An Act To Ensure Children in the Care of Caretaker Relatives Can Access Fundamental Services
Maine Legislature, Session 127, LD 1518
Committee Amendment CA_A_H627 (House)
Amends: 22 MRSA §1501, 22 MRSA §1503-A, 22 MRSA §1504, 22 MRSA §1507

COMMITTEE AMENDMENT" It" to H.P. 1043, L.D. 1518, Bill, "An Act To 
Ensure Children in the Care of Caretaker Relatives Can Access Fundamental Services" 
Amend the bill by striking out the title and substituting the following: 
'An Act To Ensure Children in the Care of Caretaker Relatives and Other 
Surrogates Can Access Health Care' 
Amend the bill by striking out everything after the enacting clause and before the 
summary and inserting the following: 
'Sec. 1. 22 MRSA §1501, sub-§§1-A and 4 are enacted to read: 
1-A. Health care. "Health care" means any care, treatment, service or procedure to 
maintain, diagnose or otherwise affect an individual's physical or mental condition. 
4. Surrogate. "Surrogate" means: 
A. An adult who is not a parent or legal guardian but who is related to a minor by 
blood, marriage or adoption and with whom the minor resides and from whom the 
minor receives the ongoing care and support expected of a parent. "Surrogate" does 
not include a person to whom a parent has delegated parental authority to consent to 
the minor's medical treatment through a power of attorney or other written 
instrument; or 
B. If an adult relative described in paragraph A does not exist, an adult to whom a 
parent or legal guardian has not delegated parental authority through a power of 
attorney or other written instrument with whom the minor resides and from whom the 
minor receives the ongoing care and support expected of a parent. 
Sec. 2. 22 MRSA §1503-A is enacted to read: 
§1503-A. Authority for consent by a surrogate 
1. Consent by a surrogate; notice of need for health care. A surrogate mav i:rive 
consent for health care for a minor except that a surrogate may not withhold or withdraw 
life-sustaining treatment or deny surgery, procedures or other interventions that are life-
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A" to H.P. 1043, L.D. 1518 
saving and medically necessary. The existence of a surrogate does not affect the ability 
of a minor to give consent as otherwise provided by law. Before the surrogate may give 
consent, the surrogate must make a reasonable good faith attempt to inform the minor's 
parents or legal guardian of the minor's need for health care and the parents' right to make 
those decisions. If parental notification is not required by other provisions of law, the 
surrogate is not required to inform or attempt to inform the minor's parents or legal 
guardian. 
2. Notice of health care received. Unless parental notification is not required by 
other provisions of law, a surrogate giving consent pursuant to subsection 1 shall make a 
reasonable good faith attempt to inform the minor's parents or legal guardian of the health 
care that the minor received. A health care practitioner or health care provider who 
provides health care pursuant to this section shall inform the minor's surrogate of this 
obligation. The sending of correspondence by regular mail, e-mail, texting, posting to a 
personal website or other written means of communication to the last known address or 
contacting by telephone using the last known telephone number of the minor's parents or 
legal guardian. whichever means the surrogate believes to be the most effective way to 
ensure actual notification, is deemed a reasonable good faith attempt to provide notice for 
purposes of this subsection. 
3. Penalties. The following penalties apply to violations of this section. 
A. A surrogate who makes decisions for a minor knowing that the decisions are 
prohibited by subsection 1 commits a Class E crime. 
B. A person who knowingly acts as a surrogate for a minor without meeting the 
definition of "surrogate" in section 1501, subsection 4 commits a Class E crime. 
C. A surrogate who fails to attempt to give notice as required in subsection 1 or 2 
commits a Class E crime. 
Sec. 3. 22 MRSA §1504, as enacted by PL 1995, c. 694, Pt. C, §8 and affected by 
Pt. E, §2, is repealed and the following enacted in its place: 
§1504. Good faith reliance on consent 
1. Reliance on minor's consent. A health care practitioner or health care provider 
who takes reasonable steps to ascertain that a minor is authorized to consent to health 
care as authorized in section 1503 and who subsequently renders health care in reliance 
on that consent is not liable for failing to have secured consent of the minor's parents or 
legal guardian prior to providing health care to the minor. 
2. Reliance on surrogate's consent. 
Recovery is not allowed against any health 
care practitioner or health care provider upon the grounds that the health care was 
rendered without informed consent if consent is given by the minor's surrogate pursuant 
to section 1503-A and the health care practitioner or provider acts with good faith 
reliance on that consent. 
Sec. 4. 22 MRSA §1507, as enacted by PL 1999, c. 90, §1, is amended to read: 
COMMITTEE AMENDMENT 
{(Cf) 
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COMMITTEE AMENDMENT .. [f.,, to H.P. 1043, L.D. 1518 
§1507. Consent for sexual assault forensic examination 
Notwithstanding the limitations set forth in section 1503 or the existence of a 
surrogate described in section 1503-A, a minor may consent to health services associated 
with a sexual assault forensic examination to collect evidence after an alleged sexual 
assault.' 
SUMMARY 
This amendment replaces the bill. Unlike the bill, which authorizes a "caretaker 
relative" to make medical and educational decisions for a minor, this amendment 
addresses only the issues related to health care for minors. 
This amendment makes changes to the laws governing minors' authority to consent to 
health care by identifying situations in which adults who voluntarily and without specific 
legal authority through a power of attorney or appointment as a legal guardian provide 
care that a parent normally would. This amendment recognizes that when parents are 
temporarily absent from a minor's life, certain adults with whom a minor resides may 
assume a surrogate role. As defined in the amendment, a surrogate may not be a parent, 
legal guardian or an adult to whom a parent has given a power of attorney authorizing 
health care treatment for the minor. Surrogates may include an adult related to a minor 
by blood, marriage or adoption and from whom the minor receives the ongoing care and 
support expected of a parent. If no such relatives exist, an adult with whom the minor 
resides and who has provided the minor with the ongoing care and support expected of a 
parent may act as a surrogate. The existence of a surrogate does not remove the ability of 
a minor to give consent under any other existing law. 
If a minor needs health care, a surrogate must make a good faith attempt to notify the 
minor's parents or legal guardian of their right to make those decisions unless parental 
notification is not required by other provisions of law. Absent a response, the surrogate 
may make most health care decisions on behalf of the minor without parental consent. A 
surrogate may not make decisions withholding or withdrawing life-sustaining treatments 
or denying consent for treatments that are life-saving and medically necessary. 
A 
surrogate giving consent on behalf of the minor must attempt to make a good faith effort 
to notify the absent parents or legal guardian of any health care received by the minor 
unless parental notification is not required by other provisions of law. 
Health care practitioners and providers may rely on the consent given by the 
surrogate. If they do so, they are immune from liability for providing treatment without 
receiving informed consent from the parents or legal guardian. Health care practitioners 
and providers must inform the surrogate of the surrogate's obligation to notify the minor's 
parents or legal guardian about the minor's treatment. 
This amendment allows the surrogate to use the means of communication the 
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surrogate believes is the most effective way to ensure actual notification of the parents or 
legal guardian. The means of communication may be regular mail, e-mail, texting, 
personal website posting or other written means of communication to the last known 
address or contacting by telephone using the last known telephone number of the absent 
parents or legal guardian. 
COMMITTEE AMENDMENT 
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COMMITTEE AMENDMENT "A "to H.P. 1043, L.D. 1518 
This amendment provides that a surrogate who makes health care decisions for the 
minor knowing that those specific decisions may not be made by the surrogate or without 
attempting to contact the parents or legal guardian about the need for the health care or 
the health care received commits a Class E crime. A person who makes health care 
decisions for a minor when not qualified as a surrogate is guilty of a Class E crime. 
This amendment provides that, as long as the health care practitioner or provider acts 
with good faith reliance on the consent of the surrogate, there is no liability against the 
health care practitioner or provider on the grounds that the health care treatment was 
rendered without informed consent. 
This amendment clarifies that a minor may consent to health services associated with 
a sexual assault forensic examination to collect evidence after an alleged sexual assault 
regardless of whether a surrogate exists. 
FmcALl'COTE Rl',QIJIIID 
... ........, 
COMMITTEE AMENDMENT 
Approved: 03/17/16 ~c. 
LD 1518 
LR 2355(02) 
An Act To Ensure Children in the Care of Caretaker Relatives Can Access Fundamental Servi~ 
Fiscal Note for Bill as Amended by Committee Amendment ·~· {fl- bd. '1) 
Committee: Judiciary 
Fiscal Note Required: Yes 
Fiscal Note 
Minor cost increase - General Fund 
Minor revenue increase - General Fund 
Correctional and Judicial Impact Statements 
Establishes new Class E crimes. 
The collection of additional fines may also increase General Fund revenue by minor amounts. 
LR2355(02) - Fiscal Note - Page 1 of 1