HBA-NRS H.B. 2989 77(R)BILL ANALYSIS Office of House Bill AnalysisH.B. 2989 By: Gutierrez Public Health 7/19/2001 Enrolled BACKGROUND AND PURPOSE Acanthosis nigricans is a disorder that causes light brown to black, velvety, rough areas or increased skin markings usually on the back and sides of the neck. Acanthosis nigricans is an indicator of insulin resistance. Insulin resistance is a primary factor in the development of type 2 diabetes mellitus. The development of type 2 diabetes mellitus can be prevented or delayed through diet and exercise if insulin resistance is identified early in life. State law requires school children to be screened for vision and hearing disorders, and screening for acanthosis nigricans can be done in conjunction with these other screenings. House Bill 2989 establishes an acanthosis nigricans screening program. RULEMAKING AUTHORITY It is the opinion of the Office of House Bill Analysis that rulemaking authority is expressly delegated to the executive council advising the Texas-Mexico Border Health Coordination Office of the University of Texas-Pan American in SECTION 1 (Section 95.002, Health and Safety Code) of this bill. ANALYSIS House Bill 2989 amends the Health and Safety Code to require the Texas-Mexico Border Health Coordination Office of The University of Texas-Pan American (office) to administer an acanthosis nigricans screening program (program) and requires the executive council advising the office (executive council) to by rule coordinate screening of individuals who attend public or private schools located in Texas Education Agency Regional Education Service Centers 1, 2, 3, 13, 15, 18, 19, and 20, including procedures necessary to administer screening activities. The bill requires the office to require acanthosis nigricans screening to be performed at the same time hearing and vision screening is performed under the Special Senses and Communication Disorders Act or spinal screening is performed to detect abnormal spinal curvature in children. The bill authorizes the office to coordinate the acanthosis nigricans screening activities of school districts, private schools, state agencies, volunteer organizations, and other entities and to provide technical assistance and educational and other material. The bill requires the office to monitor the quality of acanthosis nigricans screening activities. The bill requires each individual required by rule to be screened to undergo an acanthosis nigricans screening and to comply as soon as possible after the individual's admission to a school and as required by 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 screening if the screening conflicts with the individual's tenets or practices as an adherent or member of a recognized church or religious denomination and sets forth provisions regarding qualifying for an exemption. Furthermore, the bill requires the chief administrator of each school to ensure that each individual admitted to the school complies with the screening requirements set by the executive council or submits an affidavit of exemption. The bill requires the chief administrator of each school to maintain screening records for each individual in attendance and provides that the records are open for inspection by the office 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 indicating that an individual may have acanthosis nigricans to the individual, or the individual's guardian. The report must include an explanation of acanthosis nigricans, a statement concerning the need for further evaluation of acanthosis nigricans, and instructions to help the individual or family receive evaluation and intervention by the school district. The bill 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 to include in the report any other information required by the office. Not later than January 15 of each odd-numbered year, the bill requires the office to submit to the governor and the legislature a report concerning the effectiveness of the program. EFFECTIVE DATE September 1, 2001. The Act takes effect only if a specific appropriation for the implementation of the Act is provided in the General Appropriations Act.