Texas 2021 - 87th Regular

Texas House Bill HB3820 Compare Versions

Version 1 (Old)

Version 2 (New)

Old	New		Differences
1		-	87R18592 MCK-D
2		-	By: Klick, Noble, Hull, et al. H.B. No. 3820
3		-	Substitute the following for H.B. No. 3820:
4		-	By: Hull C.S.H.B. No. 3820
	1	+	87R10959 MCK-D
	2	+	By: Klick H.B. No. 3820
5	3
6	4
7	5		A BILL TO BE ENTITLED
8	6		AN ACT
9	7		relating to health care specialty consultations in certain child
10	8		abuse or neglect investigations and assessments.
11	9		BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
12	10		SECTION 1. Section 261.3017, Family Code, is amended by
13		-	amending Subsections (b) and (c) and adding Subsections (c-1),
14		-	(c-2), and (e) to read as follows:
	11	+	amending Subsections (b) and (c) and adding Subsections (b-1),
	12	+	(c-1), (c-2), and (e) to read as follows:
15	13		(b) Any agreement between the department and the network or
16	14		between the Department of State Health Services and the system to
17	15		provide assistance in connection with abuse and neglect
18	16		investigations conducted by the department must require the network
19	17		and the system to have the ability to obtain consultations with
20	18		physicians licensed to practice medicine in this state and board
21	19		certified in the relevant field or specialty, including
22	20		radiologists, geneticists, orthopedists, and endocrinologists, to
23	21		diagnose and treat certain [who specialize in identifying] unique
24	22		health conditions, including:
25	23		(1) rickets;
26	24		(2) Ehlers-Danlos Syndrome;
27	25		(3) osteogenesis imperfecta;
28	26		(4) vitamin D deficiency; and
29	27		(5) other medical conditions that mimic child
30	28		maltreatment or increase the risk of misdiagnosis of child
31	29		maltreatment [similar metabolic bone diseases or connective tissue
32	30		disorders].
	31	+	(b-1) The department shall refer all cases for a specialty
	32	+	consultation to a physician who:
	33	+	(1) is licensed to practice medicine in this state
	34	+	under Subtitle B, Title 3, Occupations Code;
	35	+	(2) is board certified in a field or specialty
	36	+	relevant to diagnosing and treating the conditions described by
	37	+	Subsection (b); and
	38	+	(3) was not involved with the report of suspected
	39	+	abuse or neglect.
33	40		(c) During [If, during] an abuse or neglect investigation
34	41		authorized by this subchapter or an assessment provided under
35	42		Subsection (b), the department [or a physician in the network
36	43		determines that a child requires a specialty consultation with a
37	44		physician, the department or the physician] shall refer the child's
38	45		case [to the system] for a specialty [the] consultation[,] if:
39	46		(1) the department determines the child requires a
40	47		specialty consultation with a physician;
41	48		(2) the child's primary care physician or other
42	49		primary health care provider who provided health care or treatment
43	50		or otherwise evaluated the child recommends a specialty
44	51		consultation; or
45	52		(3) the child's parent or legal guardian or, if
46	53		represented by an attorney, the attorney of the parent or legal
47	54		guardian requests a specialty consultation [the system has
48	55		available capacity to take the child's case].
49		-	(c-1) For a case in which a specialty consultation is
50		-	required by Subsection (c), the department shall refer the case to a
51		-	physician who:
52		-	(1) is licensed to practice medicine in this state
53		-	under Subtitle B, Title 3, Occupations Code;
54		-	(2) is board certified in a field or specialty
55		-	relevant to diagnosing and treating the conditions described by
56		-	Subsection (b); and
57		-	(3) was not involved with the report of suspected
58		-	abuse or neglect.
59		-	(c-2) Before referring a child's case under Subsection (c),
	56	+	(c-1) Before referring a child's case under Subsection (c),
60	57		the department shall provide to the child's parent or legal
61	58		guardian or, if represented by an attorney, the attorney of the
62	59		parent or legal guardian written notice of the name, contact
63	60		information, and credentials of the specialist. The parent, legal
64	61		guardian, or attorney, as applicable, may object to the proposed
65		-	referral and request referral to another specialist. The
66		-	department and the parent, legal guardian, or attorney, as
	62	+	referral and request referral to another specialist.
	63	+	(c-2) If a parent or legal guardian or, if represented by an
	64	+	attorney, the attorney of the parent or legal guardian objects to
	65	+	the proposed referral under Subsection (c-1), the department may
	66	+	object to the specialist proposed by the parent, legal guardian, or
	67	+	attorney, as applicable, and propose two alternative specialists.
	68	+	The department and the parent, legal guardian, or attorney, as
67	69		applicable, shall collaborate in good faith to select an acceptable
68	70		specialist from the proposed specialists.
69	71		(e) This section may not be construed to prohibit a child's
70	72		parent or legal guardian or, if represented by an attorney, the
71	73		attorney of the parent or legal guardian from otherwise obtaining
72	74		an alternative opinion at the parent's, legal guardian's, or
73	75		attorney's, as applicable, own initiative and expense. The
74	76		department shall accept and consider an alternative opinion
75	77		obtained and provided under this section and shall document its
76	78		analysis and determinations regarding the opinion.
77	79		SECTION 2. Subchapter D, Chapter 261, Family Code, is
78	80		amended by adding Section 261.30175 to read as follows:
79	81		Sec. 261.30175. MITIGATION OF PROVIDER CONFLICTS IN ABUSE
80	82		OR NEGLECT INVESTIGATION CONSULTATIONS. (a) In this section:
81	83		(1) "Forensic assessment" means a medical
82	84		examination, psychosocial evaluation, medical case review,
83	85		specialty evaluation, or other forensic evaluation service
84		-	conducted by a physician under Section 261.3017 in connection with
85		-	any investigation of a suspected case of abuse or neglect for the
86		-	primary purpose of providing the department, law enforcement, or
87		-	the court with expert advice, recommendations, or testimony on the
88		-	case.
	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.
89	90		(2) "Health care practitioner" means an individual
90	91		licensed, certified, or otherwise authorized to administer health
91	92		care services in the ordinary course of business or professional
92	93		practice. The term includes a physician, medical student, resident
93	94		physician, child abuse fellow, advanced practice registered nurse,
94	95		nurse, and physician assistant.
95	96		(3) "Network" has the meaning assigned by Section
96	97		261.3017.
97	98		(4) "System" has the meaning assigned by Section
98	99		261.3017.
99	100		(b) A health care practitioner who reports suspected abuse
100	101		or neglect of a child may not provide forensic assessment services
101	102		in connection with an investigation resulting from the report.
102	103		This subsection applies regardless of whether the practitioner is a
103	104		member of the network or system.
104	105		(c) When referring a case for forensic assessment, the
105	106		department shall refer the case to a physician authorized to
106	107		practice medicine in this state under Subtitle B, Title 3,
107	108		Occupations Code, who was not involved with the report of suspected
108	109		abuse or neglect.
109		-	(d) This section may not be construed to:
	110	+	(d) In a case in which two physicians' opinions conflict
	111	+	concerning whether a child's injuries or symptoms were the result
	112	+	of abuse or neglect, the department shall refer the case to the
	113	+	Department of State Health Services Medical Advisory Board for
	114	+	independent evaluation.
	115	+	(e) This section may not be construed to:
110	116		(1) prohibit the department from interviewing the
111	117		health care practitioner in the practitioner's capacity as a
112	118		principal or collateral source; or
113	119		(2) otherwise restrict the department's ability to
114	120		conduct an investigation as provided by this subchapter.
115		-	SECTION 3. This Act takes effect September 1, 2021.
	121	+	SECTION 3. Section 12.092, Health and Safety Code, is
	122	+	amended by adding Subsection (c) to read as follows:
	123	+	(c) The medical advisory board shall assist the Department
	124	+	of Family and Protective Services in reviewing suspected cases of
	125	+	abuse or neglect in which the conclusion of a forensic assessment
	126	+	conducted in connection with an investigation by the Department of
	127	+	Family and Protective Services conflicts with the opinion of
	128	+	another qualified medical professional who examined or treated the
	129	+	child concerning whether a child's injuries or symptoms were the
	130	+	result of abuse or neglect.
	131	+	SECTION 4. This Act takes effect September 1, 2021.