10.8 Payment for Services

By law, minors are financially dependent on their parent(s)/ guardian(s) (English, 1990). They are kept from legally entering binding contracts, so they cannot be liable for their care (English, 1990). Said another way, parent(s) or guardian(s) are financially responsible for their minor children (English, 1990). Because of these rights and responsibilities, adolescent clients have a right to appropriate financial arrangements within their family or with public funding to get the needed services (English, 1990). In developed countries like the United States, accessing care is a privilege and function of someone’s status, access to resources, and identities (Koelch, 2010). Parent(s)/ guardian(s) are responsible for supporting their child in getting necessary services.

Ethical dilemmas may arise when working with adolescent clients around their parents who are paying for services. Sometimes, parents believe that their payment entitles them to access their young person’s information or influence over treatment goals. In these cases, counselors use discernment and ethical decision-making in proceeding and advocating for their minor-age clients. Additionally, if young clients are in the foster care system, they may experience barriers in accessing care. When barriers related to payment exist, counselors work to mitigate them by engaging in case management or advocacy related to finding funding sources, health insurance options, etc., and providing adequate resources to clients (Koelch, 2010). Doing so also builds a sense of personhood and autonomy, which are particularly interesting when working with adolescents.

Sources of Funding for Adolescent Clients

Counselors should consult state law, as many states have outlined a young person’s right to care and parents’ liability for taking reasonable steps to cover it financially (English, 1990). If parents have access to insurance coverage for themselves and family members, they cannot legally remove children from the plan or block coverage (English, 2010). When parents cannot fund treatment via insurance coverage or private funds, counselors can help families pursue publicly funded programming to fund adolescent health care (English, 1990). There are about a dozen federally funded programs for this. For example, Medicaid is a federal program that reimburses medical costs on a “fee-for-service” basis to families meeting the criteria (English, 1990). Counselors evaluate resources, eligibility requirements, and state laws to help adolescent clients and their families financially access services.