Wisconsin youth can't seek health care without parental consent. New legislative effort would change that.

A homeless Wisconsin youth needs a broken arm set. An abandoned Wisconsin youth needs mental health treatment. An estranged Wisconsin youth needs a chipped tooth fixed.

Can any of them receive treatment?

Under Wisconsin law, the answer is no — not without the consent of a parent, who may be incarcerated, deceased or permanently out of touch. Young people in Wisconsin do not have the right to their own health care unless they have written consent from a parent or legal guardian. Wisconsin is one of 15 states without any laws granting unaccompanied youths health care access.

Now, Senate Bill 704 and its companion, Assembly Bill 729, would allow unaccompanied minors to consent to and receive medical, dental and behavioral health care access without a parent or legal guardian's permission. The bills are guided by youth action boards across nearly every Wisconsin county, and were developed specifically to meet the needs of unaccompanied minors defined under federal law.

The unaccompanied minor must be at least 14 years old to consent to medical care and must not be under the supervision of a county department of human services or social services, a licensed child welfare agency, the state Department of Children and Families, or the state Department of Corrections.

Last year, USA TODAY NETWORK-Wisconsin drew widespread attention to the problem, telling the story of an unaccompanied minor who had to rely on her abusive father's signature to obtain any kind of medical assistance. Her story, and what more than 2,000 other unaccompanied Wisconsin youths are currently up against, has since been used in educational settings by Joli Guenther, the executive director of Wisconsin Association of Homeless and Runaway Services.

Here's what to know about the bills.

Why are these bills significant?

Wisconsin is one of the few states that still recognizes "defense of infancy," which descended from British common law and asserts that youth, in most cases, aren't subject to criminal prosecution. It also protects minors from signing up for credit cards or consenting to other kinds of paperwork — like health care.

Guenther met last year with youth action boards representing 69 of the 72 counties to learn about unaccompanied minors' needs. Resoundingly, young people talked about the importance of being able to access their own medical care.

"We're talking about very, very basic medical care," Guenther said, noting that young people in Wisconsin can access reproductive care and substance use disorder assessment, evaluation or treatment.

Beyond those exceptions, only in cases of life or death can young people access medical care without the consent of a legal guardian. But most people can attest that taking care of nonlife-threatening health concerns is a crucial element of basic needs.

It leaves every nonlife-threatening disease, injury or harmful circumstance up to chance.

Bronchitis, without treatment, can turn into pneumonia and thus become life-threatening, said state Rep. Jodi Emerson, D-Eau Claire, one of the Assembly bill authors. Vaccinations can help contain the spread of contagious diseases and also be lifesaving.

Related: Minors in Wisconsin need approval for physical, mental care. What if their parents refuse?

"Preventative care — treating things early — saves money and it saves lives," Emerson said. "That's one of the frustrating things about government sometimes. Why can we not deal with things before they become huge issues when they're smaller, when they're cheaper, when they're less harmful to that person and society as a whole?"

The bills are also significant because they reflect the lived experiences of young people.

Katie Polasky, 17, who sits on the Brown County Youth Advisory Board, wishes more people would listen to youth voices on issues that impact them. Polasky isn't unaccompanied — her mother was present during her interview with USA TODAY NETWORK-Wisconsin — but she was asked to be part of the youth advisory board because of her distinct lived experiences: She was born in Guatemala and spent time in a foster home before her adoption.

"The youth are the ones who are experiencing it themselves. I think in order for adults to make decisions, they need to have the input of the youth," Polasky said.

Who is considered an unaccompanied youth?

Federal law defines an unaccompanied minor as a "homeless youth not in the physical custody of a parent or guardian." But it also includes children living under the care of a family member who isn't technically their legal guardian.

Guenther said the bills cover a range of circumstances, including grandparents who are providing care to their grandchild. She's talked to many caregivers in this situation who are taking care of their grandchildren because the parents are dealing with a personal health crisis, such as alcoholism.

Emerson said family members becoming legal guardians can be a slow process, because courts are currently backed up.

"So even if mom and dad are OK with grandma watching, if that paperwork hasn't been signed, that child can't get any kind of health care unless it's life-threatening," Emerson said.

Under the bills, one of the following must confirm in writing that the minor in question is an unaccompanied youth:

• A local educational agency liaison for homeless children and youths designated under federal law.

• A school social worker or counselor.

• An employee who conducts intake at a shelter facility or transitional living program where the minor has been admitted as an unaccompanied youth under current law.

• The director, or his or her designee, of a governmental or nonprofit entity that receives public or private funding to provide services to individuals who are homeless or to unaccompanied youth.

Do SB 704 and AB 729 have bipartisan support?

Not yet.

These are bills that, theoretically, should have clear bipartisan support, Emerson said, but "hot-button political topics" such as gender-affirming care and immigration have already clouded the conversation, even though these bills focus on the health and wellness of a vulnerable youth population.

Guenther said the bills wouldn't affect the current standards of care already in place that prevent minors from getting gender-affirming surgeries.

Gender-affirming care also is not covered under Medicaid for minors and is not a service offered by free clinics in Wisconsin, which would limit unaccompanied minors from accessing these services, Guenther said.

"We are talking about youth who are indigent, who do not have fiscal resources to cover elective procedures and care," Guenther said. "This bill is about accessing existing care and standards of care."

Immigration presents its own set of issues, but it's not something Emerson is concerned about because "that's not the intention of the bill."

Emerson emphasized this is about removing barriers for unaccompanied minors to access existing medical care, which includes free clinics. It has nothing to do with creating new medical programming.

And if one undocumented, unaccompanied youth receives medical attention?

"If we're looking at the thousands of children who need medical help and somebody else from another country slips through and is taken care of? Gosh," Emerson said. "It's really about the permission to give consent to medical care, not about who is paying for it."

What other bills about unaccompanied minors should I know about?

In general, Wisconsin is an outlier in how it protects this vulnerable youth population from harm. Shared Hope International, an organization aimed at ending child and youth sex trafficking, gave Wisconsin an F, placing it among the worst states in its 2023 annual report card.

Drawing on the experiences of unaccompanied youths, several agencies including Wisconsin Association for Homeless and Runaway Services advocated for the passage of 2019 Wisconsin Act 22, which allows 17-year-olds to seek emergency shelter before turning 18. But despite being in a shelter, they still couldn't access medical care.

Further, Emerson has also presented bills that would grant stronger protections for youth runaways. Current Wisconsin law dictates that if youth runaways seek out a homeless shelter that accepts youths like House of Hope, they are unable to stay if the agency is unable to get the consent of a parent or guardian within 12 hours. That's a quarter of the time of federal legislation, which sets the window of consent to 72 hours.

Adding extra padding in the consent window could be crucial for a young person trying to get off the streets. According to the National Sexual Violence Resource Center, one in three youths risk being lured into exploitative sex within 48 hours of leaving home.

The bills died in committee.

Yet another inconsistency: Wisconsin law recognizes that children cannot legally consent to sex. And yet, they can be prosecuted for committing an act of prostitution. Further, Wisconsin is one of 20 states without "Safe Harbor" laws that prohibit arresting, detaining, charging and prosecuting children for prostitution even if they are the victims of trafficking, according to Shared Hope International.

"That conviction can follow them the rest of their lives," said Shannon Wienandt, executive director at House of Hope.

Rep. Joel Kitchens, R-Sturgeon Bay, introduced a bill last year that would prohibit criminalization of a minor for prostitution, but it's unlikely to be brought to the floor this session.

Although it's found strong bipartisan support, a previous version of the bill died in committee.

What's next for these bills?

Guenther plans to organize educational sessions in the spring to help better inform people and elevate the conversation. It's a need that Guenther said can be "very, very invisible."

"People can make assumptions that it's not there and it shouldn't be there. We assume our young people all have somebody that keeps them safe and, unfortunately, we know from the data that that's not the case," Guenther said.

For now, it doesn't appear any action will be made on these bills until next session, or next year, but for Emerson, this bill corrects gaps in a system that leaves young people vulnerable.

"The way I look at it, if we're going to take care of kids who are slipping through the cracks, let's take care of kids who are slipping through the cracks," Emerson said. "I'm not willing to say yes to this procedure but not this other procedure. We (politicians) need to stop pretending we are doctors."

Danielle DuClos of the Press-Gazette contributed to this report.

Natalie Eilbert covers mental health issues for USA TODAY NETWORK-Wisconsin. She welcomes story tips and feedback. You can reach her at neilbert@gannett.com or view her Twitter profile at @natalie_eilbert. If you or someone you know is dealing with suicidal thoughts, call the National Suicide Prevention Lifeline at 988 or text "Hopeline" to the National Crisis Text Line at 741-741.

This article originally appeared on Green Bay Press-Gazette: Wisconsin bills would give unaccompanied youths health care access