1-1     By:  Gutierrez, Chavez (Senate Sponsor - Madla)       H.B. No. 1860
 1-2           (In the Senate - Received from the House May 7, 1999;
 1-3     May 10, 1999, read first time and referred to Committee on Health
 1-4     Services; May 14, 1999, reported favorably, as amended, by the
 1-5     following vote:  Yeas 5, Nays 0; May 14, 1999, sent to printer.)
 1-6     COMMITTEE AMENDMENT NO. 1                                By:  Madla
 1-7           Amend H.B. 1860 on page 2, line 59, by adding the following
 1-8     SECTION 8, and renumbering the remaining sections as appropriate.
 1-9     "SECTION 8.  This Act takes effect only if a specific appropriation
1-10     for the implementation of this Act is provided in H.B. No. 1
1-11     (General Appropriations Act), Acts of the 76th Legislature, Regular
1-12     Session, 1999.  If no specific appropriation is provided in H.B.
1-13     No. 1, the General Appropriations Act, this Act has no effect."
1-14                            A BILL TO BE ENTITLED
1-15                                   AN ACT
1-16     relating to establishing an acanthosis nigricans screening pilot
1-17     program in public and private schools in certain counties.
1-18           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-19           SECTION 1.  DEFINITIONS.  In this Act:
1-20                 (1)  "Acanthosis nigricans" means a light brown or
1-21     black velvety, rough, or thickened area on the surface of the skin
1-22     that may signal high insulin levels indicative of insulin
1-23     resistance.
1-24                 (2)  "Executive council" means the executive council of
1-25     the Texas-Mexico Border Health Coordination Office of The
1-26     University of Texas System.
1-27                 (3)  "Office" means the Texas-Mexico Border Health
1-28     Coordination Office of The University of Texas System.
1-29                 (4)  "Professional examination" means a diagnostic
1-30     evaluation performed by an appropriately licensed professional.
1-31                 (5)  "School" means an educational institution that
1-32     admits children who are five years of age or older but younger than
1-33     21 years of age.
1-34                 (6)  "Screening test" means a rapid analytical
1-35     procedure to determine the need for further diagnostic evaluation.
1-36     The term does not include the removal or partial removal of
1-37     clothing.
1-38           SECTION 2.  PILOT PROGRAM ESTABLISHED.  Not later than the
1-39     1999-2000 school year, the Texas-Mexico Border Health Coordination
1-40     Office of The University of Texas System shall establish an
1-41     acanthosis screening pilot program in accordance with this Act.
1-42     The pilot program applies only in El Paso, Hudspeth, Cameron,
1-43     Hidalgo, Jim Hogg, Starr, Webb, Willacy, and Zapata counties.
1-44           SECTION 3.  ACANTHOSIS NIGRICANS SCREENING PILOT PROGRAM.
1-45     (a)  The executive council by rule shall require screening of
1-46     individuals who attend public or private schools to detect
1-47     acanthosis nigricans. In developing the rules, the executive
1-48     council may consider the number of individuals to be screened and
1-49     the availability of personnel qualified to administer the required
1-50     screening.
1-51           (b)  The rules must include procedures necessary to
1-52     administer screening activities.
1-53           (c)  The office shall require acanthosis nigricans screening
1-54     to be performed at the same time hearing and vision screening is
1-55     performed under Chapter 36, Health and Safety Code.
1-56           (d)  The office may coordinate the acanthosis nigricans
1-57     screening activities of school districts, private schools, state
1-58     agencies, volunteer organizations, and other entities so that the
1-59     efforts of each entity are complementary and not fragmented and
1-60     duplicative.  The office may provide technical assistance to those
1-61     entities in developing screening programs and may provide
1-62     educational and other material to assist local screening
1-63     activities.
 2-1           (e)  The office shall monitor the quality of screening
 2-2     activities provided under this Act.
 2-3           SECTION 4.  COMPLIANCE WITH SCREENING REQUIREMENTS.  (a)
 2-4     Each individual required by rules adopted under this Act to be
 2-5     screened shall undergo approved screening for acanthosis nigricans.
 2-6     The individual shall comply with the requirements as soon as
 2-7     possible after the individual's admission to a school and as
 2-8     required by rule.  The individual or, if the individual is a minor,
 2-9     the minor's parent, managing conservator, or guardian may
2-10     substitute a professional examination for the screening.
2-11           (b)  An individual is exempt from screening if screening
2-12     conflicts with the tenets and practices of a recognized church or
2-13     religious denomination of which the individual is an adherent or a
2-14     member.  To qualify for the exemption, the individual or, if the
2-15     individual is a minor, the individual's parent, managing
2-16     conservator, or guardian must submit to the chief administrator of
2-17     the school on or before the day of the screening procedure an
2-18     affidavit stating the objections to the screening.
2-19           (c)  The chief administrator of each school shall ensure that
2-20     each individual admitted to the school complies with the screening
2-21     requirements set by the executive council or submits an affidavit
2-22     of exemption.
2-23           SECTION 5.  RECORDS; REPORTS.  (a)  The chief administrator
2-24     of each school shall maintain, on a form prescribed by the
2-25     executive council, screening records for each individual in
2-26     attendance, and the records are open for inspection by the office
2-27     or the local health department.
2-28           (b)  The office may, directly or through local health
2-29     departments, enter a school and inspect records maintained by the
2-30     school relating to screening for acanthosis nigricans.
2-31           (c)  An individual's screening records may be transferred
2-32     among schools without the consent of the individual or, if the
2-33     individual is a minor, the minor's parent, managing conservator, or
2-34     guardian.
2-35           (d)  The person performing the screening shall send a report
2-36     indicating that an individual may have acanthosis nigricans to the
2-37     individual or, if the individual is a minor, the minor's parent,
2-38     managing conservator, or guardian.  The report must include:
2-39                 (1)  an explanation of acanthosis nigricans and related
2-40     conditions;
2-41                 (2)  a statement concerning an individual's or family's
2-42     access to financial or medical assistance for evaluation and
2-43     treatment of conditions related to acanthosis nigricans; and
2-44                 (3)  instructions to help the individual or family
2-45     receive evaluation and treatment.
2-46           (e)  Each school shall submit to the office an annual report
2-47     on the screening status of the individuals in attendance during the
2-48     reporting year and shall include in the report any other
2-49     information required by the office.  The report must be on a form
2-50     prescribed by the executive council and must be submitted according
2-51     to the executive council's rules.
2-52           SECTION 6.  REPORTS.  Not later than January 1, 2001, the
2-53     Texas-Mexico Border Health Coordination Office of The University of
2-54     Texas System shall submit to the governor and the legislature a
2-55     report concerning the effectiveness of the pilot program
2-56     established under this Act.
2-57           SECTION 7.  EXPIRATION DATE.  This Act expires September 1,
2-58     2001.
2-59           SECTION 8.  EMERGENCY.  The importance of this legislation
2-60     and the crowded condition of the calendars in both houses create an
2-61     emergency and an imperative public necessity that the
2-62     constitutional rule requiring bills to be read on three several
2-63     days in each house be suspended, and this rule is hereby suspended.
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