The Network was recently contacted by the director of a state emergency pediatrics project for guidance on the legal and health concerns related to unaccompanied children in emergency situations. With some exceptions, under normal circumstances health care workers (HCWs) must obtain consent from parents or legal guardians in order to provide treatment to minors. However, in an emergency situation, minors may become separated from their parents or legal guardians, or health facilities may become overwhelmed and lack the resources to obtain proper consent.
The Network provided a number of resources to the requestor that help address the complexity of legal issues involved in providing emergency health care to minors.
- The American Academy of Pediatrics has issued a policy statement indicating that in disasters, health care workers may be able to treat minors without securing proper consent where “the minor’s life or health would be jeopardized by delay.” When it is not possible to secure timely informed consent for treating the minor, HWCs must provide stabilizing treatment and act in the patient’s best interest until consent is properly secured.
- The New York Department of Mental Health and Hygiene issued hospital guidelines asserting that children “require special attention and more resources since they must be accompanied by staff” and thus may “require special discharge procedures.” It further notes that “children eight years of age or younger who lack an accompanying caretaker, those with special needs, or those five years of age or younger in the presence of a care taker should not be considered stable solely on visual inspection. These children require more detailed histories and physical examinations for this determination.”
- The American Academy of Pediatrics Disaster Preparedness Advisory Council notes that HCWs caring for unaccompanied minors in disasters may be granted waivers related to confidentiality via the HIPAA Privacy Rules to facilitate reunification with caregivers. Emergency medical services and other agencies should prepare to have child-safe supplies and pre-established dosages “readily available to pediatric health care sites and other locations where children may congregate.”
- The Center for Pediatric Emergency Medicine and Emergency Medical Services for Children National Resource Center stress that unaccompanied children must be rapidly identified, and reported to the emergency operations center and the National Center for Missing and Exploited Children.
- The Federal Emergency Management Agency has created the Unaccompanied Minors Registry to which emergency personnel should report displaced children. Once reported, unaccompanied children should undergo a health and social screening and be tracked using an identification tag or band with a unique tracking number.