By: Hirschi H.B. No. 486
73R1051 LGF-F
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 and municipal jails
1-4 and other 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
1-9 SUBCHAPTER A. GENERAL PROVISIONS
1-10 Sec. 89.001. DEFINITIONS. In this chapter:
1-11 (1) "County jail" includes:
1-12 (A) a facility operated by or for a county for
1-13 the confinement of persons accused or convicted of an offense; and
1-14 (B) a county jail or a correctional facility
1-15 authorized by Subchapter F, Chapter 351, Local Government Code.
1-16 (2) "Health authority" has the meaning assigned by
1-17 Section 121.021.
1-18 (3) "Local health department" means a health
1-19 department created under Subchapter D, Chapter 121.
1-20 (4) "Municipal jail" includes:
1-21 (A) a facility operated by or for a municipality
1-22 for the confinement of persons accused or convicted of an offense;
1-23 and
1-24 (B) a municipal jail or other correctional
2-1 facility authorized by Subchapter E, Chapter 361, Local Government
2-2 Code.
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 governing body
2-17 of each municipality shall require that each employee or volunteer
2-18 working or providing services in a county or municipal jail, who
2-19 meets the screening guidelines prescribed by board rule, present to
2-20 the court or governing body a certificate signed by a physician
2-21 that states that:
2-22 (1) the employee or volunteer has been tested for
2-23 tuberculosis infection in accordance with board rules; and
2-24 (2) the results of the test indicate that the person
2-25 does not have tuberculosis.
2-26 (b) In lieu of a screening test, an employee or volunteer
2-27 with a history of a positive screening test may provide:
3-1 (1) documentation of that positive test result and of
3-2 any diagnostic and therapeutic follow-up; and
3-3 (2) a certificate signed by a physician that states
3-4 that the person does not have tuberculosis.
3-5 (c) The health authority may require an employee or
3-6 volunteer to have an additional screening test or medical
3-7 examination if the department determines that an additional test or
3-8 examination is necessary and appropriate to protect the public
3-9 health.
3-10 Sec. 89.012. FOLLOW-UP EVALUATIONS AND TREATMENT. (a) An
3-11 employee or a volunteer with a positive screening test result must
3-12 obtain a diagnostic evaluation from the person's own physician to
3-13 determine if the person has tuberculosis.
3-14 (b) If the employee or volunteer has tuberculosis, the
3-15 commissioners court or the governing body of the municipality, as
3-16 appropriate, may not permit the person to begin or continue the
3-17 person's employment duties or volunteer services unless the person
3-18 is under treatment for the disease by a physician and the person
3-19 provides to the court or governing body a certificate signed by the
3-20 attending physician stating that the patient is noninfectious.
3-21 Sec. 89.013. CERTIFICATE REQUIRED. (a) The commissioners
3-22 court, the governing body of the municipality, or a designee of
3-23 either shall confirm that each employee or volunteer required to be
3-24 screened under this subchapter has the required certificate.
3-25 (b) The commissioners court or governing body of the
3-26 municipality may not permit an employee or volunteer to carry out
3-27 the person's duties if the person does not have the required
4-1 certificate.
4-2 Sec. 89.014. COST OF TESTS, FOLLOW-UP, AND TREATMENT. The
4-3 employee or volunteer shall pay the expense of a screening test,
4-4 diagnostic evaluation, or other professional medical service
4-5 required under this subchapter unless the commissioners court, the
4-6 governing body of the municipality, or a local health department or
4-7 public health district elects to provide the service.
4-8 (Sections 89.015-89.050 reserved for expansion
4-9 SUBCHAPTER C. INMATE SCREENING AND TREATMENT
4-10 Sec. 89.051. INMATE SCREENING REQUIRED. (a) The
4-11 commissioners court of each county and the governing body of each
4-12 municipality shall require each inmate in a county or municipal
4-13 jail to undergo a screening test for tuberculosis infection
4-14 approved by the board if:
4-15 (1) the inmate will probably be confined in jail for
4-16 more than 14 days; and
4-17 (2) the inmate meets the screening guidelines
4-18 prescribed by board rules.
4-19 (b) The inmate must be tested on or before the 14th day
4-20 after the day the inmate is first confined.
4-21 (c) An inmate listed by Subsection (a) is not required to be
4-22 retested at each rebooking if the inmate is booked into a jail more
4-23 than once during a calendar year unless the inmate shows symptoms
4-24 of tuberculosis or is known 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 governing body of the municipality to provide an
5-1 additional screening test or a diagnostic evaluation if the health
5-2 authority determines that an additional screening test or a
5-3 diagnostic evaluation is necessary and appropriate to protect the
5-4 health of the jail 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 governing body shall provide a diagnostic evaluation to
5-8 determine whether the inmate has tuberculosis.
5-9 (b) The sheriff or jail administrator shall provide
5-10 appropriate accommodations to an inmate who has tuberculosis or is
5-11 suspected of having tuberculosis, including respiratory isolation,
5-12 if necessary, and adequate medical care and treatment that meets
5-13 the accepted standards of medical practice.
5-14 (c) The county or municipal jail shall provide preventive
5-15 therapy to an infected inmate if the preventive therapy is
5-16 prescribed by the attending physician and the inmate consents to
5-17 the treatment.
5-18 Sec. 89.054. INMATES FROM OTHER JURISDICTIONS. (a) A
5-19 county or municipal jail may not book into the jail an inmate under
5-20 the jurisdiction of an entity other than a municipality or county
5-21 located in this state unless the inmate is shown to be free from
5-22 infectious tuberculosis.
5-23 (b) The transferring entity shall pay the expense of
5-24 administering screening tests, diagnostic tests, preventive care,
5-25 or treatment for tuberculosis.
5-26 Sec. 89.055. INMATE TRANSFER AND RELEASE. A copy of an
5-27 inmate's medical records or documentation of screenings or
6-1 treatment received during confinement must accompany an inmate
6-2 transferred from one jail to another and be available for medical
6-3 review on arrival of the inmate.
6-4 (Sections 89.056-89.070 reserved for expansion
6-5 SUBCHAPTER D. REPORTING; RULEMAKING; MINIMUM STANDARDS
6-6 Sec. 89.071. REPORTING. (a) A case of tuberculosis shall
6-7 be reported to the appropriate health authority or to the
6-8 department not later than the third day after the day on which the
6-9 diagnosis is suspected.
6-10 (b) The results of a screening test shall be reported to the
6-11 department monthly in a manner approved by the department.
6-12 Sec. 89.072. RULEMAKING. After consulting with the
6-13 Commission on Jail Standards, the board shall adopt rules to carry
6-14 out this chapter, including rules describing:
6-15 (1) the types of screening tests and diagnostic
6-16 evaluations and the scope of the professional examinations that may
6-17 be used to meet the requirements of this chapter;
6-18 (2) the categories of employees, volunteers, or
6-19 inmates who must have a screening test under this chapter;
6-20 (3) the form and content of the certificate required
6-21 under Subchapter B for employees and volunteers;
6-22 (4) the deadlines for filing a certificate;
6-23 (5) the transfer of employee or volunteer certificates
6-24 and inmate records between county or municipal facilities;
6-25 (6) the frequency of screening tests for employees,
6-26 volunteers, and inmates;
6-27 (7) the criteria for requiring an additional screening
7-1 test or a diagnostic evaluation or examination; and
7-2 (8) the reporting of a screening test or an evaluation
7-3 or examination result to the appropriate health authority or to the
7-4 department.
7-5 Sec. 89.073. ADOPTION OF LOCAL STANDARDS. (a) The
7-6 standards prescribed by this chapter and the rules adopted by the
7-7 board relating to screening tests or examinations for tuberculosis
7-8 required for certain employees and volunteers are minimum
7-9 standards.
7-10 (b) With the prior approval of the department:
7-11 (1) a commissioners court or the governing body of a
7-12 municipality may adopt and enforce standards for carrying out this
7-13 chapter if the standards are compatible with and equal to or more
7-14 stringent than the standards prescribed by this chapter and the
7-15 board's rules; and
7-16 (2) a private facility may adopt and enforce standards
7-17 for carrying out this chapter if the standards are compatible with
7-18 and equal to or more stringent than the standards prescribed by
7-19 this chapter and the board's rules.
7-20 (c) The board shall adopt substantive and procedural rules
7-21 to govern the submission of county, municipal, or private jail
7-22 standards. At a minimum these rules must contain:
7-23 (1) a procedure for the submission of standards for
7-24 departmental review; and
7-25 (2) an internal departmental appeal process by which a
7-26 county, municipality, or private entity may seek a review of the
7-27 department's decision to reject the entity's proposed standards.
8-1 SECTION 2. (a) Except as provided by Subsection (b), this
8-2 Act takes effect September 1, 1993.
8-3 (b) Each county commissioners court and governing body of a
8-4 municipality shall begin the screening activities prescribed by
8-5 Chapter 89, Health and Safety Code, as added by this Act, not later
8-6 than March 15, 1994.
8-7 SECTION 3. The importance of this legislation and the
8-8 crowded condition of the calendars in both houses create an
8-9 emergency and an imperative public necessity that the
8-10 constitutional rule requiring bills to be read on three several
8-11 days in each house be suspended, and this rule is hereby suspended.