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79R5465 YDB-D

By:  Madla                                                        S.B. No. 545


A BILL TO BE ENTITLED
AN ACT
relating to the creation of the Type 2 Diabetes Screening Program Advisory Council and the establishment of a Type 2 diabetes screening program for school children. 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. TYPE 2 DIABETES [ACANTHOSIS NIGRICANS] SCREENING
SECTION 2. Section 95.001, Health and Safety Code, as added by Chapter 1465, Acts of the 77th Legislature, Regular Session, 2001, is amended by amending Subdivisions (2) and (3) and adding Subdivision (2-a) to read as follows: (2) "Advisory council" means the Type 2 Diabetes Screening Program Advisory Council. (2-a) "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]. (3) "Executive commissioner" means the executive commissioner of the Health and Human Services Commission ["Office" means the Texas-Mexico Border Health Coordination Office of The University of Texas-Pan American]. SECTION 3. Section 95.002, Health and Safety Code, as added by Chapter 1465, Acts of the 77th Legislature, Regular Session, 2001, is amended to read as follows: Sec. 95.002. TYPE 2 DIABETES [ACANTHOSIS NIGRICANS] EDUCATION AND SCREENING PROGRAM [PROJECT]. (a) The department [office] shall administer a Type 2 diabetes [an acanthosis nigricans] screening program in accordance with this chapter. To administer the screening program, the department shall 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 Diabetes Research Center, and may assign to an institution under a contract any duty required by this chapter. (b) The executive commissioner [council] by rule shall coordinate screening of individuals who attend public or private schools in this state [located in Texas Education Agency Regional Education Service Centers 1, 2, 3, 4, 10, 11, 13, 15, 18, 19, and 20]. (c) The rules must include procedures necessary to administer and track screening activities, including rules that require the department and each school to record and track the information collected during screening activities using the Centers for Disease Control and Prevention's Epi Info or a similar data tracking program selected by the department and designed to develop questionnaires and customize and analyze data. (d) Unless the executive commissioner by rule establishes different times or age groups, the department [The office] shall require 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 Type 2 diabetes screening should: (1) identify students with a body mass index above the normal range; (2) further screen students identified under Subdivision (1) for acanthosis nigricans and identify students with an above normal grade of acanthosis nigricans; and (3) further screen students identified under Subdivision (2) for elevated blood pressure. (e) The department [office] may: (1) coordinate the Type 2 diabetes [acanthosis nigricans] screening activities of school districts, private schools, state agencies, volunteer organizations, 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 screening programs. (f) The department shall: (1) [and may] provide educational and other material to assist local screening activities; (2)[. (f) The office shall] monitor the quality of 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 screening activities under this chapter. SECTION 4. Sections 95.003(a) and (c), Health and Safety Code, as added by Chapter 1465, Acts of the 77th Legislature, Regular Session, 2001, are amended to read as follows: (a) Each individual required by rules adopted under this chapter to be screened shall undergo approved 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 screening. (c) The chief administrator of each school shall ensure that each individual admitted to the school complies with the screening requirements set by the department [executive council] or submits an affidavit of exemption. SECTION 5. Section 95.004, Health and Safety Code, as added by Chapter 1465, Acts of the 77th Legislature, Regular Session, 2001, is amended by amending Subsections (a), (b), (d), (e), and (f) and adding Subsections (g) and (h) to read as follows: (a) The chief administrator of each school shall maintain, on a form prescribed by the department [executive council], screening records for each individual in attendance and enter the screening information for each individual on the Centers for Disease Control and Prevention's Epi Info or another data tracking program selected by the department in accordance with executive commissioner rules. The screening[, and the] records are open for inspection by the [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 screening for Type 2 diabetes [acanthosis nigricans]. (d) The school nurse or other person performing the 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 the Type 2 diabetes screening process, body mass index, [acanthosis nigricans and] related conditions associated with developing Type 2 diabetes, such as acanthosis nigricans or elevated blood pressure, and why the individual was identified in the screening process as at risk for developing Type 2 diabetes; (2) a statement concerning an individual's or family's need for further evaluation for Type 2 diabetes and related [of] conditions that indicate the individual is at risk for developing Type 2 diabetes [related to acanthosis nigricans]; and (3) instructions to help the individual or family receive evaluation and intervention by the school district or by a physician or health care provider. (e) Each school shall submit to the department [office] an annual report on the 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 data tracking program and be on a form prescribed by the department in accordance with executive commissioner [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 Type 2 diabetes [acanthosis nigricans] screening program established by this chapter. SECTION 6. Chapter 95, Health and Safety Code, as added by Chapter 1465, Acts of the 77th Legislature, Regular Session, 2001, is amended by adding Sections 95.005 and 95.006 to read as follows: Sec. 95.005. ADVISORY COUNCIL. (a) The department shall establish the Type 2 Diabetes Screening Program Advisory Council to advise the department on the Type 2 diabetes screening program conducted under this chapter. (b) The advisory council is composed of: (1) the following representatives appointed by the executive head of the agency, organization, or school the representative serves: (A) one representative of the Texas Diabetes Institute; (B) one representative of the department; (C) one representative of the Texas Education Agency; (D) a representative from each institution of higher education selected by the department; (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 school nurse representative from a rural school selected by the department; and (I) one school nurse representative from an urban school selected by the department; and (2) one parent or guardian of a child in this state with Type 2 diabetes, appointed by the Texas Diabetes Institute. (c) A person may not be a member of the advisory council 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 department. (d) The representative of the Texas Diabetes Institute appointed under Subsection (b)(1)(A) shall serve as the presiding officer of the advisory council. (e) Chapter 2110, Government Code, does not apply to the size, composition, or duration of the advisory council. Sec. 95.006. ADVISORY COUNCIL DUTIES. The advisory council shall: (1) recommend the person who should be responsible for conducting screening activities under this chapter for schools that do not employ a school nurse; (2) advise the department on the age groups that would benefit most from the screening activities under this chapter; (3) develop a method to track the number of children who are identified in the screening process as 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) develop a timeline for the department to implement the advisory council's recommended screening activities, tracking methods, reports, and quality improvements; and (5) contribute to the state plan for diabetes treatment developed by the Texas Diabetes Council under Section 103.013 by providing statistics and information on the screening activities conducted under this chapter and recommendations for assisting children in this state at risk for developing Type 2 diabetes. SECTION 7. (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 Screening Program Advisory Council created under Section 95.005, Health and Safety Code, as added by this Act: (1) Texas Diabetes Institute; (2) Department of State Health Services; (3) Texas Education Agency; (4) Texas Medical Association; (5) Texas Pediatric Society; (6) American Heart Association; (7) the institutions of higher education selected by the Department of State Health Services for this purpose; and (8) the schools selected by the Department of State Health Services for this purpose. (b) As early as possible after the effective date of this Act, the head of the Texas Diabetes Institute shall appoint a parent or guardian of a child in this state with Type 2 diabetes to serve on the Type 2 Diabetes Screening Program Advisory Council created under Section 95.005, Health and Safety Code, as added by this Act. SECTION 8. This Act takes effect September 1, 2005.