85R11123 JG-F     By: Miller H.B. No. 4083       A BILL TO BE ENTITLED   AN ACT   relating to trauma screening for certain children and   trauma-informed care training for certain providers participating   in the Medicaid managed care program.          BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:          SECTION 1.  Section 266.0042, Family Code, is amended to   read as follows:          Sec. 266.0042.  CONSENT FOR PSYCHOTROPIC   MEDICATION.  Consent to the administration of a psychotropic   medication is valid only if:                (1)  the consent is given voluntarily and without undue   influence; and                (2)  the person authorized by law to consent for the   foster child receives verbally or in writing information that   describes:                      (A)  the specific condition to be treated;                      (B)  the beneficial effects on that condition   expected from the medication;                      (C)  the probable health and mental health   consequences of not consenting to the medication;                      (D)  the probable clinically significant side   effects and risks associated with the medication; [and]                      (E)  the generally accepted alternative   medications and non-pharmacological interventions to the   medication, if any, and the reasons for the proposed course of   treatment; and                      (F)  the determination, following a screening of   the foster child for trauma, that the symptoms exhibited by the   foster child are related to a diagnosed mental disorder and not a   traumatic event or that the administration of the psychotropic   medication is recommended for temporary relief for symptoms related   to a traumatic event.          SECTION 2.  Section 533.0052, Government Code, is amended to   read as follows:          Sec. 533.0052.  STAR HEALTH PROGRAM:  TRAUMA-INFORMED CARE   TRAINING. (a)  A contract between a managed care organization and   the commission for the organization to provide health care services   to recipients under the STAR Health program must require that:                (1)  [include a requirement that trauma-informed care   training be offered to] each contracted physician or provider who   diagnoses mental health conditions or disorders for, prescribes   psychotropic medications for, or provides non-pharmacological   interventions or therapeutic treatment for mental health   conditions or disorders to foster children in the conservatorship   of the Department of Family and Protective Services receives a   minimum of eight hours of trauma-informed care training that the   Department of Family and Protective Services, after consultation   with the Department of State Health Services, considers appropriate   and that includes training on:                      (A)  attachment theory;                      (B)  the impact of trauma on a child's:                            (i)  brain development;                            (ii)  neurochemistry;                            (iii)  behavior; and                            (iv)  cognitive processes and perception;                      (C)  managing psychological triggers of traumatic   memories;                      (D)  to reduce the chances of misdiagnosis,   distinctions between symptoms related to trauma exposure and   symptoms related to mental health disorders;                      (E)  the types and appropriate uses of   non-pharmacological interventions and evidence-based treatment   modalities for trauma;                      (F)  the factors to consider regarding the   potential use of psychotropic medications by children who have   experienced traumatic events; and                      (G)  the impact of alcohol use on the brain   development of a child in utero and the impact of fetal alcohol   spectrum disorder on a child's behavior; and                (2)  each contracted physician or provider who provides   non-pharmacological interventions or therapeutic treatment to   foster children in the conservatorship of the Department of Family   and Protective Services be certified to use at least one   evidence-based, trauma-informed intervention or therapy that has   received a positive rating for the strength of the research   evidence supporting the intervention or therapy from the California   Evidence-Based Clearinghouse for Child Welfare.          (a-1)  The commission shall make the training described by   Subsection (a)(1) available at no cost to each contracted physician   or provider.          (a-2)  A contracted physician or provider may meet the   requirements in Subsection (a) by providing documentation to the   commission of relevant training and certification.          (b)  The commission shall require [encourage] each managed   care organization providing health care services to recipients   under the STAR Health program to require that each contracted   physician or provider receives [make] training in distinguishing   post-traumatic stress disorder from other mental health disorders,   such as [and] attention-deficit/hyperactivity disorder, bipolar   disorder, and oppositional defiant disorder, not later than   [available to a contracted physician or provider within a   reasonable time after] the date the physician or provider begins   providing services under the managed care plan.          (c)  Notwithstanding any other law, a contracted physician   or provider is not required to meet the training and certification   requirements of this section before September 1, 2019.  This   subsection expires September 1, 2021.          SECTION 3.  (a)  Section 533.0052, Government Code, as   amended by this Act, applies only to a contract between the Health   and Human Services Commission and a managed care organization that   is entered into or renewed on or after the effective date of this   Act.          (b)  To the extent permitted by law or the terms of the   contract, the Health and Human Services Commission shall amend a   contract entered into before the effective date of this Act with a   managed care organization to require compliance with Section   533.0052, Government Code, as amended by this Act.          SECTION 4.  If before implementing any provision of this Act   a state agency determines that a waiver or authorization from a   federal agency is necessary for implementation of that provision,   the agency affected by the provision shall request the waiver or   authorization and may delay implementing that provision until the   waiver or authorization is granted.          SECTION 5.  This Act takes effect September 1, 2017.