74R10499 CAG-F
By Van de Putte H.B. No. 1456
Substitute the following for H.B. No. 1456:
By Rodriguez C.S.H.B. No. 1456
A BILL TO BE ENTITLED
1-1 AN ACT
1-2 relating to the identification of children suffering from lead
1-3 poisoning and to control measures for lead contamination.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subtitle D, Title 2, Health and Safety Code, is
1-6 amended by adding Chapter 88 to read as follows:
1-7 CHAPTER 88. REPORTS OF CHILDHOOD LEAD POISONING
1-8 Sec. 88.001. DEFINITIONS. In this chapter:
1-9 (1) "Child care" includes a school, preschool,
1-10 kindergarten, nursery school, or other similar activity that
1-11 provides care or instruction for young children.
1-12 (2) "Child care facility" means a public place or a
1-13 residence in which a person furnishes child care.
1-14 (3) "Health authority" means a physician appointed as
1-15 such under Chapter 121.
1-16 (4) "Health professional" means an individual whose:
1-17 (A) vocation or profession is directly or
1-18 indirectly related to the maintenance of health in another
1-19 individual; and
1-20 (B) duties require a specified amount of formal
1-21 education and may require a special examination, certificate or
1-22 license, or membership in a regional or national association.
1-23 (5) "Lead" includes metallic lead and lead-containing
2-1 materials.
2-2 (6) "Lead poisoning" means the presence of blood lead
2-3 concentrations known to be associated with mental and physical
2-4 disorders due to absorption, ingestion, or inhalation of lead as
2-5 specified in the most recent criteria issued by the United States
2-6 Department of Health and Human Services, United States Public
2-7 Health Service, Centers for Disease Control of the United States
2-8 Public Health Service, or other national public health organization
2-9 specified by board rule.
2-10 (7) "Local health department" means a department
2-11 created under Chapter 121.
2-12 (8) "Physician" means a person licensed to practice
2-13 medicine by the Texas State Board of Medical Examiners.
2-14 (9) "Public health district" means a district created
2-15 under Chapter 121.
2-16 (10) "Public place" means all or any portion of an
2-17 area, building or other structure, or conveyance that is not used
2-18 for private residential purposes, regardless of ownership.
2-19 (11) "Regional director" means a physician appointed
2-20 by the board as the chief administrative officer of a public health
2-21 region under Chapter 121.
2-22 Sec. 88.002. CONFIDENTIALITY. (a) Except as specifically
2-23 authorized by this chapter, reports, records, and information
2-24 furnished to a health authority, a regional director, or the
2-25 department that relate to cases or suspected cases of childhood
3-1 lead poisoning are confidential and may be used only for the
3-2 purposes of this chapter.
3-3 (b) Reports, records, and information relating to cases or
3-4 suspected cases of childhood lead poisoning are not public
3-5 information under the open records law, Chapter 552, Government
3-6 Code, and may not be released or made public on subpoena or
3-7 otherwise except as provided by this chapter.
3-8 (c) Medical, epidemiologic, or toxicologic information may
3-9 be released:
3-10 (1) for statistical purposes if released in a manner
3-11 that prevents the identification of any person;
3-12 (2) with the consent of each person identified in the
3-13 information;
3-14 (3) to medical personnel, appropriate state agencies,
3-15 health authorities, regional directors, and public officers of
3-16 counties and municipalities as necessary to comply with this
3-17 chapter and related rules;
3-18 (4) to appropriate federal agencies, such as the
3-19 Centers for Disease Control of the United States Public Health
3-20 Service, except that the information must be limited to the
3-21 information requested by the agency; or
3-22 (5) to medical personnel to the extent necessary in a
3-23 medical emergency to protect the health or life of the child
3-24 identified in the information.
3-25 (d) The commissioner, a regional director or other
4-1 department employee, a health authority or employee of a public
4-2 health district, a health authority or employee of a county or
4-3 municipal health department, or a public official of a county or
4-4 municipality may not be examined in a civil, criminal, special, or
4-5 other proceeding as to the existence or contents of pertinent
4-6 records of or reports or information about a child identified,
4-7 examined, or treated for lead poisoning by the department, a public
4-8 health district, a local health department, or a health authority
4-9 without the consent of the child's parents, managing conservator,
4-10 guardian, or other person authorized by law to give consent.
4-11 Sec. 88.003. REPORTABLE HEALTH CONDITIONS. (a) Early
4-12 childhood lead poisoning is a reportable health condition.
4-13 (b) The board by rule may designate:
4-14 (1) blood lead concentrations in children that must be
4-15 reported; and
4-16 (2) the ages of children for whom the reporting
4-17 requirements apply.
4-18 (c) The board may adopt rules that establish a registry of
4-19 children with lead poisoning.
4-20 Sec. 88.004. PERSONS REQUIRED TO REPORT. (a) A person
4-21 required to report early childhood lead poisoning shall report to
4-22 the department in the manner specified by board rule. Except as
4-23 provided by this section, a person required by this section to
4-24 report must make the report immediately after the person gains
4-25 knowledge of the case or suspected case of childhood lead
5-1 poisoning.
5-2 (b) A physician shall report a case or suspected case of
5-3 childhood lead poisoning after the physician's first examination of
5-4 a child for whom reporting is required by board rule.
5-5 (c) A person in charge of an independent clinical
5-6 laboratory, a hospital or clinic laboratory, or other facility in
5-7 which a laboratory examination of a specimen derived from the human
5-8 body yields evidence of childhood lead poisoning shall report the
5-9 findings to the department as required by board rule.
5-10 (d) If a report is not made as required by Subsection (b) or
5-11 (c), the following persons shall report a case or suspected case of
5-12 childhood lead poisoning and all information known concerning the
5-13 child:
5-14 (1) the administrator of a hospital licensed under
5-15 Chapter 241;
5-16 (2) a professional registered nurse;
5-17 (3) an administrator or director of a public or
5-18 private child care facility;
5-19 (4) an administrator of a home health agency;
5-20 (5) an administrator or health official of a public or
5-21 private institution of higher education;
5-22 (6) a superintendent, manager, or health official of a
5-23 public or private camp, home, or institution;
5-24 (7) a parent, managing conservator, guardian, or
5-25 residence owner; and
6-1 (8) a health professional.
6-2 Sec. 88.005. REPORTING PROCEDURES. (a) The board shall
6-3 prescribe the form and method of reporting under this chapter,
6-4 including a report in writing, by telephone, or by electronic data
6-5 transmission.
6-6 (b) Board rules may require the reports to contain any
6-7 information relating to a case that is necessary for the purposes
6-8 of this chapter, including:
6-9 (1) the child's name, address, age, sex, and race;
6-10 (2) the child's blood lead concentration;
6-11 (3) the procedure used to determine the child's blood
6-12 lead concentration; and
6-13 (4) the name of the attending physician.
6-14 (c) The commissioner may authorize an alternate routing of
6-15 information in particular cases if the commissioner determines that
6-16 the customary reporting procedure would cause the information to be
6-17 unduly delayed.
6-18 Sec. 88.006. REPORTS OF HOSPITALIZATION; DEATH. (a) A
6-19 physician who attends a child during the child's hospitalization
6-20 shall immediately notify the department if the physician knows or
6-21 suspects that the child has lead poisoning and the physician
6-22 believes the lead poisoning resulted from the child's exposure to a
6-23 dangerous level of environmental lead that may be a threat to the
6-24 public health.
6-25 (b) A physician who attends a child during the child's last
7-1 illness shall immediately notify the department if the physician:
7-2 (1) knows or suspects that the child died of lead
7-3 poisoning; and
7-4 (2) believes the lead poisoning resulted from the
7-5 child's exposure to a dangerous level of environmental lead that
7-6 may be a threat to the public health.
7-7 (c) An attending physician, health authority, or regional
7-8 director, with the consent of the child's survivors, may request an
7-9 autopsy if the physician, health authority, or regional director
7-10 needs further information concerning the cause of death in order to
7-11 protect the public health. The health authority or regional
7-12 director may order the autopsy to determine the cause of death if
7-13 the child's survivors do not consent to the autopsy. The autopsy
7-14 results shall be reported to the department.
7-15 (d) A justice of the peace acting as coroner or a medical
7-16 examiner in the course of an inquest under Chapter 49, Code of
7-17 Criminal Procedure, who finds that a child's cause of death was
7-18 lead poisoning that resulted from exposure to a dangerous level of
7-19 environmental lead that the justice of the peace or medical
7-20 examiner believes may be a threat to the public health shall
7-21 immediately notify the health authority or the regional director in
7-22 the jurisdiction in which the finding is made.
7-23 SECTION 2. This Act takes effect January 1, 1996.
7-24 SECTION 3. The importance of this legislation and the
7-25 crowded condition of the calendars in both houses create an
8-1 emergency and an imperative public necessity that the
8-2 constitutional rule requiring bills to be read on three several
8-3 days in each house be suspended, and this rule is hereby suspended.