By: Uresti H.B. No. 3325
A BILL TO BE ENTITLED
AN ACT
relating to providing all Texas newborns with a comprehensive
newborn screening program and establishing a Texas newborn
screening advisory committee
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
Subchapter A, Chapter 33, Health and Safety Code, is amended
as follows:
Sec. 33.001. DEFINITIONS. In this chapter:
(1) "Heritable disease" means an inherited disease
that may result in mental or physical retardation or death.
(2) "Hypothyroidism" means a condition that may cause
severe mental retardation if not treated.
(3) "Other benefit" means a benefit, other than a
benefit under this chapter, to which an individual is entitled for
the payment of the costs of services. The term includes:
(A) benefits available under:
(i) an insurance policy, group health plan,
or prepaid medical care plan;
(ii) Title XVIII of the Social Security Act
(42 U.S.C. Section 1395);
(iii) Title XIX of the Social Security Act
(42 U.S.C. Section 1396);
(iv) the Veterans' Administration;
(v) the Civilian Health and Medical Program
of the Uniformed Services; or
(vi) workers' compensation or any other
compulsory employers insurance program;
(B) a public program created by federal or state
law or by ordinance or rule of a municipality or political
subdivision of the state, except those benefits created by the
establishment of a municipal or county hospital, a joint
municipal-county hospital, a county hospital authority, a hospital
district, or by the facilities of a publicly supported medical
school; and
(C) benefits resulting from a cause of action for
health care expenses, or a settlement or judgment based on the cause
of action, if the expenses are related to the need for services
provided under this chapter.
(4) "Phenylketonuria" means an inherited condition
that may cause severe mental retardation if not treated.
(5) "Screening test" means a rapid analytical
procedure to determine the need for further diagnostic evaluation.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.002. DETECTION AND TREATMENT PROGRAM
ESTABLISHED. (a) The department shall carry out a comprehensive
program to combat morbidity, including mental retardation, and
mortality in persons who have phenylketonuria, other heritable
diseases, or hypothyroidism, and such other conditions as specified
by the Board.
(b) The State Board of Health shall determine and specify
the conditions that will be included in the comprehensive newborn
screening program in addition to those conditions listed in (a) of
this section, upon the advice and recommendations of the Newborn
Screening Advisory Committee. The Department of State Health
Services shall maintain a list and description of each of the
conditions included in the comprehensive newborn screening
program, which shall be made available to physicians and other
health care providers. The Board shall adopt rules necessary to
carry out the program, including a rule specifying other treatable
diseases covered by this chapter.
(c) The department may establish and maintain a laboratory
to:
(1) conduct experiments, projects, and other
activities necessary to develop screening or diagnostic tests for
the early detection of phenylketonuria, other heritable diseases,
and hypothyroidism;
(2) develop ways and means or discover methods to be
used to prevent or treat phenylketonuria, other heritable diseases,
and hypothyroidism; and
(3) serve other purposes considered necessary by the
department to carry out the program.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.003. COOPERATION OF HEALTH CARE PROVIDERS AND
GOVERNMENTAL ENTITIES. (a) The department may invite all
physicians, hospitals, and other health care providers in the state
that provide maternity and newborn infant care to cooperate and
participate in any program established by the department under this
chapter.
(b) Other boards, agencies, departments, and political
subdivisions of the state capable of assisting the department in
carrying out the program may cooperate with the department and are
encouraged to furnish their services and facilities to the program.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.004. NEWBORN SCREENING ADVISORY COMMITTEE AND
EFFICACY, COST EFFECTIVENESS OF PROGRAM. A Newborn Screening
Advisory Committee shall be established comprised of seven (7)
members, which shall include two (2) members appointed by the
Speaker of the House of Representatives, two (2) members appointed
by the Lieutenant Governor, and three (3) members appointed by the
Governor, and shall include the Commissioner of State Health
Services, at least two (2) pediatricians and one (1) consumer
representative from a family that has experience with a newborn
affected with a heritable disease.
The Department of State Health Services shall provide on-going
surveillance of the comprehensive newborn screening program so that
Newborn Screening Advisory Committee members can determine its
efficacy, cost effectiveness, and to ensure that needed adjustments
to the program occur in a timely fashion with appropriate comment by
clinicians and other pediatric specialists.
SUBCHAPTER B. NEWBORN SCREENING
Sec. 33.011. TEST REQUIREMENT. (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 State Board of Health to
detect those conditions listed in Section 33.002 and the other
conditions specified by the State Board of Health for the
comprehensive newborn screening program.
(b) The department may prescribe the screening test
procedures to be used and the standards of accuracy and precision
required for each test.
(c) The screening tests required by this section may be
performed by the laboratory established by the department or by a
laboratory approved by the department under Section 33.016.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.012. EXEMPTION. (a) Screening tests may not be
administered to a newborn child whose parents, managing
conservator, or guardian objects on the ground that the tests
conflict with the religious tenets or practices of an organized
church of which they are adherents.
(b) If a parent, managing conservator, or guardian objects
to the screening tests, the physician or the person attending the
newborn child that is not attended by a physician shall ensure that
the objection of the parent, managing conservator, or guardian is
entered into the medical record of the child. The parent, managing
conservator, or guardian shall sign the entry.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.013. LIMITATION ON LIABILITY. A physician,
technician, or other person administering the screening tests
required by this chapter is not liable or responsible because of the
failure or refusal of a parent, managing conservator, or guardian
to consent to the tests for which this chapter provides.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.014. DIAGNOSIS; FOLLOW-UP. (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, 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 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.
(b) If a screening test indicates that a newborn child is at
high risk, the department shall recommend that the child be placed
under the medical care of a licensed physician for diagnosis and
provide the name of a consultant pediatric specialist in the
child's geographic area.
(c) The department, the health authority, and the
consulting pediatric specialist may follow up a positive test with
the attending physician or with a parent of the newborn child if the
child was not attended by a physician at birth.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.015. REPORTS; RECORD KEEPING. (a) Each physician,
health authority, or other individual who has the information of a
confirmed case of a disorder for which a screening test is required
that has been detected by a mechanism other than identification
through a screening of a specimen by the department's diagnostic
laboratory shall report the confirmed case to the department.
(b) The department may collect data to derive incidence and
prevalence rates of disorders covered by this chapter from the
information on the specimen form submitted to the department for
screening determinations.
(c) The department shall maintain a roster of children born
in this state who have been diagnosed as having one of the disorders
for which the screening tests are required.
(d) The department may cooperate with other states in the
development of a national roster of individuals who have been
diagnosed as having one of the disorders for which the screening
tests are required if:
(1) participation in the national roster encourages
systematic follow-up in the participating states;
(2) incidence and prevalence information is made
available to participating newborn screening programs in other
states; and
(3) each participating newborn screening program
subscribes to an agreement to protect the identity and diagnosis of
the individuals whose names are included in the national roster.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.016. APPROVAL OF LABORATORIES. (a) The department
may develop a program to approve any laboratory that wishes to
perform the tests required to be administered under this chapter.
To the extent that they are not otherwise provided in this chapter,
the board may adopt rules prescribing procedures and standards for
the conduct of the program.
(b) The department may prescribe the form and reasonable
requirements for the application and the procedures for processing
the application.
(c) The department may prescribe the test procedure to be
employed and the standards of accuracy and precision required for
each test.
(d) The department may extend or renew any approval in
accordance with reasonable procedures prescribed by the board.
(e) The department may for good cause, after notice to the
affected laboratory and a hearing if requested, restrict, suspend,
or revoke any approval granted under this section.
(f) Hearings under this section shall be conducted in
accordance with the hearing rules adopted by the board and the
applicable provisions of Chapter 2001, Government Code.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991;
Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49), eff. Sept. 1, 1995.
SUBCHAPTER C. NEWBORN SCREENING PROGRAM SERVICES
Sec. 33.031. COORDINATION WITH CHILDREN WITH SPECIAL HEALTH
CARE NEEDS SERVICES. (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, and may be financially eligible may be referred to the
department's services program for children with special health care
needs.
(b) An individual who is determined to be eligible for
services under the services program for children with special
health care needs shall be given approved services through that
program. An individual who does not meet that eligibility criteria
shall be referred to the newborn screening program for a
determination of eligibility for newborn screening program
services.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991;
Acts 1999, 76th Leg., ch. 1505, Sec. 3.11, eff. Sept. 1, 1999.
Sec. 33.032. PROGRAM SERVICES. (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.
(b) The board may adopt:
(1) rules specifying the type, amount, and duration of
program services to be offered;
(2) rules establishing the criteria for eligibility
for services, including the medical and financial criteria;
(3) rules establishing the procedures necessary to
determine the medical, financial, and other eligibility of the
individual;
(4) substantive and procedural rules for applying for
program services and processing those applications;
(5) rules for providing services according to a
sliding scale of financial eligibility;
(6) substantive and procedural rules for the denial,
modification, suspension, and revocation of an individual's
approval to receive services; and
(7) substantive and procedural rules for the approval
of providers to furnish program services.
(c) The department may select providers according to the
criteria in the board's rules.
(d) The board may charge fees for the provision of services,
except that services may not be denied to an individual because of
the individual's inability to pay the fees.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.033. CONSENT. The department may not provide
services without the consent of the individual or, if the
individual is a minor, the minor's parent, managing conservator, or
guardian.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.034. DENIAL, MODIFICATION, SUSPENSION, AND
REVOCATION OF APPROVAL TO PROVIDE SERVICES. (a) After notice and
an opportunity for a fair hearing, the department may deny the
approval or modify, suspend, or revoke the approval of a person to
provide services under this chapter.
(b) Notice shall be given and the hearing shall be conducted
in accordance with the department's informal hearing procedures.
(c) Chapter 2001, Government Code, do not apply to the
notice and hearing required by this section.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991;
Acts 1995, 74th Leg., ch. 76, Sec. 5.95(66), eff. Sept. 1, 1995.
Sec. 33.035. INDIVIDUALS ELIGIBLE FOR SERVICES. (a) An
individual is not eligible to receive the services authorized by
this chapter at no cost or reduced cost to the extent that the
individual or the parent, managing conservator, guardian, or other
person with a legal obligation to support the individual is
eligible for some other benefit that would pay for all or part of
the services.
(b) The department may waive ineligibility under Subsection
(a) if the department finds that:
(1) good cause for the waiver is shown; and
(2) enforcement of the requirement would tend to
defeat the purpose of this chapter or disrupt the administration or
prevent the provision of services to an otherwise eligible
recipient.
(c) When an application for services is filed or at any time
that an individual is eligible for or receiving services, the
applicant or recipient shall inform the department of any other
benefit to which the applicant, recipient, or person with a legal
obligation to support the applicant or recipient may be entitled.
(d) The board by rule shall provide criteria for actions
taken under this section.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.036. DENIAL, MODIFICATION, SUSPENSION, AND
REVOCATION OF ELIGIBILITY TO RECEIVE SERVICES. (a) After notice
to the individual or, if the individual is a minor, the individual's
parent, managing conservator, or guardian and an opportunity for a
fair hearing, the department may deny, modify, suspend, or revoke
the determination of a person's eligibility to receive services at
no cost or at reduced cost under this chapter.
(b) Notice shall be given and the hearing shall be conducted
in accordance with the department's informal hearing procedures.
(c) Chapter 2001, Government Code, do not apply to the
notice and hearing required by this section.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991;
Acts 1995, 74th Leg., ch. 76, Sec. 5.95(66), eff. Sept. 1, 1995.
Sec. 33.037. REIMBURSEMENT. (a) The board may require an
individual or, if the individual is a minor, the minor's parent,
managing conservator, or guardian, or other person with a legal
obligation to support the individual to pay or reimburse the
department for all or part of the cost of the services provided.
(b) The recipient or the parent, managing conservator,
guardian, or other person with a legal obligation to support an
individual who has received services from the department that are
covered by some other benefit shall, when the other benefit is
received, reimburse the department for the cost of services
provided.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.
Sec. 33.038. RECOVERY OF COSTS. (a) The department is
entitled to recover an expenditure for services provided under this
chapter from:
(1) a person who does not reimburse the department as
required by this chapter; or
(2) a third party with a legal obligation to pay other
benefits and who has received prior written notice of the
department's interests in the other benefits.
(b) This section creates a separate and distinct cause of
action, and the commissioner may request the attorney general to
bring suit in the appropriate court of Travis County on behalf of
the department.
(c) In a judgment in favor of the department, the court may
award attorney fees, court costs, and interest accruing from the
date on which the department provides the service to the date on
which the department is reimbursed.
(d) The board by rule shall provide criteria for actions
taken under this section.
Amended by Acts 1991, 72nd Leg., ch. 14, Sec. 8, eff. Sept. 1, 1991.