CHAPTER 95. RISK ASSESSMENT FOR TYPE 2 DIABETES - Texas Statutes

HEALTH AND SAFETY CODE

TITLE 2. HEALTH

SUBTITLE D. PREVENTION, CONTROL, AND REPORTS OF DISEASES

CHAPTER 95. RISK ASSESSMENT FOR TYPE 2 DIABETES

Sec. 95.001. DEFINITIONS. In this chapter:

(1) "Acanthosis nigricans" means a light brown or black velvety,

rough, or thickened area on the surface of the skin that may

signal high insulin levels indicative of insulin resistance.

(1-a) "Advisory committee" means the Type 2 Diabetes Risk

Assessment Program Advisory Committee established under Section

95.006.

(1-b) "Council" means the Texas Diabetes Council.

(2) Repealed by Acts 2007, 80th Leg., R.S., Ch. 504, Sec. 6,

eff. September 1, 2007.

(3) "Office" means The University of Texas-Pan American Border

Health Office.

(4) "Professional examination" means an evaluation performed by

an appropriately licensed professional.

(5) "School" means an educational institution that admits

children who are five years of age or older but younger than 21

years of age.

(6) Repealed by Acts 2007, 80th Leg., R.S., Ch. 504, Sec. 6,

eff. September 1, 2007.

Added by Acts 2001, 77th Leg., ch. 1465, Sec. 1, eff. Sept. 1,

2001.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

504, Sec. 2, eff. September 1, 2007.

Acts 2007, 80th Leg., R.S., Ch.

504, Sec. 6, eff. September 1, 2007.

Sec. 95.002. TYPE 2 DIABETES EDUCATION AND RISK ASSESSMENT

PROGRAM. (a) The office shall administer a risk assessment

program for Type 2 diabetes in accordance with this chapter.

(b) The office, after reviewing recommendations made by the

advisory committee, by rule shall coordinate the risk assessment

for Type 2 diabetes of individuals who attend public or private

schools located in Texas Education Agency Regional Education

Service Centers 1, 2, 3, 4, 10, 11, 13, 15, 18, 19, and 20 and,

by using existing funding as efficiently as possible or by using

other available funding, in additional regional education service

centers.

(c) The rules must include procedures necessary to administer

the risk assessment program, including procedures that require

each school to record and report risk assessment activities

using:

(1) an existing database used to administer and track risk

assessment data; or

(2) widely accepted surveillance software selected by the

office.

(d) The office shall require a risk assessment for Type 2

diabetes 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 acanthosis nigricans; and

(2) further assess students identified under Subdivision (1) to

determine the students':

(A) body mass index; and

(B) blood pressure.

(e) The office may:

(1) coordinate the risk assessment for Type 2 diabetes

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) provide technical assistance to those entities in developing

risk assessment programs.

(f) The office shall:

(1) provide educational and other material to assist local risk

assessment activities;

(2) monitor the quality of risk assessment 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 office shall provide on the office's Internet website

information on obesity, Type 2 diabetes, and related conditions

to health care providers and update the information at least

annually.

Added by Acts 2001, 77th Leg., ch. 1465, Sec. 1, eff. Sept. 1,

2001. Amended by Acts 2003, 78th Leg., ch. 1125, Sec. 1, eff.

Sept. 1, 2003.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

504, Sec. 3, eff. September 1, 2007.

Sec. 95.003. COMPLIANCE WITH RISK ASSESSMENT REQUIREMENTS. (a)

Each individual required by rules adopted under this chapter to

be assessed shall undergo approved risk assessment for Type 2

diabetes. 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.

(b) An individual is exempt from risk assessment if risk

assessment 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 an affidavit stating the

objections to the risk assessment.

(c) The chief administrator of each school shall ensure that

each individual admitted to the school complies with the risk

assessment requirements set by the office or submits an affidavit

of exemption.

Added by Acts 2001, 77th Leg., ch. 1465, Sec. 1, eff. Sept. 1,

2001.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

504, Sec. 3, eff. September 1, 2007.

Sec. 95.004. RECORDS; REPORTS. (a) The chief administrator of

each school shall maintain, on a form prescribed by the office,

risk assessment records for each individual in attendance and

enter the risk assessment information for each individual on the

surveillance software selected by the office. The risk

assessment records are open for inspection by the office or the

local health department.

(b) The office may, directly or through local health

departments, enter a school and inspect records maintained by the

school relating to risk assessment for Type 2 diabetes.

(c) An individual's risk assessment 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 shall send a

report indicating that an individual may be at risk for

developing Type 2 diabetes 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 reasons the individual was identified in the risk

assessment process as being at risk for developing Type 2

diabetes;

(C) the risk factors associated with developing Type 2 diabetes;

and

(D) the individual's body mass index;

(2) a statement concerning an individual's or family's need for

further evaluation for Type 2 diabetes and related conditions;

(3) instructions to help the individual or family receive

evaluation by a physician or other health care provider; and

(4) information on procedures for applying for the state child

health plan program and the state Medicaid program.

(e) Each school shall submit to the office an annual report on

the risk assessment status of the individuals in attendance

during the reporting year and shall include in the report any

other information required by the office.

(f) The report required under Subsection (e) must:

(1) be compiled from the information entered into the

surveillance software;

(2) be on a form prescribed by the office; and

(3) be submitted according to the timetable established by the

office's rules.

(g) After the end of the reporting period under Subsection (e),

the office shall:

(1) analyze and compile a summary of the reports submitted by

schools during that reporting period;

(2) file a copy of the summary with the advisory committee; and

(3) post on an Internet website accessible to each school

required to submit a report under Subsection (e):

(A) the number of students and the percentage of the student

population identified by each of those schools during the

reporting period as at risk for Type 2 diabetes; and

(B) comparison data and analyses regarding the information

required to be reported under that subsection.

(h) The office shall deliver to the chief administrator of each

school and the school nurse or other person responsible for

conducting risk assessment activities for the school under this

chapter an annual summary compilation of the reports submitted by

schools under Subsection (e).

(i) Not later than January 15 of each odd-numbered year, the

office shall submit to the governor and the legislature a report

relating to the implementation and effectiveness of the Type 2

diabetes risk assessment program established by this chapter that

includes a detailed description of the expenses related to the

program.

Added by Acts 2001, 77th Leg., ch. 1465, Sec. 1, eff. Sept. 1,

2001.

Amended by:

Acts 2007, 80th Leg., R.S., Ch.

504, Sec. 3, eff. September 1, 2007.

Sec. 95.005. GIFTS AND GRANTS. The office may accept gifts,

grants, and donations to support the Type 2 diabetes risk

assessment program conducted under this chapter.

Added by Acts 2007, 80th Leg., R.S., Ch.

504, Sec. 4, eff. September 1, 2007.

Sec. 95.006. ADVISORY COMMITTEE. (a) The Type 2 Diabetes Risk

Assessment Program Advisory Committee is established to advise

the office on the Type 2 diabetes risk assessment program

conducted under this chapter.

(b) The advisory committee is composed of:

(1) the following representatives appointed by the executive

director of the office:

(A) one representative of the office;

(B) one representative of the Texas Education Agency;

(C) one representative of the Texas Pediatric Society;

(D) one representative of the American Diabetes Association;

(E) one representative who is a member of the board of regents

of The University of Texas--Pan American;

(F) one school nurse representative from an urban school located

within the boundaries of a regional education service center;

(G) one parent or guardian of a child who resides within the

boundaries of a regional education service center; and

(H) one person with knowledge and experience in health care in

school settings; and

(2) the following representatives appointed by the chairman of

the council:

(A) one representative of the council;

(B) one representative of the Texas Medical Association;

(C) one school district administrator representative from a

school district located within the boundaries of a regional

education service center;

(D) one school principal representative from a school district

located within the boundaries of a regional education service

center; and

(E) one school nurse representative from a rural school located

within the boundaries of a regional education service center.

(c) A person may not be a member of the advisory committee 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

council.

(d) The representative of the office appointed under Subsection

(b)(1)(A) shall serve as the presiding officer of the advisory

committee.

(e) The advisory committee shall meet at least twice a year and

at other times at the call of the presiding officer. The

advisory committee may meet by teleconference if an in-person

meeting of all the members is not practicable.

(f) Members of the advisory committee may not receive

compensation for service on the committee. An advisory committee

member is entitled to reimbursement of travel expenses incurred

by the member while conducting the business of the advisory

committee to the extent that funds are available to the office

for that purpose.

(g) Chapter 2110, Government Code, does not apply to the size,

composition, or duration of the advisory committee.

(h) The advisory committee 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 office on the age groups that would benefit most

from the risk assessment activities under this chapter;

(3) recommend a method to record and report 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) recommend a deadline, which may not be later than the first

anniversary of the date the advisory committee submits a

recommendation to the office under this section, by which the

office shall implement the advisory committee's recommended risk

assessment activities, surveillance methods, reports, and quality

improvements;

(5) contribute to the state plan for diabetes treatment

developed by the 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;

and

(6) recommend any additional information to be included in the

report required by Section 95.004.

(i) The advisory committee shall submit to the office a report

of the recommendations developed under Subsection (h) not later

than September 1 of each even-numbered year. The office, subject

to the availability of funds, shall implement each advisory

committee recommendation concerning the Type 2 diabetes risk

assessment program.

(j) In this section, "regional education service center" means a

Texas Education Agency Regional Education Service Center listed

in Section 95.002(b).

Added by Acts 2007, 80th Leg., R.S., Ch.

504, Sec. 4, eff. September 1, 2007.