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A BILL TO BE ENTITLED
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AN ACT
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relating to certain mental health and medical services for children |
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in foster care and the conservatorship of the state, including the |
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administration of psychotropic drugs. |
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BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: |
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SECTION 1. Section 266.001, Family Code, is amended by |
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adding Subdivisions (6) and (7) to read as follows: |
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(6) "Mental illness" has the meaning assigned by |
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Section 571.003, Health and Safety Code. |
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(7) "Psychotropic drug" has the meaning assigned by |
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Section 261.111. |
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SECTION 2. The heading to Section 266.005, Family Code, is |
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amended to read as follows: |
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Sec. 266.005. PARENTAL NOTIFICATION OF CERTAIN |
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[SIGNIFICANT] MEDICAL CONDITIONS OR ENROLLMENT OR PARTICIPATION IN |
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DRUG RESEARCH PROGRAM. |
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SECTION 3. Section 266.005(b), Family Code, is amended to |
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read as follows: |
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(b) Except as provided by Subsection (c), the department |
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shall make reasonable efforts to notify the child's parents within |
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24 hours of: |
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(1) a significant medical condition involving a foster |
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child; [and] |
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(2) the enrollment or participation of a foster child |
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in a drug research program under Section 266.0041; |
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(3) the diagnosis of a foster child with a mental |
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illness; or |
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(4) the prescription of a psychotropic drug for a |
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foster child. |
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SECTION 4. Subchapter A, Chapter 266, Family Code, is |
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amended by adding Sections 266.011, 266.012, 266.013, 266.014, and |
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266.015 to read as follows: |
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Sec. 266.011. PRIOR AUTHORIZATION FOR CERTAIN PSYCHOTROPIC |
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DRUGS. The executive commissioner shall adopt rules requiring |
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prior authorization from the STAR Health Medicaid managed care |
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program before a psychotropic drug prescribed for a foster child |
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may be dispensed. The rules must: |
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(1) prohibit a pharmacy from dispensing a psychotropic |
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drug prescribed for a foster child until the pharmacy receives |
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prior authorization from the STAR Health Medicaid managed care |
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program for the prescribed psychotropic drug if the prescription is |
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for: |
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(A) four or more psychotropic drugs to be taken |
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concurrently; |
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(B) two or more psychotropic drugs of the same |
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class to be taken concurrently; |
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(C) a psychotropic drug prescribed for a child |
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younger than five years of age; or |
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(D) a psychotropic drug the commission |
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determines should be reviewed; and |
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(2) require the STAR Health Medicaid managed care |
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program to respond to a request for authorization required under |
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Subdivision (1) not later than 24 hours after receiving the |
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request. |
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Sec. 266.012. MEDICAL REPORT FOR PRESCRIPTION OF |
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PSYCHOTROPIC DRUG. (a) The commission, in conjunction with the |
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department, and with the assistance of appropriate health and human |
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services agencies, community partners, and physicians and other |
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health care providers, shall develop a form to report the |
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prescription of a psychotropic drug to a foster child. |
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(b) The foster child's physician shall use the form |
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described by Subsection (a) to report the prescription of a |
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psychotropic drug to a foster child or a change in the dosage of a |
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psychotropic drug prescribed for the child and shall update the |
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report as appropriate to document the child's progress in reaching |
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the child's treatment goals. |
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(c) The executive commissioner shall adopt rules specifying |
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the information required to be included in the report. The report |
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must include: |
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(1) the child's diagnosis and a description of the |
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symptoms and behaviors for which the physician is prescribing the |
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psychotropic drug; |
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(2) any possible side effects of the psychotropic drug |
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that the child's care provider should monitor; |
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(3) a description of generally accepted alternatives |
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to the psychotropic drug, if any, and the reasons why the physician |
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believes that the alternatives are not appropriate; |
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(4) a description of clearly defined target symptoms |
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and treatment goals based on recognized clinical rating scales or |
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other measures to quantify the child's progress toward the |
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treatment goals; |
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(5) other information that the physician considers |
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appropriate, including the child's height, weight, blood pressure, |
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and laboratory results; and |
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(6) if the child has been taking the psychotropic drug |
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for longer than six months, the physician's analysis of the |
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necessity of continuing the psychotropic drug. |
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(d) The physician and the person authorized to consent to |
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medical care for the foster child under this chapter must review and |
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sign the medical report. |
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(e) The department shall make the medical report available |
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as part of the child's health passport described by Section |
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266.006. |
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Sec. 266.013. COMPREHENSIVE ASSESSMENTS. Not later than |
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the 30th day after the date a child enters the conservatorship of |
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the department, the child shall receive a comprehensive, |
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multidisciplinary assessment that includes a screening for trauma. |
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Sec. 266.014. ASSESSMENT REQUIRED BEFORE PRESCRIBING |
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PSYCHOTROPIC DRUG. Except for authorizing a refill of an existing |
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prescription or in an emergency that requires the urgent |
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administration of a psychotropic drug, a physician may not |
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prescribe a psychotropic drug for a foster child until the |
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assessment described by Section 266.013 is complete. |
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Sec. 266.015. STUDY REGARDING USE OF PSYCHOTROPIC DRUGS; |
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REPORT. (a) The department shall review the use of psychotropic |
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drugs in the treatment of foster children. |
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(b) Not later than December 1 of each even-numbered year, |
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the department shall deliver a report on the review conducted under |
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Subsection (a), including an analysis of any trends in the use of |
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psychotropic drugs in the treatment of foster children, to the |
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governor, the lieutenant governor, and the speaker of the house of |
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representatives. |
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SECTION 5. Section 533.0161(b), Government Code, is amended |
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to read as follows: |
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(b) The commission shall implement a system under which the |
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commission will use Medicaid prescription drug data to monitor the |
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prescribing of psychotropic drugs for [children who are]: |
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(1) children who are in the conservatorship of the |
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Department of Family and Protective Services[;] and |
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[(2)] enrolled in the STAR Health Medicaid managed care |
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program or eligible for both Medicaid and Medicare; and |
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(2) children who are under the supervision of the |
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Department of Family and Protective Services through an agreement |
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under the Interstate Compact on the Placement of Children under |
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Subchapter B, Chapter 162, Family Code. |
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SECTION 6. (a) Except as provided by Subsection (b) of |
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this section, this Act takes effect September 1, 2013. |
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(b) Section 266.012, Family Code, as added by this Act, |
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takes effect February 1, 2014. |