HBA-NMO, JRA H.B. 1860 76(R)BILL ANALYSIS Office of House Bill AnalysisH.B. 1860 By: Gutierrez Public Health 7/29/1999 Enrolled BACKGROUND AND PURPOSE Acanthosis nigricans is a primary marker for high insulin levels that are indicative of insulin resistance. Insulin resistance is a primary factor in the development of Type 2 diabetes. The development of Type 2 diabetes can be prevented by identifying insulin resistance early in life. State law requires school children to be screened for vision and hearing disorders. Screening for acanthosis nigricans involves only a visual check of the child's neck and can be done in conjunction with vision, hearing, and scoliosis screening. H.B. 1860 requires that school children be screened for acanthosis nigricans during the required vision and hearing screening. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the executive council of the Texas-Mexico Border Health Coordination Office of the University of Texas System in SECTION 3 of this bill. SECTION BY SECTION ANALYSIS SECTION 1. DEFINITIONS. Defines "acanthosis nigricans," "executive council," "office," "professional examination," "school," and "screening test." SECTION 2. PILOT PROGRAM ESTABLISHED. Requires the Texas-Mexico Border Health Coordination Office of the University of Texas System (office), not later than the 1999-2000 school year, to establish an acanthosis screening pilot program in accordance with this Act. Provides that the pilot program applies only in El Paso, Hudspeth, Cameron, Hidalgo, Jim Hogg, Starr, Webb, Willacy, and Zapata counties. SECTION 3. ACANTHOSIS NIGRICANS SCREENING PILOT PROGRAM. (a) Requires the executive council of the office (executive council), by rule, to require screening of individuals who attend public or private schools to detect acanthosis nigricans. Authorizes the executive council, in developing the rules, to consider the number of individuals to be screened and the availability of personnel qualified to administer the required screening. (b) Provides that the rules must include procedures necessary to administer screening activities. (c) Requires the office to require acanthosis nigricans screening to be performed at the same time as the required hearing and vision screening. (d) Authorizes the office to coordinate the 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. Authorizes the office to provide technical assistance in developing screening programs and education and other material to assist local screening activities. (e) Requires the office to monitor the quality of screening activities provided under this chapter. SECTION 4. COMPLIANCE WITH SCREENING REQUIREMENTS. (a) Requires each individual required to be screened to undergo approved screening for acanthosis nigricans as soon as possible after the individual's admission to a school and annually as required by rule. Authorizes the individual, or the individual's parent if the individual is a minor, to substitute a professional examination for the screening. (b) Exempts an individual from screening if screening conflicts with tenets and practices of a recognized church or religious denomination of which the individual is an adherent or a member. Provides that the individual, or the individual's parent, managing conservator, or guardian, must submit an affidavit stating the objection to the screening to the chief administrator of the school on or before the day of the screening procedure to qualify for the exemption. (c) Requires the chief administrator of each school to ensure that each individual admitted to the school complies with the screening requirements set by the board or submits an affidavit of exemption. SECTION 5. RECORDS; REPORTS. (a) Requires the chief administrator of each school to maintain, on a form prescribed by the executive council, and screening records for each individual in attendance, which must be open for inspection by the office or the local health department. (b) Authorizes the office to enter a school and inspect acanthosis nigricans screening records. (c) Authorizes the transfer of an individual's screening records among schools without the consent of the individual or, if the individual is a minor, the minor's parent, managing conservator, or guardian. (d) Requires the person performing the screening to send a report indicating that an individual may have acanthosis nigricans to the individual or, if the individual is a minor, the minor's parent, managing conservator, or guardian. Provides that the report must include an explanation of acanthosis nigricans and related conditions, a statement concerning an individual's or family's access to financial or medical assistance for evaluation and treatment of conditions related to acanthosis nigricans, and instructions to help the individual or family receive evaluation and treatment. (e) Requires each school to submit to the office an annual report on the screening status of the individuals in attendance during the reporting year and any other information required by the office on a form prescribed by the executive council and according to executive council rules. SECTION 6. REPORTS. Requires the office, not later than January 1, 2001, to submit to the governor and the legislature a report concerning the effectiveness of the pilot program established under this Act. SECTION 7. EXPIRATION DATE. Provides that this Act expires on September 1, 2001. SECTION 8. Provides that this Act has no effect if no specific appropriation for its implementation is provided in H.B. 1, the General Appropriations Act. SECTION 9. Emergency clause.