73R6956 MLR-F By Hirschi H.B. No. 486 Substitute the following for H.B. No. 486: By Hirschi C.S.H.B. No. 486 A BILL TO BE ENTITLED 1-1 AN ACT 1-2 relating to the screening and treatment for tuberculosis of 1-3 employees, volunteers, and inmates in county jails and other 1-4 correctional facilities. 1-5 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-6 SECTION 1. Subtitle D, Title 2, Health and Safety Code, is 1-7 amended by adding Chapter 89 to read as follows: 1-8 CHAPTER 89. SCREENING AND TREATMENT FOR TUBERCULOSIS IN JAILS AND 1-9 OTHER CORRECTIONAL FACILITIES 1-10 SUBCHAPTER A. GENERAL PROVISIONS 1-11 Sec. 89.001. DEFINITIONS. In this chapter: 1-12 (1) "Community corrections facility" means a facility 1-13 established under Article 42.13, Code of Criminal Procedure. 1-14 (2) "County jail" means a facility operated by or for 1-15 a county for the confinement of persons accused or convicted of an 1-16 offense and that has a capacity of 100 beds or more and includes: 1-17 (A) a facility operated by or for a county for 1-18 the confinement of persons accused or convicted of an offense; 1-19 (B) a county jail or a correctional facility 1-20 authorized by Subchapter F, Chapter 351, Local Government Code; and 1-21 (C) a county corrections center authorized by 1-22 Subchapter H, Chapter 351, Local Government Code. 1-23 (3) "Health authority" has the meaning assigned by 1-24 Section 121.021. 2-1 (4) "Local health department" means a health 2-2 department created under Subchapter D, Chapter 121. 2-3 (5) "Physician" means a person licensed to practice 2-4 medicine in a state of the United States. 2-5 (6) "Public health district" means a health district 2-6 established under Subchapter E, Chapter 121. 2-7 (7) "Screening test" means a rapid analytical 2-8 laboratory or other procedure to determine the need for further 2-9 diagnostic evaluation. 2-10 (8) "Tuberculosis" means a disease caused by 2-11 Mycobacterium tuberculosis or other members of the Mycobacterium 2-12 tuberculosis complex. 2-13 (Sections 89.002-89.010 reserved for expansion 2-14 SUBCHAPTER B. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS 2-15 Sec. 89.011. SCREENING FOR JAIL EMPLOYEES AND VOLUNTEERS. 2-16 (a) The commissioners court of each county and the district 2-17 judges governing a community corrections facility, through the 2-18 community supervision and corrections department, shall require 2-19 that each employee or volunteer working or providing services in a 2-20 county jail or a community corrections facility, who meets the 2-21 screening guidelines prescribed by board rule, present to the court 2-22 or judicial district a certificate signed by a physician that 2-23 states that: 2-24 (1) the employee or volunteer has been tested for 2-25 tuberculosis infection in accordance with board rules; and 2-26 (2) the results of the test indicate that the person 2-27 does not have tuberculosis. 3-1 (b) In lieu of a screening test, an employee or volunteer 3-2 with a history of a positive screening test may provide: 3-3 (1) documentation of that positive test result and of 3-4 any diagnostic and therapeutic follow-up; and 3-5 (2) a certificate signed by a physician that states 3-6 that the person does not have tuberculosis. 3-7 (c) The health authority may require an employee or 3-8 volunteer to have an additional screening test or medical 3-9 examination if the department determines that an additional test or 3-10 examination is necessary and appropriate to protect the public 3-11 health. 3-12 Sec. 89.012. FOLLOW-UP EVALUATIONS AND TREATMENT. (a) An 3-13 employee or a volunteer with a positive screening test result must 3-14 obtain a diagnostic evaluation from the person's own physician to 3-15 determine if the person has tuberculosis. 3-16 (b) If the employee or volunteer has tuberculosis, the 3-17 commissioners court or the judicial district, as appropriate, may 3-18 not permit the person to begin or continue the person's employment 3-19 duties or volunteer services unless the person is under treatment 3-20 for the disease by a physician and the person provides to the court 3-21 or judicial district a certificate signed by the attending 3-22 physician stating that the patient is noninfectious. 3-23 Sec. 89.013. CERTIFICATE REQUIRED. (a) The commissioners 3-24 court, judicial district, or a designee of either shall confirm 3-25 that each employee or volunteer required to be screened under this 3-26 subchapter has the required certificate. 3-27 (b) The commissioners court or judicial district may not 4-1 permit an employee or volunteer to carry out the person's duties if 4-2 the person does not have the required certificate. 4-3 Sec. 89.014. COST OF TESTS, FOLLOW-UP, AND TREATMENT. The 4-4 employee or volunteer shall pay the expense of a screening test, 4-5 diagnostic evaluation, or other professional medical service 4-6 required under this subchapter unless the commissioners court or a 4-7 local health department or public health district elects to provide 4-8 the service. 4-9 (Sections 89.015-89.050 reserved for expansion 4-10 SUBCHAPTER C. INMATE SCREENING AND TREATMENT 4-11 Sec. 89.051. INMATE SCREENING REQUIRED. (a) Each inmate in 4-12 a county jail or community corrections facility shall undergo a 4-13 screening test for tuberculosis infection approved by the board if: 4-14 (1) the inmate will probably be confined in jail or a 4-15 community corrections facility for more than 14 days; and 4-16 (2) the inmate meets the screening guidelines 4-17 prescribed by board rules. 4-18 (b) The inmate must be tested on or before the 14th day 4-19 after the day the inmate is first confined. 4-20 (c) An inmate listed by Subsection (a) is not required to be 4-21 retested at each rebooking if the inmate is booked into a jail or a 4-22 community corrections facility more than once during a calendar 4-23 year unless the inmate shows symptoms of tuberculosis or is known 4-24 to have been exposed to tuberculosis. 4-25 Sec. 89.052. RESCREENING; DIAGNOSTIC EVALUATIONS. The 4-26 department or a health authority may require the commissioners 4-27 court or the judicial district to provide an additional screening 5-1 test or a diagnostic evaluation if the health authority determines 5-2 that an additional screening test or a diagnostic evaluation is 5-3 necessary and appropriate to protect the health of the jail 5-4 inmates, employees, volunteers, or the public. 5-5 Sec. 89.053. FOLLOW-UP EVALUATIONS. (a) If an inmate has a 5-6 confirmed positive screening test result, the commissioners court 5-7 or judicial district shall provide a diagnostic evaluation to 5-8 determine whether the inmate has tuberculosis. 5-9 (b) The sheriff, jail administrator, or director of the 5-10 community corrections facility shall provide appropriate 5-11 accommodations to an inmate who has tuberculosis or is suspected of 5-12 having tuberculosis, including respiratory isolation, if necessary, 5-13 and adequate medical care and treatment that meet the accepted 5-14 standards of medical practice. 5-15 (c) The county jail or community corrections facility shall 5-16 provide preventive therapy to an infected inmate if the preventive 5-17 therapy is prescribed by the attending physician and the inmate 5-18 consents to the treatment. 5-19 Sec. 89.054. INMATE TRANSFER AND RELEASE. A copy of an 5-20 inmate's medical records or documentation of screenings or 5-21 treatment received during confinement must accompany an inmate 5-22 transferred from one jail or community corrections facility to 5-23 another and be available for medical review on arrival of the 5-24 inmate. 5-25 (Sections 89.055-89.070 reserved for expansion 5-26 SUBCHAPTER D. REPORTING; RULEMAKING; MINIMUM STANDARDS 5-27 Sec. 89.071. REPORTING. (a) A case of tuberculosis shall 6-1 be reported to the appropriate health authority or to the 6-2 department not later than the third day after the day on which the 6-3 diagnosis is suspected. 6-4 (b) The results of a screening test shall be reported to the 6-5 department monthly in a manner approved by the department. 6-6 Sec. 89.072. RULEMAKING. The department shall recommend to 6-7 the Commission on Jail Standards and the Texas Department of 6-8 Criminal Justice rules to carry out this chapter, including rules 6-9 describing: 6-10 (1) the types of screening tests and diagnostic 6-11 evaluations and the scope of the professional examinations that may 6-12 be used to meet the requirements of this chapter; 6-13 (2) the categories of employees, volunteers, or 6-14 inmates who must have a screening test under this chapter; 6-15 (3) the form and content of the certificate required 6-16 under Subchapter B for employees and volunteers; 6-17 (4) the deadlines for filing a certificate; 6-18 (5) the transfer of employee or volunteer certificates 6-19 and inmate records between county or judicial district facilities; 6-20 (6) the frequency of screening tests for employees, 6-21 volunteers, and inmates; 6-22 (7) the criteria for requiring an additional screening 6-23 test or a diagnostic evaluation or examination; and 6-24 (8) the reporting of a screening test or an evaluation 6-25 or examination result to the appropriate health authority or to the 6-26 department. 6-27 Sec. 89.073. ADOPTION OF LOCAL STANDARDS. (a) The 7-1 standards prescribed by this chapter and the rules adopted by the 7-2 board relating to screening tests or examinations for tuberculosis 7-3 required for certain employees and volunteers are minimum 7-4 standards. 7-5 (b) With the prior approval of the department: 7-6 (1) a commissioners court or a judicial district may 7-7 adopt and enforce standards for carrying out this chapter if the 7-8 standards are compatible with and equal to or more stringent than 7-9 the standards prescribed by this chapter and the board's rules; and 7-10 (2) a private facility may adopt and enforce standards 7-11 for carrying out this chapter if the standards are compatible with 7-12 and equal to or more stringent than the standards prescribed by 7-13 this chapter and the board's rules. 7-14 (c) The board shall adopt substantive and procedural rules 7-15 to govern the submission of county, judicial district, or private 7-16 jail standards. At a minimum these rules must contain: 7-17 (1) a procedure for the submission of standards for 7-18 departmental review; and 7-19 (2) an internal departmental appeal process by which a 7-20 county, judicial district, or private entity may seek a review of 7-21 the department's decision to reject the entity's proposed 7-22 standards. 7-23 SECTION 2. (a) The Texas Department of Health shall supply 7-24 the materials, drugs, and laboratory service to jails and community 7-25 corrections facilities that are necessary to accomplish the 7-26 screening required by this Act. The department is not required to 7-27 supply a private jail, but a private jail may receive reimbursement 8-1 under its contract with a county. 8-2 (b) The Texas Department of Criminal Justice shall provide 8-3 funds for administering screenings, evaluating inmates, and 8-4 administering drugs to inmates suspected of having an active case 8-5 of tuberculosis, for inmates whose paperwork and processing 8-6 required under Section 8(a), Article 42.09, Code of Criminal 8-7 Procedure, has been completed, and inmates in a community 8-8 corrections facility. The department shall reimburse a county or 8-9 judicial district in the same manner as provided for reimbursements 8-10 under Section 499.123, Government Code. 8-11 (c) A county or judicial district shall provide funds for 8-12 administering screenings, evaluating inmates, and administering 8-13 drugs to inmates suspected of having an active case of 8-14 tuberculosis, for inmates who are pretrial, inmates whose paperwork 8-15 and processing under Section 8(a), Article 42.09, Code of Criminal 8-16 Procedure, is incomplete, or inmates who are not to be transferred 8-17 to a Texas Department of Criminal Justice facility. 8-18 SECTION 3. (a) Except as provided by Subsection (b), this 8-19 Act takes effect September 1, 1993. 8-20 (b) Each county commissioners court and governing body of a 8-21 judicial district shall begin the screening activities prescribed 8-22 by Chapter 89, Health and Safety Code, as added by this Act, not 8-23 later than March 15, 1994. 8-24 SECTION 4. The importance of this legislation and the 8-25 crowded condition of the calendars in both houses create an 8-26 emergency and an imperative public necessity that the 8-27 constitutional rule requiring bills to be read on three several 9-1 days in each house be suspended, and this rule is hereby suspended.