By Van de Putte 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; providing
1-4 penalties.
1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-6 SECTION 1. Subtitle D, Title 2, Health and Safety Code, is
1-7 amended by adding Chapter 88 to read as follows:
1-8 CHAPTER 88. REPORTS OF CHILDHOOD LEAD POISONING
1-9 Sec. 88.001. DEFINITIONS. In this chapter:
1-10 (1) "Child care" includes a school, preschool,
1-11 kindergarten, nursery school, or other similar activity that
1-12 provides care or instruction for young children.
1-13 (2) "Child care facility" means a public place or a
1-14 residence in which a person furnishes child care.
1-15 (3) "Health authority" means a physician appointed as
1-16 such under Chapter 121.
1-17 (4) "Health professional" means an individual whose:
1-18 (A) vocation or profession is directly or
1-19 indirectly related to the maintenance of health in another
1-20 individual; and
1-21 (B) duties require a specified amount of formal
1-22 education and may require a special examination, certificate or
1-23 license, or membership in a regional or national association.
2-1 (5) "Lead" includes metallic lead and lead-containing
2-2 materials.
2-3 (6) "Lead poisoning" means the presence of blood lead
2-4 concentrations known to be associated with mental and physical
2-5 disorders due to absorption, ingestion, or inhalation of lead as
2-6 specified in the most recent criteria issued by the United States
2-7 Department of Health and Human Services, United States Public
2-8 Health Service, Centers for Disease Control of the United States
2-9 Public Health Service, or other national public health organization
2-10 specified by board rule.
2-11 (7) "Local health department" means a department
2-12 created under Chapter 121.
2-13 (8) "Physician" means a person licensed to practice
2-14 medicine by the Texas State Board of Medical Examiners.
2-15 (9) "Public health district" means a district created
2-16 under Chapter 121.
2-17 (10) "Public place" means all or any portion of an
2-18 area, building or other structure, or conveyance that is not used
2-19 for private residential purposes, regardless of ownership.
2-20 (11) "Regional director" means a physician appointed
2-21 by the board as the chief administrative officer of a public health
2-22 region under Chapter 121.
2-23 Sec. 88.002. CONFIDENTIALITY. (a) Except as specifically
2-24 authorized by this chapter, reports, records, and information
2-25 furnished to a health authority, a regional director, or the
3-1 department that relate to cases or suspected cases of childhood
3-2 lead poisoning are confidential and may be used only for the
3-3 purposes of this chapter.
3-4 (b) Reports, records, and information relating to cases or
3-5 suspected cases of childhood lead poisoning are not public
3-6 information under the open records law, Chapter 552, Government
3-7 Code, and may not be released or made public on subpoena or
3-8 otherwise except as provided by this chapter.
3-9 (c) Medical, epidemiologic, or toxicologic information may
3-10 be released:
3-11 (1) for statistical purposes if released in a manner
3-12 that prevents the identification of any person;
3-13 (2) with the consent of each person identified in the
3-14 information;
3-15 (3) to medical personnel, appropriate state agencies,
3-16 health authorities, regional directors, and public officers of
3-17 counties and municipalities as necessary to comply with this
3-18 chapter and related rules;
3-19 (4) to appropriate federal agencies, such as the
3-20 Centers for Disease Control of the United States Public Health
3-21 Service, except that the information must be limited to the
3-22 information requested by the agency; or
3-23 (5) to medical personnel to the extent necessary in a
3-24 medical emergency to protect the health or life of the child
3-25 identified in the information.
4-1 (d) The commissioner, a regional director or other
4-2 department employee, a health authority or employee of a public
4-3 health district, a health authority or employee of a county or
4-4 municipal health department, or a public official of a county or
4-5 municipality may not be examined in a civil, criminal, special, or
4-6 other proceeding as to the existence or contents of pertinent
4-7 records of or reports or information about a child identified,
4-8 examined, or treated for lead poisoning by the department, a public
4-9 health district, a local health department, or a health authority
4-10 without the consent of the child's parents, managing conservator,
4-11 guardian, or other person authorized by law to give consent.
4-12 Sec. 88.003. REPORTABLE HEALTH CONDITIONS. (a) Early
4-13 childhood lead poisoning is a reportable health condition.
4-14 (b) The board by rule may designate:
4-15 (1) blood lead concentrations in children that must be
4-16 reported; and
4-17 (2) the ages of children for whom the reporting
4-18 requirements apply.
4-19 (c) The board may adopt rules that establish a registry of
4-20 children with lead poisoning.
4-21 Sec. 88.004. PERSONS REQUIRED TO REPORT. (a) A person
4-22 required to report early childhood lead poisoning shall report to
4-23 the department in the manner specified by board rule. Except as
4-24 provided by this section, a person required by this section to
4-25 report must make the report immediately after the person gains
5-1 knowledge of the case or suspected case of childhood lead
5-2 poisoning.
5-3 (b) A physician shall report a case or suspected case of
5-4 childhood lead poisoning after the physician's first examination of
5-5 a child for whom reporting is required by board rule.
5-6 (c) A person in charge of an independent clinical
5-7 laboratory, a hospital or clinic laboratory, or other facility in
5-8 which a laboratory examination of a specimen derived from the human
5-9 body yields evidence of childhood lead poisoning shall report the
5-10 findings to the department as required by board rule.
5-11 (d) If a report is not made as required by Subsection (b) or
5-12 (c), the following persons shall report a case or suspected case of
5-13 childhood lead poisoning and all information known concerning the
5-14 child:
5-15 (1) the administrator of a hospital licensed under
5-16 Chapter 241;
5-17 (2) a professional registered nurse;
5-18 (3) an administrator or director of a public or
5-19 private child care facility;
5-20 (4) an administrator of a home health agency;
5-21 (5) an administrator or health official of a public or
5-22 private institution of higher education;
5-23 (6) a superintendent, manager, or health official of a
5-24 public or private camp, home, or institution;
5-25 (7) a parent, managing conservator, guardian, or
6-1 residence owner; and
6-2 (8) a health professional.
6-3 Sec. 88.005. REPORTING PROCEDURES. (a) The board shall
6-4 prescribe the form and method of reporting under this chapter,
6-5 including a report in writing, by telephone, or by electronic data
6-6 transmission.
6-7 (b) Board rules may require the reports to contain any
6-8 information relating to a case that is necessary for the purposes
6-9 of this chapter, including:
6-10 (1) the child's name, address, age, sex, and race;
6-11 (2) the child's blood lead concentration;
6-12 (3) the procedure used to determine the child's blood
6-13 lead concentration; and
6-14 (4) the name of the attending physician.
6-15 (c) The commissioner may authorize an alternate routing of
6-16 information in particular cases if the commissioner determines that
6-17 the customary reporting procedure would cause the information to be
6-18 unduly delayed.
6-19 Sec. 88.006. REPORTS OF HOSPITALIZATION; DEATH. (a) A
6-20 physician who attends a child during the child's hospitalization
6-21 shall immediately notify the department if the physician knows or
6-22 suspects that the child has lead poisoning and the physician
6-23 believes the lead poisoning resulted from the child's exposure to a
6-24 dangerous level of environmental lead that may be a threat to the
6-25 public health.
7-1 (b) A physician who attends a child during the child's last
7-2 illness shall immediately notify the department if the physician:
7-3 (1) knows or suspects that the child died of lead
7-4 poisoning; and
7-5 (2) believes the lead poisoning resulted from the
7-6 child's exposure to a dangerous level of environmental lead that
7-7 may be a threat to the public health.
7-8 (c) An attending physician, health authority, or regional
7-9 director, with the consent of the child's survivors, may request an
7-10 autopsy if the physician, health authority, or regional director
7-11 needs further information concerning the cause of death in order to
7-12 protect the public health. The health authority or regional
7-13 director may order the autopsy to determine the cause of death if
7-14 the child's survivors do not consent to the autopsy. The autopsy
7-15 results shall be reported to the department.
7-16 (d) A justice of the peace acting as coroner or a medical
7-17 examiner in the course of an inquest under Chapter 49, Code of
7-18 Criminal Procedure, who finds that a child's cause of death was
7-19 lead poisoning that resulted from exposure to a dangerous level of
7-20 environmental lead that the justice of the peace or medical
7-21 examiner believes may be a threat to the public health shall
7-22 immediately notify the health authority or the regional director in
7-23 the jurisdiction in which the finding is made.
7-24 SECTION 2. This Act takes effect January 1, 1996.
7-25 SECTION 3. The importance of this legislation and the
8-1 crowded condition of the calendars in both houses create an
8-2 emergency and an imperative public necessity that the
8-3 constitutional rule requiring bills to be read on three several
8-4 days in each house be suspended, and this rule is hereby suspended.