87R18592 MCK-D
By: Klick, Noble, Hull, et al. H.B. No. 3820
Substitute the following for H.B. No. 3820:
By: Hull C.S.H.B. No. 3820
A BILL TO BE ENTITLED
AN ACT
relating to health care specialty consultations in certain child
abuse or neglect investigations and assessments.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. Section 261.3017, Family Code, is amended by
amending Subsections (b) and (c) and adding Subsections (c-1),
(c-2), and (e) to read as follows:
(b) Any agreement between the department and the network or
between the Department of State Health Services and the system to
provide assistance in connection with abuse and neglect
investigations conducted by the department must require the network
and the system to have the ability to obtain consultations with
physicians licensed to practice medicine in this state and board
certified in the relevant field or specialty, including
radiologists, geneticists, orthopedists, and endocrinologists, to
diagnose and treat certain [who specialize in identifying] unique
health conditions, including:
(1) rickets;
(2) Ehlers-Danlos Syndrome;
(3) osteogenesis imperfecta;
(4) vitamin D deficiency; and
(5) other medical conditions that mimic child
maltreatment or increase the risk of misdiagnosis of child
maltreatment [similar metabolic bone diseases or connective tissue
disorders].
(c) During [If, during] an abuse or neglect investigation
authorized by this subchapter or an assessment provided under
Subsection (b), the department [or a physician in the network
determines that a child requires a specialty consultation with a
physician, the department or the physician] shall refer the child's
case [to the system] for a specialty [the] consultation[,] if:
(1) the department determines the child requires a
specialty consultation with a physician;
(2) the child's primary care physician or other
primary health care provider who provided health care or treatment
or otherwise evaluated the child recommends a specialty
consultation; or
(3) the child's parent or legal guardian or, if
represented by an attorney, the attorney of the parent or legal
guardian requests a specialty consultation [the system has
available capacity to take the child's case].
(c-1) For a case in which a specialty consultation is
required by Subsection (c), the department shall refer the case to a
physician who:
(1) is licensed to practice medicine in this state
under Subtitle B, Title 3, Occupations Code;
(2) is board certified in a field or specialty
relevant to diagnosing and treating the conditions described by
Subsection (b); and
(3) was not involved with the report of suspected
abuse or neglect.
(c-2) Before referring a child's case under Subsection (c),
the department shall provide to the child's parent or legal
guardian or, if represented by an attorney, the attorney of the
parent or legal guardian written notice of the name, contact
information, and credentials of the specialist. The parent, legal
guardian, or attorney, as applicable, may object to the proposed
referral and request referral to another specialist. The
department and the parent, legal guardian, or attorney, as
applicable, shall collaborate in good faith to select an acceptable
specialist from the proposed specialists.
(e) This section may not be construed to prohibit a child's
parent or legal guardian or, if represented by an attorney, the
attorney of the parent or legal guardian from otherwise obtaining
an alternative opinion at the parent's, legal guardian's, or
attorney's, as applicable, own initiative and expense. The
department shall accept and consider an alternative opinion
obtained and provided under this section and shall document its
analysis and determinations regarding the opinion.
SECTION 2. Subchapter D, Chapter 261, Family Code, is
amended by adding Section 261.30175 to read as follows:
Sec. 261.30175. MITIGATION OF PROVIDER CONFLICTS IN ABUSE
OR NEGLECT INVESTIGATION CONSULTATIONS. (a) In this section:
(1) "Forensic assessment" means a medical
examination, psychosocial evaluation, medical case review,
specialty evaluation, or other forensic evaluation service
conducted by a physician under Section 261.3017 in connection with
any investigation of a suspected case of abuse or neglect for the
primary purpose of providing the department, law enforcement, or
the court with expert advice, recommendations, or testimony on the
case.
(2) "Health care practitioner" means an individual
licensed, certified, or otherwise authorized to administer health
care services in the ordinary course of business or professional
practice. The term includes a physician, medical student, resident
physician, child abuse fellow, advanced practice registered nurse,
nurse, and physician assistant.
(3) "Network" has the meaning assigned by Section
261.3017.
(4) "System" has the meaning assigned by Section
261.3017.
(b) A health care practitioner who reports suspected abuse
or neglect of a child may not provide forensic assessment services
in connection with an investigation resulting from the report.
This subsection applies regardless of whether the practitioner is a
member of the network or system.
(c) When referring a case for forensic assessment, the
department shall refer the case to a physician authorized to
practice medicine in this state under Subtitle B, Title 3,
Occupations Code, who was not involved with the report of suspected
abuse or neglect.
(d) This section may not be construed to:
(1) prohibit the department from interviewing the
health care practitioner in the practitioner's capacity as a
principal or collateral source; or
(2) otherwise restrict the department's ability to
conduct an investigation as provided by this subchapter.
SECTION 3. This Act takes effect September 1, 2021.