(a) A foster child who is at least 16 years of age may consent to the provision of medical care, except as provided by Chapter 33, if the court with continuing jurisdiction determines that the child has the capacity to consent to medical care. If the child provides consent by signing a consent form, the form must be written in language the child can understand.
(b) A court with continuing jurisdiction may make the determination regarding the foster child’s capacity to consent to medical care during a hearing under Chapter 263 or may hold a hearing to make the determination on its own motion. The court may issue an order authorizing the child to consent to all or some of the medical care as defined by § 266.001. In addition, a foster child who is at least 16 years of age, or the foster child’s attorney ad litem, may file a petition with the court for a hearing. If the court determines that the foster child lacks the capacity to consent to medical care, the court may consider whether the foster child has acquired the capacity to consent to medical care at subsequent hearings under § 263.5031.

(c) If the court determines that a foster child lacks the capacity to consent to medical care, the person authorized by the court under § 266.004 shall continue to provide consent for the medical care of the foster child.
(d) If a foster child who is at least 16 years of age and who has been determined to have the capacity to consent to medical care refuses to consent to medical care and the department or private agency providing substitute care or case management services to the child believes that the medical care is appropriate, the department or the private agency may file a motion with the court requesting an order authorizing the provision of the medical care.
(e) The motion under Subsection (d) must include:
(1) the child’s stated reasons for refusing the medical care; and
(2) a statement prepared and signed by the treating physician that the medical care is the proper course of treatment for the foster child.
(f) If a motion is filed under Subsection (d), the court shall appoint an attorney ad litem for the foster child if one has not already been appointed. The foster child’s attorney ad litem shall:
(1) discuss the situation with the child;
(2) discuss the suitability of the medical care with the treating physician;
(3) review the child’s medical and mental health records; and
(4) advocate to the court on behalf of the child’s expressed preferences regarding the medical care.
(g) The court shall issue an order authorizing the provision of the medical care in accordance with a motion under Subsection (d) to the foster child only if the court finds, by clear and convincing evidence, after the hearing that the medical care is in the best interest of the foster child and:
(1) the foster child lacks the capacity to make a decision regarding the medical care;
(2) the failure to provide the medical care will result in an observable and material impairment to the growth, development, or functioning of the foster child; or
(3) the foster child is at risk of suffering substantial bodily harm or of inflicting substantial bodily harm to others.
(h) In making a decision under this section regarding whether a foster child has the capacity to consent to medical care, the court shall consider:
(1) the maturity of the child;
(2) whether the child is sufficiently well informed to make a decision regarding the medical care; and
(3) the child’s intellectual functioning.
(i) In determining whether the medical care is in the best interest of the foster child, the court shall consider:
(1) the foster child’s expressed preference regarding the medical care, including perceived risks and benefits of the medical care;
(2) likely consequences to the foster child if the child does not receive the medical care;
(3) the foster child’s prognosis, if the child does receive the medical care; and
(4) whether there are alternative, less intrusive treatments that are likely to reach the same result as provision of the medical care.
(j) This section does not apply to emergency medical care. An emergency relating to a foster child who is at least 16 years of age, other than a child in an inpatient mental health facility, is governed by § 266.009.
(k) This section does not apply to the administration of medication under Subchapter G, Chapter 574, Health and Safety Code, to a foster child who is at least 16 years of age and who is placed in an inpatient mental health facility.
(l) Before a foster child reaches the age of 16, the department or the private agency providing substitute care or case management services to the foster child shall advise the foster child of the right to a hearing under this section to determine whether the foster child may consent to medical care. The department or the private agency providing substitute care or case management services shall provide the foster child with training on informed consent and the provision of medical care as part of the Preparation for Adult Living Program.