BILL ANALYSIS
C.S.H.B. 1456
By: Van de Putte
04-26-95
Committee Report (Substituted)
BACKGROUND
Lead poisoning of small children often results in severe mental
retardation and possibly death. Modest exposure to lead can cause
reduced learning capacity, hypertension, and destroy the body's
defense against chemical damage to the nervous system. The Texas
Department of Health (Department) has applied for a grant from the
Center for Disease Control to collect the necessary data to
determine the scope of the lead poisoning problem in Texas.
Currently, the only testing of blood lead levels in children occurs
through the Medicaid Early Periodic Screening, Detection and
Treatment (EPSDT) program. Of the total number of children tested,
recent statistics show that the following percentages were shown as
having elevated blood lead levels: Bexar County, 9.8% of children
tested, or 1,616 children; Dallas County, 8.9%, or 2,688 children;
Harris County, 8.4%, or 2,487 children; Nueces County, 5.2%, or 143
children; El Paso County, 7.6%, or 1,151 children; and statewide,
8.3%, or 7,095 children.
PURPOSE
This bill amends the Health and Safety Code by making childhood
lead poisoning a reportable condition.
RULEMAKING AUTHORITY
It is the committee's opinion that Section I of this bill grants
the Texas Department of Health additional rulemaking authority in
the following sections of the Health and Safety Code: Sec. 88.003,
Sec. 88.004, and Sec. 88.005.
SECTION BY SECTION ANALYSIS
SECTION 1. Adds Chapter 88 to Subtitle D, Title 2, Health and
Safety Code, "REPORTS OF CHILDHOOD LEAD POISONING," as follows:
Sec. 88.001. DEFINITIONS. Provides definitions of
facilities, physicians, health professionals, materials and
locations related to this Chapter.
Sec. 88.002. CONFIDENTIALITY. (a) States that reports,
records and information furnished to specified health
authorities are confidential, except as authorized under this
chapter.
(b) States that reports, records and information of this
chapter are not public information under the Open
Records Act nor are they subject to release by subpoena
or for any purpose not specified by this chapter.
(c) Stipulates that medical, epidemiologic, or
toxicologic information may be released under the
following conditions:
(1) for statistical purposes without identifiers;
(2) with the consent of each person identified;
(3) to medical personnel, health authorities, or
public officials acting in compliance with this
chapter;
(4) to federal agencies at their request; or,
(5) to medical personnel to the extent necessary to
protect the health or life of the child identified.
(d) Prohibits any of the involved public health
professionals from testifying or revealing the existence
or contents of the treatment records of an identified
child without the approval of an adult authorized to
give consent for the child.
Sec. 88.003. REPORTABLE HEALTH CONDITIONS. (a) States that
early childhood lead poisoning is a reportable health
condition.
(b) Allows the Texas Board of Health (Board), by rule,
to designate the level of blood lead concentrations to
be reported and the ages of children for whom reporting
requirements apply.
(c) Gives the Board authority to establish, by rule, a
registry of children with lead poisoning.
Sec. 88.004. PERSONS REQUIRED TO REPORT. (a) States that a
person required to report early childhood lead poisoning must
report to the Department in the manner specified by Board
rule. The reports must be made immediately after the person
required to report acquires the knowledge of the case or
suspected case.
(b) Requires a physician to report a case of childhood
lead poisoning or suspected poisoning upon the first
examination of a child for whom reporting is required
by Board rule.
(c) Requires a person in charge of a laboratory to
report evidence of childhood lead poisoning as required
by Board rules.
(d) Specifies the persons who must report a case or
suspected case of childhood lead poisoning if a report
is not made according to Subsections (b) and (c) of this
section.
Sec. 88.005. REPORTING PROCEDURES. (a) The Board must
prescribe the necessary form and method of reporting,
including a report in writing, by telephone, or by electronic
data transmission.
(b) States that Board rules may require the reports to
contain any information necessary to carry out the
purposes of this Chapter, and outlines specific points
of information Board rule may require.
(c) Allows the commissioner to authorize alternate
methods of reporting in particular cases if the
customary reporting procedure would cause the
information to be unduly delayed.
Sec. 88.006. REPORTS OF HOSPITALIZATION; DEATH. (a)
Requires immediate notification of the Department by the
physician treating a hospitalized child with lead poisoning if
the physician knows or suspects that the source of the child's
exposure is a public health risk.
(b) Requires immediate notification of the Department
by a physician if that physician knows or suspects that
a child died of lead poisoning and if the physician
believes the source of the child's exposure to be a
public health threat.
(c) An attending physician or a health authority may
request an autopsy, with consent of the child's
survivors, if further information is needed concerning
the cause of death in order to protect the public
health. The health authority or regional director may
order the autopsy if the child's survivors do not
consent to the autopsy; the results must be reported to
the Department.
(d) Requires the medical examiner or acting coroner,
conducting an inquest under Chapter 49 of the Code of
Criminal Procedure, to immediately notify the health
authority or the regional director if a child's cause
of death is determined to be lead poisoning and resulted
from exposure to a dangerous level of environmental lead
that is considered to pose a threat to the public
health.
SECTION 2. Effective date. January 1, 1996.
SECTION 3. Emergency clause.
COMPARISON OF ORIGINAL TO SUBSTITUTE
The substitute for H.B. 1456 contains non-substantive language
changes as recommended by the Legislative Council.
SUMMARY OF COMMITTEE ACTION
H.B. 1456 was considered by the Public Health Committee in a public
hearing on April 19, 1995.
The following persons testified in favor of the bill:
Rebecca Rex, representing self.
Timothy G. Lignoul, representing City of Houston.
Representative Van de Putte, author of the bill.
The following person testified neutrally on the bill:
R. Kinnan Goleman, representing ASARCO Incorporated.
The bill was left pending.
The bill was considered by the committee as pending business on
April 26, 1995. The committee considered a complete substitute for
the bill. The substitute was adopted without objection. The bill
was reported favorably as substituted with the recommendation that
it do pass and be printed, by a record vote of 7 AYES, 0 NAYS, 0
PNV, and 2 ABSENT.
COMPARISON OF ORIGINAL TO SUBSTITUTE
SUMMARY OF COMMITTEE ACTION