Relating to periodic health screenings for firefighters.
ModeratePlan for compliance
High Cost
Effective:2026-06-01
Enforcing Agencies
Texas Commission on Fire Protection
01
Compliance Analysis
Key implementation requirements and action items for compliance with this legislation
Implementation Timeline
Effective Date: June 1, 2026.
Compliance Deadline: June 1, 2026. All HR tracking systems and medical vendor contracts must be active to capture firefighters entering their fifth year of service immediately upon this date.
Agency Rulemaking: The Texas Commission on Fire Protection (TCFP) must adopt rules establishing minimum standards and defining "substantial compliance" for alternative plans prior to the effective date. Expect a regulatory "gray zone" regarding specific medical protocols until Q1 2026.
Immediate Action Plan
Audit Tenure Data: Identify exactly how many employees will have 5+ years of service by June 1, 2026, to calculate the Year 1 budget shock.
Issue RFPs for Medical Vendors: Many standard occupational clinics do not offer breast cancer screenings or advanced pulmonary function tests on-site. Begin vendor selection in Q3 2025.
Establish the "X-Ray Cycle": Configure tracking systems to separate the annual blood/urine/ECG cycle from the chest x-ray cycle (required only every 5 years).
Monitor TCFP Agenda: Assign staff to track TCFP meetings for the release of draft rules regarding the "Alternative Plan" submission process.
Operational Changes Required
Contracts
Medical Service Agreements (MSAs): Existing contracts with occupational health providers likely fail compliance. You must amend Scopes of Work (SOW) to explicitly include the seven statutory requirements: blood analysis, urine analysis, ECG, pulmonary function tests, infectious disease screening, breast cancer screening, and chest x-rays (5-year cycle).
Collective Bargaining Agreements (CBAs): Review "duty time" provisions. Time spent undergoing these mandatory screenings is compensable. Ensure shift coverage protocols account for these medical appointments.
Hiring/Training
HRIS Configuration: Update Human Resources Information Systems to trigger an automatic alert when a firefighter approaches their fifth anniversary of employment.
Tenure Audits: You must audit current personnel files immediately. There is no phase-in period; any firefighter with 5+ years of tenure on June 1, 2026, is immediately eligible.
Reporting & Record-Keeping
Confidentiality Firewall: Establish a strict separation between medical results and general personnel files. Management is entitled only to "Fit for Duty" status, not diagnostic data.
Alternative Plan Filing: If opting out of the statutory test list in favor of an NFPA-compliant plan (Section 2(f)), you must file this plan with TCFP annually by February 1.
Refusal Documentation: Create a standardized waiver form. If a firefighter refuses screening, you must document the offer and the refusal to insulate the subdivision from future liability.
Fees & Costs
100% Employer Funded: The statute explicitly prohibits passing costs to the employee. You cannot use deductibles or co-pays.
Budget Forecasting: Project costs based on: (Cost of 7-point Screen) x (Number of Firefighters with >5 Years Tenure). Anticipate a High fiscal impact for FY 2026 budgets.
Strategic Ambiguities & Considerations
"Substantial Compliance" (Alternative Plans): Entities may opt for an alternative "occupational medical examination plan" if it meets NFPA standards. However, TCFP has not yet defined what constitutes "substantial compliance." Relying on this exception before rules are published creates a compliance risk.
Infectious Disease Scope: The statute mandates "infectious disease screening" but does not list specific pathogens (e.g., HIV, Hepatitis, TB). TCFP rulemaking will likely define the required panel. Until then, default to NFPA 1582 standards.
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Due to exposure to toxic substances while on duty, firefighters can face an increased risk of long-term health problems, including an elevated risk of cancer. According to the International Association of Fire Fighters (IAFF), 72 percent of IAFF member line-of-duty deaths in 2023 were caused by occupational cancer. Additionally, according to the Firefighter Cancer Support Network, from 2002 to 2019, cancer accounted for 66 percent of career firefighter line-of-duty deaths. Texas has recently lost many firefighters because of cancer, including Lieutenant Dennis Page from the Dallas Fire Department, Captain William Gunderson from the Houston Fire Department, and James Bobbitt and Wade Cannonfrom the Flower Mound Fire Department. Cannon's diagnosis and commitment to spreading cancer awareness prompted several of the members of the Flower Mound Fire Department to undergo cancer screenings, leading to early cancer detections for two colleagues. H.B. 198 seeks to combat the elevated risk of cancer to firefighters by requiring political subdivisions that employ firefighters to offer occupational cancer screenings to firefighters at no cost during the firefighter's fifth year of service and then subsequently every three years.
CRIMINAL JUSTICE IMPACT
It is the committee's opinion that this bill does not expressly create a criminal offense, increase the punishment for an existing criminal offense or category of offenses, or change the eligibility of a person for community supervision, parole, or mandatory supervision.
RULEMAKING AUTHORITY
It is the committee's opinion that this bill does not expressly grant any additional rulemaking authority to a state officer, department, agency, or institution.
ANALYSIS
H.B. 198 amends the Local Government Code to require a political subdivision that employs firefighters to offer an occupational cancer screening to each firefighter at no cost to the firefighter in the fifth year of the firefighter's employment, and once every three years following the initial screening. The screening must be confidential and test for each type of cancer, including colorectal cancer; lung cancer; brain cancer; and prostate cancer, if applicable. The bill defines "firefighter" as an individual defined as fire protection personnel under Government Code provisions relating to the regulation of and assistance to fire fighters and fire departments by the Texas Commission on Fire Protection.
Honorable Cecil Bell, Chair, House Committee on Intergovernmental Affairs
FROM:
Jerry McGinty, Director, Legislative Budget Board
IN RE:
HB198 by Bumgarner (Relating to periodic occupational cancer screenings for firefighters.), As Introduced
No fiscal implication to the State is anticipated.
Local Government Impact
There could be an impact to units of local government that employ firefighters and do not already offer occupational cancer screenings to those firefighters.
Source Agencies:
LBB Staff:
JMc, SZ, BC, , CMA
Related Legislation
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HB 198, the "Wade Cannon Act," imposes a strict statutory mandate on all Texas political subdivisions employing firefighters to fund and administer comprehensive annual cancer and health screenings starting in the employee's fifth year of service. This legislation shifts the financial and logistical burden of early detection entirely to the employer, requiring immediate budgetary forecasting and the renegotiation of occupational health contracts to meet specific diagnostic criteria by 2026. Implementation Timeline Effective Date: June 1, 2026.
Q
Who authored HB198?
HB198 was authored by Texas Representative Ben Bumgarner during the Regular Session.
Q
When was HB198 signed into law?
HB198 was signed into law by Governor Greg Abbott on May 29, 2025.
Q
Which agencies enforce HB198?
HB198 is enforced by Texas Commission on Fire Protection.
Q
How urgent is compliance with HB198?
The compliance urgency for HB198 is rated as "moderate". Businesses and organizations should review the requirements and timeline to ensure timely compliance.
Q
What is the cost impact of HB198?
The cost impact of HB198 is estimated as "high". This may vary based on industry and implementation requirements.
Q
What topics does HB198 address?
HB198 addresses topics including city government, city government--employees/officers, fire fighters & police, fire fighters & police--general and health.
Legislative data provided by LegiScanLast updated: November 25, 2025
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