TX
Texas House Bill HB2134

Texas 2019 - 86th Regular

Texas House Bill HB2134 Compare Versions

OldNewDifferences
1-86R24872 SCL-F
2- By: Klick, Noble H.B. No. 2134
3- Substitute the following for H.B. No. 2134:
4- By: Noble C.S.H.B. No. 2134
1+86R8296 SCL-F
2+ By: Klick H.B. No. 2134
53
64
75 A BILL TO BE ENTITLED
86 AN ACT
97 relating to health care specialty consultations in certain child
108 abuse or neglect investigations and assessments.
119 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1210 SECTION 1. Section 261.3017, Family Code, as added by
1311 Chapter 502 (H.B. 2848), Acts of the 85th Legislature, Regular
1412 Session, 2017, is amended by amending Subsections (b) and (c) and
15- adding Subsections (b-1), (c-1), (c-2), and (e) to read as follows:
13+ adding Subsections (c-1), (c-2), and (e) to read as follows:
1614 (b) Any agreement between the department and the network or
1715 between the Department of State Health Services and the system to
1816 provide assistance in connection with abuse and neglect
1917 investigations conducted by the department must require the network
2018 and the system to have the ability to obtain consultations with
21- physicians licensed to practice medicine in this state and board
22- certified in the relevant field or specialty, including
23- radiologists, geneticists, orthopedists, and endocrinologists, to
24- diagnose and treat certain [who specialize in identifying] unique
25- health conditions, including:
19+ physicians, including radiologists, geneticists, orthopedists, and
20+ endocrinologists, who specialize in identifying unique health
21+ conditions, including:
2622 (1) rickets;
2723 (2) Ehlers-Danlos Syndrome;
2824 (3) osteogenesis imperfecta;
2925 (4) vitamin D deficiency; and
30- (5) other medical conditions that mimic child
31- maltreatment or increase the risk of misdiagnosis of child
32- maltreatment [similar metabolic bone diseases or connective tissue
33- disorders].
34- (b-1) The department shall refer all cases for a specialty
35- consultation to a physician who:
36- (1) is licensed to practice medicine in this state
37- under Subtitle B, Title 3, Occupations Code;
38- (2) is board certified in a field or specialty
39- relevant to diagnosing and treating the conditions described by
40- Subsection (b); and
41- (3) was not involved with the report of suspected
42- abuse or neglect.
43- (c) During [If, during] an abuse or neglect investigation
44- authorized by this subchapter or an assessment provided under
45- Subsection (b), the department [or a physician in the network
46- determines that a child requires a specialty consultation with a
47- physician, the department or the physician] shall refer the child's
48- case [to the system] for a specialty [the] consultation[,] if:
49- (1) the department determines the child requires a
50- specialty consultation with a physician;
51- (2) the child's primary care physician or other
52- primary health care provider who provided health care or treatment
53- or otherwise evaluated the child recommends a specialty
54- consultation; or
55- (3) the child's parent or legal guardian or, if
56- represented by an attorney, the attorney of the parent or legal
57- guardian requests a specialty consultation [the system has
58- available capacity to take the child's case].
26+ (5) other similar metabolic bone diseases or
27+ connective tissue disorders.
28+ (c) During [If, during] an abuse or neglect investigation or
29+ an assessment provided under Subsection (b), the department or a
30+ physician in the network [determines that a child requires a
31+ specialty consultation with a physician, the department or the
32+ physician] shall refer the child's case to the system for a
33+ specialty [the] consultation[,] if:
34+ (1) the department or physician determines that the
35+ child requires a specialty consultation with another physician;
36+ (2) the child's primary care physician or other health
37+ care provider who provided health care or treatment or otherwise
38+ evaluated the child recommends a specialty consultation; or
39+ (3) the child's parent or legal guardian or the
40+ attorney of the parent or guardian requests a specialty
41+ consultation [the system has available capacity to take the child's
42+ case].
5943 (c-1) Before referring a child's case under Subsection (c),
60- the department shall provide to the child's parent or legal
61- guardian or, if represented by an attorney, the attorney of the
62- parent or legal guardian written notice of the name, contact
63- information, and credentials of the specialist. The parent, legal
64- guardian, or attorney, as applicable, may object to the proposed
65- referral and request referral to another specialist.
66- (c-2) If a parent or legal guardian or, if represented by an
67- attorney, the attorney of the parent or legal guardian objects to
68- the proposed referral under Subsection (c-1), the department may
69- object to the specialist proposed by the parent, legal guardian, or
70- attorney, as applicable, and propose two alternative specialists.
71- The department and the parent, legal guardian, or attorney, as
72- applicable, shall collaborate in good faith to select an acceptable
73- specialist from the proposed specialists.
44+ the department or physician in the network shall provide to the
45+ child's parent or legal guardian and any attorney of the parent or
46+ guardian written notice of the name, contact information, and
47+ credentials of the specialist. The parent or guardian may reject
48+ the proposed referral and request referral to a specialist who is
49+ selected by the parent or guardian and who has adequate expertise in
50+ identifying the unique health conditions described by Subsection
51+ (b).
52+ (c-2) If a parent or legal guardian makes a request under
53+ Subsection (c-1), the department or physician and the parent or
54+ guardian shall collaborate in good faith to identify a mutually
55+ acceptable specialist with the appropriate expertise.
7456 (e) This section may not be construed to prohibit a child's
75- parent or legal guardian or, if represented by an attorney, the
76- attorney of the parent or legal guardian from otherwise obtaining
77- an alternative opinion at the parent's, legal guardian's, or
78- attorney's, as applicable, own initiative and expense.
57+ parent or legal guardian from obtaining a second opinion from a
58+ physician or other health care provider of the parent's or
59+ guardian's choice.
7960 SECTION 2. Subchapter D, Chapter 261, Family Code, is
8061 amended by adding Section 261.30175 to read as follows:
8162 Sec. 261.30175. MITIGATION OF PROVIDER CONFLICTS IN ABUSE
8263 OR NEGLECT INVESTIGATION CONSULTATIONS. (a) In this section:
83- (1) "Forensic assessment" means a medical
84- examination, psychosocial evaluation, medical case review,
85- specialty evaluation, or other forensic evaluation service
86- conducted by a physician in connection with any investigation of a
87- suspected case of abuse or neglect for the primary purpose of
88- providing the department, law enforcement, or the court with expert
89- advice, recommendations, or testimony on the case.
90- (2) "Health care practitioner" means an individual
91- licensed, certified, or otherwise authorized to administer health
92- care services in the ordinary course of business or professional
93- practice. The term includes a physician, medical student, resident
94- physician, child abuse fellow, advanced practice registered nurse,
95- nurse, and physician assistant.
64+ (1) "Consultation" means a medical evaluation,
65+ psychosocial assessment, medical case review, specialty
66+ evaluation, or other forensic consultation service provided in
67+ connection with a suspected case of abuse or neglect.
68+ (2) "Health care provider" means an individual or
69+ facility licensed, certified, or otherwise authorized to
70+ administer health care services, for profit or otherwise, in the
71+ ordinary course of business or professional practice. The term
72+ includes a physician, medical student, resident physician, child
73+ abuse fellow, advanced practice registered nurse, nurse, and
74+ physician assistant.
9675 (3) "Network" has the meaning assigned by Section
97- 261.3017, as added by Chapter 502 (H.B. 2848), Acts of the 85th
98- Legislature, Regular Session, 2017.
76+ 261.3017.
9977 (4) "System" has the meaning assigned by Section
100- 261.3017, as added by Chapter 502 (H.B. 2848), Acts of the 85th
101- Legislature, Regular Session, 2017.
102- (b) A health care practitioner who reports suspected abuse
103- or neglect of a child may not provide forensic assessment services
104- in connection with an investigation resulting from the report.
105- This subsection applies regardless of whether the practitioner is a
106- member of the network or system.
107- (c) When referring a case for forensic assessment, the
108- department shall refer the case to a physician authorized to
109- practice medicine in this state under Subtitle B, Title 3,
110- Occupations Code, who was not involved with the report of suspected
111- abuse or neglect.
112- (d) This section may not be construed to:
113- (1) prohibit the department from interviewing the
114- health care practitioner in the practitioner's capacity as a
115- principal or collateral source; or
116- (2) otherwise restrict the department's ability to
117- conduct an investigation as provided by this subchapter.
78+ 261.3017.
79+ (b) A health care provider who reports the suspected abuse
80+ or neglect of a child may not serve as a consultant to the
81+ department on the reported case, and the department shall refer the
82+ case to another health care provider for consultation. This
83+ subsection applies regardless of whether the provider is a member
84+ of the network or system.
85+ (c) The network and system shall provide consultations for
86+ the department on suspected child abuse or neglect cases through a
87+ blind peer review process that conceals the identity of the alleged
88+ victim, the alleged perpetrator, and the reporting health care
89+ provider.
90+ (d) To protect the integrity of an investigation and ensure
91+ the privacy of all parties to the investigation, the network and
92+ system shall select for a consultation on a suspected child abuse or
93+ neglect case a health care provider who is located outside the
94+ geographic areas where the alleged abuse or neglect occurred and
95+ the reporting health care provider practices.
11896 SECTION 3. This Act takes effect September 1, 2019.