Galena Park ISD Contracts with Legacy Community Health Center; Parental Consent Requirements Unclear

In April 2023, Project Veritas obtained undercover footage on Legacy Community Health Center’s pediatric gender services. In June 2023, Parents Defending Education (PDE) filed a public records request with two of the school systems – Galena Park ISD and YES Prep – that partner with Legacy Community Health Center for copies of contracts with Legacy.

Both YES Prep and Galena ISD declined to provide these contracts and requested a ruling from the Texas Attorney General’s office; on August 31, the AG’s office ordered the requested information to be turned over to PDE.

The first contract provided between Galena ISD & Legacy is for the period of August 1, 2020-July 31, 2021; services to be provided are “certain limited onsite health and behavioral healthcare services”:

Schools where Legacy services would be provided included North Shore Senior High School and Green Valley Elementary School (listed on page 12 of PDF under “Exhibit A: List of Schools”).

Interesting clauses include:

• II.2.e, which notes “Legacy shall have the right to bill students, student’s siblings, and the children of Galena Park ISD staff members for health care Services provided by Legacy’s professional staff in accordance with Legacy’s usual and customary fee schedule” and that “to the extent permitted by law, Galena Park ISD shall cooperate with Legacy to obtain health insurance information, if any, from any and all students and their parents or guardians who receive Services under this Agreement.”
• II.2.h, which notes “Legacy shall have the right to contact students and parents or guardians to provide and improve parent, student and community awareness of Legacy through contacts, promotional events, print materials and otherwise to enhance the general awareness of the services offered by Legacy at the Schools. Such education and awareness shall be presented by means of direct mail promotional materials, internet, telephonically and other lawful and appropriate means customary to the provision of Services.”
• IV.1, which notes “All medical records shall remain the property of Legacy.”

In May 2023, the Biden Administration’s Education Department released a proposed rule that would streamline Medicaid’s billing permission for students with disabilities by “remov[ing] the requirement for public agencies to obtain parental consent prior to accessing for the first time a child’s public benefits or insurance ( e.g., Medicaid, Children’s Health Insurance Program (CHIP)) to provide or pay for required IDEA Part B services.” Interestingly, the Legacy-Galena Park ISD contract explicitly states in Section V.2, “Of these students, it is estimated that 80% of them qualify for the Free and Reduced Lunch program—an indicator of economic need.”

While the contract does state “For Patients who are referred to Legacy for Services, other than emergency care, it is agreed that the Patients’ parents or caregivers must first execute a voluntary Pediatric Consent and Acknowledgement of Services Form (Consent) as contained in Exhibit B prior to the initiation of Services” (Section IV.1), it also states that “This Consent, once executed by the applicable parties, enables Legacy to initiate Services and provide appropriate follow-up for each Patient as may be necessary.”

The consent form authorized services are listed as including but not being limited to:

• Any mandated school health services requested from Legacy.
• Comprehensive physical examination (complete medical examination) including those for school, sports, working papers, and new school admissions.
• Medically prescribed laboratory tests.
• Medical care and treatment, including diagnosis of acute and chronic illness and disease, and dispensing and prescribing of medications.
• Behavioral health services including counseling, therapy, evaluation, diagnosis, treatment, and referrals.
• Health education and counseling for the prevention of risk-taking behaviors such as: drug, alcohol, and smoking abuse, as well as education on pregnancy prevention, sexually transmitted infections, and HIV, as age appropriate.
• A child in Texas (defined in the Texas Family Code as less than 18 years of age) can consent for the treatment of a reportable infectious, contagious, or communicable disease (for example only and not limited to: HIV/AIDS, other sexually transmitted diseases, tuberculosis, and hepatitis); for treatment related to a pregnancy (other than abortion) and, if the child is a self-pay or Medicaid patient, for prescription contraception/birth control.

The contract was renewed the following year – adding Galena Park Middle School as an additional school location in Exhibit A.

In November 2022, an addendum to the contract was signed, adding a fourth location (the Almatha Clark Taylor Health Clinic) to the list of locations serviced by Legacy.