BILL ANALYSIS Senate Research Center S.B. 128 89R4291 MPF-D By: Hall Health & Human Services 4/16/2025 As Filed AUTHOR'S / SPONSOR'S STATEMENT OF INTENT When a child appears at a hospital with injuries or health issues that may be indicative of child abuse or neglect, a report is required to be made to the Department of Family and Protective Services (DFPS). Though this is an important and often-times necessary measure, it can also be used as a tool of intimidation against parents who disagree with a doctor's plan of treatment. The Pardo case is one such example. In 2019, after filing a complaint against a doctor who was treating their medically fragile son and seeking a second opinion, Ashley and Daniel Pardo were surprised when CPS showed up at their doorstep with law enforcement and forcibly removed their four-year-old son, Drake. After a six-month court battle, during which time DFPS placed Drake in foster care, the Texas Supreme Court ordered Drake returned to his family stating that DFPS did not have enough evidence to remove him. Parents have the legal right to seek a second opinion for medical treatments, yet when CPS rushes in and removes the child before they can do so, it impedes the parents' legitimate right to obtain a second opinion, and their right to direct the medical care of their child. This bill seeks to make changes that would hold reporting hospitals to a higher standard and level of accountability, so they only report legitimate cases of child abuse. This would ensure a reduction in false alarms, sparing children from unnecessarily and traumatic separation from their parents. Therefore, this would require a hospital to submit a report to the Health and Human Services Commission (HHSC) each month with certain information to ensure that standards were met. It would outline a penalty fee structure for failure to comply with the reporting requirement, and require enforcement and implementation. As proposed, S.B. 128 amends current law relating to hospital reporting requirements regarding suspected child abuse, exploitation, or neglect and authorizes an administrative penalty. RULEMAKING AUTHORITY Rulemaking authority is expressly granted to the executive commissioner of the Texas Health and Human Services Commission in SECTION 1 (Section 241.454, Health and Safety Code) of this bill. SECTION BY SECTION ANALYSIS SECTION 1. Amends Chapter 241, Health and Safety Code, by adding Subchapter N, as follows: SUBCHAPTER N. CHILD ABUSE, EXPLOITATION, OR NEGLECT REPORTING REQUIREMENTS Sec. 241.451. SUSPECTED CHILD ABUSE, EXPLOITATION, OR NEGLECT REPORTS. (a) Defines "abuse," "exploitation," and "neglect." (b) Requires a hospital, not later than the fifth day of each month, to submit a report to the Health and Human Services Commission (HHSC) containing the following information: (1) the number of reports made during the preceding month by the hospital or an agent or employee of the hospital to the Department of Family and Protective Services under Chapter 261 (Investigation of Report of Child Abuse or Neglect), Family Code, regarding alleged or suspected abuse, exploitation, or neglect of a child; (2) whether the hospital informed the parent, legal guardian, managing conservator, or possessory conservator of a child who is the subject of a report described by Subdivision (1) that the parent, legal guardian, managing conservator, or possessory conservator may obtain an alternative opinion regarding the appropriate course of medical treatment for the child; and (3) any code indicating alleged or suspected abuse, exploitation, or neglect that the hospital used for purposes of diagnosing or treating a child who is the subject of a report described by Subdivision (1), including, as applicable, the Current Procedural Terminology (CPT) code, the Diagnosis Related Group (DRG) code, the International Classification of Diseases (ICD) code, or another common identifier. (c) Requires a hospital to attach to each report submitted under Subsection (b) a signed affidavit from each physician who during the period covered by the report assigned or caused to be assigned a code described by Subsection (b)(3) for purposes of diagnosing or treating a child who is a subject of the report. Requires that the affidavit include the name of the physician who assigned the code or caused the code to be assigned and a statement establishing whether the physician assigned the code based on the physician's direct observation of the child or based on information provided to the physician by an agent or employee of the hospital. Provides that the information contained in an affidavit required under this subsection is confidential and not subject to disclosure under Chapter 552 (Public Information), Government Code. (d) Requires the hospital, if the information required to be included in the report under Subsection (b)(3) is not available at the time a report is submitted, to include that information in the next report required to be submitted by the hospital after the date the information required by that subdivision becomes available and attach to that next report any affidavit described by Subsection (c) related to that information. (e) Requires a hospital to submit the report required under Subsection (b) in the form and manner prescribed by HHSC rule. Sec. 241.452. ADMINISTRATIVE PENALTY. (a) Requires HHSC to impose an administrative penalty on a hospital that violates Section 241.451. (b) Requires HHSC, before imposing an administrative penalty under Subsection (a), to provide written notice to the hospital that: (1) the hospital is in violation of Section 241.451 because the hospital has failed to timely submit a report required under that section; (2) the hospital has 15 days to submit the required report; and (3) if the hospital does not submit the required report within 15 days of receiving notice of the violation, the hospital will be subject to an administrative penalty for each day the violation continues. (c) Requires HHSC to set an administrative penalty imposed under this section in an amount sufficient to ensure compliance by hospitals with Section 241.451, subject to the limitations prescribed by Subsection (d). (d) Prohibits the penalty imposed by HHSC, for a hospital with one of the following total gross revenues as reported to the Centers for Medicare and Medicaid Services or to another entity designed by HHSC rule in the year preceding the year in which an administrative penalty is imposed under this section, from exceeding: (1) $10 for each day the hospital violates Section 241.451, beginning on the 16th day after the date the hospital received notice from HHSC, if the hospital's total gross revenue is less than $10 million; (2) $100 for each day the hospital violates Section 241.451, beginning on the 16th day after the date the hospital received notice from HHSC, if the hospital's total gross revenue is $10 million or more and less than $100 million; and (3) $1,000 for each day the hospital violates Section 241.451, beginning on the 16th day after the date the hospital received notice from HHSC, if the hospital's total gross revenue is $100 million or more. (e) Provides that each day a violation continues is considered a separate violation. (f) Provides that an administrative penalty, notwithstanding any other provision of this section, ceases to be incurred on the date a violation is corrected. (g) Requires HHSC to consider certain factors in determining the amount of an administrative penalty to impose on a hospital under this section. (h) Requires that an administrative penalty collected under this section be deposited to the credit of an account in the general revenue fund administered by HHSC. Provides that money in the account is authorized to be appropriated only to HHSC. Sec. 241.453. SUMMARY REPORT. Requires HHSC to submit a written quarterly report to the legislature summarizing the content of the reposts submitted to HHSC under Section 241.451(b) during the preceding quarter. Sec. 241.454. RULES. Requires the executive commissioner of HHSC to adopt rules necessary to implement this subchapter. SECTION 2. Effective date: September 1, 2025.
BILL ANALYSIS
Senate Research Center S.B. 128
89R4291 MPF-D By: Hall
Health & Human Services
4/16/2025
As Filed
Senate Research Center
S.B. 128
89R4291 MPF-D
By: Hall
Health & Human Services
4/16/2025
As Filed
AUTHOR'S / SPONSOR'S STATEMENT OF INTENT
When a child appears at a hospital with injuries or health issues that may be indicative of child abuse or neglect, a report is required to be made to the Department of Family and Protective Services (DFPS). Though this is an important and often-times necessary measure, it can also be used as a tool of intimidation against parents who disagree with a doctor's plan of treatment. The Pardo case is one such example. In 2019, after filing a complaint against a doctor who was treating their medically fragile son and seeking a second opinion, Ashley and Daniel Pardo were surprised when CPS showed up at their doorstep with law enforcement and forcibly removed their four-year-old son, Drake.
After a six-month court battle, during which time DFPS placed Drake in foster care, the Texas Supreme Court ordered Drake returned to his family stating that DFPS did not have enough evidence to remove him.
Parents have the legal right to seek a second opinion for medical treatments, yet when CPS rushes in and removes the child before they can do so, it impedes the parents' legitimate right to obtain a second opinion, and their right to direct the medical care of their child. This bill seeks to make changes that would hold reporting hospitals to a higher standard and level of accountability, so they only report legitimate cases of child abuse. This would ensure a reduction in false alarms, sparing children from unnecessarily and traumatic separation from their parents.
Therefore, this would require a hospital to submit a report to the Health and Human Services Commission (HHSC) each month with certain information to ensure that standards were met. It would outline a penalty fee structure for failure to comply with the reporting requirement, and require enforcement and implementation.
As proposed, S.B. 128 amends current law relating to hospital reporting requirements regarding suspected child abuse, exploitation, or neglect and authorizes an administrative penalty.
RULEMAKING AUTHORITY
Rulemaking authority is expressly granted to the executive commissioner of the Texas Health and Human Services Commission in SECTION 1 (Section 241.454, Health and Safety Code) of this bill.
SECTION BY SECTION ANALYSIS
SECTION 1. Amends Chapter 241, Health and Safety Code, by adding Subchapter N, as follows:
SUBCHAPTER N. CHILD ABUSE, EXPLOITATION, OR NEGLECT REPORTING REQUIREMENTS
Sec. 241.451. SUSPECTED CHILD ABUSE, EXPLOITATION, OR NEGLECT REPORTS. (a) Defines "abuse," "exploitation," and "neglect."
(b) Requires a hospital, not later than the fifth day of each month, to submit a report to the Health and Human Services Commission (HHSC) containing the following information:
(1) the number of reports made during the preceding month by the hospital or an agent or employee of the hospital to the Department of Family and Protective Services under Chapter 261 (Investigation of Report of Child Abuse or Neglect), Family Code, regarding alleged or suspected abuse, exploitation, or neglect of a child;
(2) whether the hospital informed the parent, legal guardian, managing conservator, or possessory conservator of a child who is the subject of a report described by Subdivision (1) that the parent, legal guardian, managing conservator, or possessory conservator may obtain an alternative opinion regarding the appropriate course of medical treatment for the child; and
(3) any code indicating alleged or suspected abuse, exploitation, or neglect that the hospital used for purposes of diagnosing or treating a child who is the subject of a report described by Subdivision (1), including, as applicable, the Current Procedural Terminology (CPT) code, the Diagnosis Related Group (DRG) code, the International Classification of Diseases (ICD) code, or another common identifier.
(c) Requires a hospital to attach to each report submitted under Subsection (b) a signed affidavit from each physician who during the period covered by the report assigned or caused to be assigned a code described by Subsection (b)(3) for purposes of diagnosing or treating a child who is a subject of the report. Requires that the affidavit include the name of the physician who assigned the code or caused the code to be assigned and a statement establishing whether the physician assigned the code based on the physician's direct observation of the child or based on information provided to the physician by an agent or employee of the hospital. Provides that the information contained in an affidavit required under this subsection is confidential and not subject to disclosure under Chapter 552 (Public Information), Government Code.
(d) Requires the hospital, if the information required to be included in the report under Subsection (b)(3) is not available at the time a report is submitted, to include that information in the next report required to be submitted by the hospital after the date the information required by that subdivision becomes available and attach to that next report any affidavit described by Subsection (c) related to that information.
(e) Requires a hospital to submit the report required under Subsection (b) in the form and manner prescribed by HHSC rule.
Sec. 241.452. ADMINISTRATIVE PENALTY. (a) Requires HHSC to impose an administrative penalty on a hospital that violates Section 241.451.
(b) Requires HHSC, before imposing an administrative penalty under Subsection (a), to provide written notice to the hospital that:
(1) the hospital is in violation of Section 241.451 because the hospital has failed to timely submit a report required under that section;
(2) the hospital has 15 days to submit the required report; and
(3) if the hospital does not submit the required report within 15 days of receiving notice of the violation, the hospital will be subject to an administrative penalty for each day the violation continues.
(c) Requires HHSC to set an administrative penalty imposed under this section in an amount sufficient to ensure compliance by hospitals with Section 241.451, subject to the limitations prescribed by Subsection (d).
(d) Prohibits the penalty imposed by HHSC, for a hospital with one of the following total gross revenues as reported to the Centers for Medicare and Medicaid Services or to another entity designed by HHSC rule in the year preceding the year in which an administrative penalty is imposed under this section, from exceeding:
(1) $10 for each day the hospital violates Section 241.451, beginning on the 16th day after the date the hospital received notice from HHSC, if the hospital's total gross revenue is less than $10 million;
(2) $100 for each day the hospital violates Section 241.451, beginning on the 16th day after the date the hospital received notice from HHSC, if the hospital's total gross revenue is $10 million or more and less than $100 million; and
(3) $1,000 for each day the hospital violates Section 241.451, beginning on the 16th day after the date the hospital received notice from HHSC, if the hospital's total gross revenue is $100 million or more.
(e) Provides that each day a violation continues is considered a separate violation.
(f) Provides that an administrative penalty, notwithstanding any other provision of this section, ceases to be incurred on the date a violation is corrected.
(g) Requires HHSC to consider certain factors in determining the amount of an administrative penalty to impose on a hospital under this section.
(h) Requires that an administrative penalty collected under this section be deposited to the credit of an account in the general revenue fund administered by HHSC. Provides that money in the account is authorized to be appropriated only to HHSC.
Sec. 241.453. SUMMARY REPORT. Requires HHSC to submit a written quarterly report to the legislature summarizing the content of the reposts submitted to HHSC under Section 241.451(b) during the preceding quarter.
Sec. 241.454. RULES. Requires the executive commissioner of HHSC to adopt rules necessary to implement this subchapter.
SECTION 2. Effective date: September 1, 2025.