California Assembly Bill 665 lowered the threshold for minors aged 12 and older to consent to outpatient mental health treatment on their own. Before the change took effect on July 1, 2024, most young people on Medi-Cal could only get confidential counseling if they were in crisis or were victims of abuse. Now a minor 12 or older only needs a treating provider to find them mature enough to participate meaningfully in care.
What the Law Changed
California Family Code Section 6924 used to require two things before a minor could consent to outpatient mental health treatment. The provider had to find the minor mature enough to participate, and the minor had to meet a separate, higher bar: they were at risk of serious harm to themselves or others, or they were an alleged victim of incest or child abuse.1California State Board of Behavioral Sciences. Bill Analysis – AB 665 That second condition effectively forced a young person to reach a crisis point before getting confidential help.
The gap it created was uneven. Minors on private insurance already had access under a different statute, Health and Safety Code Section 124260, which required only the maturity finding. Minors on Medi-Cal were routed through the stricter Family Code standard. AB 665 stripped the crisis condition out of Section 6924, so the two pathways now match.2California Legislative Information. California Family Code FAM 6924 Any qualifying minor 12 or older can consent to outpatient mental health treatment regardless of how their care is paid for.
Who Can Consent Now
Under the current version of Section 6924, a minor 12 or older may consent to outpatient mental health treatment or counseling, or to residential shelter services, if the attending provider finds them mature enough to participate intelligently in those services.2California Legislative Information. California Family Code FAM 6924 Nothing else is required. No showing of danger, no allegation of abuse.
The statute doesn’t define “mature enough to participate intelligently.” That is a clinical judgment left to the treating professional, who weighs whether the young person understands what the services involve, the potential risks, and the likely benefits. Two providers looking at the same minor could reasonably reach different conclusions.
Children under 12 cannot use this pathway. For them, a parent or guardian still has to consent.
What Services Are Covered
The consent authority reaches two categories. The first is outpatient mental health treatment or counseling delivered by a government agency, an agency under contract with the government, a community-funded agency, a runaway house or crisis resolution center, or an individual qualifying provider. The second is residential shelter services, meaning temporary or emergency housing in a facility that serves only minors, such as a licensed community care facility or crisis resolution center.2California Legislative Information. California Family Code FAM 6924
Three things are off the table. A minor cannot consent on their own to convulsive therapy, psychosurgery, or psychotropic medication. Those require a parent or guardian’s approval.3California Legislative Information. California Family Code FAM 6924 The medication exclusion is the one that affects everyday care most: a psychiatrist cannot prescribe to a minor on the minor’s consent alone. If medication becomes part of the plan, the parent has to be brought in for that decision, even if the minor started therapy independently.
Providers Who Can Treat Under This Pathway
AB 665 also aligned the definition of who counts as a treating professional. Family Code 6924 now points to Health and Safety Code 124260, which covers mental health professionals designated in state regulations, marriage and family therapists, licensed educational psychologists, credentialed school psychologists, clinical psychologists, and licensed professional clinical counselors.4California Legislative Information. Today’s Law As Amended – AB 665 Supervised trainees and associates in those fields can also provide services, with a requirement to notify their supervisor within 24 hours, and immediately if the minor appears to be a danger to themselves or others.5California Legislative Information. California Health and Safety Code HSC 124260
When Parents Are Involved
The law does not cut parents out by default. Section 6924 says treatment “shall include involvement of the minor’s parent or guardian” unless the treating professional, after consulting with the minor, decides that involvement would be inappropriate.2California Legislative Information. California Family Code FAM 6924 The statute doesn’t spell out what “inappropriate” means. In clinical practice, it can cover situations where a parent is the source of the minor’s distress, where safety could be at risk if the parent learned of treatment, or where notice would damage the therapeutic relationship.
Either way, the provider has to document the decision. The record must show whether and when the provider tried to contact the parent, whether that attempt succeeded, or the reason contact was thought inappropriate.2California Legislative Information. California Family Code FAM 6924 For residential shelter services, the provider must make “best efforts” to notify the parent or guardian regardless of the involvement decision.
Who Pays
A parent or guardian is not financially liable for outpatient mental health services provided under Section 6924 unless the parent actually participates in the treatment. Even then, liability is limited to the sessions in which the parent took part.2California Legislative Information. California Family Code FAM 6924 The same rule applies to residential shelter services. For Medi-Cal enrollees the state program covers the cost. For minors on a parent’s private plan, filing a claim can create its own disclosure problem, which is where the confidentiality rules come in.
Keeping Treatment Confidential From Insurance Notices
A right to consent doesn’t mean much if an insurance mailing reveals the visit. California Civil Code Section 56.107 and Insurance Code Section 791.29 require health plans to suppress Explanation of Benefits notices and similar communications that would disclose a minor’s confidential services to the plan subscriber. A minor can direct their insurer to send communications about sensitive services, including care under Section 6924, to the minor directly rather than to the subscribing parent.
For Medi-Cal managed care plans, the Department of Health Care Services issued guidance in late 2024 requiring plans and providers to prevent appointment notifications, benefit determinations, and other communications from being routed to a parent or guardian when confidentiality applies. Plans and providers cannot disclose information about minor consent services without the minor’s express permission.
Federal law adds another layer. Under HIPAA, a covered provider may decline to treat a parent as a minor’s personal representative if the provider reasonably believes the minor has been or could be subjected to abuse or neglect by that parent, or that treating the parent as a representative could endanger the minor.6U.S. Department of Health and Human Services. Personal Representatives and Minors When the provider makes that call, the parent loses access to the minor’s treatment records under federal privacy law.
Effective Date
AB 665 was signed on September 11, 2023, and took effect on January 1, 2024. The consent changes themselves became operative on July 1, 2024, giving state agencies, Medi-Cal managed care plans, and providers time to update their procedures.7LegiScan. Bill Text – CA AB665 2023-2024 Regular Session – Chaptered The old version of Section 6924, with the crisis condition intact, applied during the transition and was formally repealed on January 1, 2025.