Client Rights: Minors, Admission to Inpatient Treatment

The information provided below relates to individuals under the age of 18 who are receiving services for developmental disability, mental health, and/or substance use. The rules are complex. The information provided below does not constitute legal advice. It is intended to be used as general guidance on these issues. For more information, review the following publication: Rights of Minors Receiving Services for Development Disability, Mental Health, and Substance Use, P-01844 (PDF).  

May a minor consent to inpatient treatment without parent/guardian authorization?

Developmental Disability

Under the age of 14 No Application for admission must be signed by a parent/guardian for minor to receive inpatient developmental disability treatment. Wis. Stat. § 51.13(1)(a).
14 years of age or over No Both the minor and the parent/guardian must consent to treatment. A minor cannot consent to inpatient treatment without parent/guardian authorization. Wis. Stat. §§ 51.13(1)(b), 51.13(6)(a)(2), and 51.61(6).

 

Mental Health

Under the age of 14 No Only the parent/guardian must agree in writing to a minor receiving inpatient mental health treatment. Wis. Stat. § 51.13(1)(a).
14 years of age or over No Parent/guardian AND the minor must agree in writing to the minor receiving inpatient mental health treatment. Wis. Stat. § 51.13(1)(b).

 

Substance Use

Under the age of 14 No Only the parent/guardian must agree in writing to a minor receiving inpatient alcoholism or drug abuse treatment. Wis. Stat. § 51.13(1)(a).
14 years of age or over No A minor cannot consent to inpatient treatment because the parent/guardian must complete the application for admission. Wis. Stat. § 51.13(1)(bm).

 

Alcohol and Drug Treatment without Parental Consent

Under the age of 12 No A minor cannot consent to treatment unless a parent/guardian cannot be found or there is no parent/guardian. Wis. Stat. § 51.47(1).
12 years of age or over Yes A minor can consent to treatment and any physician or licensed facility can provide limited services (preventative, diagnostic, assessment, evaluation, or treatment services for the abuse of alcohol or drugs) without obtaining the consent of or notifying the minor's parent/guardian. Wis. Stat. § 51.47(1).

 

The minor's parent/guardian's consent is required for:

  • Surgical procedures unless it is essential to save his or her life.
  • Administering any controlled substances unless it is for detoxification services.
  • Admission to an inpatient facility, unless it is to detoxification services.
  • Any admission for detox if it extends past 72 hours.

(Wis. Stat. § 51.47(2))

The physician or facility must obtain the minor's consent before billing a third party. If the minor does not consent, the minor is solely responsible for paying for the services. Wis. Stat. § 51.47(1).

What if the parent/guardian is unavailable or refuses to consent?

Under the age of 14 Yes The minor may petition the court to be admitted to inpatient treatment under Wis. Stat. chs. 48 or 938.
14 years of age or over Yes If a minor wishes to be admitted to an inpatient treatment facility, the minor, or the person action on the minor's behalf, may petition the court and the court may temporarily approve the admission pending a hearing of the petition, if such a hearing is required. Wis. Stat. § 51.13(4).

 

What authority and limitations do parents/guardians have over minors in treatment settings?

Role

This is the legal role of parents/guardians:

  • Ensure that basic needs (food, shelter, clothing, education) are provided by the facility.
  • Ensure that there is a treatment plan in place that is appropriate for the minor's needs.
  • Participate in the planning of the care and treatment of the minor.
  • Act and make decisions in the best interests of the child.

Consents

Parents/guardians are expected to provide consents to:

  • Psychotropic medications.
  • Behavior treatment programs, behavior support plans, and any nonemergency use of restrictive management techniques (such as time-out).
  • Experimental research and any drastic treatment.
  • Filming, taping, and some releases of treatment records.

Parents/guardians always have the right to provide input and to make requests of caregivers and treatment providers. However, the treatment team within the facility or program has the primary role to care for the minor.

Influence

Parents/guardians may influence decisions in the following areas:

  • Individual preferences of clothes, food, drink, etc.
  • Lifestyle choices and leisure activities (freedom of expression).
  • Friendships and associations with others (freedom of association).
  • Community and community involvement (freedom of movement).

In these areas, individual rights and autonomy are to be respected as much as possible. Service providers are to place the least possible restrictions on personal liberty and the exercising of personal rights while protecting a minor from exploitation or harm.

May a minor refuse treatment?

Yes; however, the minor will be admitted despite refusal, and discharge based on refusal is dependent on a number of factors. If the admission was made under an application completed by the minor's parent/guardian despite the minor's refusal, or if a hearing has been requested by the minor or by the minor's counsel, parent, or guardian, the court must order an independent evaluation of the minor and hold a hearing to review the admission within seven (7) days, after admission or application for admission, whichever is sooner, and must appoint counsel to represent the minor if the minor is not represented. If the court considers it necessary, the court must also appoint a guardian ad litem to represent the minor. The minor must be informed about how to contact the state protection and advocacy agency, Disability Rights Wisconsin. Wis. Stat. § 51.13(4)

What if the minor is under the age of 14?
The minor may refuse, but will be admitted because the parent/guardian has authority to apply for admission of the minor for treatment for mental illness, developmental disability, alcoholism, or drug abuse. However, any statement or conduct by a minor indicating that the minor does not agree to admission to the facility must be noted on the front page of the application for admission. Wis. Stat. § 51.13(1)(a).

What if the minor is 14 or older?
It depends on the type of services. See below. 

  • Developmental Disability—Yes, because the minor and the parent/guardian must consent to admission. However, the minor can be admitted with parent/guardian consent as long as any statement or conduct by the minor indicating that the minor does not agree to admission to the facility is noted on the front page of the application and in the petition filed. Wis. Stat. §§ 51.13(1)(b), (c), and (bm).   
  • Mental Health—Yes, a minor may refuse treatment for mental health because the minor and the parent/guardian must consent to admission. However, the minor can be admitted with parent/guardian consent as long as any statement or conduct by the minor indicating that the minor does not agree to admission to the facility is noted on the front page of the application and in the petition filed.  Wis. Stat. §§ 51.13(1)(b), (c), and (bm) .
  • Substance Use: No. For inpatient treatment, the minor’s parent/guardian must complete the application for admission and provide consent for treatment.  Wis. Stat. § 51.13(1)(bm) Consent of the minor is not required. Wis. Stat. §  51.48. However, any statement or conduct by a minor who is the subject of an application for inpatient admission indicating that the minor does not agree to admission to the facility must be noted on the front page of the application and in the petition filed.  Wis. Stat. § 51.13(1)(bm).

Can a minor who is 14 or older refuse an assessment? 
No. If assessment is determined to be a less restrictive means of assisting the minor, a minor's parent/guardian may consent to have the minor tested for the presence of alcohol or other drugs in the minor's body or to have the minor assessed by an approved treatment facility for the minor's abuse of alcohol or other drugs according to the criteria described in Wis. Stat. § 938.547(4), namely, an intake worker must determine whether or not a juvenile is in need of an alcohol or other drug abuse assessment. This treatment may consist of outpatient treatment, day treatment or, if the minor is admitted in accordance with Wis. Stat. § 51.13, inpatient treatment. The parent/guardian of the minor may consent to the treatment recommended. Consent of the minor for testing, assessment, or treatment is not required. Wis. Stat. § 51.48.  

What does admission have to be based on?

  • An informed professional opinion that the minor is in need of services for developmental disability, mental health, and/or substance use. 
  • The treatment facility must offer inpatient therapy or treatment that is appropriate for the minor’s needs and that inpatient care in the facility is the least restrictive therapy or treatment consistent with the minor’s needs. Wis. Stat. § 51.13(1)(em).
  • In the case of substance use, approval must also be based on the results of an alcohol or other drug abuse assessment that conforms to criteria described in Wis. Stat. § 938.547(4)

What should happen upon admission?

Prior to admission or as soon thereafter as possible, a self-admitted minor and parent/guardian must be informed, orally and in writing, of:

  • The minor’s right to request discharge 
  • To be discharged within 48 hours (unless a petition is filed)
  • The minor’s right to consent to or refuse treatment

On admission all minors and their parent/guardian must be informed, orally and in writing, of their client rights. Wis. Stat. § 51.61(1)(a).

In addition, writing materials for use in requesting a hearing or discharge must be available at all times. Staff must assist minors in preparing and submitting any request for discharge or hearing. Wis. Stat. § 51.13(3)(e).

If possible, prior to admission, or as soon after as possible, the minor and the minor's parent/guardian must be informed by facility staff, both orally and in writing, in easily understandable language, of the petition and review procedure, including court standards and possible court decisions. Wis. Stat. § 51.13(3)(am)

The parent/guardian also must be informed of the following. 

  • The minor’s right to an independent evaluation, if ordered by the court. 
  • The minor’s right to be informed about how to contact the state protection and advocacy agency (Disability Rights Wisconsin). 
  • The minor’s right to a hearing upon request; the right to appointed counsel if a hearing is held.
  • The minor’s right to request a discharge under some circumstances. Wis. Stat. § 51.13(3)(am)
  • The minor’s right to a hearing to determine continued appropriateness of the admission, under some circumstances. Wis. Stat. § 51.13(3).
  • The minor’s right under some circumstances to be discharged within 48 hours of the request, if nothing is filed for emergency detention, emergency commitment, involuntary commitment, or protective placement. Wis. Stat. § 51.13(3)(b) and Wis. Stat. § 51.13(7)(b).
  • The minor’s right (if admitted when parent/guardian could not be found or refused to consent to admission) to consent or to refuse treatment. Wis. Stat. § 51.13(3)(b).

What is a petition for treatment?

A petition for admission to inpatient treatment is a document that can be filed with a court in order to have a judge review the admission of a minor for treatment services. Wis. Stat. § 51.13(4).

A petition for admission to inpatient treatment should be filed with the local circuit court when: 

  • The minor is 14 years of age or older and refuses to sign the application.
  • The minor wants treatment and the minor's parent/guardian refuses to sign the application.
  • There is no parent/guardian.
  • The parent/guardian cannot be found.

A copy of the petition must be provided by the petitioner to the minor and, if available, his or her parent/guardian within five (5) days after admission. Wis. Stat. § 51.13(4).

What are the criteria for approving admission?
Within five (5) days after the filing of the petition, the court must be decide whether there is enough evidence that:

  • The minor is in need of services for developmental disability, mental health, or substance use. 
  • The treatment facility offers inpatient therapy or treatment that is appropriate to the minor's needs. 
  • The inpatient care in the treatment facility is the least restrictive therapy or treatment consistent with the needs of the minor. 
  • If the minor 14 years of age or older has been admitted to the treatment facility for the primary purpose of treatment for mental illness or developmental disability, that the admission was made under an application completed by the minor and the minor's parent/guardian. Wis. Stat. § 51.13(4)(d).

If such a showing is made, the court must permit admission. Wis. Stat. § 51.13(4)(g).  

When must a hearing be held?
A court hearing is mandatory (not optional) if:

  • The petition notes that the minor is unwilling to be admitted.
  • The minor is 14 or over and the parent/guardian admitted the minor over the minor’s refusal.
  • A request for a hearing was made by the minor, the minor’s counsel, parent/guardian.

What is required in the hearing?

  • Any mandatory hearings should be held within seven (7) working days after admission or application for admission, whichever is sooner. 
  • Counsel must be appointed if the minor is unrepresented. 
  • The court may also, if it deems necessary, appoint a Guardian ad Litem.
  • The minor must be informed of how to contact Disability Rights Wisconsin.

Wis. Stat. § 51.13(4)(d)

More information about petitions and hearings regarding inpatient admissions of minors can be found in the Rights of Minors Receiving Services for Developmental Disability, Mental Health, and Substance Use, P-01844 (PDF).

What does it mean if my child is admitted via petition?
Approval of an admission under this subsection does not constitute a finding of mental illness, developmental disability, or substance use.  Wis. Stat. § 51.13(4)

Can the decision be appealed?
Any person who is aggrieved by a decision or order under this section and who is directly affected by it may appeal to the Court of Appeals under Wis. Stat. § 809.30. Wis. Stat. § 51.13(5) 

Are there special rules for short-term admissions?

Yes. A minor may be admitted to an inpatient treatment facility without petition and review, for diagnosis and evaluation or for dental, medical, or psychiatric services, for up to 12 days. 

  • The application for short-term admission of a minor must be signed by the minor's parent/guardian, unless the minor lacks a parent/guardian. 
  • The application must be reviewed by the treatment director of the facility or, in the case of a state center for the developmentally disabled, by the director, and must be accepted only if the director determines that the admission constitutes the least restrictive means of obtaining adequate diagnosis and evaluation of the minor or adequate provision of medical, dental, or psychiatric services. 
  • At the end of the 12-day period, the minor must be released unless an application has been filed for admission; a statement has been filed for emergency detention; or a petition has been filed for emergency commitment, involuntary commitment, or protective placement. 

​Wis. Stat. § 51.13(6).  

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Last Revised: May 16, 2019