Project HOPE-VA Youth Summit
Older Youth Experiencing Homelessness
June 2013
Skip Steinhauser, Director of Division of Benefit Programs;
tom.steinhauser@dss.virginia.gov
Patricia Julianelle, NAEHCY Legal Director; pjulianelle@naehcy.org
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Minors’ access to health care
Brad is a high school junior. He recently moved
into a shelter after his parents kicked him out
of the house. He has no contact with his
parents, but it is not clear why they
abandoned him.
Brad gets bullied at school and needs some
mental health support. The swim team is his
life line. But in order to keep swimming, he
needs an updated physical and a Hepatitis B
vaccine.
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Brad
 Can Brad consent for a physical? Can his case
manager at the shelter?
 Strategies to help Brad access medical care?
 Strategies to help Brad access mental health
care?
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Can the coach consent to the physical?
Can Brad? What about mental health?

Generally, only persons age 18 and over can consent
to their own medical, dental, and health care;
minors need consent of a parent or guardian.

State law (54.1-2969) provides exceptions, including:
 Emergency treatment (with the consent of the minor if 14
or older)
 Outpatient mental health and substance abuse treatment
 Birth control, family planning and pregnancy related care
(not including abortion) and care of the youth’s child
 Care for infectious and sexually-transmitted diseases
 Married and emancipated youth can consent
 Any person standing “in loco parentis” can consent
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Medical and mental health consent (cont.)

Many states have general exceptions that apply to
unaccompanied youth
 Over a minimum age of 14 or 15 (AL, KS, OR, LA, SC)
 Youth living apart from their parents/guardians and
managing their own financial affairs (CA, CO, IN, ME,
MD, MA, MN, MO, MT, NV, NM, OK, TX, WY)
 Any homeless youth (AZ)
 Mature minor doctrine: any person of ordinary
intelligence and awareness sufficient to comprehend
the need for, nature of and risks involved in medical
care is competent to consent (ID, AR, courts)
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But what can we do in Virginia?
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Does Brad have a recent physical from a previous
school or health care provider?
Is the case manager in loco parentis?
Can we get a parent sign a health care power of
attorney?
Can we get phone consent from a parent?
Health care for the Homeless providers or other
specialty clinics
Advocacy from the case manager, liaison or other
adult
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Food security for unaccompanied youth

There is no age minimum for SNAP; No parent
signature is required; and SNAP cannot be denied
due to lack of address or photo ID.

SNAP eligibility is based on the “household”: people
who customarily purchase and prepare food
together.

Youth who purchase and prepare their own food are
their own household, if no one is exercising
“parental control”.
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Beware…
It’s important for youth and the people they are
staying with to talk about SNAP and how the youth’s
application could affect the household.
 What happens when parents keep the youth on the
parents’ application?
 What can youth do if they are denied benefits due to
an illegal reason, like age?

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Other food resources
 Free school meals: homeless students are
automatically eligible and guidance is
forthcoming
 Food banks: Will they set aside ready-to-eat
food items? Will they give food to minors?
 Soup kitchens: Are they youth-friendly?
 Weekend food boxes
 http://center.serve.org/nche/downloads/brie
fs/nutrition.pdf
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Social Security Survivor Benefits
Social Security Survivor benefits are based on a
parent’s contributions to Social Security if:
1. The parent is disabled or retired and entitled to
Social Security benefits, or
2. The parent died after having worked long
enough in a job where he or she paid Social
Security taxes
 Unmarried youth are eligible to age 18, and up to 19
if a full-time high school student
 Even if not living with guardian

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Can youth get SS Survivor Benefits in their own
name?

Yes! Prior to 18th birthday, direct payments can be
made to a youth if the youth is:
 Living alone and supporting himself or herself
 Capable of using the benefits to provide for his or her
current needs and no qualified payee is available
 Within 7 months of attaining age 18 and is initially filing an
application for benefits
 Other categories, as well
Benefits automatically transfer to youth on 18th
birthday
 NAEHCY Unaccompanied Youth Toolkit

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What about SSI?

Monthly cash payment to individuals with disabilities
and limited income. Automatic Medicaid eligibility.
 Parents’ or guardians’ income counts only if the youth lives with
his or her parents.

Youth 16-18 may sign their own applications, if they:
 are mentally competent
 have no court appointed representative, and
 are not in the care of another person or institution.

For youth under age 16, a court appointed
representative, person caring for the youth, or
manager of an institution where the youth is residing
may sign the application.
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Additional Resources
National Association for the Education of Homeless
Children and Youth
www.naehcy.org
www.naehcy.org/educational-resources/youth
 National Center for Homeless Education
www.serve.org/nche; 1-800-308-2145
 National Network for Youth
www.nn4youth.org
 National Runaway Safeline

www.1800runaway.org; 1-800-621-4000
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