Texas Child Protection Law Bench Book

Updated September 2025

J. Medical Consent

1. Medical Care and Treatment

Except in an emergency, medical care may not be provided to a child in foster care, unless the person authorized by court order consents to the medical care. Tex. Fam. Code § 266.004(a).

2. Medical Consenter

The court may designate DFPS as the medical consenter, but DFPS must within 5 business days file with the court and each party the name of an individual who will exercise the duty and responsibility of providing informed consent on behalf of DFPS. Tex. Fam. Code § 266.004(b)(2) and (c).

A person may not be authorized to consent to medical care provided to a foster child unless the person has completed a DFPS-approved training program related to informed consent and the provision of all areas of medical care as defined by Tex. Fam. Code § 266.001. Tex. Fam. Code § 266.004(h).

Tex. Fam. Code § 266.004(h) addresses required medical consenter training as follows:

•   The training required by Tex. Fam. Code § 266.004(h) must include training related to informed consent for the administration of psychotropic medication and the appropriate use of psychosocial therapies, behavior strategies, and other non-pharmacological interventions that should be considered before or concurrently with the administration of psychotropic medications. Tex. Fam. Code § 266.004(h-1).

•   Each person required to complete a training program under Tex. Fam. Code § 266.004(h) must acknowledge in writing that the person:

◦   has received the training described by Tex. Fam. Code § 266.004(h-1);

◦   understands the principles of informed consent for the administration of psychotropic medication; and

◦   understands that non-pharmacological interventions should be considered and discussed with the prescribing physician, physician assistant, or advanced practice nurse before consent to the use of a psychotropic medication. Tex. Fam. Code § 266.004(h-2).

DFPS may consent to health care services ordered or prescribed by a health care provider authorized to order or prescribe health care services regardless of whether services are provided under the medical assistance program under Tex. Hum. Res. Code Chapter 32, if DFPS otherwise has the authority under Tex. Fam. Code § 266.004 to consent to health care services. Tex. Fam. Code § 266.004(k).

3. Consent by Child 16 Years of Age

A child who is at least 16 years of age may consent to the provision of medical care if the court determines that the child has the capacity to consent to medical care. Tex. Fam. Code § 266.010(a).

An attorney ad litem appointed for a child in a proceeding under Tex. Fam. Code Chapter 262 or Chapter 263 shall, for a child at least 16 years of age, advise the child of the child's right to consent to the child's own medical care under Tex. Fam. Code § 266.010. Tex. Fam. Code § 107.003(b)(3).

4. Assumption of Financial Responsibility by Medical Consenters

A person, other than DFPS, who is authorized by a court to consent to medical care for a foster child, may assume financial responsibility for medical care, including behavioral health services, provided to a foster child by an out-of-network provider engaged by the medical consenter on behalf of the child. For that purpose, assuming financial responsibility may include the medical consenter enrolling the child in a health insurance plan. Tex. Fam. Code § 266.0043(b). DFPS is not liable for the cost of such care, unless a court orders DFPS to cover the cost of the medical care. Tex. Fam. Code § 266.0043(c). The assumption of financial responsibility authorized by Tex. Fam. Code § 266.0043 may not be construed to:

•   Limit or restrict a foster child's access to Medicaid benefits, including in-network benefits provided under the Medicaid managed care program;

•   Change or limit the rights of parents of children in the temporary managing conservatorship of DFPS; or

•   Limit a court's authority to order DFPS to assume financial responsibility for the cost of services provided to a foster child by an out-of-network provider. Tex. Fam. Code § 266.0043(d)

A medical consenter is required, not later than the 10^th business day after the date medical care for which the consenter assumes financial responsibility is provided, to notify the child's caseworker of the provision of that care in the form and manner prescribed by DFPS. DFPS must ensure the child's health passport included records of the medical care provided. Tex. Fam. Code § 266.0043(e).

A Medicaid managed care organization (MCO) is prohibited from taking adverse action to prevent or discourage a recipient from accessing health care and related services and benefits in accordance with Tex. Fam. Code § 266.0043. Tex. Govt. Code § 540.0807.