By Dukes                                        H.B. No. 2219

      75R5581 DLF-D                           

                                A BILL TO BE ENTITLED

 1-1                                   AN ACT

 1-2     relating to lead poisoning screening and lead inspection and

 1-3     abatement requirements for certain facilities; providing penalties.

 1-4           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

 1-5           SECTION 1.  Chapter 88, Health and Safety Code, as added by

 1-6     Section 52, Chapter 965, Acts of the 74th Legislature, Regular

 1-7     Session, 1995, is amended to read as follows:

 1-8              CHAPTER 88. [REPORTS OF] CHILDHOOD LEAD POISONING

 1-9                      SUBCHAPTER A. GENERAL PROVISIONS

1-10           Sec. 88.001.  DEFINITIONS.  In this chapter:

1-11                 (1)  "Blood lead level of concern" means the presence

1-12     of blood lead concentrations suspected to be associated with mental

1-13     and physical disorders due to absorption, ingestion, or inhalation

1-14     of lead as specified in the most recent criteria issued by the

1-15     United States Department of Health and Human Services, United

1-16     States Public Health Service, Centers for Disease Control and

1-17     Prevention of the United States Public Health Service.

1-18                 (2)  "Child care" includes a school, preschool,

1-19     kindergarten, nursery school, or other similar activity that

1-20     provides care or instruction for young children.

1-21                 (3) [(2)]  "Child care facility" means a public place

1-22     or a residence in which a person furnishes child care.

1-23                 (4) [(3)]  "Health authority" means a physician

1-24     appointed as such under Chapter 121.

 2-1                 (5) [(4)]  "Health professional" means an individual

 2-2     whose:

 2-3                       (A)  vocation or profession is directly or

 2-4     indirectly related to the maintenance of health in another

 2-5     individual;  and

 2-6                       (B)  duties require a specified amount of formal

 2-7     education and may require a special examination, certificate or

 2-8     license, or membership in a regional or national association.

 2-9                 (6)  "Imminent lead hazard" means a lead hazard that,

2-10     if allowed to continue, will place a child younger than six years

2-11     of age at risk of developing lead poisoning or a blood lead level

2-12     of concern.

2-13                 (7)  "Interim control activity" means an action

2-14     designed to temporarily reduce human exposure or likely exposure to

2-15     a lead hazard, including specialized cleaning, repair, maintenance,

2-16     painting, temporary containment, and ongoing monitoring of lead

2-17     hazards and potential lead hazards.

2-18                 (8) [(5)]  "Lead" includes metallic lead and materials

2-19     containing metallic lead with a potential for release in sufficient

2-20     concentrations to pose a threat to public health.

2-21                 (9)  "Lead hazard" means a substance, surface, or

2-22     object that contains lead and that, due to its condition, location,

2-23     or nature, may contribute to lead poisoning or a blood lead level

2-24     of concern in a child younger than six years of age.

2-25                 (10)  "Lead hazard abatement" means an action designed

2-26     to permanently eliminate a lead hazard, including:

2-27                       (A)  removal of lead-bearing paint and

 3-1     lead-contaminated dust or soil;

 3-2                       (B)  permanent containment or encapsulation of

 3-3     lead-bearing paint;

 3-4                       (C)  replacement of surfaces or fixtures painted

 3-5     with lead-bearing paint;

 3-6                       (D)  covering of lead-contaminated soil; and

 3-7                       (E)  any preparation, cleanup, disposal, and

 3-8     testing activity associated with an activity described by

 3-9     Paragraphs (A)-(D).

3-10                 (11)  "Lead hazard reduction" means an action designed

3-11     to reduce human exposure to lead hazards, including lead hazard

3-12     abatement and interim control activities involving lead-bearing

3-13     paint or lead-contaminated dust or soil.

3-14                 (12) [(6)  "Blood lead levels of concern" means the

3-15     presence of blood lead concentrations suspected to be associated

3-16     with mental and physical disorders due to absorption, ingestion, or

3-17     inhalation of lead as specified in the most recent criteria issued

3-18     by the United States Department of Health and Human Services,

3-19     United States Public Health Service, Centers for Disease Control

3-20     and Prevention of the United States Public Health Service.]

3-21                 [(7)]  "Lead poisoning" means the presence of a

3-22     confirmed venous blood level established by board rule in the range

3-23     specified for medical evaluation and possible pharmacologic

3-24     treatment in the most recent criteria issued by the United States

3-25     Department of Health and Human Services, United States Public

3-26     Health Service, Centers for Disease Control and Prevention of the

3-27     United States Public Health Service.

 4-1                 (13) [(8)]  "Local health department" means a

 4-2     department created under Chapter 121.

 4-3                 (14) [(9)]  "Physician" means a person licensed to

 4-4     practice medicine by the Texas State Board of Medical Examiners.

 4-5                 (15) [(10)]  "Public health district" means a district

 4-6     created under Chapter 121.

 4-7                 (16) [(11)]  "Regional director" means a physician

 4-8     appointed by the board as the chief administrative officer of a

 4-9     public health region under Chapter 121.

4-10           Sec. 88.002.  STATEWIDE PROGRAM; GRANTS.  (a)  The department

4-11     shall develop and implement a comprehensive statewide lead

4-12     poisoning or lead exposure prevention and treatment program to

4-13     implement this chapter.

4-14           (b)  The department, in accordance with the General

4-15     Appropriations Act, may award grants of money to fund:

4-16                 (1)  programs to educate the public about the danger of

4-17     lead poisoning or lead exposure;

4-18                 (2)  screening for lead poisoning and blood lead levels

4-19     of concern;

4-20                 (3)  coordination of care and follow-up services for

4-21     children younger than six years of age;

4-22                 (4)  administration or enforcement of responsibilities

4-23     delegated to a health authority under this chapter; or

4-24                 (5)  another activity related to prevention of lead

4-25     poisoning or lead exposure.

4-26           Sec. 88.003.  DELEGATION.  (a)  The department may delegate

4-27     enforcement or administration of any part of this chapter to  a

 5-1     health authority.

 5-2           (b)  The department may not make a delegation under this

 5-3     section unless the department provides an appropriate grant of

 5-4     money to the health authority.

 5-5           Sec. 88.004.  TECHNICAL ADVISORY COMMITTEES.  (a)  The board

 5-6     shall appoint one or more technical advisory committees to assist

 5-7     the board in adopting rules necessary to implement this chapter.

 5-8           (b)  A technical advisory committee must include one or more

 5-9     representatives of:

5-10                 (1)  health authorities to which enforcement or

5-11     administration of a part of this chapter is delegated;

5-12                 (2)  the housing industry;

5-13                 (3)  persons who are certified under Chapter 332, Acts

5-14     of the 74th Legislature, Regular Session, 1995 (Article 9029,

5-15     Vernon's Texas Civil Statutes);

5-16                 (4)  physicians or other appropriate representatives of

5-17     health care providers; and

5-18                 (5)  facilities serving children younger than six years

5-19     of age.

5-20           Sec. 88.005.  CONFIDENTIALITY.  (a)  Except as specifically

5-21     authorized by this chapter, reports, records, and information

5-22     furnished to a health authority, a regional director, or the

5-23     department that relate to cases or suspected cases of children with

5-24     blood lead levels of concern or lead poisoning and written evidence

5-25     provided to a child care facility under Section 88.063 are

5-26     confidential and  may be used only for the purposes of this

5-27     chapter.

 6-1           (b)  Reports, records, and information relating to cases or

 6-2     suspected cases of childhood lead poisoning and children with blood

 6-3     lead levels of concern and written evidence obtained under Section

 6-4     88.063 are not public information under the open records law,

 6-5     Chapter 552,  Government Code, and may not be released or made

 6-6     public on subpoena or otherwise except as provided by this chapter.

 6-7           (c)  Medical, epidemiologic, or toxicologic information may

 6-8     be released:

 6-9                 (1)  for statistical purposes if released in a manner

6-10     that prevents the identification of any person;

6-11                 (2)  with the consent of each person identified in the

6-12     information;

6-13                 (3)  to medical personnel, appropriate state agencies,

6-14     health authorities, regional directors, and public officers of

6-15     counties and municipalities as necessary to comply with this

6-16     chapter and related rules;

6-17                 (4)  to appropriate federal agencies, such as the

6-18     Centers for Disease Control and Prevention of the United States

6-19     Public Health Service, except that the information must be limited

6-20     to the information requested by the agency;  or

6-21                 (5)  to medical personnel to the extent necessary in a

6-22     medical emergency to protect the health or life of the child

6-23     identified in the information.

6-24           (d)  The commissioner, a regional director or other

6-25     department employee, a health authority or employee of a public

6-26     health district, a health authority or employee of a county or

6-27     municipal health department, or a public official of a county or

 7-1     municipality may not be examined in a civil, criminal, special, or

 7-2     other proceeding as to the existence or contents of pertinent

 7-3     records of or reports or information about a child identified,

 7-4     examined, or treated for lead poisoning or about a child possessing

 7-5     blood lead levels of concern by the department, a public health

 7-6     district, a local health department, or a health authority without

 7-7     the consent of the child's parents, managing conservator, guardian,

 7-8     or other person authorized by law to give consent.

 7-9           (e)  An officer, employee, or other agent of a child care

7-10     facility may not be examined in a civil, criminal, special, or

7-11     other proceeding as to the existence or contents of written

7-12     evidence provided to the facility under Section 88.063 without the

7-13     consent of the child's parents, managing conservator, or guardian.

7-14              (Sections 88.006-88.010 reserved for expansion 

7-15                    SUBCHAPTER B.  REPORTING REQUIREMENTS

7-16           Sec. 88.011 [88.003].  REPORTABLE HEALTH CONDITION.

7-17     (a)  Childhood blood lead levels of concern are reportable.

7-18           (b)  Subject to Section 88.012, the [The] board by rule may

7-19     designate:

7-20                 (1)  blood lead concentrations in children that must be

7-21     reported; and

7-22                 (2)  the ages of children for whom the reporting

7-23     requirements apply.

7-24           Sec. 88.012.  CHILDREN YOUNGER THAN SIX YEARS OF AGE.  A

7-25     person who screens a child younger than six years of age for lead

7-26     poisoning or lead exposure shall report the results of the

7-27     screening to the department.

 8-1           Sec. 88.013.  REGISTRY.  [(c)]  The board may adopt rules

 8-2     that establish a registry of children with blood lead levels of

 8-3     concern and lead poisoning.

 8-4           Sec. 88.014 [88.004].  PERSONS REQUIRED TO REPORT.  (a)  A

 8-5     person required to report under Section 88.011 or 88.012 [childhood

 8-6     blood  lead levels of concern] shall report to the department in

 8-7     the manner specified by board rule.

 8-8           (b)  A person required to report under Section 88.012 shall

 8-9     report within the time period specified by board rule. Except as

8-10     provided by this section, a person required to report under Section

8-11     88.011 [by this section to report] must make the report immediately

8-12     after the person gains knowledge of the case or suspected case of a

8-13     child with a blood lead level of concern.

8-14           (c) [(b)]  A physician shall report a case or suspected case

8-15     of childhood lead poisoning or of a child with a blood lead level

8-16     of concern after the physician's first examination of a child for

8-17     whom reporting is required by board rule.

8-18           (d) [(c)]  A person in charge of an independent clinical

8-19     laboratory, a hospital or clinic laboratory, or other facility in

8-20     which a laboratory examination of a specimen derived from the human

8-21     body yields evidence of a child with a blood lead level of concern

8-22     shall report the findings to the department as required by board

8-23     rule.

8-24           (e) [(d)]  If a report is not made as required by Subsection

8-25     [(b) or] (c) or (d), the following persons shall report a case or

8-26     suspected case of a child with lead poisoning or a blood lead level

8-27     of concern and all information known concerning the child:

 9-1                 (1)  the administrator of a hospital licensed under

 9-2     Chapter 241;

 9-3                 (2)  a professional registered nurse;

 9-4                 (3)  an administrator or director of a public or

 9-5     private child care facility;

 9-6                 (4)  an administrator of a home health agency;

 9-7                 (5)  an administrator or health official of a public or

 9-8     private institution of higher education;

 9-9                 (6)  a superintendent, manager, or health official of a

9-10     public or private camp, home, or institution;

9-11                 (7)  a parent, managing conservator, or guardian;  and

9-12                 (8)  a health professional.

9-13           Sec. 88.015 [88.005].  REPORTING PROCEDURES.  (a)  The board

9-14     shall prescribe the form and method of reporting under this

9-15     chapter, including a report in writing, by telephone, or by

9-16     electronic data transmission.

9-17           (b)  Board rules may require the reports to contain any

9-18     information relating to a case that is necessary for the purposes

9-19     of this chapter, including:

9-20                 (1)  the child's name, address, age, sex, and race;

9-21                 (2)  the child's blood lead concentration;

9-22                 (3)  the procedure used to determine the child's blood

9-23     lead concentration;  and

9-24                 (4)  the name of the attending physician.

9-25           (c)  The commissioner may authorize an alternate routing of

9-26     information in particular cases if the commissioner determines that

9-27     the customary reporting procedure would cause the information to be

 10-1    unduly delayed.

 10-2          Sec. 88.016 [88.006].  REPORTS OF HOSPITALIZATION; DEATH.

 10-3    (a)  A physician who attends a child during the child's

 10-4    hospitalization shall  immediately notify the department if the

 10-5    physician knows or suspects that the child has lead poisoning or a

 10-6    blood lead level of concern and the physician believes the lead

 10-7    poisoning or blood lead level of concern resulted from the child's

 10-8    exposure to a dangerous level of lead that may be a threat to the

 10-9    public health.

10-10          (b)  A physician who attends a child during the child's last

10-11    illness shall immediately notify the department if the physician:

10-12                (1)  knows or suspects that the child died of lead

10-13    poisoning;  and

10-14                (2)  believes the lead poisoning resulted from the

10-15    child's exposure to a dangerous level of lead that may be a threat

10-16    to the public health.

10-17          (c)  An attending physician, health authority, or regional

10-18    director, with the consent of the child's survivors, may request an

10-19    autopsy if the physician, health authority, or regional director

10-20    needs further information concerning the cause of death in order to

10-21    protect the public health.  The health authority or regional

10-22    director may order the autopsy to determine the cause of death if

10-23    the child's survivors do not consent to the autopsy.  The autopsy

10-24    results shall be reported to the department.

10-25          (d)  A justice of the peace acting as coroner or a medical

10-26    examiner in the course of an inquest under Chapter 49, Code of

10-27    Criminal Procedure, who finds that a child's cause of death was

 11-1    lead poisoning that resulted from exposure to a dangerous level of

 11-2    lead that the justice of the peace or medical examiner believes may

 11-3    be a threat to the public health shall immediately notify the

 11-4    health authority or the regional director in the jurisdiction in

 11-5    which the finding is made.

 11-6          Sec. 88.017.  IMMUNITY.  A person who makes a report under

 11-7    this subchapter in good faith is not civilly or criminally liable

 11-8    for making that report.

 11-9              (Sections 88.018-88.030 reserved for expansion

11-10                        SUBCHAPTER C.  INSPECTIONS

11-11          Sec. 88.031.  SCOPE OF SUBCHAPTER.  (a)  Only the following

11-12    premises are subject to this subchapter:

11-13                (1)  a dwelling in which a child younger than six years

11-14    of age resides;

11-15                (2)  a child care facility that provides services to

11-16    children younger than six years of age; and

11-17                (3)  a facility made subject to this subchapter by

11-18    board rule adopted under Subsection (b).

11-19          (b)  The board by rule may identify a class of facility that

11-20    poses a significant risk to contributing to lead poisoning or lead

11-21    exposure of children younger than six years of age.

11-22          (c)  The premises subject to this subchapter under Subsection

11-23    (a) include:

11-24                (1)  the building in which the dwelling is located or

11-25    in which the facility operates, the attached structures, and the

11-26    real property on which the building is located; and

11-27                (2)  any playground located on the real property on

 12-1    which the building is located.

 12-2          Sec. 88.032.  INSPECTION AFTER NOTICE OF LEAD POISONING OR

 12-3    BLOOD LEAD LEVEL OF CONCERN.  (a)  On receiving a report indicating

 12-4    that a child who is younger than six years of age has lead

 12-5    poisoning or a blood lead level of concern, the department shall

 12-6    conduct a lead inspection of:

 12-7                (1)  the dwelling in which the child resides; and

 12-8                (2)  any other premises subject to this subchapter with

 12-9    respect to which the child has regular contact.

12-10          (b)  A lead inspection conducted under this section must be

12-11    conducted during business hours, unless:

12-12                (1)  the owner or occupant of the dwelling or other

12-13    premises consents to an inspection at another time; or

12-14                (2)  the department determines that the dwelling or

12-15    other premises presents an imminent lead hazard.

12-16          (c)  The department may remove a sample or object necessary

12-17    for laboratory analysis to determine the presence of a lead hazard

12-18    in the dwelling or other premises.

12-19          (d)  The department shall make reasonable efforts to provide

12-20    prior notice of the lead inspection to the owner of the dwelling or

12-21    premises and to obtain consent for the inspection from the owner or

12-22    occupant or a representative of the owner or occupant.  If the

12-23    department is unable to obtain consent to the inspection, the

12-24    department may apply to a court for an order authorizing the

12-25    department to inspect the dwelling or other premises.  An order

12-26    issued under this subsection must state the scope of the inspection

12-27    authorized by the order.

 13-1          Sec. 88.033.  INSPECTION OF CERTAIN LEASED PREMISES.

 13-2    (a)  The board by rule may require the owner or operator of a

 13-3    dwelling or other premises that is leased to another person to be

 13-4    inspected for lead hazards if any part of the dwelling or other

 13-5    premises was constructed before January 1, 1978.

 13-6          (b)  In adopting rules under this section, the board may

 13-7    specify classes of dwellings or other premises that must be

 13-8    inspected based on the  age, condition, and location of the

 13-9    dwellings or other premises, the age of any occupants of a

13-10    dwelling, and other appropriate factors.

13-11          Sec. 88.034.  PERIODIC INSPECTIONS FOR CERTAIN FACILITIES.

13-12    (a)  The department may adopt rules requiring any of the following

13-13    facilities to have periodic lead inspections, at intervals

13-14    established by rule, or to otherwise demonstrate that the facility

13-15    does not contain a lead hazard:

13-16                (1)  a child care facility; or

13-17                (2)  any other facility made subject to this chapter

13-18    under Section 88.031(a)(3).

13-19          (b)  The rules may limit the periodic inspections to

13-20    facilities constructed before a specified date.

13-21          Sec. 88.035.  INSPECTION REPORT.  The department shall

13-22    prepare a written report of any inspection conducted under this

13-23    subchapter and shall make the report available to the public on

13-24    request. This subsection does not authorize the release of

13-25    information that is confidential under Section 88.005.

13-26          Sec. 88.036.  INSPECTION PROCEDURES.  (a)  The department may

13-27    adopt rules establishing procedures for lead inspections of

 14-1    dwellings and other premises subject to this subchapter. The rules

 14-2    must meet, but may not exceed, any requirements established under

 14-3    regulations adopted by the federal Environmental Protection Agency

 14-4    under Title IV,  Toxic Substances Control Act (15 U.S.C. Section

 14-5    2681 et seq.).

 14-6          (b)  The rules adopted under this section may include:

 14-7                (1)  procedures for inspecting, testing, or sampling:

 14-8                      (A)  painted, varnished, or otherwise finished

 14-9    surfaces;

14-10                      (B)  drinking water;

14-11                      (C)  household dust;

14-12                      (D)  soil; and

14-13                      (E)  other materials that may contain lead;

14-14                (2)  procedures for notifying owners, operators,

14-15    occupants, prospective occupants, and mortgage and lien holders of:

14-16                      (A)  lead levels identified during an inspection;

14-17    and

14-18                      (B)  any health risk that is associated with  the

14-19    lead level and the condition of the lead found during the

14-20    inspection;

14-21                (3)  the form of lead inspection reports, the

14-22    requirements for filing the reports with the department, and the

14-23    procedures by which members of the public may obtain copies of the

14-24    inspection reports; and

14-25                (4)  requirements for posting of warnings, as

14-26    appropriate, of the presence of a lead hazard.

14-27          (c)  An inspection under this subchapter must be conducted in

 15-1    accordance with Chapter 332, Acts of the 74th Legislature, Regular

 15-2    Session, 1995 (Article 9029, Vernon's Texas Civil Statutes).

 15-3          Sec. 88.037.  DEPARTMENT ACTION.   If the department

 15-4    determines that a lead hazard is present in any dwelling or other

 15-5    premises subject to this subchapter, the department may:

 15-6                (1)  require a notice of the lead hazard to be posted

 15-7    in a conspicuous place on the dwelling or other premises;

 15-8                (2)  inform the regional director or health authority

 15-9    of the lead hazard and the results of any inspection that resulted

15-10    in the department's determination that a lead hazard exists and

15-11    recommend procedures to reduce or eliminate the lead hazard;

15-12                (3)  notify the occupant or owner of the dwelling or

15-13    other premises, or a representative of the occupant or owner, that

15-14    a lead hazard is present on or in the dwelling or premises and that

15-15    the lead hazard may constitute a health hazard; or

15-16                (4)  issue an order requiring lead hazard reduction

15-17    under Section 88.038.

15-18          Sec. 88.038.  LEAD HAZARD REDUCTION; DEPARTMENT ORDER.

15-19    (a)  The department may issue an order to the owner of a dwelling

15-20    or other premises subject to this subchapter that requires lead

15-21    hazard reduction.

15-22          (b)  An order issued under this section may require lead

15-23    hazard  reduction for an imminent lead hazard not later than the

15-24    fifth day after the date the order is issued and may require the

15-25    lead hazard reduction for a lead hazard other than an imminent lead

15-26    hazard not later than the 30th day after the date of the order.

15-27          (c)  On good cause shown, the department may extend the

 16-1    period within which the owner is required to comply with the order.

 16-2          Sec. 88.039.  FAILURE TO COMPLY WITH DEPARTMENT ORDER; CIVIL

 16-3    ACTION.  (a)  In any civil action brought against the owner of a

 16-4    dwelling or other premises subject to this subchapter:

 16-5                (1)  failure to comply with an order issued by the

 16-6    department under Section 88.038 is prima facie evidence of the

 16-7    owner's negligence with respect to injuries that result from lead

 16-8    poisoning or lead exposure and that result after the date set for

 16-9    compliance with the order, including any extension; and

16-10                (2)  compliance with the order by the date set for

16-11    compliance with the order, including any extension, establishes a

16-12    rebuttable presumption that the owner exercised reasonable care

16-13    with respect to injuries that:

16-14                      (A)  result from lead poisoning or lead exposure

16-15    and that result after the date set for compliance with the order,

16-16    including any extension; and

16-17                      (B)  are caused by lead hazards covered by the

16-18    order.

16-19          (b)  If the order of the department requires only an interim

16-20    control activity, the rebuttable presumption established under

16-21    Subsection (a)(2) applies only during the period for which the

16-22    interim control activity is reasonably expected to reduce or abate

16-23    the lead hazard.

16-24          Sec. 88.040.  LEAD HAZARD REDUCTION; RULES.  (a)  The

16-25    department may adopt rules governing lead hazard reduction. The

16-26    rules must meet but may not exceed any requirements applicable

16-27    under federal regulations adopted under Title IV, Toxic Substances

 17-1    Control Act (15 U.S.C. Section 2681 et seq.).  The rules may:

 17-2                (1)  define the level of lead that constitutes a lead

 17-3    hazard or an imminent lead hazard in various sources or media,

 17-4    including lead-bearing paint, soil, dust, water, and air;

 17-5                (2)  require owners of dwellings or other premises

 17-6    subject to inspection under this subchapter to provide lead hazard

 17-7    reduction;

 17-8                (3)  include a priority-based schedule of the classes

 17-9    of dwellings and other premises that must complete lead hazard

17-10    reduction, based on the age, condition, and location of the

17-11    dwellings or other premises, the age of any occupants of a

17-12    dwelling, and other appropriate factors;

17-13                (4)  specify acceptable lead hazard reduction methods

17-14    for lead in various media;

17-15                (5)  require containment and cleanup during lead hazard

17-16    reduction;

17-17                (6)  require reinspection of dwellings or other

17-18    premises after lead hazard reduction;

17-19                (7)  specify requirements for managing lead hazard

17-20    reduction projects, including requirements to protect the health

17-21    and safety of occupants, neighbors, and the public; and

17-22                (8)  require safe disposal of lead-contaminated waste.

17-23          (b)  Rules adopted under Subsection (a)(7) may restrict

17-24    occupants of a dwelling to areas of the dwelling that do not

17-25    contain a lead hazard during the lead hazard reduction.

17-26          Sec. 88.041.  PRIORITY.  In administering this subchapter,

17-27    the department shall give priority to eliminating lead hazards from

 18-1    dwellings in which children reside who are younger than six years

 18-2    of age and who have been diagnosed with lead poisoning or blood

 18-3    lead levels of concern.

 18-4              (Sections 88.042-88.060 reserved for expansion

 18-5                SUBCHAPTER D.  SCREENING; CARE FOR CHILDREN

 18-6          Sec. 88.061.  SCREENING.  (a)  The board shall adopt rules

 18-7    specifying recommended methods to screen children younger than six

 18-8    years of age for lead poisoning and blood lead levels of concern.

 18-9    The rules must:

18-10                (1)  specify the intervals at which the screening must

18-11    be conducted; and

18-12                (2)  meet any federal requirement for screening

18-13    children younger than six years of age.

18-14          (b)  The rules must  permit a physician or registered nurse

18-15    to perform the screening and may permit other appropriate health

18-16    care professionals to perform the screening.

18-17          (c)  The rules may require an appropriate questionnaire

18-18    designed to identify potential sources of lead exposure for a

18-19    child.

18-20          Sec. 88.062.  EXEMPTION.  A child is not required to be

18-21    screened for lead poisoning or a blood lead level of concern if the

18-22    child's parent, managing conservator, or guardian signs a written

18-23    objection to the screening.

18-24          Sec. 88.063.  REQUIREMENTS FOR CHILD CARE FACILITIES.  (a)  A

18-25    child care facility that provides services to children younger than

18-26    six years of age shall obtain written evidence that each child who

18-27    is younger than six years of age and who receives services from the

 19-1    facility:

 19-2                (1)  has been screened for lead poisoning and blood

 19-3    lead levels of concern as required by board rule under Section

 19-4    88.061;

 19-5                (2)  has been screened for lead poisoning and blood

 19-6    lead levels of concern in accordance with the law of another state,

 19-7    if the department determines that the other state's law is at least

 19-8    as stringent as the requirements of this state; or

 19-9                (3)  is exempt from the screening requirement under

19-10    Section 88.062.

19-11          (b)  A child care facility required to obtain written

19-12    evidence under Subsection (a) shall, at the time the facility

19-13    requests the evidence from the parent, managing conservator, or

19-14    guardian of the child, provide written information to the parent,

19-15    managing conservator, or guardian relating to the importance of the

19-16    screening, how and where the screening may be obtained, and the

19-17    conditions under which a child is exempt from the screening

19-18    requirement.  The department shall adopt a form to be used in

19-19    providing information under this subsection.

19-20          (c)  The department may require that the facility report to

19-21    the department or provide copies of the written evidence to the

19-22    department.

19-23          Sec. 88.064.  DEPARTMENT RULES; COORDINATION OF CARE.

19-24    (a)  The department may adopt rules establishing standards for

19-25    coordination of and follow-up on care provided to children younger

19-26    than six years of age who are diagnosed with lead poisoning or a

19-27    blood lead level of concern.

 20-1          (b)  Rules adopted under this section must meet any federal

 20-2    requirement for coordination of and follow-up on care for children

 20-3    with elevated blood lead levels.

 20-4          (c)  Rules adopted under this section may specify different

 20-5    requirements for coordination of and follow-up on care for children

 20-6    with different blood lead levels and may, as appropriate, require:

 20-7                (1)  a physical, developmental, and nutritional

 20-8    assessment of the child;

 20-9                (2)  parent education;

20-10                (3)  a medical evaluation of the child;

20-11                (4)  a lead inspection of all or part of the child's

20-12    dwelling or other dwellings or premises subject to inspection under

20-13    Subchapter C that may have contributed to the child's lead

20-14    poisoning or lead exposure;

20-15                (5)  assistance to be provided to develop a plan for

20-16    lead hazard reduction or other actions needed to reduce exposure to

20-17    lead and the consequence of the exposure;

20-18                (6)  assistance to be provided, as necessary, to the

20-19    family of the child to obtain permanent or temporary housing in

20-20    which a lead hazard does not exist;

20-21                (7)  nutritional supplements for the child; and

20-22                (8)  follow-up care, including monitoring the provision

20-23    of services to the child.

20-24              (Sections 88.065-88.100 reserved for expansion

20-25                         SUBCHAPTER E. ENFORCEMENT

20-26          Sec. 88.101.  CRIMINAL PENALTY.  A person who knowingly

20-27    violates this chapter, a rule adopted under this chapter, or an

 21-1    order issued under this chapter commits an offense.  An offense

 21-2    under this section is a Class C misdemeanor.

 21-3          Sec. 88.102.  CIVIL PENALTY.  (a)  A person who violates this

 21-4    chapter, a rule adopted under this chapter, or an order issued

 21-5    under this chapter is liable for a civil penalty of not less than

 21-6    $100 or more than $1,000 for each act of violation.

 21-7          (b)  Each day of a continuing violation constitutes a

 21-8    separate ground for recovery.

 21-9          Sec. 88.103.  RENT WITHHOLDING.   On application of the

21-10    department or an affected party, a court may order an occupant of a

21-11    leased dwelling or other  premises to pay any rental payment owed

21-12    to the owner of the dwelling or other premises to an escrow account

21-13    if the court finds that the owner is violating this chapter, a rule

21-14    adopted under this chapter, or an order issued under this chapter.

21-15    Money paid into escrow under this section may not be paid to the

21-16    owner until the violation is corrected to the satisfaction of the

21-17    court.

21-18          SECTION 2.  Section 2(3), Chapter 332, Acts of the 74th

21-19    Legislature, Regular Session, 1995 (Article 9029, Vernon's Texas

21-20    Civil Statutes), is amended to read as follows:

21-21                (3)  "Lead-based paint activity" means inspection,

21-22    testing, risk assessment, risk reduction, lead abatement project

21-23    design or planning, or abatement or removal of lead-based paint

21-24    hazards. The term includes lead hazard reduction, as that term is

21-25    defined by Section 88.001, Health and Safety Code.

21-26          SECTION 3.  Sections 3(a) and (b),  Chapter 332, Acts of the

21-27    74th Legislature, Regular Session, 1995 (Article 9029, Vernon's

 22-1    Texas Civil Statutes), are amended to read as follows:

 22-2          (a)  The department shall establish a program for

 22-3    certification of a person involved in a lead-based paint activity

 22-4    in target housing or in other dwellings or premises subject to

 22-5    Chapter 88, Health and Safety Code, and for accreditation of

 22-6    training providers in  compliance with federal law and rules.

 22-7          (b)  Rules adopted under this section must:

 22-8                (1)  set minimum training requirements by accredited

 22-9    training providers;

22-10                (2)  set standards for lead-based paint activities in

22-11    target housing or other dwellings or premises subject to Chapter

22-12    88, Health and Safety Code, that cover reliability, effectiveness,

22-13    and safety;

22-14                (3)  set standards for accrediting training providers;

22-15                (4)  require the use of certified and accredited

22-16    personnel in any lead-based paint activity in target housing or

22-17    other dwellings or premises subject to Chapter 88, Health and

22-18    Safety Code;

22-19                (5)  be revised as necessary to comply with federal law

22-20    and rules and to maintain eligibility for federal funding;

22-21                (6)  facilitate reciprocity and communication with

22-22    other states having a certification program;  and

22-23                (7)  provide for decertification, deaccreditation, and

22-24    financial assurance for a person certified or accredited by the

22-25    department.

22-26          SECTION 4.  Chapter 332, Acts of the 74th Legislature,

22-27    Regular Session, 1995 (Article 9029, Vernon's Texas Civil

 23-1    Statutes), is amended by adding Section 3A to read as follows:

 23-2          Sec. 3A.  EXEMPTION.  (a)  A person involved in a lead-based

 23-3    paint activity is not required to be certified under this Act if:

 23-4                (1)  the person's activities are limited to interim

 23-5    control activities, as that term is defined by Section 88.001,

 23-6    Health and Safety Code, and the activities are not directly funded

 23-7    by a federal grant;

 23-8                (2)  the person's activities do not involve

 23-9    lead-bearing paint or lead-contaminated soil or dust; or

23-10                (3)  the person is the owner of real property and

23-11    engages in a lead-based paint activity only for the person's own

23-12    real property, and the real property is not available for lease to

23-13    another person.

23-14          (b)  Notwithstanding Subsection (a) of this section, a person

23-15    must be certified under this Act if the lead-based paint activity

23-16    is required to comply with an order of the Texas Department of

23-17    Health issued under Chapter 88, Health and Safety Code, and the

23-18    order requires that the activity be conducted by a person certified

23-19    under this Act.

23-20          SECTION 5.  Section 42.072(a), Human Resources Code, is

23-21    amended to read as follows:

23-22          (a)  The division may deny or revoke the license or

23-23    certification of approval of a facility that does not comply with:

23-24                (1)  the requirements of this chapter;

23-25                (2)  [,] the standards and rules of the department;

23-26                (3)  [, or] the specific terms of the license or

23-27    certification; or

 24-1                (4)  Chapter 88, Health and Safety Code, a rule adopted

 24-2    under that chapter, or an order issued under that chapter.

 24-3          SECTION 6.  Subchapter E, Chapter 21, Insurance Code, is

 24-4    amended by adding Article 21.52J to read as follows:

 24-5          Art. 21.52J.  LEAD POISONING SCREENING

 24-6          Sec. 1.  DEFINITION.  In this article, "health benefit plan"

 24-7    means a health benefit plan to which this article applies under

 24-8    Section 2 of this article.

 24-9          Sec. 2.  SCOPE OF ARTICLE.  (a)  This article applies only to

24-10    a  health benefit plan that:

24-11                (1)  provides benefits for medical or surgical expenses

24-12    incurred as a result of a health condition, accident, or sickness,

24-13    including:

24-14                      (A)  an individual, group, blanket, or franchise

24-15    insurance policy or insurance agreement, a group hospital service

24-16    contract, or an individual or group evidence of coverage that is

24-17    offered by:

24-18                            (i)  an insurance company;

24-19                            (ii)  a group hospital service corporation

24-20    operating under Chapter 20 of this code;

24-21                            (iii)  a fraternal benefit society

24-22    operating under Chapter 10 of this code;

24-23                            (iv)  a stipulated premium insurance

24-24    company operating under Chapter 22 of this code; or

24-25                            (v)  a health maintenance organization

24-26    operating under the Texas Health Maintenance Organization Act

24-27    (Chapter 20A, Vernon's Texas Insurance Code);

 25-1                      (B)  to the extent permitted by the Employee

 25-2    Retirement Income Security Act of 1974 (29 U.S.C. Section 1001 et

 25-3    seq.), a health benefit plan that is offered by:

 25-4                            (i)  a multiple employer welfare

 25-5    arrangement as defined by Section 3, Employee Retirement Income

 25-6    Security Act of 1974 (29 U.S.C. Section 1002)  or another analogous

 25-7    benefit arrangement; or

 25-8                            (ii)  any other entity not licensed under

 25-9    this code or another insurance law of this state that contracts

25-10    directly for health care services on a risk-sharing basis,

25-11    including an entity that contracts for health care services on a

25-12    capitation basis; or

25-13                      (C)  a self-insured plan offered to cover the

25-14    officers or employees of a county, municipality, school district,

25-15    or other political subdivision of this state; or

25-16                (2)  is offered by an approved nonprofit health

25-17    corporation that is certified under Section 5.01(a), Medical

25-18    Practice Act (Article 4495b, Vernon's Texas Civil Statutes), and

25-19    that holds a certificate of authority  issued by the commissioner

25-20    under Article 21.52F of this code.

25-21          (b)  This article does not apply to:

25-22                (1)  a plan that provides coverage:

25-23                      (A)  only for a specified disease;

25-24                      (B)  only for accidental death or dismemberment;

25-25                      (C)  for wages or payments in lieu of wages for a

25-26    period during which an employee is absent from work because of

25-27    sickness or injury; or

 26-1                      (D)  as a supplement to liability insurance;

 26-2                (2)  a small employer health benefit plan written under

 26-3    Chapter 26 of this code;

 26-4                (3)  a Medicare supplemental policy as defined by

 26-5    Section 1882(g)(1), Social Security Act (42 U.S.C. 1395ss);

 26-6                (4)  workers' compensation insurance coverage;

 26-7                (5)  medical payment insurance issued as part of a

 26-8    motor vehicle insurance policy; or

 26-9                (6)  a long-term care policy, including a nursing home

26-10    fixed indemnity policy, unless the commissioner determines that the

26-11    policy provides benefit coverage so comprehensive that the policy

26-12    is a health benefit plan as described by Subsection (a) of this

26-13    section.

26-14          Sec. 3.  BENEFITS FOR LEAD POISONING SCREENING.  (a)  A

26-15    health benefit plan must provide benefits for periodic blood lead

26-16    tests for children younger than six years of age who are covered

26-17    under the plan.  The Texas Board of Health, after consulting with

26-18    the commissioner of insurance, shall adopt rules governing the

26-19    intervals at which the covered blood lead tests must be provided.

26-20          (b)  To be eligible for benefits under this section, the

26-21    blood lead tests must be conducted in accordance with the lead

26-22    screening method required by rules adopted by the Texas Board of

26-23    Health under Chapter 88, Health and Safety Code.

26-24          Sec. 4.  COPAYMENT OR DEDUCTIBLE.  An issuer of a health

26-25    benefit plan may impose a copayment or deductible applicable to

26-26    benefits required under Section 3 of this article if the copayment

26-27    or deductible is not greater than the copayment or deductible

 27-1    applicable to other similar health care services for which benefits

 27-2    are provided under the plan.

 27-3          SECTION 7.  Not later than January 1, 1998, the Texas Board

 27-4    of Health shall adopt rules necessary to implement the change in

 27-5    law made by this Act to Chapter 88, Health and Safety Code.

 27-6          SECTION 8.  A person is not required to comply with Chapter

 27-7    88, Health and Safety Code, as amended by this Act, before January

 27-8    1, 1998.

 27-9          SECTION 9.  Article 21.52J, Insurance Code, as added by this

27-10    Act, applies only to a health benefit plan that is delivered,

27-11    issued for delivery, or renewed on or after January 1, 1998.  A

27-12    health benefit plan that is delivered, issued for delivery, or

27-13    renewed before January 1, 1998, is governed by the law as it

27-14    existed immediately before the effective date of this Act, and that

27-15    law is continued in effect for this purpose.

27-16          SECTION 10.  (a)  Except as provided by Subsection (b) of

27-17    this section, this Act takes effect September 1, 1997.

27-18          (b)  Subchapter E, Chapter 88, Health and Safety Code, as

27-19    added by this Act, takes effect January 1, 1998.

27-20          SECTION 11.  The importance of this legislation and the

27-21    crowded condition of the calendars in both houses create an

27-22    emergency and an imperative public necessity that the

27-23    constitutional rule requiring bills to be read on three several

27-24    days in each house be suspended, and this rule is hereby suspended.