79(R) HB 790 - House Committee Report version

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79R11898 YDB-D


By:  Crownover, Luna, et al.                                      H.B. No. 790

Substitute the following for H.B. No. 790:                                    

By:  Laubenberg                                               C.S.H.B. No. 790



A BILL TO BE ENTITLED

AN ACT

relating to the conduct of newborn screening by the Department of 
State Health Services.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:                        
	SECTION 1.  The heading to Chapter 33, Health and Safety 
Code, is amended to read as follows:

CHAPTER 33. PHENYLKETONURIA, OTHER HERITABLE DISEASES, [AND] 
HYPOTHYROIDISM, AND CERTAIN OTHER DISORDERS
	SECTION 2.  Subchapter A, Chapter 33, Health and Safety 
Code, is amended by adding Section 33.004 to read as follows:
	Sec. 33.004.  STUDY ON NEWBORN SCREENING METHODOLOGY AND 
EQUIPMENT.  (a)  Not later than March 1, 2006, the department shall:
		(1)  conduct a study to determine the most 
cost–effective method of conducting newborn screening, including 
screening for disorders listed in the core uniform panel of newborn 
screening conditions recommended in the 2005 report by the American 
College of Medical Genetics entitled "Newborn Screening: Toward a 
Uniform Screening Panel and System" or another report determined by 
the department to provide more appropriate newborn screening 
guidelines, to protect the health and welfare of this state's 
newborns and to maximize the number of newborn screenings that may 
be conducted with the funding available for the screening; and
		(2)  obtain proposals or information regarding the 
conduct of newborn screening and compare the costs of the 
department performing newborn screening services to the costs of 
outsourcing screening to a qualified laboratory with at least two 
years' experience performing newborn screening tests.
	(b)  In performing the department's duties under Subsection 
(a), the department shall consult with:
		(1)  a physician licensed to practice medicine in this 
state who is a clinical geneticist;
		(2)  a physician licensed to practice medicine in this 
state who practices family medicine;
		(3)  a physician licensed to practice medicine in this 
state who is a pediatrician;
		(4)  a representative of a hospital in this state;                     
		(5)  a representative of a nonprofit organization 
devoted to preventing birth defects and infant mortality; and
		(6)  a parent of a child diagnosed with a genetic malady 
or disorder.
	(c)  If the department determines under Subsection (a) that 
the department's performance of newborn screening services is more 
cost-effective than outsourcing newborn screening, the department 
shall obtain the use of screening methodologies, including tandem 
mass spectrometers, and hire the employees necessary to administer 
newborn screening under this chapter.
	(d)  If the department determines under Subsection (a) that 
outsourcing of newborn screening is more cost-effective, the 
department shall contract for the resources and services necessary 
to conduct newborn screening using a competitive procurement 
process.
	(e)  The department shall periodically review the newborn 
screening program as revised under this section to determine the 
efficacy and cost-effectiveness of the program and determine 
whether adjustments to the program are necessary to protect the 
health and welfare of this state's newborns and to maximize the 
number of newborn screenings that may be conducted with the funding 
available for the screening.
	(f)  The department may adjust the amounts charged for 
newborn screening fees, including fees assessed for follow-up 
services, tracking confirmatory testing, and diagnosis.
	SECTION 3.  Section 33.011, Health and Safety Code, is 
amended by amending Subsection (a) and adding Subsection (a-1) to 
read as follows:
	(a)  The physician attending a newborn child or the person 
attending the delivery of a newborn child that is not attended by a 
physician shall subject the child to screening tests approved by 
the department for phenylketonuria, other heritable diseases, 
[and] hypothyroidism, and other disorders for which screening is 
required by the department.
	(a-1)  To the extent funding is available for the screening, 
the department shall require newborn screening tests to screen for 
disorders listed in the core uniform panel of newborn screening 
conditions recommended in the 2005 report by the American College 
of Medical Genetics entitled "Newborn Screening: Toward a Uniform 
Screening Panel and System" or another report determined by the 
department to provide more appropriate newborn screening 
guidelines to protect the health and welfare of this state's 
newborns.
	SECTION 4.  Section 33.014(a), Health and Safety Code, is 
amended to read as follows:
	(a)  If, because of an analysis of a specimen submitted under 
Section 33.011, the department reasonably suspects that a newborn 
child may have phenylketonuria, another heritable disease, [or] 
hypothyroidism, or another disorder for which the screening tests 
are required, the department shall notify the person who submits 
the specimen that the results are abnormal and provide the test 
results to that person.  The department may notify one or more of 
the following that the results of the analysis are abnormal and 
recommend [that] further testing when [is] necessary:
		(1)  the physician attending the newborn child or the 
physician's designee; 
		(2)  the person attending the delivery of the newborn 
child that was not attended by a physician;
		(3)  the parents of the newborn child;                                        
		(4)  the health authority of the jurisdiction in which 
the newborn child was born or in which the child resides, if known;  
or
		(5)  physicians who are cooperating pediatric 
specialists for the program.  
	SECTION 5.  Section 33.031(a), Health and Safety Code, is 
amended to read as follows:
	(a)  All newborn children and other individuals under 21 
years of age who have been screened, have been found to be 
presumptively positive through the newborn screening program for 
phenylketonuria, other heritable diseases, hypothyroidism, or 
another disorder for which the screening tests are required, and 
may be financially eligible may be referred to the department's 
services program for children with special health care needs.
	SECTION 6.  Section 33.032(a), Health and Safety Code, is 
amended to read as follows:
	(a)  Within the limits of funds available for this purpose 
and in cooperation with the individual's physician, the department 
may provide services directly or through approved providers to 
individuals of any age who meet the eligibility criteria specified 
by board rules on the confirmation of a positive test for 
phenylketonuria, other heritable diseases, [or] hypothyroidism, or 
another disorder for which the screening tests are required.
	SECTION 7.  Not later than November 1, 2006, the Department 
of State Health Services shall implement the expanded newborn 
screening program using the most cost-effective methods as 
determined by the department under Section 33.004, Health and 
Safety Code, as added by this Act.
	SECTION 8.  This Act takes effect September 1, 2005.