1-1 By: Truan S.B. No. 269
1-2 (In the Senate - Filed January 19, 1995; January 23, 1995,
1-3 read first time and referred to Committee on Health and Human
1-4 Services; April 20, 1995, reported adversely, with favorable
1-5 Committee Substitute by the following vote: Yeas 7, Nays 0;
1-6 April 20, 1995, sent to printer.)
1-7 COMMITTEE SUBSTITUTE FOR S.B. No. 269 By: Truan, Madla
1-8 A BILL TO BE ENTITLED
1-9 AN ACT
1-10 relating to the identification of children suffering from lead
1-11 poisoning.
1-12 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-13 SECTION 1. Subtitle D, Title 2, Health and Safety Code, is
1-14 amended by adding Chapter 88 to read as follows:
1-15 CHAPTER 88. REPORTS OF CHILDHOOD LEAD POISONING
1-16 Sec. 88.001. DEFINITIONS. In this chapter:
1-17 (1) "Child care" includes a school, preschool,
1-18 kindergarten, nursery school, or other similar activity that
1-19 provides care or instruction for young children.
1-20 (2) "Child care facility" means a public place or a
1-21 residence in which a person furnishes child care.
1-22 (3) "Health authority" means a physician appointed as
1-23 such under Chapter 121.
1-24 (4) "Health professional" means an individual whose:
1-25 (A) vocation or profession is directly or
1-26 indirectly related to the maintenance of health in another
1-27 individual; and
1-28 (B) duties require a specified amount of formal
1-29 education and may require a special examination, certificate or
1-30 license, or membership in a regional or national association.
1-31 (5) "Lead" includes metallic lead and materials
1-32 containing metallic lead with a potential for release in sufficient
1-33 concentrations to pose a threat to public health.
1-34 (6) "Blood lead levels of concern" means the presence
1-35 of blood lead concentrations suspected to be associated with mental
1-36 and physical disorders due to absorption, ingestion, or inhalation
1-37 of lead as specified in the most recent criteria issued by the
1-38 United States Department of Health and Human Services, United
1-39 States Public Health Service, Centers for Disease Control and
1-40 Prevention of the United States Public Health Service.
1-41 (7) "Lead poisoning" means the presence of a confirmed
1-42 venous blood level established by board rule in the range specified
1-43 for medical evaluation and possible pharmacologic treatment in the
1-44 most recent criteria issued by the United States Department of
1-45 Health and Human Services, United States Public Health Service,
1-46 Centers for Disease Control and Prevention of the United States
1-47 Public Health Service.
1-48 (8) "Local health department" means a department
1-49 created under Chapter 121.
1-50 (9) "Physician" means a person licensed to practice
1-51 medicine by the Texas State Board of Medical Examiners.
1-52 (10) "Public health district" means a district created
1-53 under Chapter 121.
1-54 (11) "Regional director" means a physician appointed
1-55 by the board as the chief administrative officer of a public health
1-56 region under Chapter 121.
1-57 Sec. 88.002. CONFIDENTIALITY. (a) Except as specifically
1-58 authorized by this chapter, reports, records, and information
1-59 furnished to a health authority, a regional director, or the
1-60 department that relate to cases or suspected cases of children with
1-61 blood lead levels of concern or lead poisoning are confidential and
1-62 may be used only for the purposes of this chapter.
1-63 (b) Reports, records, and information relating to cases or
1-64 suspected cases of childhood lead poisoning and children with blood
1-65 lead levels of concern are not public information under the open
1-66 records law, Chapter 552, Government Code, and may not be released
1-67 or made public on subpoena or otherwise except as provided by this
1-68 chapter.
2-1 (c) Medical, epidemiologic, or toxicologic information may
2-2 be released:
2-3 (1) for statistical purposes if released in a manner
2-4 that prevents the identification of any person;
2-5 (2) with the consent of each person identified in the
2-6 information;
2-7 (3) to medical personnel, appropriate state agencies,
2-8 health authorities, regional directors, and public officers of
2-9 counties and municipalities as necessary to comply with this
2-10 chapter and related rules;
2-11 (4) to appropriate federal agencies, such as the
2-12 Centers for Diseases Control and Prevention of the United States
2-13 Public Health Service, except that the information must be limited
2-14 to the information requested by the agency; or
2-15 (5) to medical personnel to the extent necessary in a
2-16 medical emergency to protect the health or life of the child
2-17 identified in the information.
2-18 (d) The commissioner, a regional director or other
2-19 department employee, a health authority or employee of a public
2-20 health district, a health authority or employee of a county or
2-21 municipal health department, or a public official of a county or
2-22 municipality may not be examined in a civil, criminal, special, or
2-23 other proceeding as to the existence or contents of pertinent
2-24 records of or reports or information about a child identified,
2-25 examined, or treated for lead poisoning or about a child possessing
2-26 blood lead levels of concern by the department, a public health
2-27 district, a local health department, or a health authority without
2-28 the consent of the child's parents, managing conservator, guardian,
2-29 or other person authorized by law to give consent.
2-30 Sec. 88.003. REPORTABLE HEALTH CONDITION. (a) Childhood
2-31 blood lead levels of concern are reportable.
2-32 (b) The board by rule may designate:
2-33 (1) blood lead concentrations in children that must be
2-34 reported; and
2-35 (2) the ages of children for whom the reporting
2-36 requirements apply.
2-37 (c) The board may adopt rules that establish a registry of
2-38 children with blood lead levels of concern and lead poisoning.
2-39 Sec. 88.004. PERSONS REQUIRED TO REPORT. (a) A person
2-40 required to report childhood blood lead levels of concern shall
2-41 report to the department in the manner specified by board rule.
2-42 Except as provided by this section, a person required by this
2-43 section to report must make the report immediately after the person
2-44 gains knowledge of the case or suspected case of a child with a
2-45 blood lead level of concern.
2-46 (b) A physician shall report a case or suspected case of
2-47 childhood lead poisoning or of a child with a blood lead level of
2-48 concern after the physician's first examination of a child for whom
2-49 reporting is required by board rule.
2-50 (c) A person in charge of an independent clinical
2-51 laboratory, a hospital or clinic laboratory, or other facility in
2-52 which a laboratory examination of a specimen derived from the human
2-53 body yields evidence of a child with a blood lead level of concern
2-54 shall report the findings to the department as required by board
2-55 rule.
2-56 (d) If a report is not made as required by Subsection (b) or
2-57 (c), the following persons shall report a case or suspected case of
2-58 a child with lead poisoning or a blood lead level of concern and
2-59 all information known concerning the child:
2-60 (1) the administrator of a hospital licensed under
2-61 Chapter 241;
2-62 (2) a professional registered nurse;
2-63 (3) an administrator or director of a public or
2-64 private child care facility;
2-65 (4) an administrator of a home health agency;
2-66 (5) an administrator or health official of a public or
2-67 private institution of higher education;
2-68 (6) a superintendent, manager, or health official of a
2-69 public or private camp, home, or institution;
2-70 (7) a parent, managing conservator, guardian, or
3-1 residence owner; and
3-2 (8) a health professional.
3-3 Sec. 88.005. REPORTING PROCEDURES. (a) The board shall
3-4 prescribe the form and method of reporting under this chapter,
3-5 including a report in writing, by telephone, or by electronic data
3-6 transmission.
3-7 (b) Board rules may require the reports to contain any
3-8 information relating to a case that is necessary for the purposes
3-9 of this chapter, including:
3-10 (1) the child's name, address, age, sex, and race;
3-11 (2) the child's blood lead concentration;
3-12 (3) the procedure used to determine the child's blood
3-13 lead concentration; and
3-14 (4) the name of the attending physician.
3-15 (c) The commissioner may authorize an alternate routing of
3-16 information in particular cases if the commission determines that
3-17 the customary reporting procedure would cause the information to be
3-18 unduly delayed.
3-19 Sec. 88.006. REPORTS OF HOSPITALIZATION; DEATH. (a) A
3-20 physician who attends a child during the child's hospitalization
3-21 shall immediately notify the department if the physician knows or
3-22 suspects that the child has lead poisoning or a blood lead level of
3-23 concern and the physician believes the lead poisoning or blood lead
3-24 level of concern resulted from the child's exposure to a dangerous
3-25 level of lead that may be a threat to the public health.
3-26 (b) A physician who attends a child during the child's last
3-27 illness shall immediately notify the department if the physician:
3-28 (1) knows or suspects that the child died of lead
3-29 poisoning; and
3-30 (2) believes the lead poisoning resulted from the
3-31 child's exposure to a dangerous level of lead that may be a threat
3-32 to the public health.
3-33 (c) An attending physician, health authority, or regional
3-34 director, with the consent of the child's survivors, may request an
3-35 autopsy if the physician, health authority, or regional director
3-36 needs further information concerning the cause of death in order to
3-37 protect the public health. The health authority or regional
3-38 director may order the autopsy to determine the cause of death if
3-39 the child's survivors do not consent to the autopsy. The autopsy
3-40 results shall be reported to the department.
3-41 (d) A justice of the peace acting as coroner or a medical
3-42 examiner in the course of an inquest under Chapter 49, Code of
3-43 Criminal Procedure, who finds that a child's cause of death was
3-44 lead poisoning that resulted from exposure to a dangerous level of
3-45 lead that the justice of the peace or medical examiner believes may
3-46 be a threat to the public health shall immediately notify the
3-47 health authority or the regional director in the jurisdiction in
3-48 which the finding is made.
3-49 SECTION 2. This Act takes effect January 1, 1996.
3-50 SECTION 3. The importance of this legislation and the
3-51 crowded condition of the calendars in both houses create an
3-52 emergency and an imperative public necessity that the
3-53 constitutional rule requiring bills to be read on three several
3-54 days in each house be suspended, and this rule is hereby suspended.
3-55 * * * * *