This article was published in partnership with the Houston Chronicle.
HOUSTON — Texas child welfare workers and family courts will be required to consider additional medical opinions before taking children from parents in cases of suspected child abuse, under a new law going into effect Sept. 1.
The law, signed by Gov. Greg Abbott on Friday, also orders a state commission to study the work of state-funded doctors who are tasked with diagnosing child abuse. The commission will propose improvements to the process that Texas Child Protective Services workers follow when relying on these doctors’ medical reports.
The legislation follows a 2019 NBC News and Houston Chronicle investigation into the plight of parents who were accused of abuse based on mistaken reports by doctors. State Rep. James Frank, a Republican from Wichita Falls and one of the bill’s sponsors, said its goal is to prevent CPS from taking children from parents based on flawed or incomplete medical reports.
“False removals are traumatic for kids first and foremost, but also for their parents,” he said. “So we have to be more precise in the way we go through the removal process. I think sometimes when an expert in a white suit says something, there’s a tendency for CPS to go, ‘They're 100 percent right.’ But that’s not always the case.”
The NBC News and Chronicle reporting focused on the work of child abuse pediatricians, a small but growing subspecialty of doctors who work closely with state child welfare agencies. When a child — especially one too young to speak — comes into a hospital with serious injuries, child abuse pediatricians review medical images and witness statements to determine whether the injuries were accidental or inflicted.
Child abuse pediatricians provide expert reports and court testimony in thousands of child welfare cases across the country every year, shielding untold numbers of abused children from additional harm. But when the evidence is not clear, the investigation found, a mistaken or overstated diagnosis of child abuse can devastate a family.
Under the new law, caregivers accused of abuse based on a medical report will be allowed to request that CPS get another opinion from a doctor whose expertise is relevant to the child’s injuries. And when parents get a second medical opinion on their own, the law will require judges to consider that evidence before issuing orders for children to be taken into state custody.
In 2016, Ann Marie Timmerman rushed her lethargic 4-month-old son to a Houston hospital, where she learned he had suffered a small amount of bleeding around his brain. A child abuse pediatrician told CPS that the injury could only have been the result of abuse.
Based on that opinion alone — and without considering a report from a pediatric neurosurgeon who disagreed, saying the injury was probably the result of childbirth — CPS took emergency custody of the baby, records show. The agency dropped the case seven months later based on additional medical findings.
The first thing Timmerman saw when she woke up Saturday morning was a text from an advocate with a single sentence bearing the news: The governor signed the bill. She shook her husband awake: “It’s official!” she told him.
Timmerman, one of the parents featured in the NBC News and Chronicle series, made several trips to Austin to testify in support of the law. She said if it had been in place five years ago, her baby might not have been stripped from her care.
“This would have stopped it,” Timmerman said. “We had the treating neurosurgeon in the hospital saying it was birth trauma — we had the second diagnosis right there and CPS chose not to talk to him.”
Patrick Crimmins, a spokesman for the Texas Department of Family and Protective Services, which oversees CPS, said the agency does not comment on legislation or its handling of individual cases.
The law also might have made a difference in the case of Melissa and Dillon Bright, whose ordeal was chronicled in the 2020 NBC News and Wondery podcast "Do No Harm." In their case, a Houston child abuse pediatrician told CPS that their 5-month-old’s head injuries didn’t match the Brights’ account of him accidentally falling head-first from a lawn chair onto their concrete driveway. The Brights consulted a pediatric radiologist who disagreed, but neither CPS nor a judge considered that opinion before taking emergency custody of both of the Brights’ children, records show.
A judge later ordered CPS to return the Bright children to their parents and issued a $127,000 sanction against the state agency for its handling of the case.
Child welfare advocacy groups in Texas have broadly endorsed the new law’s goal of preventing needless child removals but have also raised concerns about potential unintended consequences. Child abuse pediatricians, for example, warned lawmakers this spring that the process of seeking additional medical opinions could lead to delays in removing children from dangerous homes.
In the end, the law passed with broad bipartisan support in both chambers of the Texas Legislature. State Rep. Gene Wu, a Houston Democrat and a lawyer who handles CPS cases, said he supported the bill because it ensures that the agency and judges have more information to make better decisions for children and families.
“Like all things that CPS does, there is a delicate balance,” he said. “If you tip it too far on one side, then you will have kids who are returning to families that are abusing them, and if you tip it too far the other way, then you have families that are having their kids stripped away because of a medical mistake. And this is an attempt at trying to figure out ways that we can make the process a little more fair.”