BILL ANALYSIS

Senate Research Center	H.B. 4091
	By: Johnson, Ann et al. (Kolkhorst)
	Health & Human Services
	5/12/2023
	Engrossed

AUTHOR'S / SPONSOR'S STATEMENT OF INTENT

Interested parties contend that there is a lack of available in-patient mental health services for children in the managing conservatorship of the State of Texas, which has contributed to the problem of stable placements for certain foster children. The Department of Family and Protective Services (DFPS) has developed a pilot program in partnership with the University of Texas Health Science Center at Houston��Successful Transitions for Adolescents Recovery Trajectories Success (START)��to provide robust mental health treatment for foster children who have experienced significant trauma, have persistent mental health needs, and are struggling with repeat foster placement attempts. Under the program, UTHealth Houston will provide a fully dedicated 18-bed unit in Harris County intended to provide extended care up to 60 days for these children with the provision of customized therapy and recovery services.

H.B. 4091 amends Texas Health and Safety Code to eliminate statutory barriers for the admission of a foster child in an inpatient facility. The bill will clarify that DFPS may request admission to an inpatient mental health facility for a minor in the managing conservatorship who can benefit from extended stay in a specialty inpatient stabilization treatment program.

H.B. 4091 amends current law relating to a request for admission to a specialty inpatient stabilization treatment program by the Department of Family and Protective Services of certain minors in the managing conservatorship of the department.

RULEMAKING AUTHORITY

This bill does not expressly grant any additional rulemaking authority to a state officer, institution, or agency.

SECTION BY SECTION ANALYSIS

SECTION 1. Amends Section 572.001, Health and Safety Code, by amending Subsection (c-2) and adding Subsections (c-5), (c-6), (c-7), and (c-8), as follows:

(c-2) Authorizes the Department of Family and Protective Services (DFPS) to request the admission to an inpatient mental health facility of a minor in the managing conservatorship of DFPS only if:

(1) creates this subdivision from existing text; or

(2) for a minor who is at least 13 years of age and not older than 17 years of age, a court, after reviewing any relevant evidence, including a physician's opinion and detailed reasons for that opinion, determines that the minor is a person whose mental health has deteriorated to the point where the minor would benefit from admission into a specialty inpatient stabilization treatment program designed specifically to meet the mental health needs of minors who need further treatment to successfully transition into a residential treatment program or another less restrictive foster care setting.

(c-5) Provides that the admission of a minor to a specialty inpatient stabilization treatment program under Subsection (c-2) is subject to review by a court under Section 263.002 (Review of Placements by Court; Findings), Family Code.

(c-6) Requires the court, if a minor is or may be placed in a specialty stabilization treatment program under Subsection (c-2), to determine whether:

(1) the child's needs can be met through placement in a family-like setting;

(2) the placement can provide the most effective and appropriate level of care for the child; and

(3) the placement is the least restrictive setting consistent with the child's best interest and individual needs.

(c-7) Authorizes the court, in making a determination under Subsection (c-6), to consider:

(1) medical, psychological, or psychiatric assessments;

(2) the child's current treatment plan and progress made under that plan;

(3) any significant medical, legal, or behavioral incidents involving the child;

(4) the reasons for the child's discharge from any previous placement or the child's current placement;

(5) the programs available at the facility to address the child's needs;

(6) the facility's plan to discharge the child after treatment;

(7) whether other programs may meet the child's needs more effectively; and

(8) any other information that would assist the court in making its determination.

(c-8) Requires DFPS, not later than December 1 of each year, to submit a report to the governor, lieutenant governor, and speaker of the house of representatives regarding the admission of minors to a specialty inpatient stabilization treatment program under Subsection (c-2), including:

(1) the number of total minors admitted to the program;

(2) which courts decided to admit a minor to the program;

(3) the location of each program where a minor was admitted; and

(4) the outcomes of minors admitted to each facility, including:

(A) the number of minors served;

(B) the average length of inpatient admission;

(D)� any recommendations to improve the program.

SECTION 2. Effective date: upon passage or September 1, 2023.