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  S.B. No. 1578
 
 
 
 
AN ACT
  relating to the use of opinions from medical professionals in
  making certain determinations relating to the abuse or neglect of a
  child.
         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; however the department
  may refer the child's case to a specialist over the objection of the
  parent, legal guardian, or attorney.
         (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 261.30171 to read as follows:
         Sec. 261.30171.  FORENSIC ASSESSMENT CENTER NETWORK
  EVALUATION. (a)  In this section, "network" means the Forensic
  Assessment Center Network.
         (b)  The department, with the assistance of the Supreme Court
  of Texas Children's Commission, shall:
               (1)  evaluate the department's use of the network; and 
               (2)  develop joint recommendations to improve:
                     (A)  the evaluation of agreements between the
  department and the network; and
                     (B)  the best practices for using assessments
  provided by the network in connection with abuse and neglect
  investigations conducted by the department.
         (c)  Not later than September 1, 2022, the department shall
  prepare and submit to the legislature a written report containing
  the department's findings and recommendations under Subsection (b)
  and any recommendations for legislative or other action.
         (d)  This section expires September 1, 2023.
         SECTION 3.  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 4.  Section 261.504, Family Code, is amended by
  adding Subsection (a-1) to read as follows:
         (a-1)  In making a determination whether the child is or has
  been a victim of abuse or neglect, the court shall consider the
  opinion of a medical professional obtained by an individual against
  whom a protective order is sought.
         SECTION 5.  Section 262.102, Family Code, is amended by
  adding Subsection (b-1) to read as follows:
         (b-1)  A determination under this section that there is an
  immediate danger to the physical health or safety of a child or that
  the child has been a victim of neglect or sexual abuse may not be
  based solely on the opinion of a medical professional under
  contract with the Department of Family and Protective Services who
  did not conduct a physical examination of the child.
         SECTION 6.  Section 262.104, Family Code, is amended by
  adding Subsection (c) to read as follows:
         (c)  An authorized representative of the Department of
  Family and Protective Services, a law enforcement officer, or a
  juvenile probation officer may not take possession of a child under
  Subsection (a) based solely on the opinion of a medical
  professional under contract with the Department of Family and
  Protective Services who did not conduct a physical examination of
  the child.
         SECTION 7.  Section 262.201, Family Code, is amended by
  adding Subsection (i-1) to read as follows:
         (i-1)  In making a determination whether there is an
  immediate danger to the physical health or safety of a child, the
  court shall consider the opinion of a medical professional obtained
  by the child's parent, managing conservator, possessory
  conservator, guardian, caretaker, or custodian.
         SECTION 8.  The changes in law made by this Act apply only to
  a suit affecting the parent-child relationship filed on or after
  the effective date of this Act.  A suit affecting the parent-child
  relationship filed before the effective date of this Act is
  governed by the law in effect on the date the suit was filed, and the
  former law is continued in effect for that purpose.
         SECTION 9.  This Act takes effect September 1, 2021.
 
 
 
 
 
  ______________________________ ______________________________
     President of the Senate Speaker of the House     
 
         I hereby certify that S.B. No. 1578 passed the Senate on    
  April 19, 2021, by the following vote: Yeas 31, Nays 0; and that
  the Senate concurred in House amendments on May 27, 2021, by the
  following vote: Yeas 31, Nays 0.
 
 
  ______________________________
  Secretary of the Senate    
 
         I hereby certify that S.B. No. 1578 passed the House, with
  amendments, on May 23, 2021, by the following vote: Yeas 144,
  Nays 2, one present not voting.
 
 
  ______________________________
  Chief Clerk of the House   
 
 
 
  Approved:
 
  ______________________________ 
              Date
 
 
  ______________________________ 
            Governor