Part 1.
TEXAS DEPARTMENT OF HEALTH
Chapter 37.
MATERNAL AND INFANT HEALTH SERVICES
Subchapter Q. REPORTING OF ELEVATED LEVELS OF CHILDHOOD LEAD
25 TAC §§37.331 - 37.336
The Texas Department of Health (department) proposes amendments
to §§37.331-37.336 concerning childhood lead reporting.
Government Code, §2001.039 requires that each state agency review
and consider for readoption each rule adopted by that agency pursuant to the
Government Code, Chapter 2001 (Administrative Procedure Act). Sections 37.331-37.336
have been reviewed and the department has determined that reasons for adopting
the sections continue to exist; however changes were necessary as described
in this preamble.
The amendments change the reporting level from ten micrograms per deciliter
of lead to reporting of all blood lead levels, clarify when to report, change
reporting of blood lead levels to 40 micrograms per deciliter immediately
to the department to a specified phone number, and clarify that race and ethnicity
are reported separately.
The department published a Notice of Intention to Review for §§37.331-37.336
as required by Government Code, §2001.039 in the
Texas Register
on April 28, 2002 (25 TexReg 3799). No comments were
received in regards to the publication of the notice.
Judy Henry, Division Co-director, has determined that for each year of
the first five years the sections are in effect, there will be no fiscal implication
to state or local government as a result of enforcing or administering the
sections as proposed.
Judy Henry has also determined that for each year of the first five years
the amendments are in effect, the public benefit anticipated as a result of
enforcing or administering the sections will be at no cost. This benefit is
better information to the public of the lowered reporting level, facilitating
better follow up for children at risk. There will be no cost effects on micro
businesses or small businesses. This was determined by interpretation of the
rules that small businesses and micro-businesses will not be required to alter
their business practices in order to comply with the rules as proposed. There
are no anticipated economic costs to persons who are required to comply with
the amendments as proposed. There is no anticipated impact on local employment.
Comments on the proposal may be submitted to Teresa Willis, Texas Department
of Health, 1100 West 49th Street, Austin, Texas 78756, (512) 458-7269, fax
(512) 458-7699. Comments will be accepted for 30 days following publication
of the proposal in the
Texas Register
.
The amendments are proposed under Health and Safety Code, §88.003,
which authorizes the board of health (board) to adopt rules relating to the
reporting of childhood blood lead levels; and Health and Safety Code, §12.001,
which provides the board with the authority to adopt rules for its procedure
and for the performance of each duty imposed by law on the board, the department,
or the commissioner of health.
The amendments affect Health and Safety Code, Chapters 88 and 12; and implements
Government Code, §2001.039.
§37.331.Purpose.
The purpose of these sections is to implement the provisions of Acts
1995, 74th Legislature, Chapter 965, adding Chapter 88 to the Health and Safety
Code which provides the Texas Board of Health with the authority to adopt
rules relating to the reporting of childhood lead levels [
§37.332.Definitions.
The following words and terms, when used in these sections, shall have
the following meanings, unless the context clearly indicates otherwise.
(1)
Blood lead level of concern -- Presence of blood lead concentrations
suspected to be associated with mental and physical disorders due to absorption,
ingestion, or inhalation of lead as specified in the most recent criteria
issued by the United States Department of Health and Human Services, United
States Public Health Service, Centers for Disease Control and Prevention (CDC).
[
(2) - (13)
(No change.)
§37.333.Confidentiality of Information Provided to the Department.
(a)
Reports, records, and other information collected by,
or maintained by,
or provided to the Texas Department of Health relating
to
children's reports of blood lead testing
[
(b)
(No change.)
§37.334.Reportable Health Condition.
(a)
All blood
[
(b)
The department will maintain a registry of
children's
blood lead test results
[
(c)
(No change.)
§37.335.Persons Required to Report.
(a)
The following persons are required to report
all blood
lead results
[
(1)
(No change.)
(2)
the
[
(A) - (B)
(No change.)
(C)
a facility in which a laboratory conducts blood lead
testing.
[
(b)
If a report is not made as required in subsection (a)(1)
or (2) of this section, the following persons shall report
all blood
lead results
[
(1) - (8)
(No change.)
§37.336.Reporting Procedures.
(a)
The reporting physician, laboratory director, or alternate
person as set forth in §37.335(b) of this title (relating to Persons
Required to Report) shall make the report of the childhood blood lead level
results
[
(b)
(No change.)
(c)
When a child with a blood lead
result
[
(d)
Blood lead levels of
40
[
(1)
the child's name, address, date of birth or age, sex
,
[
(2) - (4)
(No change.)
This agency hereby certifies that the proposal has been
reviewed by legal counsel and found to be within the agency's legal authority
to adopt.
Filed with the Office of
the Secretary of State on May 3, 2002.
TRD-200202772
Susan Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 16, 2002
For further information, please call: (512) 458-7236
Subchapter B. IMMUNIZATION REQUIREMENTS IN TEXAS ELEMENTARY AND SECONDARY SCHOOLS AND INSTITUTIONS OF HIGHER EDUCATION
25 TAC §97.63
The Texas Department of Health (department) proposes an amendment
to §97.63 concerning immunization requirements for Texas child-care facilities,
elementary and secondary schools and institutions of higher education.
Specifically, this amendment allows a four-day grace period when the school
immunization requirements specify a minimum age for administration of a specific
vaccine. The proposed revision to existing requirements will incorporate recent
recommendations of the Advisory Committee on Immunization Practices (ACIP).
This committee, which has representatives of the American Academy of Pediatrics,
recommends that vaccine doses administered up to four days before the minimum
interval or age can be counted as valid. ACIP believes that administering
a dose a few days earlier than the minimum interval or age is unlikely to
have a significant negative effect on the immune response to that dose.
Linda S. Linville, M.S., R.N., Chief, Bureau Immunization and Pharmacy
Support, has determined that for the first five-year period that the section
will be in effect there will be no fiscal implications to state and local
government as a result of enforcing and administering the section as proposed.
Ms. Linville, has also determined that for each year of the first five
years that the section is in effect the public benefits anticipated as a result
of enforcing and administering the section as proposed will emerge as a decrease
in revaccination of children who do not meet the minimum age for a particular
vaccine or minimum interval between doses of the same vaccine. There will
be no impact on micro-businesses and small businesses. The only fiscal impact
expected will be a decrease in medical costs for parents due to the decrease
in the cost of revaccination. There will be no impact on local employment.
Comments on the proposal may be submitted to Janie Garcia, Immunization
Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas
78756, (512) 458-7284, or (800) 252-9152. Comments will be accepted for 30
days following publication of this proposal in the
Texas Register
.
This amendment is proposed under Health and Safety Code §81.023,
which requires the Board of Health (board) to develop immunization requirements
for children; Education Code §38.001, which allows the board to develop
immunization requirements for admission to any elementary or secondary school;
Education Code §51.933, which allows the board to develop immunization
requirements for students at any institution of higher education who are pursuing
a course of study in a health profession; Human Resources Code, §42.043,
which requires the department to make rules regarding the immunization of
children admitted to child-care facilities; and Health and Safety Code §12.001,
which provides the board with the authority to adopt rules for the performance
of every duty imposed by law on the board, the department and the commissioner
of health.
This section affects Health and Safety Code §81.023; Texas Education
Code, §38.001, 51.933; and Human Resource Code §42.043.
§97.63.Required Immunizations.
(a) - (b)
(No change.)
(c)
The following immunizations are required in the respective
age groupings. A child or student must meet all the immunization requirements
specific to an age group upon first entering the age group. Implementation
of requirements for hepatitis B vaccine for adolescents and varicella vaccine
and hepatitis A for all ages is contingent upon the appropriation of funds
to the department for these purposes. By July 1 of each odd-numbered year,
the department will publish a statement on whether or not these vaccines have
been funded and are required as specified.
(1)
Children less than five years of age: polio vaccine; diphtheria-tetanus-pertussis
(DTP) or diphtheria-tetanus-acellular pertussis (DTaP) vaccine; measles, mumps,
and rubella vaccine (MMR); Haemophilus influenzae type b conjugate vaccine
(HibCV), hepatitis A, and varicella vaccine.
(A) - (D)
(No change.)
(E)
Children 12 months of age, but not yet 15 months of age
(12 months through 14 months of age):
(i) - (ii)
(No change.)
(iii)
one dose of MMR vaccine is required. Only doses received
on or after the first birthday
, or in accordance with the most recent
General Recommendations on Immunizations issued by the Advisory Committee
on Immunization Practices (ACIP)
will meet this requirement. Serologic
confirmation of measles, mumps, or rubella immunity or serologic evidence
of infection is acceptable in lieu of vaccination for that disease only. For
further information see §97.67 of this title (relating to Verification
of Immunity to Measles, Rubella, Mumps, Hepatitis A, Hepatitis B, or Varicella
)
; and
(iv)
(No change.)
(v)
no later then August 1, 2000, one dose of varicella vaccine
is required. This vaccine must have been received on or after the first birthday
, or in accordance with the most recent General Recommendations on Immunizations
issued by the Advisory Committee on Immunization Practices (ACIP)
. A
parent- or physician-validated history of varicella illness (chickenpox) or
serologic confirmation of varicella immunity is acceptable in lieu of vaccine.
For further information, see §97.67 of this title.
(F)
Children 15 months of age, but not yet five years of age
(15 months through four years of age):
(i) - (ii)
(No change.)
(iii)
one dose of MMR vaccine is required. Only doses received
on or after the first birthday
, or in accordance with the most recent
General Recommendations on Immunizations issued by the Advisory Committee
on Immunization Practices (ACIP)
will meet this requirement. Serologic
confirmation of measles, mumps, or rubella immunity or serologic evidence
of infection is acceptable in lieu of vaccination for that disease only. For
further information see §97.67 of this title; and
(iv)
(No change.)
(v)
no later then August 1, 2000, one dose of varicella vaccine
is required. This vaccine must have been received on or after the first birthday
, or in accordance with the most recent General Recommendations on Immunizations
issued by the Advisory Committee on Immunization Practices (ACIP)
. A
parent-or physician-validated history of varicella illness (chickenpox) or
serologic confirmation of varicella immunity is acceptable in lieu of vaccine.
For further information, see §97.67 of this title; and
(vi)
no later then August 1, 2000, children subject to these
requirements as described in §97.61 (relating to Children and Students
Included in Requirements) must comply with the following requirement for hepatitis
A vaccine if the facility, school or institution attended is located in any
of the following counties: Brewster, Brooks, Cameron, Crockett, Culberson,
Dimmitt, Duval, Edwards, El Paso, Frio, Hidalgo, Hudspeth, Jeff Davis, Jim
Hogg, Kenedy, Kinney, La Salle, Maverick, McMullen, Pecos, Presidio, Real,
Reeves, Starr, Sutton, Terrell, Uvalde, Val Verde, Webb, Willacy, Zapata,
and Zavala. Serologic confirmation of immunity to hepatitis A or serologic
evidence of infection is acceptable in lieu of vaccine. In addition to the
above hepatitis A vaccine requirements, the Texas Department of Health (department)
pursuant to the requirements of Health and Safety Code §81.023 shall
require hepatitis A vaccine for children residing in other geographic areas
specified by the department when the incidence rate of hepatitis A during
a representative period of time of no less than 180 days has reached the rate
at least twice the national average, as recommended by the Centers for Disease
Control and Prevention's Advisory Committee on Immunization Practices. Serologic
confirmation of immunity to hepatitis A or serologic evidence of infection
is acceptable in lieu of vaccine. For further information, see §97.67
of this title. Doses of hepatitis A vaccine are required as follows:
(I)
children 2 years of age but not yet 3 years of age are
required to show proof by 30 days past their second birthday
, or in accordance
with the most recent General Recommendations on Immunizations issued by the
Advisory Committee on Immunization Practices (ACIP)
of one dose of hepatitis
A vaccine administered on or after their second birthday
, or in accordance
with the most recent General Recommendations on Immunizations issued by the
Advisory Committee on Immunization Practices (ACIP)
; and
(II)
children 3 years of age but not yet 5 years of age are
required to have received two doses of hepatitis A vaccine administered on
or after their second birthday
, or in accordance with the most recent
General Recommendations on Immunizations issued by the Advisory Committee
on Immunization Practices (ACIP)
.
(2)
Children and students five years of age or older.
(A) - (B)
(No change.)
(C)
Measles.
(i)
Beginning September 1, 1990:
(I)
all children and students must have received measles vaccine
on or after their first birthday,
or in accordance with the most recent
General Recommendations on Immunizations issued by the Advisory Committee
on Immunization Practices (ACIP),
provide serologic confirmation of
measles immunity or serologic evidence of infection; and
(II)
the requirement for measles vaccine administered on or
after the first birthday
, or in accordance with the most recent General
Recommendations on Immunizations issued by the Advisory Committee on Immunization
Practices (ACIP)
will apply if a child's/student's immunization record
is updated; a child/student enters a child-care facility or school for the
first time; or a child/student transfers from another state into a Texas school
or child-care facility.
(ii)
Beginning January 1, 1991, children and students born
on or after September 1, 1978 will be required to show serologic proof of
measles immunity, serologic evidence of infection, or receipt of two doses
of measles vaccine administered on or after the first birthday
, or in
accordance with the most recent General Recommendations on Immunizations issued
by the Advisory Committee on Immunization Practices (ACIP)
. This proof
is not required until the child's 12th birthday. The two doses of measles
vaccine must have been administered at least 28 days apart. Children and students
may have 30 days past their 12th birthday to be in compliance with this clause.
For further information see §97.65 of this title and §97.67 of this
title.
(iii)
Effective August 1, 1997:
(I)
children born on or after September 2, 1991, will be required
to show proof of either:
(-a-)
two doses of measles vaccine administered on or after
the first birthday
, or in accordance with the most recent General Recommendations
on Immunizations issued by the Advisory Committee on Immunization Practices
(ACIP)
and at least 28 days apart; or
(-b-)
(No change.)
(II)
children born prior to September 2, 1991 will be required
to show proof by 30 days past their 12th birthday of either:
(-a-)
two doses of measles vaccine administered on or after
the first birthday
, or in accordance with the most recent General Recommendations
on Immunizations issued by the Advisory Committee on Immunization Practices
(ACIP)
, and at least 28 days apart; or
(-b-)
(No change.)
(D)
Rubella. Beginning September 1, 1991:
(i)
all children and students must have received rubella vaccine
on or after their first birthday,
or in accordance with the most recent
General Recommendations on Immunizations issued by the Advisory Committee
on Immunization Practices (ACIP),
provide serologic confirmation of
rubella immunity, or serologic evidence of infection; and
(ii)
the requirement for rubella vaccine administered on or
after the first birthday,
or in accordance with the most recent General
Recommendations on immunizations issued by the Advisory Committee on Immunization
Practices (ACIP)
will apply if a child's/student's immunization record
is updated; a child/student enters a child-care facility or school for the
first time; or a child/student transfers from another state into a Texas school
or child-care facility. For further information see §97.65 of this title
and §97.67 of this title.
(E)
Mumps. Beginning September 1, 1990:
(i)
all children or students will be required to have received
mumps vaccine administered on or after their first birthday
, or in accordance
with the most recent General Recommendations on Immunizations issued by the
Advisory Committee on Immunization Practices (ACIP)
, provide serologic
confirmation of mumps immunity, or serologic evidence of infection; and
(ii)
the requirement for mumps vaccine administered on or after
the first birthday
, or in accordance with the most recent General Recommendations
on Immunizations issued by the Advisory Committee on Immunization Practices
(ACIP)
will apply if a child's/student's immunization record is updated,
a child/student enters a child-care facility or school for the first time;
or a child/student transfers from another state into a Texas school or child-care
facility. For further information see §97.65 of this title and §97.67
of this title.
(F)
(No change.)
(G)
Varicella.
(i)
No later then August 1, 2000, children born on or after
September 2, 1994, will be required to show proof of either:
(I)
one dose of varicella vaccine received on or after the
first birthday
, or in accordance with the most recent General Recommendations
on Immunizations issued by the Advisory Committee on Immunization Practices
(ACIP)
(two doses are required if the child is 13 years old or older
at the time the first dose of varicella vaccine is received); or
(II)
(No change.)
(ii)
No later than August 1, 2000, children born on or after
September 2, 1988, but before September 2, 1994, will be required to show
proof by 30 days past their 12th birthday of either:
(I)
one dose of varicella vaccine received on or after the
first birthday
, or in accordance with the most recent General Recommendations
on Immunizations issued by the Advisory Committee on Immunization Practices
(ACIP)
(two doses are required if the child is 13 years old or older
at the time the first dose of varicella vaccine is received); or
(II)
(No change.)
(H)
Hepatitis A. Effective August 1, 1999, children subject
to these requirements as described in §97.61 of this title (relating
to Children and Students Included in Requirements) must comply with the following
requirement for hepatitis A vaccine if the facility, school or institution
attended is located in any of the following counties: Brewster, Brooks, Cameron,
Crockett, Culberson, Dimmitt, Duval, Edwards, El Paso, Frio, Hidalgo, Hudspeth,
Jeff Davis, Jim Hogg, Kenedy, Kinney, La Salle, Maverick, McMullen, Pecos,
Presidio, Real, Reeves, Starr, Sutton, Terrell, Uvalde, Val Verde, Webb, Willacy,
Zapata, and Zavala. Serologic confirmation of immunity to hepatitis A or serologic
evidence of infection is acceptable in lieu of vaccine. In addition to the
above hepatitis A vaccine requirements, the department pursuant to the requirements
of Health and Safety Code §81.023 shall require hepatitis A vaccine for
children residing in other geographic areas specified by the department when
the incidence rate of hepatitis A during a representative period of time of
no less than 180 days has reached the rate at least twice the national average,
as recommended by the Centers for Disease Control and Prevention's Advisory
Committee on Immunization Practices. Serologic confirmation of immunity to
hepatitis A or serologic evidence of infection is acceptable in lieu of vaccine.
For further information, see §97.67 of this title. Children and students
born on or after September 2, 1992, will be required to have received two
doses of hepatitis A vaccine administered on or after their second birthday
, or in accordance with the most recent General Recommendations on Immunizations
issued by the Advisory Committee on Immunization Practices (ACIP)
.
(3)
Students in institutions of higher education (colleges,
universities, and other teaching facilities above the high school level).
(A) - (D)
(No change.)
(E)
Measles. Beginning January 1, 1992:
(i)
all students defined previously in subparagraph (A) of
this paragraph who were born on or after January 1, 1957, must show proof
of either:
(I)
two doses of measles vaccine administered since January
1, 1968, and on or after their first birthday
, or in accordance with
the most recent General Recommendations on Immunizations issued by the Advisory
Committee on Immunization Practices (ACIP)
and at least 28 days apart;
or
(II)
at least one dose of measles vaccine administered on or
after their first birthday,
or in accordance with the most recent General
Recommendations on Immunizations issued by the Advisory Committee on Immunization
Practices (ACIP),
which must be received by students enrolled in health-related
courses prior to direct patient contact and completion of the measles requirement
must be accomplished as rapidly as is medically feasible; or
(III)
(No change.)
(ii)
(No change.)
(F)
Rubella. Beginning January 1, 1992:
(i)
all students defined previously in subparagraph (A) of
this paragraph must show, prior to patient contact, proof of either:
(I)
one dose of rubella vaccine administered on or after their
first birthday
, or in accordance with the most recent General Recommendations
on Immunizations issued by the Advisory Committee on Immunization Practices
(ACIP)
; or
(II)
(No change.)
(ii)
(No change.)
(G)
Mumps, Beginning January 1, 1992:
(i)
all students defined previously in subparagraph (A) of
this paragraph who were born on or after January 1, 1957, must show, prior
to patient contact, proof of either:
(I)
one dose of mumps vaccine administered on or after their
first birthday
, or in accordance with the most recent General Recommendations
on Immunizations issued by the Advisory Committee on Immunization Practices
(ACIP);
or
(II)
(No change.)
(ii)
(No change.)
(H) - (I)
(No change.)
(J)
Varicella. Beginning August 1, 1999, varicella vaccine
is required of all students defined previously in subparagraph (A) of this
paragraph. One dose of vaccine is required for students who received this
vaccine prior to 13 years of age; two doses are required for students who
were not vaccinated before their thirteenth birthday. All doses of this vaccine
must have been received on or after the first birthday
, or in accordance
with the most recent General Recommendations on Immunizations issued by the
Advisory Committee on Immunization Practices (ACIP)
. A history of varicella
illness (chickenpox) validated by the student, the student's parent or the
student's physician or serologic confirmation of varicella immunity is acceptable
in lieu of vaccine. For further information, see §97.67 of this title.
This agency hereby certifies that the proposal
has been reviewed by legal counsel and found to be within the agency's legal
authority to adopt.
Filed with the Office of
the Secretary of State on May 6, 2002.
TRD-200202779
Susan Steeg
General Counsel
Texas Department of Health
Earliest possible date of adoption: June 16, 2002
For further information, please call: (512) 458-7236
Subchapter G. VACCINATION STAMPS
The Texas Department of Health (department) proposes amendments to §§97.151-97.153,
97.155-97.156 and the repeal of §97.154 concerning the criteria for issuing
yellow fever immunization stamps to physicians.
These are proposed rules concerning the criteria for issuing yellow fever
immunization stamps to physicians. The Texas Department of Health (department))
is the governmental entity which determines which physicians in the state
are authorized to administer yellow fever vaccine and validate cholera vaccination
for persons who travel outside the United States. Physician's application
for and accessibility to yellow fever vaccination stamps will remain basically
unchanged. However, the department proposes the deletion of all references
to cholera vaccination and validation of cholera vaccination. The manufacture
and sale of the only licensed cholera vaccine in the United States have been
discontinued. The risk of cholera to United States' travelers is so low that
vaccination is of questionable benefit according to the Centers for Disease
Control and Prevention's Health Information for International Travel, 2001-2002.
Government Code, §2001.039 requires that each state agency review
and consider for readoption each rule adopted by that agency pursuant to the
Government Code, Chapter 2001 (Administrative Procedure Act). The department
has reviewed §§97.151-97.156 and has determined that reasons for
adopting the sections continue to exist; however, a repeal of a rule and amendments
are necessary to delete all references to cholera vaccination and make the
rules more accessible, understandable, and usable.
The department published a Notice of Intention to Review §§97.151-97.156
as required by Government Code, §2001.039 in the
Texas Register
on January 14, 2000 (25 TexReg 275). No comments were
received following the publication of the notice.
Linda S. Linville, M.S., R.N., Chief, Bureau Immunization and Pharmacy
Support, has determined that for the first five-year period that the sections
will be in effect there will be no fiscal implications as a result of enforcing
and administering the sections as proposed. There is no cost to local government
since it involves only private physicians and the state health department.
Ms. Linville, has also determined that for each year of the first five
years the sections are in effect, physicians who administer yellow fever vaccinations
to persons who travel outside of the United States will continue to apply
for the stamps as they do currently. Ms. Linville has determined it necessary
to delete the references relating to cholera vaccination and the cholera vaccination
stamp since cholera vaccine is no longer available in the United States. The
deletion of these references is expected to have no impact on either the physicians
or the traveling public since cholera vaccination is no longer available in
the United States. The proposed revisions shall have no fiscal impact on small
businesses. There should be no fiscal impact on micro-businesses such as clinics
or physicians' offices since the cost of obtaining the yellow fever vaccination
stamp is unchanged. The fiscal impact on travelers to areas outside the United
States is expected to remain unchanged since the cost of the stamp remains
the same. There will be no impact on local employment.
Comments on the proposal may be submitted to Janie Garcia, Immunization
Division, Texas Department of Health, 1100 West 49th Street, Austin, Texas
78756, (512) 458-7284, extension 6430, or (800) 252-9152. Comments will be
accepted for 30 days following publication of this proposal in the
Texas Register
.
of concern
] and control of elevated blood lead levels in children through an understanding
of the prevalence and nature of the problem of childhood lead poisoning in
Texas.
The current level recommended by CDC is a blood lead concentration of
ten micrograms of lead per deciliter of blood or greater.
]
children known
or suspected to have blood lead levels of concern or lead poisoning
]
are not public information under open records law and may not be released
or made public on subpoena or otherwise, except as described in subsection
(b) of this section.
Blood
] lead levels [
of concern (greater than or equal to ten micrograms per deciliter)
]
in children 14 years of age or younger are reportable to the Texas Department
of Health (department). Elevated blood lead levels for individuals over 14
years of age shall be reported in accordance with Chapter 99 of this title
(relating to Occupational
Condition Reporting
[
Diseases
]).
children with blood lead levels of concern
and lead poisoning
].
a case or suspected case of a child with a blood
lead level of concern after gaining knowledge of the case
]:
a
] person in charge of:
other facility in which a laboratory examination of a
specimen from a child indicates a blood lead level of concern.
]
a case or suspected case of a child with a blood
lead level of concern
]:
of concern
] in writing to the local health authority
or the Texas Department of Health (department) immediately after
receiving
the blood lead test result
[
gaining knowledge of the blood lead
level of concern
]. A local health authority or the department may authorize
one or more employees under his or her supervision to receive the report from
the physician, laboratory director, or alternate person by telephone. The
local health authority or the department shall implement a method for verifying
the identity of the telephone caller when that person is unfamiliar to the
employee.
level of concern
] resides outside the local health jurisdiction that
received the report, the local health authority shall notify the appropriate
local health authority
or public health region
where the child
or children reside. The department shall assist the local health authority
in providing such notifications if requested.
The receiving local health
authority shall collect the reports and transmit the information at weekly
intervals to the department.
45
] micrograms
per deciliter or greater shall be reported
immediately
[
within
one working day
] by telephone to the local health authority or the department
at (800) 588-1248
. The following information shall be reported [
on a child with a blood lead level of concern or lead poisoning
]:
and
] race
and ethnicity
;
Chapter 97.
COMMUNICABLE DISEASES
Chapter 97.
COMMUNICABLE DISEASES