By:  Madla                                             S.B. No. 345
                (In the Senate - Filed February 12, 1993; February 15, 1993,
          read first time and referred to Committee on Education;
          May 12, 1993, reported adversely, with favorable Committee
          Substitute by the following vote:  Yeas 7, Nays 0; May 12, 1993,
          sent to printer.)
                                    COMMITTEE VOTE
                                  Yea     Nay      PNV      Absent 
                Ratliff            x                               
                Haley              x                               
                Barrientos         x                               
                Bivins             x                               
                Harris of Tarrant                             x    
                Luna               x                               
                Montford                                      x    
                Shapiro                                       x    
                Sibley                                        x    
                Turner             x                               
                Zaffirini          x                               
          COMMITTEE SUBSTITUTE FOR S.B. No. 345                    By:  Haley
                                 A BILL TO BE ENTITLED
    1-1                                AN ACT
    1-2  relating to the provision of health services in public schools.
    1-3        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-4        SECTION 1.  Subchapter Z, Chapter 21, Education Code, is
    1-5  amended by adding Section 21.938 to read as follows:
    1-6        Sec. 21.938.  PROVISION OF HEALTH SERVICES.  (a)  The Central
    1-7  Education Agency, with the advice of the Texas Department of Health
    1-8  and the advisory committee appointed under Subsection (b) of this
    1-9  section, shall adopt advisory guidelines for the provision of
   1-10  health services to students by a school district.  The advisory
   1-11  guidelines must address:
   1-12              (1)  legal considerations involved in the provision of
   1-13  health services, including compliance with statutes and rules
   1-14  governing the practice of medicine, professional nursing, and
   1-15  pharmacy and applicable public health statutes and rules;
   1-16              (2)  staffing and personnel requirements;
   1-17              (3)  the types of students, including those with
   1-18  disabilities, to whom health services may be provided and how
   1-19  special needs of students may be met;
   1-20              (4)  coordination of school health services with other
   1-21  student services and related instructional programs;
   1-22              (5)  coordination of school health services with health
   1-23  resources in the community;
   1-24              (6)  performance criteria for evaluating the adequacy
   1-25  of school health programs; and
   1-26              (7)  other issues the agency determines appropriate.
   1-27        (b)  The commissioner of education and the commissioner of
   1-28  health shall appoint an advisory committee to assist in developing
   1-29  the advisory guidelines.  The committee must include
   1-30  representatives of organizations that represent nursing interests,
   1-31  school districts, school administrators, classroom teachers,
   1-32  parents of students, child advocacy interests, and public health
   1-33  interests.  A member of the advisory committee may not receive
   1-34  compensation for serving on the committee and is not entitled to
   1-35  reimbursement for expenses while serving on the committee.
   1-36        (c)  The commissioner of education shall conduct an annual
   1-37  survey of school districts regarding the extent to which districts
   1-38  are providing school health services in accordance with the
   1-39  advisory guidelines.
   1-40        (d)  In this section, "advisory guidelines" means standards,
   1-41  practices, or procedures that are recommended for use by school
   1-42  districts.
   1-43        SECTION 2.  Not later than March 1, 1994, the Central
   1-44  Education Agency shall finally adopt school health services
   1-45  advisory guidelines as provided by Section 21.938, Education Code,
   1-46  as added by this Act.  Not later than October 1, 1994, the
   1-47  commissioner of education shall survey school districts to
   1-48  determine the extent to which districts are providing school health
   1-49  services in accordance with the advisory guidelines as provided by
   1-50  Section 21.938, Education Code, as added by this Act.  The
   1-51  commissioner of education shall report to the 74th Legislature in
   1-52  January, 1995, on the advisory guidelines adopted under Section
   1-53  21.938, Education Code, as added by this Act, the results of the
   1-54  commissioner's survey, and recommendations for legislation relating
   1-55  to school health services.
   1-56        SECTION 3.  The importance of this legislation and the
   1-57  crowded condition of the calendars in both houses create an
   1-58  emergency and an imperative public necessity that the
   1-59  constitutional rule requiring bills to be read on three several
   1-60  days in each house be suspended, and this rule is hereby suspended.
   1-61                               * * * * *
   1-62                                                         Austin,
   1-63  Texas
   1-64                                                         May 12, 1993
   1-65  Hon. Bob Bullock
   1-66  President of the Senate
   1-67  Sir:
   1-68  We, your Committee on Education to which was referred S.B. No. 345,
    2-1  have had the same under consideration, and I am instructed to
    2-2  report it back to the Senate with the recommendation that it do not
    2-3  pass, but that the Committee Substitute adopted in lieu thereof do
    2-4  pass and be printed.
    2-5                                                         Ratliff,
    2-6  Chairman
    2-7                               * * * * *
    2-8                               WITNESSES
    2-9                                                  FOR   AGAINST  ON
   2-10  ___________________________________________________________________
   2-11  Name:  Charles T. Harms                          x
   2-12  Representing:  Northside ISD
   2-13  City:  San Antonio
   2-14  -------------------------------------------------------------------
   2-15  Name:  Shirley Schrriber                         x
   2-16  Representing:  Texas Assoc. of School Nurses
   2-17  City:  San Antonio
   2-18  -------------------------------------------------------------------
   2-19  Name:  Sandy Kibby                               x
   2-20  Representing:  Texas PTA
   2-21  City:  Austin
   2-22  -------------------------------------------------------------------
   2-23  Name:  James Willmann                            x
   2-24  Representing:  Texas Nurses Assoc.
   2-25  City:  Austin
   2-26  -------------------------------------------------------------------