BILL ANALYSIS


                                                     C.S.S.B. 269
                                                        By: Truan
                                        Health and Human Services
                                                          4-20-95
                                   Committee Report (Substituted)
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

As proposed, C.S.S.B. 269 sets forth requirements for reporting
cases of childhood lead poisoning or blood lead levels of concern.

RULEMAKING AUTHORITY

It is the committee's opinion that rulemaking authority is granted
to the Texas Board of Health in SECTION 1 (Sections 88.003(b) and
(c), 88.004(a), (b), and (c); and 88.005(b), Health and Safety
Code) of this bill.

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 are 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 to give consent for the child (legal guardian).
     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 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 (medical professional), 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.