BILL ANALYSIS S.B. 269 By: Truan, Madla (Van de Putte) May 4, 1995 Committee Report (Unamended) BACKGROUND Lead poisoning is one of the most common and preventable environmental problems facing children in the United States, affecting virtually every system in the body. Lead exposure can occur from many sources, including lead-based paint and dust, soil, water, pottery and home exposures from the parent's occupation or hobby. Although it affects people of all ages, children are more vulnerable to the dangerous effects of lead, even at lower concentrations. Because the developing nervous system is particularly susceptible to lead toxicity, reducing lead exposure among infants, toddlers, and preschool children is of particular concern. PURPOSE S.B. 269 would set forth requirements for reporting cases of childhood lead poisoning or blood lead levels of concern. RULEMAKING AUTHORITY It is the committee's opinion that this bill expressly grants additional rulemaking authority to the Texas Board of Health in SECTION 1 (Sections 88.003, 88.004, and 88.005, Health and Safety Code). SECTION BY SECTION ANALYSIS SECTION 1. Amends Title 2D, Health and Safety Code, by adding Chapter 88, as follows: CHAPTER 88. REPORTS OF CHILDHOOD LEAD POISONING Sec. 88.001. DEFINITIONS. Defines "child care," "child care facility," "health authority," "health professional," "lead," "blood lead levels of concern," "lead poisoning," "local health department," "physician," "public health district," and "regional director." Sec. 88.002. CONFIDENTIALITY. (a) Provides that except as specifically authorized by this chapter, reports, records, and information furnished to a health authority, a regional director, or the Texas Department of Health (department) that relates to cases or suspected cases of childhood blood lead levels of concern or lead poisoning are confidential and authorizes the information to be used only for the purposes of this chapter. (b) Provides that information relating to cases or suspected cases of childhood lead poisoning and children with blood lead levels of concern is not public information and prohibits the information from being released or made public on subpoena except as provided by this chapter. (c) Sets forth circumstances for the authorized release of medical, epidemiologic, or toxologic information. (d) Prohibits certain public health officials and public servants from being examined in a proceeding as to the existence or contents of pertinent records of or information about a child identified, examined, or treated for lead poisoning or about a child with blood lead levels of concern by certain public health facilities without the consent of the child's parents, managing conservator, guardian, or other person authorized to give consent for the child. Sec. 88.003. REPORTABLE HEALTH CONDITION. (a) Provides that early childhood blood lead levels of concern are reportable. (b) Authorizes the board, by rule, to designate blood lead concentrations or the ages of children for whom reporting requirements apply. (c) Authorizes the board to adopt rules to establish a registry of children with blood lead levels of concern and poisoning. Sec. 88.004. PERSONS REQUIRED TO REPORT. (a) Requires a person to report early childhood blood lead levels of concern, if required to do so, to the department in a manner specified by board rule. Requires a person required to make a report to do so immediately after gaining knowledge of the case or suspected case of a child with blood lead levels of concern. (b) Requires a physician to report a case or suspected case of childhood lead poisoning or blood lead levels of concern after the physician's first examination of a child for whom reporting is required by board rule. (c) Requires a person in charge of facilities in which a laboratory examination of a specimen yields evidence of a child with a blood lead level of concern to report the findings to the department as required by board rule. (d) Sets forth a list of persons required to report a case or suspected case of childhood lead poisoning or blood lead levels of concern if a report is not made. Sec. 88.005. REPORTING PROCEDURES. (a) Requires the board to prescribe the form and method of reporting. (b) Authorizes the board rules to require reports to contain any information relating to a case that is necessary for the purposes of this chapter. (c) Authorizes the commissioner to allow an alternate routing of information in particular cases if the commissioner determines that the customary reporting procedure would cause undue delays. Sec. 88.006. REPORTS OF HOSPITALIZATION; DEATH. (a)-(b) Require a physician who attends to a child during the child's hospitalization or who attended the child during the child's last illness, to immediately notify the department if the physician knows or suspects the child has lead poisoning or a blood lead level of concern and believes the poisoning of blood lead level of concern resulted from exposure to a dangerous level of lead that may be a threat to the public health. (c) Authorizes an attending physician, health authority, or regional director, with the consent of the child's survivors, to request an autopsy if the attending medical professional needs further information concerning the cause of death in order to protect public health. Authorizes the medical professional to order the autopsy if the child's survivors do not consent. Requires the results to be reported to the department. (d) Requires a justice of the peace acting as coroner or medical examiner in the course of an inquest who finds that a child's cause of death resulted from exposure to a dangerous level of environmental lead that the justice of the peace or medical examiner believes may be a threat to the public health to immediately notify the health authority or the regional medical director in the jurisdiction in which the finding is made. SECTION 2. Effective date: January 1, 1996. SECTION 3. Emergency clause. SUMMARY OF COMMITTEE ACTION S.B. 269 was considered by the Public Health Committee in a formal meeting on May 4, 1995. The bill was reported favorably without amendment, and with the recommendation that it do pass and be printed, by a record vote of 7 ayes, 0 nays, 0 PNV, and 2 absent.