By:  Nelson, Moncrief                                  S.B. No. 285
                                A BILL TO BE ENTITLED
 1-1                                   AN ACT
 1-2     relating to cancer incidence reporting.
 1-3           BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
 1-4           SECTION 1.  Section 82.002, Health and Safety Code, is
 1-5     amended to read as follows:
 1-6           Sec. 82.002.  DEFINITIONS.  In this chapter:
 1-7                 (1)  "Cancer" includes:
 1-8                       (A)  a large group of diseases characterized by
 1-9     uncontrolled growth and spread of abnormal cells;
1-10                       (B)  any condition of tumors having the
1-11     properties of anaplasia, invasion, and metastasis;
1-12                       (C)  a cellular tumor the natural course of which
1-13     is fatal; and
1-14                       (D)  malignant neoplasm.
1-15                 (2)  ["Cancer treatment center" means a special health
1-16     facility devoted to the study, prevention, diagnosis, and
1-17     management of neoplastic and allied diseases.]
1-18                 [(3)]  "Clinical laboratory" means an accredited
1-19     facility in which:
1-20                       (A)  tests are performed identifying findings of
1-21     anatomical changes; and
1-22                       (B)  specimens are interpreted and pathological
1-23     diagnoses are made.
1-24                 (3) [(4)]  "Health care facility [Hospital]" means:
1-25                       (A)  a general or special hospital as defined by
 2-1     [licensed under] Chapter 241 (Texas Hospital Licensing Law); [or]
 2-2                       (B)  an ambulatory surgical center licensed under
 2-3     Chapter 243;
 2-4                       (C)  an institution licensed under Chapter 242;
 2-5     or
 2-6                       (D)  any other facility, including an outpatient
 2-7     clinic, that provides diagnosis or treatment services to patients
 2-8     with cancer.
 2-9                 (4)  "Health care practitioner" means:
2-10                       (A)  a physician as defined by Section 151.002,
2-11     Occupations Code; or
2-12                       (B)  a person who practices dentistry as
2-13     described by Section 251.003, Occupations Code [The University of
2-14     Texas System Cancer Center].
2-15                 (5)  "Precancerous disease" means abnormality of
2-16     development and organization of adult cells, which is a condition
2-17     of early cancer without the invasion of neighboring tissue.
2-18                 (6)  "Tumorous disease" means a new growth of tissue in
2-19     which the multiplication of cells is uncontrolled and progressive,
2-20     also called neoplasm.  It is a swelling, enlargement, or abnormal
2-21     mass, either benign or malignant, that performs no useful
2-22     functions.
2-23           SECTION 2.  Section 82.006, Health and Safety Code, is
2-24     amended to read as follows:
2-25           Sec. 82.006.  BOARD POWERS.  To implement this chapter, the
2-26     board may:
 3-1                 (1)  adopt rules that the board considers necessary;
 3-2                 (2)  execute contracts that the board considers
 3-3     necessary;
 3-4                 (3)  receive the data from medical records of cases of
 3-5     cancer or precancerous or tumorous disease that are in the custody
 3-6     or under the control of clinical laboratories, health care
 3-7     facilities [hospitals], and health care practitioners [cancer
 3-8     treatment centers] to record and analyze the data directly related
 3-9     to those diseases;
3-10                 (4)  compile and publish statistical and other studies
3-11     derived from the patient data obtained under this chapter to
3-12     provide, in an accessible form, information that is useful to
3-13     physicians, other medical personnel, and the general public;
3-14                 (5)  comply with requirements as necessary to obtain
3-15     federal funds in the maximum amounts and most advantageous
3-16     proportions possible;
3-17                 (6)  receive and use gifts made for the purpose of this
3-18     chapter; and
3-19                 (7)  limit cancer reporting activities under this
3-20     chapter to specified geographic areas of the state to ensure
3-21     optimal use of funds available for obtaining the data.
3-22           SECTION 3.  Section 82.008, Health and Safety Code, is
3-23     amended by amending Subsections (a), (b), (d), and (e) and adding
3-24     Subsection (f) to read as follows:
3-25           (a)  To ensure an accurate and continuing source of data
3-26     concerning precancerous and tumorous diseases specified by the
 4-1     board and concerning cancer, each health care facility [hospital],
 4-2     clinical laboratory, and health care practitioner [cancer treatment
 4-3     center] shall furnish to the board or its representative, on
 4-4     request, data the board considers necessary and appropriate that is
 4-5     derived from each medical record of a case of one of those diseases
 4-6     that is in the custody or under the control of the health care
 4-7     facility [hospital], clinical laboratory, or health care
 4-8     practitioner [treatment center].
 4-9           (b)  A health care facility [hospital], clinical laboratory,
4-10     or health care practitioner [cancer treatment center] shall furnish
4-11     the data requested under Subsection (a)  in a format and within the
4-12     period prescribed by the department.
4-13           (d)  The department is authorized to access the medical
4-14     records of a health care facility, clinical laboratory, or health
4-15     care practitioner [board by rule may determine a reasonable amount
4-16     for compensation to the hospital, clinical laboratory, or cancer
4-17     treatment center for the cost of collecting or furnishing the data
4-18     and shall pay that amount, within the limits of funds appropriated
4-19     expressly for that purpose].
4-20           (e)  The board shall adopt procedures that ensure adequate
4-21     notice is given to the health care facility, clinical laboratory,
4-22     or health care practitioner before the department accesses data
4-23     under Subsection (d).  A health care facility, clinical laboratory,
4-24     or health care practitioner that fails to furnish data as required
4-25     by this chapter shall reimburse the department or its authorized
4-26     representative for the costs of accessing and reporting the data.
 5-1     The department may assess a late fee on an account that is 60 days
 5-2     or more overdue.  The late fee may not exceed one and one-half
 5-3     percent of the total amount due on the late account for each month
 5-4     or portion of a month the account is not paid in full.
 5-5           (f)  The data required to be furnished under this section may
 5-6     [also] be shared with [furnished only to:]
 5-7                 [(1)]  cancer registries of health care facilities
 5-8     subject to the confidentiality provisions in Section 82.009
 5-9     [hospitals; and]
5-10                 [(2)  cancer registries of cancer treatment centers].
5-11           SECTION 4.  Section 82.009, Health and Safety Code, is
5-12     amended to read as follows:
5-13           Sec. 82.009.  CONFIDENTIALITY.  (a)  Reports, records, and
5-14     information [Data] obtained under this chapter are confidential and
5-15     are not subject to disclosure under Chapter 552, Government Code,
5-16     are not subject to subpoena, and may not otherwise be released or
5-17     made public except as provided by this section or Section
5-18     82.008(f).  The reports, records, and information obtained under
5-19     this chapter are [directly from the medical records of a patient
5-20     is] for the confidential use of the department and the persons or
5-21     public or private entities that the department [board] determines
5-22     are necessary to carry out the intent of this chapter.  [The data
5-23     is privileged and may not be divulged or made public in a manner
5-24     that discloses the identity of an individual whose medical records
5-25     have been used for obtaining data under this chapter.]
5-26           (b)  Medical or epidemiological information may be released:
 6-1                 (1)  for statistical purposes in a manner that prevents
 6-2     identification of any person;
 6-3                 (2)  with the consent of each person identified in the
 6-4     information; or
 6-5                 (3)  to promote cancer research, including release to
 6-6     other cancer registries and appropriate state and federal agencies,
 6-7     under rules adopted by the board to ensure confidentiality
 6-8     [Information that may identify an individual whose medical records
 6-9     have been used for obtaining data under this chapter is not
6-10     available for public inspection under Chapter 552, Government
6-11     Code].
6-12           (c)  A state employee may not testify in a civil, criminal,
6-13     special, or other proceeding as to the existence or contents of
6-14     records, reports, or information concerning an individual whose
6-15     medical records have been used in submitting data required under
6-16     this chapter unless the individual consents in advance [Statistical
6-17     information collected under this chapter is public information].
6-18           (d)  Data furnished to a [hospital] cancer registry or a
6-19     cancer researcher [treatment center cancer registry] under
6-20     Subsection (b) or Section 82.008(f) [Section 82.008(e)] is for the
6-21     confidential use of the [hospital] cancer registry or the cancer
6-22     researcher [treatment center cancer registry], as applicable, and
6-23     is subject to Subsection (a).
6-24           SECTION 5.  Section 82.010, Health and Safety Code, is
6-25     amended to read as follows:
6-26           Sec. 82.010.  IMMUNITY FROM LIABILITY.  The following persons
 7-1     subject to this chapter that act in compliance with this chapter
 7-2     are not civilly or criminally liable for furnishing the information
 7-3     required under this chapter:
 7-4                 (1)  a health care facility or [hospital,] clinical
 7-5     laboratory[, or cancer treatment center];
 7-6                 (2)  an administrator, officer, or employee of a health
 7-7     care facility or [hospital,] clinical laboratory[, or cancer
 7-8     treatment center]; and
 7-9                 (3)  a health care practitioner or employee of a health
7-10     care practitioner [physician].
7-11           SECTION 6.  This Act takes effect September 1, 2001.