1-1     By:  Gutierrez, Chavez, Capelo                        H.B. No. 2989
 1-2          (Senate Sponsor - Van de Putte)
 1-3           (In the Senate - Received from the House May 11, 2001;
 1-4     May 11, 2001, read first time and referred to Committee on Health
 1-5     and Human Services; May 11, 2001, reported favorably by the
 1-6     following vote:  Yeas 7, Nays 0; May 11, 2001, sent to printer.)
 1-7                            A BILL TO BE ENTITLED
 1-8                                   AN ACT
 1-9     relating to establishing an acanthosis nigricans screening program
1-10     in certain public and private schools.
1-11           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-12           SECTION 1.  Subtitle D, Title 2, Health and Safety Code, is
1-13     amended by adding Chapter 95 to read as follows:
1-14                 CHAPTER 95.  ACANTHOSIS NIGRICANS SCREENING
1-15           Sec. 95.001.  DEFINITIONS.  In this chapter:
1-16                 (1)  "Acanthosis nigricans" means a light brown or
1-17     black velvety, rough, or thickened area on the surface of the skin
1-18     that may signal high insulin levels indicative of insulin
1-19     resistance.
1-20                 (2)  "Executive council" means the executive council
1-21     advising the Texas-Mexico Border Health Coordination Office of The
1-22     University of Texas-Pan American.
1-23                 (3)  "Office" means the Texas-Mexico Border Health
1-24     Coordination Office of The University of Texas-Pan American.
1-25                 (4)  "Professional examination" means an evaluation
1-26     performed by an appropriately licensed professional.
1-27                 (5)  "School" means an educational institution that
1-28     admits children who are five years of age or older but younger than
1-29     21 years of age.
1-30                 (6)  "Screening test" means a rapid analytical
1-31     procedure used to recommend appropriate measures or to determine
1-32     the need for further evaluation.  The term does not include the
1-33     removal or partial removal of clothing.
1-34           Sec. 95.002.  ACANTHOSIS NIGRICANS EDUCATION AND SCREENING
1-35     PROJECT.  (a)  The office shall administer an acanthosis nigricans
1-36     screening program in accordance with this chapter.
1-37           (b)  The executive council by rule shall coordinate screening
1-38     of individuals who attend public or private schools located in
1-39     Texas Education Agency Regional Education Service Centers 1, 2, 3,
1-40     13, 15, 18, 19, and 20.
1-41           (c)  The rules must include procedures necessary to
1-42     administer screening activities.
1-43           (d)  The office shall require acanthosis nigricans screening
1-44     to be performed at the same time hearing and vision screening is
1-45     performed under Chapter 36 or spinal screening is performed under
1-46     Chapter 37.
1-47           (e)  The office may coordinate the acanthosis nigricans
1-48     screening activities of school districts, private schools, state
1-49     agencies, volunteer organizations, and other entities so that the
1-50     efforts of each entity are complementary and not fragmented and
1-51     duplicative.  The office may provide technical assistance to those
1-52     entities in developing screening programs and may provide
1-53     educational and other material to assist local screening
1-54     activities.
1-55           (f)  The office shall monitor the quality of screening
1-56     activities provided under this chapter.
1-57           Sec. 95.003.  COMPLIANCE WITH SCREENING REQUIREMENTS.  (a)
1-58     Each individual required by rules adopted under this chapter to be
1-59     screened shall undergo approved screening for acanthosis nigricans.
1-60     The individual shall comply with the requirements as soon as
1-61     possible after the individual's admission to a school and as
1-62     required by rule.  The individual or, if the individual is a minor,
1-63     the minor's parent, managing conservator, or guardian may
1-64     substitute a professional examination for the screening.
 2-1           (b)  An individual is exempt from screening if screening
 2-2     conflicts with the tenets and practices of a recognized church or
 2-3     religious denomination of which the individual is an adherent or a
 2-4     member.  To qualify for the exemption, the individual or, if the
 2-5     individual is a minor, the individual's parent, managing
 2-6     conservator, or guardian must submit to the chief administrator of
 2-7     the school on or before the day of the screening procedure an
 2-8     affidavit stating the objections to the screening.
 2-9           (c)  The chief administrator of each school shall ensure that
2-10     each individual admitted to the school complies with the screening
2-11     requirements set by the executive council or submits an affidavit
2-12     of exemption.
2-13           Sec. 95.004.  RECORDS; REPORTS.  (a)  The chief administrator
2-14     of each school shall maintain, on a form prescribed by the
2-15     executive council, screening records for each individual in
2-16     attendance, and the records are open for inspection by the office
2-17     or the local health department.
2-18           (b)  The office may, directly or through local health
2-19     departments, enter a school and inspect records maintained by the
2-20     school relating to screening for acanthosis nigricans.
2-21           (c)  An individual's screening records may be transferred
2-22     among schools without the consent of the individual or, if the
2-23     individual is a minor, the minor's parent, managing conservator, or
2-24     guardian.
2-25           (d)  The person performing the screening shall send a report
2-26     indicating that an individual may have acanthosis nigricans to the
2-27     individual or, if the individual is a minor, the minor's parent,
2-28     managing conservator, or guardian.  The report must include:
2-29                 (1)  an explanation of acanthosis nigricans and related
2-30     conditions;
2-31                 (2)  a statement concerning an individual's or family's
2-32     need for further evaluation of conditions related to acanthosis
2-33     nigricans; and
2-34                 (3)  instructions to help the individual or family
2-35     receive evaluation and intervention by the school district.
2-36           (e)  Each school shall submit to the office an annual report
2-37     on the screening status of the individuals in attendance during the
2-38     reporting year and shall include in the report any other
2-39     information required by the office.  The report must be on a form
2-40     prescribed by the executive council and must be submitted according
2-41     to the executive council's rules.
2-42           (f)  Not later than January 15 of each odd-numbered year, the
2-43     office shall submit to the governor and the legislature a report
2-44     concerning the effectiveness of the acanthosis nigricans screening
2-45     program established by this chapter.
2-46           SECTION 2.  This Act takes effect September 1, 2001.
2-47           SECTION 3.  This Act takes effect only if a specific
2-48     appropriation for the implementation of this Act is provided in
2-49     S.B. No. 1 (General Appropriations Act), Acts of the 77th
2-50     Legislature, Regular Session, 2001.  If no specific appropriation
2-51     is provided in S.B. No. 1, the General Appropriations Act, this Act
2-52     has no effect.
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