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Floor Packet Page No. 226
Amend HB 2 (House Committee Report) as follows:
(1) On page 251, strike line 20 and substitute the following:
PART K. HEALTH AND SAFETY
(2) On page 252, between lines 8 and 9, add the following
appropriately numbered SECTIONS to PART K, ARTICLE 2, of the bill:
SECTION ___. The heading to Chapter 95, Health and Safety
Code, as added by Chapter 1465, Acts of the 77th Legislature,
Regular Session, 2001, is amended to read as follows:
CHAPTER 95. RISK ASSESSMENT FOR TYPE 2 DIABETES
[ACANTHOSIS NIGRICANS SCREENING]
SECTION ___. Section 95.001, Health and Safety Code, as
added by Chapter 1465, Acts of the 77th Legislature, Regular
Session, 2001, is amended by adding Subdivision (1-a) to read as
follows:
(1-a) "Department" means the Department of State
Health Services.
SECTION ___. Sections 95.002, 95.003, and 95.004, Health
and Safety Code, as added by Chapter 1465, Acts of the 77th
Legislature, Regular Session, 2001, are amended to read as follows:
Sec. 95.002. TYPE 2 DIABETES [ACANTHOSIS NIGRICANS]
EDUCATION AND RISK ASSESSMENT PROGRAM [SCREENING PROJECT].
(a) The office shall administer a risk assessment program for Type
2 diabetes [an acanthosis nigricans screening program] in
accordance with this chapter.
(b) The executive council by rule shall coordinate the risk
assessment for Type 2 diabetes [screening] of individuals who
attend public or private schools located in Texas Education Agency
Regional Education Service Centers 1, 2, 3, 4, 10, 11, 13, 15, 18,
19, and 20 and, by using existing funding as efficiently as possible
or by using other available funding, in additional regional
education service centers.
(c) The rules must include procedures necessary to
administer the risk assessment program, including procedures that
require each school to record and report risk assessment
[screening] activities using:
(1) the Centers for Disease Control and Prevention's
Epi Info or similar surveillance software selected by the office;
or
(2) an existing database used to administer and track
risk assessment data.
(d) The office shall require a risk assessment for Type 2
diabetes [acanthosis nigricans screening] to be performed at the
same time hearing and vision screening is performed under Chapter
36 or spinal screening is performed under Chapter 37. The risk
assessment for Type 2 diabetes should:
(1) identify students with a body mass index above the
normal range; and
(2) further assess students identified under
Subdivision (1) for acanthosis nigricans and elevated blood
pressure.
(e) The office may:
(1) coordinate the risk assessment for Type 2 diabetes
[acanthosis nigricans screening] activities of school districts,
private schools, state agencies, volunteer organizations,
universities, and other entities so that the efforts of each entity
are complementary and not fragmented and duplicative; and
(2) [. The office may] provide technical assistance
to those entities in developing risk assessment [screening]
programs.
(f) The office shall:
(1) [and may] provide educational and other material
to assist local risk assessment [screening] activities;
(2) [. (f) The office shall] monitor the quality of
risk assessment [screening] activities provided under this
chapter; and
(3) consult with the Board of Nurse Examiners to
determine the training requirements necessary for a nurse or other
person to conduct risk assessment activities under this chapter.
(g) The office shall periodically provide information on
obesity, Type 2 diabetes, and related conditions to physicians.
(h) The office shall provide to the department the
information necessary for the department to conduct an evaluation
of the risk assessment program conducted under this chapter in
accordance with the recommendations of the Type 2 Diabetes Risk
Assessment Program Advisory Committee under Section 103.0125. This
subsection expires September 1, 2007.
Sec. 95.003. COMPLIANCE WITH RISK ASSESSMENT [SCREENING]
REQUIREMENTS. (a) Each individual required by rules adopted under
this chapter to be assessed [screened] shall undergo approved risk
assessment [screening] for Type 2 diabetes [acanthosis nigricans].
The individual shall comply with the requirements as soon as
possible after the individual's admission to a school and as
required by rule. The individual or, if the individual is a minor,
the minor's parent, managing conservator, or guardian may
substitute a professional examination for the risk assessment
[screening].
(b) An individual is exempt from risk assessment
[screening] if risk assessment [screening] conflicts with the
tenets and practices of a recognized church or religious
denomination of which the individual is an adherent or a member. To
qualify for the exemption, the individual or, if the individual is a
minor, the individual's parent, managing conservator, or guardian
must submit to the chief administrator of the school on or before
the day of the risk assessment process [screening procedure] an
affidavit stating the objections to the risk assessment
[screening].
(c) The chief administrator of each school shall ensure that
each individual admitted to the school complies with the risk
assessment [screening] requirements set by the executive council or
submits an affidavit of exemption.
Sec. 95.004. RECORDS; REPORTS. (a) The chief
administrator of each school shall maintain, on a form prescribed
by the executive council, risk assessment [screening] records for
each individual in attendance[,] and enter the risk assessment
information for each individual on the Centers for Disease Control
and Prevention's Epi Info or similar surveillance software selected
by the office. The risk assessment [the] records are open for
inspection by the office or the local health department.
(b) The office may, directly or through local health
departments, enter a school and inspect records maintained by the
school relating to risk assessment [screening] for Type 2 diabetes
[acanthosis nigricans].
(c) An individual's risk assessment [screening] records may
be transferred among schools without the consent of the individual
or, if the individual is a minor, the minor's parent, managing
conservator, or guardian.
(d) The person performing the risk assessment [screening]
shall send a report indicating that an individual may be at risk for
developing Type 2 diabetes [have acanthosis nigricans] to the
individual or, if the individual is a minor, the minor's parent,
managing conservator, or guardian. The report must include:
(1) an explanation of:
(A) the process for assessing risk for developing
Type 2 diabetes;
(B) the body mass index;
(C) the risk factors associated with developing
Type 2 diabetes; and
(D) the reasons the individual was identified in
the risk assessment process as being at risk for developing Type 2
diabetes [acanthosis nigricans and related conditions];
(2) a statement concerning an individual's or family's
need for further evaluation for Type 2 diabetes and related [of]
conditions [related to acanthosis nigricans]; and
(3) instructions to help the individual or family
receive evaluation by a physician or other health care provider
[and intervention by the school district].
(e) Each school shall submit to the office an annual report
on the risk assessment [screening] status of the individuals in
attendance during the reporting year and shall include in the
report any other information required by the office.
(f) The annual report required under Subsection (e) must be
compiled from the information entered into the surveillance
software and be on a form prescribed by the executive council [and
must be submitted according to the executive council's rules].
(g) The office shall analyze and compile a summary of the
reports submitted by schools under Subsection (e), file a copy of
the summary with the Type 2 Diabetes Risk Assessment Program
Advisory Committee established under Section 103.0125, and make the
summary available to schools and the public on request.
(h) [(f)] Not later than January 15 of each odd-numbered
year, the office shall submit to the department [governor and the
legislature] a report concerning the effectiveness of the risk
assessment program for Type 2 diabetes [acanthosis nigricans
screening program] established by this chapter.
SECTION ___. Chapter 95, Health and Safety Code, as added by
Chapter 1465, Acts of the 77th Legislature, Regular Session, 2001,
is amended by adding Section 95.005 to read as follows:
Sec. 95.005. GIFTS AND GRANTS. The office may accept gifts,
grants, and donations to support the Type 2 diabetes risk
assessment program conducted under this chapter.
SECTION ___. Chapter 103, Health and Safety Code, is
amended by adding Section 103.0125 to read as follows:
Sec. 103.0125. TYPE 2 DIABETES RISK ASSESSMENT PROGRAM
ADVISORY COMMITTEE. (a) The council shall establish the Type 2
Diabetes Risk Assessment Program Advisory Committee to advise the
Texas-Mexico Border Health Coordination Office of The University of
Texas--Pan American on the Type 2 diabetes risk assessment program
conducted under Chapter 95.
(b) The advisory committee is composed of:
(1) the following representatives appointed by the
executive head of the agency, organization, school, or school
district the representative serves:
(A) one representative of the council;
(B) one representative of the department;
(C) one representative of the Texas Education
Agency;
(D) a representative from The University of
Texas--Pan American;
(E) one representative of the Texas Medical
Association;
(F) one representative of the Texas Pediatric
Society;
(G) one representative of the American Heart
Association;
(H) one representative of the American Diabetes
Association;
(I) one school district administrator
representative from a school district selected by the council;
(J) one school nurse representative from a rural
school selected by the council; and
(K) one school nurse representative from an urban
school selected by the council; and
(2) one parent or guardian of a child in this state
with Type 2 diabetes, appointed by the council.
(c) A person may not be a member of the advisory committee if
the person is required to register as a lobbyist under Chapter 305,
Government Code, because of the person's activities for
compensation on behalf of a health care profession or related
business or another profession related to the operation of the
council.
(d) The representative of the council appointed under
Subsection (b)(1)(A) shall serve as the presiding officer of the
advisory committee.
(e) Chapter 2110, Government Code, does not apply to the
size, composition, or duration of the advisory committee.
(f) The advisory committee shall:
(1) recommend the person who should be responsible for
conducting risk assessment activities under Chapter 95 for schools
that do not employ a school nurse;
(2) advise the Texas-Mexico Border Health
Coordination Office of The University of Texas--Pan American on the
age groups that would benefit most from the risk assessment
activities under Chapter 95;
(3) recommend a method to record and report the number
of children who are identified in the risk assessment process as
being at risk for having or developing Type 2 diabetes and who
qualify for the national free or reduced-price lunch program
established under 42 U.S.C. Section 1751 et seq.;
(4) recommend a timeline for the Texas-Mexico Border
Health Coordination Office of The University of Texas--Pan American
to implement the advisory committee's recommended risk assessment
activities, surveillance methods, reports, and quality
improvements; and
(5) contribute to the state plan for diabetes
treatment developed by the council under Section 103.013 by
providing statistics and information on the risk assessment
activities conducted under Chapter 95 and recommendations for
assisting children in this state at risk for developing Type 2
diabetes.
(g) The advisory committee shall recommend to the
department a method for the department to evaluate the Type 2
diabetes risk assessment program administered under Chapter 95.
The department shall conduct the evaluation in accordance with this
subsection and the advisory committee's recommendations under this
subsection and file a report on the evaluation with the governor and
the presiding officer of each house of the legislature not later
than January 1, 2007. The method must include:
(1) an evaluation of the burden and benefits of the
program;
(2) an evaluation of the costs and expenses of the
program to determine the most efficient use of the resources
available for the program;
(3) recommendations for legislation that amends
Chapter 95; and
(4) any other component that the advisory committee
considers advisable.
(h) Subsection (g) and this subsection expire September 1,
2007.
SECTION ___. (a) As early as practicable after the
effective date of this Act, the executive head of the following
entities shall appoint a representative to serve on the Type 2
Diabetes Risk Assessment Program Advisory Committee created under
Section 103.0125, Health and Safety Code, as added by this Act:
(1) the Texas Diabetes Council;
(2) the Department of State Health Services;
(3) the Texas Education Agency;
(4) the Texas Medical Association;
(5) the Texas Pediatric Society;
(6) the American Heart Association;
(7) the American Diabetes Association;
(8) The University of Texas--Pan American; and
(9) the schools and school district selected by the
Texas Diabetes Council for this purpose.
(b) As early as practicable after the effective date of this
Act, the head of the Texas Diabetes Council shall appoint a parent
or guardian of a child in this state with Type 2 diabetes to serve on
the Type 2 Diabetes Risk Assessment Program Advisory Committee
created under Section 103.0125, Health and Safety Code, as added by
this Act.
SECTION ___. Subdivision (6), Section 95.001, Health and
Safety Code, as added by Chapter 1465, Acts of the 77th Legislature,
Regular Session, 2001, is repealed.