TCFP Rule §435.33: What Texas Fire Departments Need to Know
The Texas Commission on Fire Protection (TCFP) has adopted Rule §435.33, the administrative rule establishing the framework for occupational cancer screening programs under the Wade Cannon Act (HB 198).
The adoption of the rule provides Texas fire departments with the formal direction needed to begin implementing occupational cancer screening programs.
If your department is evaluating its current occupational health program or beginning development of its required Standard Operating Procedure (SOP), now is the time to begin planning.
Current TCFP Rule Status
✔ Rule §435.33 has been adopted.
✔ Departments must maintain a documented occupational cancer screening SOP.
✔ Screenings begin no later than the firefighter’s fifth year of employment.
✔ Programs must meet the latest NFPA 1580-based minimum standards.
✔ Departments retain flexibility in implementation within the rule’s requirements.
What the Rule Establishes
- Each fire department must develop and maintain a documented Standard Operating Procedure (SOP) for occupational cancer screening.
- Screenings must be offered to firefighters beginning no later than their fifth year of employment and continue annually thereafter.
- All screenings must be confidential and provided at no cost to the firefighter.
- Programs must meet the latest NFPA 1580-based minimum standards.
Departments that begin planning early will be better positioned as additional TCFP guidance is released.
Professional Health Services provides information to assist with making informed plans and organizing programs that will aid in the early detection of cancers. We work with departments nationwide to organize sustainable occupational health programs aligned with NFPA 1580.
Questions We’re Hearing From Texas Fire Departments
Since the signing of the Wade Cannon Act, one thing has become very clear: fire chiefs across Texas aren’t looking for someone to simply explain the law. They’re looking for practical guidance on how to develop an occupational cancer screening program that protects their firefighters while helping their department meet the new requirements.
Many departments are asking the same questions:
- Where do we begin?
- Can we build on our existing occupational health program?
- What should our Standard Operating Procedure include?
- How do we know we’re meeting the intent of the rule, not just the minimum requirements?
Every department is different, and there isn’t a one-size-fits-all approach. The goal is to develop a program that works for your firefighters while complying with the rule.
Building an Occupational Cancer Screening Program
With TCFP Rule §435.33 adopted, Texas fire departments are moving from planning into implementation. This is a good time to consider what kind of program will serve your firefighters long-term.
Based on conversations with departments already developing their programs, these are the implementation considerations that matter most.
Implementation Considerations
Reviewing Existing Wellness Programs
Departments with annual occupational medical exams may already have a foundation. The rule recognizes existing programs if they are NFPA 1580-aligned and physician-endorsed.
Evaluating Screening Providers
A provider experienced with firefighter occupational health and TCFP Rule §435.33 can simplify implementation.
Physician Oversight
Physician oversight is required for alternative plans under the rule and emphasized under NFPA 1580.
Mobile Screening Options
Bringing screening services directly to the station reduces logistical burden and improves participation.
Documentation & Reporting
The SOP and supporting records must be available for TCFP’s biennial inspection cycle.
Maintaining Compliance
TCFP inspections occur every two years. Inspectors verify that a documented occupational cancer screening program exists and is being implemented.
Why Early Detection Matters
Compliance is an important objective, but it isn’t the only objective.
The Wade Cannon Act was created to support earlier detection of occupational cancers.
Finding cancers earlier generally leads to:
- Better firefighter health through improved survival and less invasive treatment.
- Less family impact through reduced disruption to family life and long-term wellbeing.
- Greater career longevity by helping firefighters remain on the job longer.
- Reduced disability through earlier-stage treatment.
- Reduced workers’ compensation exposure for the cities and counties that employ them.
Texas cancer presumptive laws provide workers’ compensation protections after cancer develops. HB 198 works alongside those laws by encouraging cancer to be found before it becomes advanced.
Frequently Asked Questions
When must screening begin?
Screening must be offered beginning no later than the firefighter’s fifth year of employment as a career firefighter, with screenings every three years thereafter.
When does the five-year clock begin if a firefighter changes departments?
TCFP’s current interpretation is that the five-year period begins when the firefighter first becomes employed as a certified career firefighter in Texas. Under that interpretation, eligibility follows the firefighter’s cumulative years, and responsibility for providing the screening falls to whichever department currently employs the firefighter. However, the statute does not explicitly resolve this issue, and municipal attorneys may reach different conclusions. Departments should consult their legal counsel.
What if our department uses another occupational medical program?
The rule allows an alternative occupational medical examination plan if it is endorsed by a licensed physician, substantially complies with NFPA 1580, and is submitted annually to the Commission by February 1.
Can departments design their own program?
Yes. The rule allows implementation to be adapted to local medical resources, provided the program meets the latest NFPA 1580-based minimum standards.
What tests are required?
The rule specifies that occupational cancer screening must include, at minimum:
- Urine test
- Pulmonary function test
- Electrocardiogram (ECG)
- Infectious disease screening
- Breast cancer screening (as applicable)
- Blood test
- Chest X-ray offered once every five years
What does TCFP inspect?
TCFP inspections occur every two years. Departments must demonstrate that a documented occupational cancer screening plan exists and complies with the administrative rule. TCFP is not inspecting individual medical records or verifying firefighter participation in screening. Inspectors verify that departments have implemented an appropriate occupational cancer screening program.
Does every firefighter receive the same tests?
No. NFPA 1580 promotes evidence-based, risk-based screening rather than prescribing one universal testing package. Screening may be adjusted based on age, sex, occupational exposure history, family history, individual risk factors, clinical judgment, and current national medical screening guidelines.
Are departments required to use a specific provider?
No. Departments retain flexibility to select a provider and screening protocol that best meets their operational needs while remaining consistent with recognized firefighter occupational health practices.
Helping Departments Move Into Implementation
Developing a sustainable occupational cancer screening program is about more than meeting a regulatory requirement. It is about protecting the firefighters who protect our communities every day.
What PHS Offers Texas Fire Departments
- SOP development support
- Physician oversight
- Mobile screening services
- Implementation planning
- Documentation support
- Compliance reporting
PHS Mobile Health Solutions has supported firefighter occupational screening programs nationwide. Our team includes physician oversight, mobile screening logistics, and a reporting platform designed to help departments document compliance with TCFP Rule §435.33.
If your department is ready to begin developing its required SOP or move from planning into implementation, PHS is available to walk through how we have supported other Texas departments.