, means the custody of a child in the division
             100      as of the date of disposition.
             101          (10) "Day-care services" means care of a child for a portion of the day which is less
             102      than 24 hours[,]:
             103          (a) in [his] the child's own home by a responsible person[,]; or
             104          (b) outside of [his] the child's home in a:
             105          (i) day-care center[,];
             106          (ii) family group home[,]; or
             107          (iii) family child care home.
             108          (11) "Dependent child" or "dependency" means a child, or the condition of a child, who
             109      is homeless or without proper care through no fault of the child's parent, guardian, or custodian.
             110          (12) "Director" means the director of the Division of Child and Family Services.
             111          (13) "Division" means the Division of Child and Family Services.
             112          (14) (a) "Domestic violence services" means:
             113          (i) temporary shelter, treatment, and related services to persons who are victims of
             114      abuse and their dependent children; and
             115          (ii) treatment services for domestic violence perpetrators.
             116          (b) As used in this Subsection (14):
             117          (i) "abuse" means the same as that term is defined in [Section 30-6-1 ,] Subsection
             118      30-6-1 (1); and
             119          (ii) "domestic violence perpetrator" means a person who is alleged to have committed,
             120      has been convicted of, or has pled guilty to an act of domestic violence as defined in


             121      Subsection 77-36-1 (2).
             122          (15) "Homemaking service" means the care of individuals in their domiciles, and help
             123      given to individual caretaker relatives to achieve improved household and family management
             124      through the services of a trained homemaker.
             125          (16) (a) "Minor" means a person under 18 years of age.
             126          (b) "Minor" may also include a person under 21 years of age for whom the division has
             127      been specifically ordered by the juvenile court to provide services.
             128          (17) "Natural parent" means a minor's biological or adoptive parent, and includes a
             129      minor's noncustodial parent.
             130          (18) (a) "Neglect" means:
             131          (i) abandonment of a child, except as provided in [Title 62A, Chapter 4a,] Part 8, Safe
             132      Relinquishment of a Newborn Child;
             133          (ii) subjecting a child to mistreatment or abuse;
             134          (iii) lack of proper parental care by reason of the fault or habits of the parent, guardian,
             135      or custodian;
             136          (iv) failure or refusal of a parent, guardian, or custodian to provide proper or necessary
             137      subsistence, education, or medical care, including surgery or psychiatric services when
             138      required, or any other care necessary for [his] the child's health, safety, morals, or well-being;
             139      or
             140          (v) a child at risk of being neglected or abused because another child in the same home
             141      is neglected or abused.
             142          (b) The aspect of neglect relating to education, described in Subsection (18)(a)(iv),
             143      means that, after receiving notice that a child has been frequently absent from school without
             144      good cause, or that the child has failed to cooperate with school authorities in a reasonable
             145      manner, a parent or guardian fails to make a good faith effort to ensure that the child receives
             146      an appropriate education.
             147          (c) A parent or guardian legitimately practicing religious beliefs and who, for that
             148      reason, does not provide specified medical treatment for a child, is not guilty of neglect.
             149          (d) (i) Notwithstanding Subsection (18)(a), a health care decision made for a child by
             150      the child's parent or guardian does not constitute neglect unless the state or other party to the
             151      proceeding shows, by clear and convincing evidence, that the health care decision is not


             152      reasonable and prudent.
             153          (ii) Nothing in Subsection (18)(d)(i) may prohibit a parent or guardian from exercising
             154      the right to obtain a second medical opinion.
             155          (19) "Protective custody," with regard to the division, means the shelter of a child by
             156      the division from the time the child is removed from the child's home until the earlier of:
             157          (a) the shelter hearing[,]; or
             158          (b) the child's return home[, whichever occurs earlier].
             159          (20) "Protective services" means expedited services that are provided:
             160          (a) in response to evidence of neglect, abuse, or dependency of a minor;
             161          (b) to a cohabitant who is neglecting or abusing a child, in order to:
             162          (i) help the cohabitant develop recognition of the cohabitant's duty of care and of the
             163      causes of neglect or abuse[,]; and [to]
             164          (ii) strengthen the cohabitant's ability to provide safe and acceptable care; and
             165          (c) in cases where the child's welfare is endangered:
             166          (i) to bring the situation to the attention of the appropriate juvenile court and law
             167      enforcement agency;
             168          (ii) to cause a protective order to be issued for the protection of the minor, when
             169      appropriate; and
             170          (iii) to protect the child from the circumstances that endanger the child's welfare
             171      including, when appropriate[,]:
             172          (A) removal from the child's home[,];
             173          (B) placement in substitute care[,]; and
             174          (C) petitioning the court for termination of parental rights.
             175          (21) "Services to unwed parents" means social, educational, and medical services
             176      arranged for or provided to unwed parents to help them plan for themselves and the unborn
             177      child.
             178          (22) "Severe neglect" means neglect that causes or threatens to cause serious harm to a
             179      minor.
             180          (23) "Shelter care" means the temporary care of minors in nonsecure facilities.
             181          (24) "State" means:
             182          (a) a state of the United States[,];


             183          (b) the District of Columbia[,];
             184          (c) the Commonwealth of Puerto Rico[,];
             185          (d) the Virgin Islands[,];
             186          (e) Guam[,];
             187          (f) the Commonwealth of the Northern Mariana Islands[,]; or
             188          (g) a territory or possession administered by the United States.
             189          (25) "Severe emotional abuse" means emotional abuse that causes or threatens to cause
             190      serious harm to a minor.
             191          (26) "Severe physical abuse" means physical abuse that causes or threatens to cause
             192      serious harm to a minor.
             193          (27) "State plan" means the written description of the programs for children, youth, and
             194      family services administered by the division in accordance with federal law.
             195          (28) "Status offense" means a violation of the law that would not be a violation but for
             196      the age of the offender.
             197          (29) "Substantiated" or "substantiation" means a judicial finding based on a
             198      preponderance of the evidence that abuse or neglect occurred. Each allegation made or
             199      identified in a given case shall be considered separately in determining whether there should be
             200      a finding of substantiated.
             201          (30) "Substitute care" means:
             202          (a) the placement of a minor in a family home, group care facility, or other placement
             203      outside the minor's own home, either at the request of a parent or other responsible relative, or
             204      upon court order, when it is determined that continuation of care in the child's own home
             205      would be contrary to the child's welfare;
             206          (b) services provided for a child awaiting placement; and
             207          (c) the licensing and supervision of a substitute care facility.
             208          (31) "Supported" means a finding by the division based on the evidence available at the
             209      completion of an investigation that there is a reasonable basis to conclude that abuse, neglect,
             210      or dependency occurred. Each allegation made or identified during the course of the
             211      investigation shall be considered separately in determining whether there should be a finding of
             212      supported.
             213          (32) "Temporary custody," with regard to the division, means the custody of a child in


             214      the division from the date of the shelter hearing until disposition.
             215          (33) "Transportation services" means travel assistance given to an individual with
             216      escort service, if necessary, to and from community facilities and resources as part of a service
             217      plan.
             218          (34) "Unsubstantiated" means a judicial finding that there is insufficient evidence to
             219      conclude that abuse or neglect occurred.
             220          (35) "Unsupported" means a finding at the completion of an investigation that there is
             221      insufficient evidence to conclude that abuse, neglect, or dependency occurred. However, a
             222      finding of unsupported means also that the division worker did not conclude that the allegation
             223      was without merit.
             224          (36) "Without merit" means a finding at the completion of an investigation by the
             225      division, or a judicial finding, that the alleged abuse, neglect, or dependency did not occur, or
             226      that the alleged perpetrator was not responsible for the abuse, neglect, or dependency.
             227          Section 2. Section 62A-4a-116.1 is amended to read:
             228           62A-4a-116.1. Supported finding of severe types of abuse or neglect -- Notation in
             229      Licensing Information System -- Juvenile court petition or notice to alleged perpetrator --
             230      Rights of alleged perpetrator -- Juvenile court finding.
             231          (1) If the division makes a supported finding of one or more of the severe types of child
             232      abuse or neglect described in Subsection (2), the division shall:
             233          (a) (i) serve notice of the finding on the alleged perpetrator; and
             234          (ii) enter the following information into the Licensing Information System created in
             235      Section 62A-4a-116.2 :
             236          (A) the name and other identifying information of the perpetrator with the supported
             237      finding, without identifying the person as a perpetrator or alleged perpetrator[,]; and
             238          (B) a notation to the effect that an investigation regarding the person is pending; and
             239          (b) if the division considers it advisable, file a petition for substantiation within one
             240      year of the supported finding.
             241          (2) Except as otherwise provided in Subsection (3), the severe types of child abuse or
             242      neglect referred to in Subsection (1) are as follows:
             243          (a) if committed by a person 18 years of age or older:
             244          (i) severe or chronic physical abuse;


             245          (ii) sexual abuse;
             246          (iii) sexual exploitation;
             247          (iv) abandonment;
             248          (v) medical neglect resulting in death, disability, or serious illness;
             249          (vi) chronic or severe neglect; or
             250          (vii) chronic or severe emotional abuse; or
             251          (b) if committed by a person under the age of 18:
             252          (i) serious physical injury, as defined in Subsection 76-5-109 (1)(d), to another child
             253      which indicates a significant risk to other children; or
             254          (ii) sexual behavior with or upon another child which indicates a significant risk to
             255      other children.
             256          (3) Severe child abuse or neglect in Subsection (2) does not include:
             257          (a) the use of reasonable and necessary physical restraint or force by an educator in
             258      accordance with Subsection 53A-11-802 (2) or Section 76-2-401 ; [or]
             259          (b) a person's conduct that:
             260          (i) is justified under Section 76-2-401 ; or
             261          (ii) constitutes the use of reasonable and necessary physical restraint or force in
             262      self-defense or otherwise appropriate to the circumstances to obtain possession of a weapon or
             263      other dangerous object in the possession or under the control of a child or to protect the child or
             264      another person from physical injury[.]; or
             265          (c) a health care decision made for a child by the child's parent or guardian, unless the
             266      state or other party to the proceeding shows, by clear and convincing evidence, that the health
             267      care decision is not reasonable and prudent.
             268          (4) (a) For purposes of Subsection (2)(b), "significant risk" shall be determined in
             269      accordance with risk assessment tools and rules established by the division that focus on:
             270          (i) age[,];
             271          (ii) social factors[,];
             272          (iii) emotional factors[,];
             273          (iv) sexual factors[,];
             274          (v) intellectual factors[,];
             275          (vi) family risk factors[,]; and


             276          (vii) other related considerations.
             277          (b) The division shall train its child protection workers to apply the risk assessment
             278      tools and rules established under Subsection (4)(a).
             279          (5) The notice referred to in Subsection (1) (a) shall state that:
             280          (a) the division has conducted an investigation regarding alleged child abuse or
             281      neglect;
             282          (b) the division has made a supported finding of one of the severe types of child abuse
             283      or neglect described in Subsection (2);
             284          (c) facts gathered by the division support the supported finding;
             285          (d) as a result of the supported finding, the alleged perpetrator's name and other
             286      identifying information have been listed in the Licensing Information System in accordance
             287      with Subsection (1)(a);
             288          (e) the alleged perpetrator may be disqualified from adopting a child or being licensed
             289      by:
             290          (i) the department;
             291          (ii) a human services licensee;
             292          (iii) a child care provider or program; and
             293          (iv) a covered health care facility;
             294          (f) the alleged perpetrator has the rights described in Subsection (6); and
             295          (g) failure to take either action described in Subsection (6)(a) within one year after
             296      service of the notice will result in the action described in Subsection (6)(b).
             297          (6) (a) Upon receipt of the notice described in Subsection (5), the alleged perpetrator
             298      shall have the right to:
             299          (i) file a written request asking the division to review the findings under Subsection
             300      (2);
             301          (ii) immediately petition the juvenile court under Section 78-3a-320 ; or
             302          (iii) sign a written consent to the supported finding and entry of the alleged
             303      perpetrator's name and other information regarding the supported finding of abuse or neglect
             304      into the Licensing Information System.
             305          (b) If the alleged perpetrator fails to take action as described in Subsection (6)(a)
             306      within one year after service of the notice described in Subsection (5), the alleged perpetrator's


             307      name and the notation described in Subsection (1)(a) shall remain in the Licensing Information
             308      System. This information shall also remain in the Licensing Information System while the
             309      division awaits a response from the alleged perpetrator pursuant to Subsection (6)(a) and
             310      during the pendency of any proceeding, including an appeal of a finding of unsubstantiated or
             311      without merit, under Section 78-3a-320 .
             312          (c) The alleged perpetrator shall have no right to petition the juvenile court under
             313      Subsection (6)(b) if the court has previously held a hearing on the same alleged incident of
             314      abuse or neglect pursuant to the filing of a petition under Section 78-3a-305 by some other
             315      party.
             316          (d) Consent under Subsection (6)(a)(iii) by a minor shall be given by the minor's parent
             317      or guardian.
             318          (7) Upon the filing of a petition under Subsection (1)(b), the juvenile court shall make
             319      a finding of substantiated, unsubstantiated, or without merit as provided in Subsections
             320      78-3a-320 (1) and (2).
             321          (8) Service of the notice under Subsections (1) (a) and (5):
             322          (a) shall be personal service in accordance with Rule 4 of the Utah Rules of Civil
             323      Procedure; and
             324          (b) does not preclude civil or criminal action against the alleged perpetrator.
             325          (9) Nothing in Subsection (3)(c) may prohibit a parent or guardian from exercising the
             326      right to obtain a second medical opinion.
             327          Section 3. Section 62A-4a-116.4 is amended to read:
             328           62A-4a-116.4. Timeframes for deletion of specified information or reports.
             329          (1) Unless the executive director determines that there is good cause for keeping a
             330      report of abuse or neglect in the Management Information System, based on standards
             331      established by rule, the division shall delete any reference to:
             332          (a) a report that is without merit, if no subsequent report involving the same alleged
             333      perpetrator has occurred within one year; or
             334          (b) a report that has been determined by a court of competent jurisdiction to be
             335      unsubstantiated or without merit, if no subsequent report involving the same alleged
             336      perpetrator has occurred within five years.
             337          (2) (a) The division shall maintain a separation of reports as follows:


             338          (i) those that are supported;
             339          (ii) those that are unsupported;
             340          (iii) those that are without merit;
             341          (iv) those that are unsubstantiated under the law in effect prior to May 6, 2002;
             342          (v) those that are substantiated under the law in effect prior to May 6, 2002; and
             343          (vi) those that are consented-to supported findings under Subsection
             344      62A-4a-116.1 (6)(a)[(ii)](iii).
             345          (b) Only persons with statutory authority have access to information contained in any
             346      of the reports identified in Subsection (2)(a).
             347          Section 4. Section 76-5-109 is amended to read:
             348           76-5-109. Child abuse.
             349          (1) As used in this section:
             350          (a) "Child" means a human being who is under 18 years of age.
             351          (b) "Child abuse" means any offense described in Subsection (2) or (3), or in Section
             352      76-5-109.1 .
             353          (c) "Physical injury" means an injury to or condition of a child which impairs the
             354      physical condition of the child, including:
             355          (i) a bruise or other contusion of the skin;
             356          (ii) a minor laceration or abrasion;
             357          (iii) failure to thrive or malnutrition; or
             358          (iv) any other condition which imperils the child's health or welfare and which is not a
             359      serious physical injury as defined in Subsection (1)(d).
             360          (d) (i) "Serious physical injury" means any physical injury or set of injuries [which]
             361      that:
             362          (A) seriously impairs the child's health[, or which];
             363          (B) involves physical torture [or];
             364          (C) causes serious emotional harm to the child[,]; or [which]
             365          (D) involves a substantial risk of death to the child[, including:].
             366          (ii) "Serious physical injury" includes:
             367          [(i)] (A) fracture of any bone or bones;
             368          [(ii)] (B) intracranial bleeding, swelling or contusion of the brain, whether caused by


             369      blows, shaking, or causing the child's head to impact with an object or surface;
             370          [(iii)] (C) any burn, including burns inflicted by hot water, or those caused by placing a
             371      hot object upon the skin or body of the child;
             372          [(iv)] (D) any injury caused by use of a dangerous weapon as defined in [Section]
             373      Subsection 76-1-601 (5);
             374          [(v)] (E) any combination of two or more physical injuries inflicted by the same
             375      person, either at the same time or on different occasions;
             376          [(vi)] (F) any damage to internal organs of the body;
             377          [(vii)] (G) any conduct toward a child [which] that results in severe emotional harm,
             378      severe developmental delay or retardation, or severe impairment of the child's ability to
             379      function;
             380          [(viii)] (H) any injury [which] that creates a permanent disfigurement or protracted loss
             381      or impairment of the function of a bodily member, limb, or organ;
             382          [(ix)] (I) any conduct [which] that causes a child to cease breathing, even if
             383      resuscitation is successful following the conduct; or
             384          [(x)] (J) any conduct [which] that results in starvation or failure to thrive or
             385      malnutrition that jeopardizes the child's life.
             386          (2) Any person who inflicts upon a child serious physical injury or, having the care or
             387      custody of such child, causes or permits another to inflict serious physical injury upon a child is
             388      guilty of an offense as follows:
             389          (a) if done intentionally or knowingly, the offense is a felony of the second degree;
             390          (b) if done recklessly, the offense is a felony of the third degree; or
             391          (c) if done with criminal negligence, the offense is a class A misdemeanor.
             392          (3) Any person who inflicts upon a child physical injury or, having the care or custody
             393      of such child, causes or permits another to inflict physical injury upon a child is guilty of an
             394      offense as follows:
             395          (a) if done intentionally or knowingly, the offense is a class A misdemeanor;
             396          (b) if done recklessly, the offense is a class B misdemeanor; or
             397          (c) if done with criminal negligence, the offense is a class C misdemeanor.
             398          (4) A parent or legal guardian who provides a child with treatment by spiritual means
             399      alone through prayer, in lieu of medical treatment, in accordance with the tenets and practices


             400      of an established church or religious denomination of which the parent or legal guardian is a
             401      member or adherent shall not, for that reason alone, be [deemed] considered to have committed
             402      an offense under this section.
             403          (5) A parent or guardian of a child does not violate this section by selecting a treatment
             404      option for the medical condition of the child, if the treatment option is one that a reasonable
             405      parent or guardian would believe to be in the best interest of the child.
             406          Section 5. Section 76-5-110 is amended to read:
             407           76-5-110. Abuse or neglect of disabled child.
             408          (1) As used in this section:
             409          (a) "Abuse" means:
             410          (i) inflicting physical injury, as that term is defined in Section 76-5-109 ;
             411          (ii) having the care or custody of a disabled child, causing or permitting another to
             412      inflict physical injury, as that term is defined in Section 76-5-109 ; or
             413          (iii) unreasonable confinement.
             414          (b) "Caretaker" means:
             415          (i) any parent, legal guardian, or other person having under [his] that person's care and
             416      custody a disabled child; or
             417          (ii) any person, corporation, or public institution that has assumed by contract or court
             418      order the responsibility to provide food, shelter, clothing, medical, and other necessities to a
             419      disabled child.
             420          (c) "Disabled child" means any person under 18 years of age who is impaired because
             421      of mental illness, mental deficiency, physical illness or disability, or other cause, to the extent
             422      that [he] the person is unable to care for [his] the person's own personal safety or to provide
             423      necessities such as food, shelter, clothing, and medical care.
             424          (d) "Neglect" means failure by a caretaker to provide care, nutrition, clothing, shelter,
             425      supervision, or medical care.
             426          (2) Any caretaker who abuses or neglects a disabled child is guilty of a third degree
             427      felony.
             428          (3) (a) A parent or legal guardian who provides a child with treatment by spiritual
             429      means alone through prayer, in lieu of medical treatment, in accordance with the tenets and
             430      practices of an established church or religious denomination of which the parent or legal


             431      guardian is a member or adherent shall not, for that reason alone, be considered to be in
             432      violation under this section.
             433          (b) The exception under Subsection (3)(a) shall not preclude a court from ordering
             434      medical services from a physician licensed to engage in the practice of medicine to be provided
             435      to the child where there is substantial risk of harm to the child's health or welfare.
             436          (c) A caretaker of a disabled child does not violate this section by selecting a treatment
             437      option for a disabled child's medical condition, if the treatment option is one that a reasonable
             438      caretaker would believe to be in the best interest of the disabled child.
             439          Section 6. Section 78-3a-103 is amended to read:
             440           78-3a-103. Definitions.
             441          (1) As used in this chapter:
             442          (a) "Abused child" includes a minor less than 18 years of age who:
             443          (i) has suffered or been threatened with nonaccidental physical or mental harm,
             444      negligent treatment, or sexual exploitation; or
             445          (ii) has been the victim of any sexual abuse.
             446          (b) "Adjudication" means a finding by the court, incorporated in a decree, that the facts
             447      alleged in the petition have been proved.
             448          (c) "Adult" means a person 18 years of age or over, except that persons 18 years or
             449      over under the continuing jurisdiction of the juvenile court pursuant to Section 78-3a-121 shall
             450      be referred to as minors.
             451          (d) "Board" means the Board of Juvenile Court Judges.
             452          (e) "Child placement agency" means:
             453          (i) a private agency licensed to receive minors for placement or adoption under this
             454      code; or
             455          (ii) a private agency receiving minors for placement or adoption in another state, which
             456      agency is licensed or approved where such license or approval is required by law.
             457          (f) "Commit" means to transfer legal custody.
             458          (g) "Court" means the juvenile court.
             459          (h) "Dependent child" includes a minor who is homeless or without proper care
             460      through no fault of [his] the minor's parent, guardian, or custodian.
             461          (i) "Deprivation of custody" means transfer of legal custody by the court from a parent


             462      or the parents or a previous legal custodian to another person, agency, or institution.
             463          (j) "Detention" means home detention and secure detention as defined in Section
             464      62A-7-101 for the temporary care of minors who require secure custody in physically
             465      restricting facilities:
             466          (i) pending court disposition or transfer to another jurisdiction; or
             467          (ii) while under the continuing jurisdiction of the court.
             468          (k) "Division" means the Division of Child and Family Services.
             469          (l) "Formal referral" means a written report from a peace officer or other person
             470      informing the court that a minor is or appears to be within the court's jurisdiction and that a
             471      petition may be filed.
             472          (m) "Group rehabilitation therapy" means psychological and social counseling of one
             473      or more persons in the group, depending upon the recommendation of the therapist.
             474          (n) "Guardianship of the person" includes the authority to consent to marriage, to
             475      enlistment in the armed forces, to major medical, surgical, or psychiatric treatment, and to legal
             476      custody, if legal custody is not vested in another person, agency, or institution.
             477          (o) "Habitual truant" is a school-age minor who:
             478          (i) has received:
             479          (A) more than two truancy citations within one school year from the school in which
             480      the minor is or should be enrolled; and
             481          (B) eight absences without a legitimate or valid excuse; or [who,]
             482          (ii) in defiance of efforts on the part of school authorities as required under Section
             483      53A-11-103 , refuses to regularly attend school or any scheduled period of the school day.
             484          (p) "Legal custody" means a relationship embodying the following rights and duties:
             485          (i) the right to physical custody of the minor;
             486          (ii) the right and duty to protect, train, and discipline the minor;
             487          (iii) the duty to provide the minor with food, clothing, shelter, education, and ordinary
             488      medical care;
             489          (iv) the right to determine where and with whom the minor shall live; and
             490          (v) the right, in an emergency, to authorize surgery or other extraordinary care.
             491          (q) (i) "Minor" means a person under the age of 18 years. [It]
             492          (ii) "Minor" includes the term "child" as used in other parts of this chapter.


             493          (r) "Natural parent" means a minor's biological or adoptive parent, and includes the
             494      minor's noncustodial parent.
             495          (s) (i) "Neglected child" means a minor:
             496          (A) whose parent, guardian, or custodian has abandoned the minor, except as provided
             497      in Title 62A, Chapter 4a, Part 8, Safe Relinquishment of a Newborn Child;
             498          (B) whose parent, guardian, or custodian has subjected the minor to mistreatment or
             499      abuse;
             500          (C) who lacks proper parental care by reason of the fault or habits of the parent,
             501      guardian, or custodian;
             502          (D) whose parent, guardian, or custodian fails or refuses to provide proper or necessary
             503      subsistence, education, or medical care, including surgery or psychiatric services when
             504      required, or any other care necessary for health, safety, morals, or well-being; or
             505          (E) who is at risk of being a neglected or abused child as defined in this chapter
             506      because another minor in the same home is a neglected or abused child as defined in this
             507      chapter.
             508          (ii) The aspect of neglect related to education, described in Subsection (1)(s)(i)(D),
             509      means that, after receiving notice that a minor has been frequently absent from school without
             510      good cause, or that the minor has failed to cooperate with school authorities in a reasonable
             511      manner, a parent or guardian fails to make a good faith effort to ensure that the minor receives
             512      an appropriate education.
             513          (iii) A parent or guardian legitimately practicing religious beliefs and who, for that
             514      reason, does not provide specified medical treatment for a minor, is not guilty of neglect.
             515          (iv) Notwithstanding Subsection (1)(s)(i), a health care decision made for a child by the
             516      child's parent or guardian does not constitute neglect unless the state or other party to the
             517      proceeding shows, by clear and convincing evidence, that the health care decision is not
             518      reasonable and prudent.
             519          (v) Nothing in Subsection (1)(s)(iv) may prohibit a parent or guardian from exercising
             520      the right to obtain a second medical opinion.
             521          (t) "Nonjudicial adjustment" means closure of the case by the assigned probation
             522      officer without judicial determination upon the consent in writing of the minor, the parent,
             523      legal guardian or custodian, and the assigned probation officer.


             524          (u) "Probation" means a legal status created by court order following an adjudication
             525      on the ground of a violation of law or under Section 78-3a-104 , whereby the minor is permitted
             526      to remain in [his] the minor's home under prescribed conditions and under supervision by the
             527      probation department or other agency designated by the court, subject to return to the court for
             528      violation of any of the conditions prescribed.
             529          (v) "Protective supervision" means a legal status created by court order following an
             530      adjudication on the ground of abuse, neglect, or dependency, whereby the minor is permitted to
             531      remain in [his] the minor's home, and supervision and assistance to correct the abuse, neglect,
             532      or dependency is provided by the probation department or other agency designated by the court.
             533          (w) (i) "Residual parental rights and duties" means those rights and duties remaining
             534      with the parent after legal custody or guardianship, or both, have been vested in another person
             535      or agency, including:
             536          (A) the responsibility for support[,];
             537          (B) the right to consent to adoption[,];
             538          (C) the right to determine the child's religious affiliation[,]; and
             539          (D) the right to reasonable parent-time unless restricted by the court.
             540          (ii) If no guardian has been appointed, "residual parental rights and duties" also include
             541      the right to consent to:
             542          (A) marriage[, to];
             543          (B) enlistment[,]; and [to]
             544          (C) major medical, surgical, or psychiatric treatment.
             545          (x) "Secure facility" means any facility operated by or under contract with the Division
             546      of Juvenile Justice Services, that provides 24-hour supervision and confinement for youth
             547      offenders committed to the division for custody and rehabilitation.
             548          (y) "Shelter" means the temporary care of minors in physically unrestricted facilities
             549      pending court disposition or transfer to another jurisdiction.
             550          (z) "State supervision" means a disposition [which] that provides a more intensive
             551      level of intervention than standard probation but is less intensive or restrictive than a
             552      community placement with the Division of Juvenile Justice Services.
             553          (aa) "Substantiated" has the same meaning as defined in [Section] Subsection
             554      62A-4a-101 (29).


             555          (bb) "Supported" has the same meaning as defined in [Section] Subsection
             556      62A-4a-101 (31).
             557          (cc) "Termination of parental rights" means the permanent elimination of all parental
             558      rights and duties, including residual parental rights and duties, by court order.
             559          (dd) "Therapist" means a person employed by a state division or agency for the purpose
             560      of conducting psychological treatment and counseling of a minor in its custody, or any other
             561      person licensed or approved by the state for the purpose of conducting psychological treatment
             562      and counseling.
             563          (ee) "Unsubstantiated" has the same meaning as defined in [Section] Subsection
             564      62A-4a-101 (34).
             565          (ff) "Without merit" has the same meaning as defined in [Section] Subsection
             566      62A-4a-101 (36).
             567          (2) As used in Part 3, Abuse, Neglect, and Dependency Proceedings, with regard to the
             568      Division of Child and Family Services:
             569          (a) "Custody" means the custody of a minor in the Division of Child and Family
             570      Services as of the date of disposition.
             571          (b) "Protective custody" means the shelter of a minor by the Division of Child and
             572      Family Services from the time the minor is removed from home until the earlier of:
             573          (i) the shelter hearing[,]; or
             574          (ii) the minor's return home[, whichever occurs earlier].
             575          (c) "Temporary custody" means the custody of a minor in the Division of Child and
             576      Family Services from the date of the shelter hearing until disposition.
             577          Section 7. Section 78-3a-408 is amended to read:
             578           78-3a-408. Evidence of grounds for termination.
             579          (1) In determining whether a parent or parents have abandoned a child, it is prima facie
             580      evidence of abandonment that the parent or parents:
             581          (a) although having legal custody of the child, have surrendered physical custody of the
             582      child, and for a period of six months following the surrender have not manifested to the child
             583      or to the person having the physical custody of the child a firm intention to resume physical
             584      custody or to make arrangements for the care of the child;
             585          (b) have failed to communicate with the child by mail, telephone, or otherwise for six


             586      months;
             587          (c) failed to have shown the normal interest of a natural parent, without just cause; or
             588          (d) have abandoned an infant, as described in [Section] Subsection 78-3a-313.5 (1).
             589          (2) In determining whether a parent or parents are unfit or have neglected a child the
             590      court shall consider, but is not limited to, the following circumstances, conduct, or conditions:
             591          (a) emotional illness, mental illness, or mental deficiency of the parent that renders
             592      [him] the parent unable to care for the immediate and continuing physical or emotional needs
             593      of the child for extended periods of time;
             594          (b) conduct toward a child of a physically, emotionally, or sexually cruel or abusive
             595      nature;
             596          (c) habitual or excessive use of intoxicating liquors, controlled substances, or
             597      dangerous drugs that render the parent unable to care for the child;
             598          (d) repeated or continuous failure to provide the child with adequate food, clothing,
             599      shelter, education, or other care necessary for [his] the child's physical, mental, and emotional
             600      health and development by a parent or parents who are capable of providing that care[.
             601      However, a parent who, legitimately practicing his religious beliefs, does not provide specified
             602      medical treatment for a child is not for that reason alone a negligent or unfit parent];
             603          (e) with regard to a child who is in the custody of the division, if the parent is
             604      incarcerated as a result of conviction of a felony, and the sentence is of such length that the
             605      child will be deprived of a normal home for more than one year; or
             606          (f) a history of violent behavior.
             607          (3) A parent who, legitimately practicing the parent's religious beliefs, does not provide
             608      specified medical treatment for a child is not, for that reason alone, a negligent or unfit parent.
             609          (4) (a) Notwithstanding Subsection (2), a parent may not be considered neglectful or
             610      unfit because of a health care decision made for a child by the child's parent unless the state or
             611      other party to the proceeding shows, by clear and convincing evidence, that the health care
             612      decision is not reasonable and prudent.
             613          (b) Nothing in Subsection (4)(a) may prohibit a parent from exercising the right to
             614      obtain a second medical opinion.
             615          [(3)] (5) If a child has been placed in the custody of the division and the parent or
             616      parents fail to comply substantially with the terms and conditions of a plan within six months


             617      after the date on which the child was placed or the plan was commenced, whichever occurs
             618      later, that failure to comply is evidence of failure of parental adjustment.
             619          [(4)] (6) The following circumstances constitute prima facie evidence of unfitness:
             620          (a) sexual abuse, injury, or death of a sibling of the child, or of any child, due to known
             621      or substantiated abuse or neglect by the parent or parents;
             622          (b) conviction of a crime, if the facts surrounding the crime are of such a nature as to
             623      indicate the unfitness of the parent to provide adequate care to the extent necessary for the
             624      child's physical, mental, or emotional health and development;
             625          (c) a single incident of life-threatening or gravely disabling injury to or disfigurement
             626      of the child; or
             627          (d) the parent has committed, aided, abetted, attempted, conspired, or solicited to
             628      commit murder or manslaughter of a child or child abuse homicide.
             629          Section 8. Section 78-14-5.5 is enacted to read:
             630          78-14-5.5. Limitation on actions against health care providers when parent or
             631      guardian refuses to consent to health care of child.
             632          (1) A malpractice action against a health care provider may not be brought on the basis
             633      of the consequences resulting from the refusal of a child's parent or guardian to consent to the
             634      child's health care, if:
             635          (a) the health care is recommended by the health care provider;
             636          (b) the parent or guardian is provided with sufficient information to make an informed
             637      decision regarding the recommendation of the health care provider; and
             638          (c) the consent of the parent or guardian is required by law before the health care may
             639      be administered.
             640          (2) The prohibition on bringing a malpractice action against a health care provider in
             641      Subsection (1) does not apply if the health care provider fails to comply with the requirements
             642      of Title 62A, Chapter 4a, Part 4, Child Abuse or Neglect Reporting Requirements.
             643          (3) The sole purpose of this section is to prohibit a malpractice action against a health
             644      care provider under the circumstances set forth by this section. This section may not be
             645      construed to:
             646          (a) create a new cause of action;
             647          (b) expand an existing cause of action;


             648          (c) impose a new duty on a health care provider; or
             649          (d) expand an existing duty on a health care provider.
             650          Section 9. Legislative intent.
             651          The Legislature recognizes that parents have a fundamental liberty interest in the care,
             652      custody, and management of their children, as protected by the 14th Amendment.




Legislative Review Note
    as of 11-27-04 2:27 PM


Based on a limited legal review, this legislation has not been determined to have a high
probability of being held unconstitutional.

Office of Legislative Research and General Counsel


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