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. 2-64 * * * * *