Parental Consent via Telephone in California

[Alicia Claire]

In my experience any informed consent obtained over the telephone requires 2 medical professionals witnessing.

I am in California at an appointment only clinic doing vaccinations 

For 16 and 17 year old patients , what is the law for obtaining parental consent via telephone for a vaccination? Any information and links would be greatly appreciated!!

[CABGpatch_RN, BSN]

4 hours ago, MunoRN said:

The age of consent for general medical services in California is 15.

It is clearly stated at the State of CA vaccine info website that anyone under the age of 18 must have parental consent for the covid vaccine and that each minor must be accompanied by thier parent or legal guardian to the vaccine site OR have written consent from the parent/guardian upon presentation for vaccine.

[Alicia Claire]

I did find this information on the Vaccine scheduling website 

it clearly states that the form must be printed and signed by the legal guardian prior to appointment and must available by phone if any decisions are needed to be made

At no point does it say we can obtain consent via telephone 

https://vax.sccgov.org/

[Alicia Claire]

My question is actually if the minor arrives with no consent form signed : 

if we sign this by telephone consent do we need two medical professionals witnessing the verbal consent 

this is protocol in every situation in every state I’ve worked in 

[MunoRN, RN]

8 hours ago, CABGpatch_RN said:

It is clearly stated at the State of CA vaccine info website that anyone under the age of 18 must have parental consent for the covid vaccine and that each minor must be accompanied by thier parent or legal guardian to the vaccine site OR have written consent from the parent/guardian upon presentation for vaccine.

Does it say "anyone under the age of 18" or "minor"?  Everything I can find refers to a "minor" requiring a legal guardian.  "Minor" is defined as someone under the age of consent, which in the case of medical services is someone under 15.

[CABGpatch_RN, BSN]

2 hours ago, MunoRN said:

Does it say "anyone under the age of 18" or "minor"?  Everything I can find refers to a "minor" requiring a legal guardian.  "Minor" is defined as someone under the age of consent, which in the case of medical services is someone under 15.

It specifically states 16 and 17 yr olds.

[CABGpatch_RN, BSN]

7 hours ago, Alicia Claire said:

My question is actually if the minor arrives with no consent form signed : 

if we sign this by telephone consent do we need two medical professionals witnessing the verbal consent 

this is protocol in every situation in every state I’ve worked in 

I found the info that was eluding me last night!

"There is no requirement to obtain the patient’s signature on an “informed consent” form prior to administering the COVID-19 vaccine. Instead, health care providers must give the vaccine recipient a fact sheet for patients that is written by the vaccine manufacturer — see Pfizer’s Fact Sheet and Moderna’s Fact Sheet. "

Alicia, on the consent form you refer to at the sccvax site, there are QR codes at the bottom of the consent form.  These QR codes take the individual to the fact sheets mentioned in the above statement.

Also:

"The patient’s agreement to take the vaccine is implied by the fact that they voluntarily came to the vaccine administration site and submitted their arm for vaccination. This is called “implied consent.”" 

And:

"Related issues: Some providers have chosen to develop forms to use when vaccinating patients for COVID-19. For example, they may develop a simple form that does one or more of the following:

1. Asks the patient to sign to acknowledge receipt of the manufacturer’s fact sheet
2. Asks the patient to sign to evidence consent to be vaccinated.
3. Informs the vaccine recipient that the fact they were vaccinated will be reported to the county/state/federal governments
4. Informs the vaccine recipient that if they are pregnant/nursing they should consult their prenatal care provider prior to getting a vaccine
5. Asks for medical information about the recipient, such as allergies and recent positive COVID-19 tests

To be clear, use of such forms is not required by law. Some providers may obtain/provide the above information orally instead or choose to skip some of these steps entirely. (12/29)"

https://calhospital.org/faqs-vaccines-0/

So to answer your question, NO you do not need two hcp's to sign for a consent taken over the phone.  Any  signed consent isn't necessary period.  Only the acknowledgement of receiving the fact sheets is required (usually provided and acknowledged during the appt making process).  It may be the protocol in every state you have worked, but I think this apples to all states unless the state law takes precedent over federal law (and that is usually the case).

One of my daughters received her vax at the mass vax site I think you are talking about.  She forgot her ID (she's way over 18).  They still gave her the vaccine.  Some places, like small community centers and healthcare providers/hospitals are much more adherent to the rules they make, but again, these are their rules and apparently not required by law).  The retail stores have the fact sheets available in the appt making process and an attestation box to check stating the patient has received the forms.  Bottom line, signing a consent is not required.

Long winded, but it's interesting information.  A lot of things are different when the vax is under EUA.

[CABGpatch_RN, BSN]

Additionally, Gov Newsom put out an order on 1/27/21 protecting the licenses of the professionals who vaccinate as long as there is a declared state of emergency in CA.  Of course we never want to do anything that puts out license in jeopardy, but this is good.

Just an fyi.  ☺️

Newsom Order for RN's.pdf

[Kooky Korky, BSN, RN]

18 hours ago, Alicia Claire said:

I guess I’m being over cautious. I just feel a little uneasy with not hearing verbal consent before injecting a vaccine into a child’s body . 
Maybe I just needed some extra validation that this is legal LOL 

 

You are not being overly cautious.

Who does the Lead report to?  This is definitely an issue that should be clarified and put into writing.

The vax manufacturers can't be sued but I wonder if people who administer their products can be.

You could probably be sued for giving a bad shot (too low, too high on the arm).

If that comes up again, can you make another call to the involved adult and have a 2nd person listen in with you and you both sign as witnesses to the consent?

[MunoRN, RN]

3 hours ago, CABGpatch_RN said:

It specifically states 16 and 17 yr olds.

The only official guidance I can find is this: https://covid19.ca.gov/vaccines/

It says that "minors' must have a parent or guardian consent, but makes no mention of 16 and 17 year olds, which in terms of medical consent are not minors.

[Alicia Claire]

16 and 17 year olds are minors

[Alicia Claire]

There is an actual consent form separate from the form with QR codes

[CABGpatch_RN, BSN]

19 hours ago, MunoRN said:

The age of consent for general medical services in California is 15.

It's not that simple.  Note in regard to General Medical Care:

"“A minor may consent to the minor's medical care or dental care if all of the following conditions are satisfied: (1) The minor is 15 years of age or older. (2) The minor is living separate and apart from the minor's parents or guardian, whether with or without the consent of a parent or guardian and regardless of the duration of the separate residence. (3) The minor is managing the minor's own financial affairs, regardless of the source of the minor's income.” (Cal. Family Code § 6922(a).)"

I have some personal experience with these consent laws pertaining to minors.  Please read the attached document.

 

CA_Minor_Consent__Confidentiality_Laws (1).pdf