SB 274

As Introduced
136th General Assembly
   Regular Session  S. B. No. 274
       2025-2026
  Senators Cirino, Brenner
  To amend sections 2151.461, 3129.03, 3313.473,  1
  3798.07, and 3798.12 and to repeal section  2
  5122.04 of the Revised Code to prohibit the  3
  provision of mental health services to minors  4
  without parental consent.  5
 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF OHIO:
     Section 1. That sections 2151.461, 3129.03, 3313.473,  6
3798.07, and 3798.12 of the Revised Code be amended to read as  7
follows:  8
     Sec. 2151.461. (A) If a child is under the care and  9
supervision of a residential facility and presents to an  10
emergency department or is admitted to a hospital for an injury        11
or mental health crisis, the emergency department or hospital  12
shall do both of the following:  13
     (1) Communicate with the public children services agency  14
or private child placing agency with custody of the child about        15
the visit. Except for care that a child has consented to under  16
section 2108.31, 2151.85, 2907.29, 3701.242, 3709.241, 3719.012,       17
or 5120.172, or 5122.04 of the Revised Code, the emergency  18
department or hospital shall discuss the child's medical  19
treatment with and request authorization of care from the  20
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As Introduced
agency.  21
       (2) Notify the agency of the discharge of the child from  22
the emergency department or hospital.  23
       (B) A public children services agency or private child  24
placing agency with custody of a child who is under the care and  25
supervision of a residential facility and presents to an  26
emergency department or is admitted to a hospital for an injury  27
or mental health crisis shall respond to the emergency  28
department or hospital's communication regarding medical care  29
for the child not later than four hours after initial contact.  30
       Sec. 3129.03. (A) Notwithstanding section 5122.04 of the  31
Revised Code, no No mental health professional shall diagnose or  32
treat a minor individual who presents for the diagnosis or  33
treatment of a gender-related condition without first obtaining  34
the consent of one of the following:  35
       (1) At least one parent of the minor individual;  36
       (2) At least one legal custodian of the minor individual;  37
       (3) The minor individual's guardian.  38
       (B) No mental health professional shall diagnose or treat  39
a minor individual who presents for the diagnosis or treatment  40
of a gender-related condition without screening the minor  41
individual for both of the following during the course of  42
diagnosis and treatment:  43
       (1) Other comorbidities that may be influencing the minor  44
individual's gender-related condition, including depression,  45
anxiety, attention deficit hyperactivity disorder, autism  46
spectrum disorder, and other mental health conditions;  47
       (2) Physical, sexual, mental, and emotional abuse and  48
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As Introduced
other traumas.  49
       Sec. 3313.473. (A) The general assembly maintains that a  50
parent has a fundamental right to make decisions concerning the  51
upbringing, education, and care of the parent's child.  52
       (B) Not later than the first day of July following the  53
effective date of this sectionApril 9, 2025, the board of  54
education of each city, local, exempted village, and joint  55
vocational school district shall develop and adopt a policy to  56
promote parental involvement in the public school system. The  57
policy shall require a school district to do all of the  58
following:  59
       (1)(a) Ensure that any sexuality content is age-  60
appropriate and developmentally appropriate for the age of the  61
student receiving the instruction, regardless of the age or  62
grade level of the student.  63
       (b) Prior to providing instruction that includes sexuality  64
content or permitting a third party to provide such instruction  65
on behalf of the district, provide parents the opportunity to  66
review any instructional material that includes sexuality  67
content. Upon request of the student's parent, a student shall  68
be excused from instruction that includes sexuality content and  69
be permitted to participate in an alternative assignment.  70
       (2) Promptly notify a student's parent of any substantial  71
change in the student's services, including counseling services,  72
or monitoring related to the student's mental, emotional, or  73
physical health or well-being or the school's ability to provide  74
a safe and supportive learning environment for the student. The  75
policy shall specify in what manner a student's parent will be  76
notified of any substantial change in the student's services.  77
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       The policy shall specify that notice to parents shall  78
reinforce the fundamental right of parents to make decisions  79
regarding the upbringing and control of their children, and that  80
the school district shall not inhibit parental access to the  81
student's education and health records maintained by the school.  82
       (3) Prohibit school district personnel from directly or  83
indirectly encouraging a student to withhold from a parent  84
information concerning the student's mental, emotional, or  85
physical health or well-being, or a change in related services  86
or monitoring.  87
       The policy shall prohibit school district personnel from  88
discouraging or prohibiting parental notification of and  89
involvement in decisions affecting a student's mental,  90
emotional, or physical health or well-being.  91
       (4) Adopt a procedure to obtain authorization from parents  92
prior to providing any type of health care service to the  93
student, including physical, mental, and behavioral health care  94
services. Under the procedure, a parent may choose whether to  95
authorize a district to provide a health care service to the  96
parent's child. The procedure shall require the school district  97
to do both of the following:  98
       (a) At the beginning of the school year, notify parents of  99
each health care service offered at, or facilitated in  100
cooperation with, their student's school and their option to  101
withhold consent or decline any specified service. Parental  102
consent to health care services does not waive the parent's  103
right to access the parent's student's educational or health  104
records or to be notified about a change in the student's  105
services or monitoring as provided in this section.  106
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       (b) Prior to providing a health care service to a student,  107
notify a parent whether the service is required to be provided  108
by the school district under state law and if other options for  109
a student to access the service exist. This requirement may be  110
satisfied by an annual notice to parents at the beginning of the  111
school year.  112
       Division (B)(4) of this section does not apply to  113
emergency situations, first aid, other unanticipated minor  114
health care services, or health care services provided pursuant  115
to a student's IEP or a school district's obligation under  116
section 504 of the "Rehabilitation Act of 1973," 29 U.S.C. 794.  117
       (5) Permit a parent to file with a school principal or  118
assistant principal a written concern regarding a topic  119
addressed in this section. The policy shall establish a process  120
for a principal or assistant principal to resolve such concerns  121
within thirty days after their receipt. Under the policy, school  122
districts shall notify parents of their right to file a written  123
concern. A parent may appeal a principal's or assistant  124
principal's decision to the superintendent of that district.  125
       If a parent appeals the principal's or assistant  126
principal's decision, the superintendent, or a designee of the  127
superintendent, shall conduct a hearing on the decision. Based  128
on the findings of that hearing, the superintendent shall decide  129
whether to affirm the principal's or assistant principal's  130
decision. If the superintendent does not affirm the decision,  131
the superintendent shall determine a resolution to the parent's  132
concern. A parent may appeal the superintendent's decision to  133
the board of education of the school district. The board shall  134
review the superintendent's decision and, if the board  135
determines it necessary, hold a hearing on the decision and,  136
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based on that hearing, either affirm the superintendent's  137
decision or determine a new resolution to the parent's concern.  138
        Nothing in division (B)(5) of this section shall prevent a  139
parent from contacting a member of a board of education  140
regarding the parent's concerns with the operation of a school  141
under the supervision of that board.  142
        (C) Each school district shall make its policy adopted  143
under this section publicly available and post it prominently on  144
its publicly accessible web site, if it has one.  145
        (D) This section does not prescribe all rights of parents  146
or preempt or foreclose claims or remedies in support of  147
parental rights that are available under the constitution,  148
statutes, or common law of this state.  149
        (E) No school district or third party acting on behalf of  150
a district shall provide instruction that includes sexuality  151
content to students in grades kindergarten through three.  152
        (F)(1) Nothing in this section shall require disclosure or  153
activity that is in conflict with or in violation of any of the  154
following:  155
        (a) The HIPAA privacy rule;  156
        (b) Chapter 3798. of the Revised Code;  157
        (c) Section 2317.02, or 4732.19, or 5122.04 of the Revised  158
Code;  159
        (d) The "Family Educational Rights and Privacy Act of  160
1974," 20 U.S.C. 1232g;  161
        (e) Ohio Constitution, Article I, Section 10a and any laws  162
enacted to implement that section, including sections 2930.07  163
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As Introduced
and 2930.10 of the Revised Code.  164
       (2) Nothing in this section requires disclosure or  165
activity in violation of any court order, including any of the  166
following:  167
       (a) A condition of bond;  168
       (b) A protection order or consent agreement issued  169
pursuant to section 2151.34, 2903.213, 2903.214, 2919.26, or  170
3113.31 of the Revised Code;  171
       (c) A condition of a community control sanction, post-  172
release control sanction, or parole.  173
       (3) Nothing in this section requires disclosure or  174
activity in violation of a specific request for nondisclosure  175
made pursuant to a criminal investigation or grand jury subpoena  176
in which the student is the victim and a parent is the alleged  177
perpetrator.  178
       (4) Nothing in this section prohibits or prevents  179
mandatory reporting under section 2151.421 of the Revised Code.  180
       (5) Nothing in this section prohibits or limits the career  181
and academic mentoring and counseling between teachers and  182
students in the regular course of the school day.  183
       (G) As used in this section:  184
       (1) "Biological sex" means the biological indication of  185
male and female, including sex chromosomes, naturally occurring  186
sex hormones, gonads, and unambiguous internal and external  187
genitalia present at birth, without regard to an individual's  188
psychological, chosen, or subjective experience of gender.  189
       (2) "HIPAA privacy rule" has the same meaning as in  190
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As Introduced
section 3798.01 of the Revised Code.  191
        (3) "IEP" has the same meaning as in section 3323.01 of  192
the Revised Code.  193
        (4) "Parent" has the same meaning as in section 3313.98 of  194
the Revised Code.  195
        (5) "Sexuality content" means any oral or written  196
instruction, presentation, image, or description of sexual  197
concepts or gender ideology provided in a classroom setting.  198
        "Sexuality content" does not mean any of the following:  199
        (a) Instruction or presentations in sexually transmitted  200
infection education, child sexual abuse prevention, and sexual  201
violence prevention education provided under division (A)(5) of  202
section 3313.60 or section 3314.0310 or 3326.091 of the Revised  203
Code;  204
        (b) Instruction or presentations in sexually transmitted  205
infection education emphasizing abstinence provided under  206
section 3313.6011 of the Revised Code;  207
        (c) Incidental references to sexual concepts or gender  208
ideology occurring outside of formal instruction or  209
presentations on such topics, including references made during  210
class participation and in schoolwork.  211
        (6) "Student's mental, emotional, or physical health or  212
well-being" includes, at a minimum, any of the following:  213
        (a) A student's academic performance;  214
        (b) Any significant sickness or physical injury, or any  215
psychological trauma suffered by a student;  216
        (c) Any harassment, intimidation, or bullying, as defined  217
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As Introduced
in section 3313.666 of the Revised Code, by or against a student  218
in violation of school district policy;  219
       (d) Any request by a student to identify as a gender that  220
does not align with the student's biological sex;  221
       (e) Exhibition of suicidal ideation or persistent symptoms  222
of depression, or severe anxiety, or other mental health issues.  223
       (7) "Age-appropriate" and "developmentally appropriate"  224
content refers to activities or items that are generally  225
accepted as suitable for children of the same chronological age  226
or level of maturity or that are determined to be  227
developmentally appropriate for a child, based on the  228
development of cognitive, emotional, physical, and behavioral  229
capacities that are typical for an age or age group.  230
       Sec. 3798.07. (A) A covered entity shall be subject to the  231
following conditions when it discloses protected health  232
information to a health information exchange:  233
       (1) The covered entity shall restrict disclosure  234
consistent with all applicable federal laws governing the  235
disclosure.  236
       (2) If the protected health information concerns a minor,  237
the covered entity shall restrict disclosure in a manner that  238
complies with laws of this state pertaining to the circumstances  239
under which a minor may consent to the minor's own receipt of  240
health care or make medical decisions on the minor's own behalf,  241
including sections 2907.29, 3709.241, 3719.012, 5120.172,  242
5122.04, and 5126.043 of the Revised Code unless the minor  243
authorizes the disclosure.  244
       (3) The covered entity shall restrict disclosure in a  245
manner that is consistent with a written request from the  246
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individual or the individual's personal representative to  247
restrict disclosure of all of the individual's protected health  248
information.  249
       (B) The conditions in division (A) of this section on a  250
covered entity's disclosure of protected health information to a  251
health information exchange do not render unenforceable or  252
restrict in any manner any of the following:  253
       (1) A provision of the Revised Code that on September 10,  254
2012, requires a person or governmental entity to disclose  255
protected health information to a state agency, political  256
subdivision, or other governmental entity;  257
       (2) The confidential status of proceedings and records  258
within the scope of a peer review committee of a health care  259
entity as described in section 2305.252 of the Revised Code;  260
       (3) The confidential status of quality assurance program  261
activities and quality assurance records as described in section  262
5122.32 of the Revised Code;  263
       (4) The testimonial privilege established by division (B)  264
of section 2317.02 of the Revised Code;  265
       (5) Any of the following items that govern the  266
confidentiality, privacy, security, or privileged status of  267
protected health information in the possession or custody of an  268
agency as defined in section 111.15 of the Revised Code; govern  269
the process for obtaining from a patient consent to the  270
provision of health care or consent for participation in medical  271
or other scientific research; govern the process for determining  272
whether an adult has a physical or mental impairment or an  273
adult's capacity to make health care decisions for purposes of  274
Chapter 5126. of the Revised Code; or govern the process for  275
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determining whether a minor has been emancipated:  276
        (a) A section of the Revised Code that is not in this  277
chapter;  278
        (b) A rule as defined in section 119.01 of the Revised  279
Code;  280
        (c) An internal management rule as defined in section  281
111.15 of the Revised Code;  282
        (d) Guidance issued by an agency as defined in section  283
111.15 of the Revised Code;  284
        (e) Orders or regulations of a board of health of a city  285
health district made under section 3709.20 of the Revised Code;  286
        (f) Orders or regulations of a board of health of a  287
general health district made under section 3709.21 of the  288
Revised Code;  289
        (g) An ordinance or resolution adopted by a political  290
subdivision;  291
        (h) A professional code of ethics;  292
        (i) When a minor is authorized to consent to the minor's  293
own receipt of health care or make medical decisions on the  294
minor's own behalf, including the circumstances described in  295
sections 2907.29, 3709.241, 3719.012, 5120.172, 5122.04, and  296
5126.043 of the Revised Code.  297
        Sec. 3798.12. As used in this section, "agency" has the  298
same meaning as in section 111.15 of the Revised Code.  299
        (A) Except as provided in division (B) of this section,  300
any of the following pertaining to the confidentiality, privacy,  301
security, or privileged status of protected health information  302
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As Introduced
transacted, maintained in, or accessed through a health  303
information exchange is unenforceable if it conflicts with this  304
chapter:  305
        (1) A section of the Revised Code that is not in this  306
chapter;  307
        (2) A rule as defined in section 119.01 of the Revised  308
Code;  309
        (3) An internal management rule as defined in section  310
111.15 of the Revised Code;  311
        (4) Guidance issued by an agency;  312
        (5) Orders or regulations of a board of health of a city  313
health district made under section 3709.20 of the Revised Code;  314
        (6) Orders or regulations of a board of health of a  315
general health district made under section 3709.21 of the  316
Revised Code;  317
        (7) An ordinance or resolution adopted by a political  318
subdivision;  319
        (8) A professional code of ethics.  320
        (B) Division (A) of this section does not render  321
unenforceable or restrict in any manner any of the following:  322
        (1) A provision of the Revised Code that on the effective  323
date of this section September 10, 2012, requires a person or  324
governmental entity to disclose protected health information to  325
a state agency, political subdivision, or other governmental  326
entity;  327
        (2) The confidential status of proceedings and records  328
within the scope of a peer review committee of a health care  329
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As Introduced
entity as described in section 2305.252 of the Revised Code;  330
       (3) The confidential status of quality assurance program  331
activities and quality assurance records as described in section  332
5122.32 of the Revised Code;  333
       (4) The testimonial privilege established by division (B)  334
of section 2317.02 of the Revised Code;  335
       (5) An item described in divisions (A)(1) to (8) of this  336
section that governs any of the following:  337
       (a) The confidentiality, privacy, security, or privileged  338
status of protected health information in the possession or  339
custody of an agency;  340
       (b) The process for obtaining from a patient consent to  341
the provision of health care or consent for participation in  342
medical or other scientific research;  343
       (c) The process for determining whether an adult has a  344
physical or mental impairment or an adult's capacity to make  345
health care decisions for purposes of Chapter 5126. of the  346
Revised Code;  347
       (d) The process for determining whether a minor has been  348
emancipated.  349
       (6) When a minor is authorized to consent to the minor's  350
own receipt of health care or make medical decisions on the  351
minor's own behalf, including the circumstances described in  352
sections 2907.29, 3709.241, 3719.012, 5120.172, 5122.04, and  353
5126.043 of the Revised Code.  354
       Section 2. That existing sections 2151.461, 3129.03,  355
3313.473, 3798.07, and 3798.12 of the Revised Code are hereby  356
repealed.  357
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As Introduced
       Section 3. That section 5122.04 of the Revised Code is  358
hereby repealed.  359