HBA-JEK H.B. 2945 77(R) BILL ANALYSIS Office of House Bill AnalysisH.B. 2945 By: Capelo Public Health 3/23/2001 Introduced BACKGROUND AND PURPOSE Acanthosis nigricans is a light brown or black velvety, rough, or thickened area on the surface of the skin that may signal high insulin levels and a risk of developing diabetes. The American Diabetes Association reports that acanthosis nigricans is present in as many as 90 percent of children with type 2 diabetes, and that the incidence of type 2 diabetes in children and adolescents may be increasing. Acanthosis nigricans screening may lead to the early detection of diabetes, which could lead to better lifestyle changes that allow children with diabetes to better manage their disease. House Bill 2945 requires annual acanthosis nigricans screening for individuals who attend public or private schools. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the Texas Board of Health in SECTION 1 (Sections 50.002, 50.003, and 50.004, Health and Safety Code) of this bill. ANALYSIS House Bill 2945 amends the Health and Safety Code to require the Texas Board of Health (board) by rule to require annual acanthosis nigricans screening for individuals who attend public or private schools at the same time hearing and vision screening is performed. The bill provides that the rules must include procedures necessary to administer screening activities, and authorizes the board to consider the number of individuals to be screened and the availability of personnel qualified to administer the required screening. H.B. 2945 authorizes the Texas Department of Health (TDH) 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 and not fragmented or duplicative. The bill authorizes TDH to provide technical assistance, educational material, and other material to such entities to assist local screening activities. The bill requires TDH to monitor the quality of acanthosis nigricans screening activities. The bill requires an individual required by board rule to be screened to undergo screening as soon as possible after the individual's admission to a school, and annually as required by board rule. The bill authorizes an individual or, if the individual is a minor, the minor's parent, managing conservator, or guardian (guardian) to substitute a professional examination for the screening. The bill provides that an individual is exempt from acanthosis nigricans screening if it conflicts with the tenets and practices of a recognized church or religious denomination of which the individual is an adherent or a member. The bill requires the chief administrator of each school to ensure that each individual admitted to the school complies with the screening requirements or submits an affidavit of exemption. H.B. 2945 requires the chief administrator of each school to maintain screening records for each individual in attendance, and specifies that the records are open for inspection by TDH or the local health department. The bill authorizes an individual's screening records to be transferred among schools without the consent of the individual or the individual's guardian. The bill requires the person performing the screening to send a report to the individual or the individual's guardian indicating that an individual may have acanthosis nigricans, and provides that the report must include an explanation of acanthosis nigricans and its 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. H.B. 2945 requires each school to submit to TDH an annual report on the screening status of the individuals in attendance during the reporting year, and provides that the report must be on a form prescribed by TDH and submitted according to the board's rules. EFFECTIVE DATE On passage, or if the Act does not receive the necessary vote, the Act takes effect September 1, 2001. The screening required by this Act shall be conducted beginning with the 2001-2002 school year.