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2005S0489-1 03/08/05
By: Lucio, Madla S.B. No. 1239
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
Council.
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, 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 Risk
Assessment 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. 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 Science 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 the risk assessment for Type 2 diabetes [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 risk assessment [screening] activities,
including rules that require the department and each school to
record and track the information collected during risk assessment
activities using:
(1) 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; or
(2) an existing database used to administer and track
risk assessment activities.
(d) Unless the executive commissioner establishes different
times or age groups, the department [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;
(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 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
through provider bulletins.
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 [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 another data tracking
program selected by the department in accordance with executive
commissioner rules. 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 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 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 data tracking
program and be on a form prescribed by the department in accordance
with [executive council and must be submitted according to] the
executive commissioner's [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 Sections 95.005 and 95.006 to read as follows:
Sec. 95.005. ADVISORY COUNCIL. (a) The department shall
establish the Type 2 Diabetes Risk Assessment Program Advisory
Council to advise the department on the Type 2 diabetes risk
assessment 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
Council;
(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 representative of the American Diabetes
Association;
(I) one school nurse representative from a rural
school selected by the department; and
(J) 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 Council.
(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 Council
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 risk assessment 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 risk assessment activities under this
chapter;
(3) develop a method to track 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) develop a timeline for the department to implement
the advisory council's recommended risk assessment 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 risk
assessment activities conducted under this chapter and
recommendations for assisting children in this state at risk for
developing Type 2 diabetes.
SECTION 5. (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 Council created under Section 95.005,
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 institutions of higher education selected by
the Department of State Health Services for this purpose; and
(9) 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 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 Council
created under Section 95.005, Health and Safety Code, as added by
this Act.
SECTION 6. Subdivision (6), Section 95.001, Health and
Safety Code, as added by Chapter 1465, Acts of the 77th Legislature,
Regular Session, 2001, is repealed.
SECTION 7. This Act takes effect September 1, 2005.