79R14689 YDB-F
By: McReynolds H.B. No. 3099
Substitute the following for H.B. No. 3099:
By: Laubenberg C.S.H.B. No. 3099
A BILL TO BE ENTITLED
AN ACT
relating to a risk assessment program for Type 2 diabetes and the
creation of the Type 2 Diabetes Risk Assessment Program Advisory
Committee.
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1. 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 2. Section 95.001(2), Health and Safety Code, as
added by Chapter 1465, Acts of the 77th Legislature, Regular
Session, 2001, is amended to read as follows:
(2) "Department" means the Department of State Health
Services ["Executive council" means the executive council advising
the Texas-Mexico Border Health Coordination Office of The
University of Texas-Pan American].
SECTION 3. 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 department [office] shall administer a risk assessment
program for Type 2 diabetes [an acanthosis nigricans screening
program] in accordance with this chapter. To administer the risk
assessment program, the department may contract with one or more
institutions of higher education, such as the Texas-Mexico Border
Health Coordination Office of The University of Texas--Pan American
or the Texas Tech University Health Sciences Center, and may assign
to an institution under a contract any duty required by this
chapter.
(b) The department [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 in additional regional education
service centers as funding is available.
(c) The department shall establish 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
department; or
(2) an existing database used to administer and track
risk assessment data.
(d) The department [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 department [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 department 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 department shall periodically provide information
on obesity, Type 2 diabetes, and related conditions to physicians.
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 department
[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 department, risk assessment [executive council, 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 department. The risk assessment [the]
records are open for inspection by the department [office] or the
local health department.
(b) The department [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 health care provider [and
intervention by the school district].
(e) Each school shall submit to the department [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
department [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 department [executive
council and must be submitted according to the executive council's
rules].
(g) The department shall analyze and compile a summary of
the reports submitted by schools under Subsection (e) 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 department [office] shall submit to the 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 4. 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 department may accept
gifts, grants, and donations to support the Type 2 diabetes risk
assessment program conducted under this chapter.
SECTION 5. 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
department 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 an institution of
higher education involved in Type 2 diabetes research selected by
the council;
(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; and
(I) one school district administrator
representative from a school district selected by the council;
(2) the following representatives selected jointly by
the Texas School Nurses Organization and the Texas School Nurse
Administrators Association:
(A) one school nurse representative from a rural
school; and
(B) one school nurse representative from an urban
school; and
(3) 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 department 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 department 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.
SECTION 6. (a) As early as possible 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 institution of higher education involved in
Type 2 diabetes research selected by the Texas Diabetes Council for
this purpose; and
(9) the schools and school district selected by the
Texas Diabetes Council for this purpose.
(b) As early as possible after the effective date of this
Act, the Texas School Nurses Organization and the Texas School
Nurse Administrators Association shall jointly select a nurse
representative from a rural school and a nurse representative from
an urban school 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.
(c) As early as possible 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 7. Subdivisions (3) and (6), Section 95.001, Health
and Safety Code, as added by Chapter 1465, Acts of the 77th
Legislature, Regular Session, 2001, are repealed.
SECTION 8. This Act takes effect September 1, 2005.