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.