By: Moncrief S.B. No. 18
A BILL TO BE ENTITLED
AN ACT
1-1 relating to the screening and treatment for tuberculosis of
1-2 employees, volunteers, and inmates in county, municipal, and
1-3 private jails and other correctional facilities.
1-4 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
1-5 SECTION 1. Subtitle D, Title 2, Health and Safety Code, is
1-6 amended by adding Chapter 89 to read as follows:
1-7 CHAPTER 89. SCREENING FOR TUBERCULOSIS IN JAILS
1-8 SUBCHAPTER A. GENERAL PROVISIONS
1-9 Sec. 89.001. DEFINITIONS
1-10 (Sections 89.002 to 89.010 reserved for expansion
1-11 SUBCHAPTER B. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS
1-12 Sec. 89.011. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS
1-13 Sec. 89.012. CERTIFICATE REQUIRED
1-14 Sec. 89.013. RESCREENING; PROFESSIONAL EXAMINATIONS
1-15 Sec. 89.014. FOLLOW-UP EVALUATIONS AND TREATMENT
1-16 Sec. 89.015. COST OF TESTS, FOLLOW-UP, AND TREATMENT
1-17 (Sections 89.016 to 89.020 reserved for expansion
1-18 SUBCHAPTER C. STATE GRANTS FOR TUBERCULOSIS SCREENING
1-19 OF INMATES IN CERTAIN JAILS
1-20 Sec. 89.021. STATE GRANT PROGRAM
1-21 Sec. 89.022. GRANT PROGRAM STRUCTURE; RULES
1-22 Sec. 89.023. DEPARTMENT TO SELECT GRANTEES
1-23 Sec. 89.024. MODIFICATION, SUSPENSION, OR TERMINATION OF AWARD
2-1 Sec. 89.025. EXEMPTION
2-2 (Sections 89.026 to 89.030 reserved for expansion
2-3 SUBCHAPTER D. INMATE SCREENING
2-4 Sec. 89.031. INMATE SCREENING REQUIRED
2-5 Sec. 89.032. RESCREENING; DIAGNOSTIC EVALUATIONS
2-6 Sec. 89.033. FOLLOW-UP EVALUATIONS
2-7 Sec. 89.034. INMATES FROM OTHER JURISDICTIONS
2-8 Sec. 89.035. INMATE TRANSFER AND RELEASE
2-9 (Sections 89.036 to 89.040 reserved for expansion
2-10 SUBCHAPTER E. CASE REPORTING; RULEMAKING; MINIMUM STANDARDS
2-11 Sec. 89.041. CASE REPORTING
2-12 Sec. 89.042. RULEMAKING
2-13 Sec. 89.043. MINIMUM STANDARDS
2-14 Sec. 89.044. ADOPTION OF LOCAL STANDARDS
2-15 CHAPTER 89. SCREENING FOR TUBERCULOSIS IN JAILS
2-16 SUBCHAPTER A. GENERAL PROVISIONS
2-17 Sec. 89.001. DEFINITIONS. In this chapter:
2-18 (1) "County jail" or "municipal jail" means all types
2-19 of correctional facilities within the jurisdiction of a county or a
2-20 municipality, including a privately owned or operated facility that
2-21 under a contract serves as a place of incarceration for a prisoner
2-22 in the custody of county or municipal law enforcement authorities
2-23 while awaiting trial or after sentencing by a court of competent
2-24 jurisdiction.
2-25 (2) "Health authority" means a physician appointed as
3-1 such under Subchapter B, Chapter 121 (Local Public Health
3-2 Reorganization Act).
3-3 (3) "Local health department" means a department
3-4 created under Subchapter D, Chapter 121 (Local Public Health
3-5 Reorganization Act).
3-6 (4) "Physician" means a person licensed to practice
3-7 medicine in this state or another state of the United States.
3-8 (5) "Public health district" means a district created
3-9 under Subchapter E, Chapter 121 (Local Public Health Reorganization
3-10 Act).
3-11 (6) "Screening test" means rapid analytical laboratory
3-12 or other procedure for the determination of the need for further
3-13 diagnostic evaluation.
3-14 (7) "Tuberculosis" means the disease caused by
3-15 Mycobacterium tuberculosis or other members of the Mycobacterium
3-16 tuberculosis complex.
3-17 (Sections 89.002 to 89.010 reserved for expansion
3-18 SUBCHAPTER B. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS
3-19 Sec. 89.011. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS.
3-20 (a) The commissioners court of every county and the governing body
3-21 of every municipality shall require that each employee or volunteer
3-22 in a county jail or municipal jail who is included within a class
3-23 of employees or volunteers specified by board rule present to the
3-24 court or the governing body a certificate signed by a physician
3-25 that states that the employee or volunteer has been tested for
4-1 tuberculosis infection as directed by board rule and that discloses
4-2 the results of the test.
4-3 (b) In lieu of the screening tests required in Subsection
4-4 (a), an employee or volunteer with a history of positive screening
4-5 test results may provide documentation of the test results and
4-6 diagnostic and therapeutic follow-up.
4-7 Sec. 89.012. CERTIFICATE REQUIRED. (a) The commissioners
4-8 court, the governing body, or a designee of either shall confirm
4-9 that each employee or volunteer in a category specified by board
4-10 rule has the required certificate.
4-11 (b) The commissioners court or governing body may not permit
4-12 an employee or volunteer to carry out his or her duties in the
4-13 absence of the certificate.
4-14 Sec. 89.013. RESCREENING; PROFESSIONAL EXAMINATIONS. The
4-15 health authority may require an employee or volunteer to have
4-16 additional screening tests or medical examinations if the
4-17 department determines that additional tests or examinations are
4-18 necessary and appropriate to protect the public health.
4-19 Sec. 89.014. FOLLOW-UP EVALUATIONS AND TREATMENT. (a) An
4-20 employee or volunteer with a positive screening test result must
4-21 obtain a diagnostic evaluation from his or her own physician to
4-22 determine if he or she has tuberculosis.
4-23 (b) If the employee or volunteer has tuberculosis, the
4-24 commissioners court or governing body may not permit the person to
4-25 begin or continue his or her employment duties or volunteer
5-1 services unless the person is under treatment for the disease by a
5-2 physician and the attending physician determines that the patient
5-3 is not infectious.
5-4 Sec. 89.015. COST OF TESTS, FOLLOW-UP, AND TREATMENT. The
5-5 expenses of the screening tests, diagnostic evaluations, and other
5-6 professional medical services required under this subchapter must
5-7 be borne by the employee or volunteer, unless the commissioners
5-8 court, the governing body, or a local health department or public
5-9 health district elects to provide the services.
5-10 (Sections 89.016 to 89.020 reserved for expansion
5-11 SUBCHAPTER B. STATE GRANTS FOR TUBERCULOSIS SCREENING OF INMATES
5-12 IN CERTAIN JAILS
5-13 Sec. 89.021. STATE GRANT PROGRAM. (a) The board may
5-14 establish and administer a state grant program to assist counties
5-15 and municipalities to establish and maintain a program to screen
5-16 inmates of certain county and municipal jails and other
5-17 correctional facilities for tuberculosis and, as necessary, to
5-18 provide treatment and preventive care.
5-19 (b) If a program is established, the board shall adopt rules
5-20 to restrict the grant awards to jails and other correctional
5-21 facilities in municipalities and counties that:
5-22 (1) have a history of inmates with tuberculosis
5-23 infection or are located in a community with a high incidence and
5-24 prevalence rate for tuberculosis; and
5-25 (2) meet other criteria that are determined by the
6-1 board to be necessary or desirable and that are specified by board
6-2 rule.
6-3 Sec. 89.022. GRANT PROGRAM STRUCTURE; RULES. (a) The board
6-4 shall adopt substantive and procedural rules which:
6-5 (1) specify a process for the selection of counties
6-6 and municipalities to receive a grant award;
6-7 (2) establish criteria for the denial, modification,
6-8 suspension, or termination of a grant award; and
6-9 (3) if budgetary limitations exist, establish criteria
6-10 and procedures to reduce or terminate grants to counties and
6-11 municipalities to assure that the funds appropriated to the
6-12 department are used most effectively.
6-13 (b) At a minimum, board rules shall require that a
6-14 successful applicant for a grant:
6-15 (1) exhibit an interest in and the ability to carry
6-16 out an inmate screening program that conforms to Subchapter D and
6-17 the board's rules either through the use of the jurisdiction's
6-18 medical staff or by contracting with local health departments or
6-19 public health districts or nonprofit organizations capable of
6-20 discharging the jurisdiction's inmate screening responsibility;
6-21 (2) agree to coordinate the jurisdiction's local or
6-22 federal funds with funds received through the state grant award;
6-23 (3) agree not to supplant local funds appropriated or
6-24 federal funds granted for inmate tuberculosis screening with grant
6-25 funds;
7-1 (4) comply with board rules and cooperate with the
7-2 department in the administration of the grant program by filing
7-3 related reports with the department in a timely manner; and
7-4 (5) agree, as a condition of the grant award, to
7-5 periodic review by the department of and provide the department
7-6 access to inmate screening records and financial records of the
7-7 entity that are related to the receipt and expenditure of grant
7-8 funds.
7-9 Sec. 89.023. DEPARTMENT TO SELECT GRANTEES. The department
7-10 shall select counties and municipalities to receive grant awards
7-11 according to the criteria and following the procedures prescribed
7-12 by board rule.
7-13 Sec. 89.024. MODIFICATION, SUSPENSION, OR TERMINATION OF
7-14 AWARD. (a) The board may provide a due process hearing procedure
7-15 for the modification, suspension, or termination of a grant award
7-16 to a county or municipality. Sections 13 through 20,
7-17 Administrative Procedure and Texas Register Act (Article 6252-13a,
7-18 Vernon's Texas Civil Statutes), do not apply to hearings conducted
7-19 under this subsection.
7-20 (b) The department shall render the final administrative
7-21 decision in a due process hearing to modify, suspend, or terminate
7-22 the approval of a grant award recipient.
7-23 (c) The department may not terminate a grant award while a
7-24 due process hearing is pending under this section. The department
7-25 may withhold payments while the hearing is pending but shall
8-1 deliver the withheld payments and resume grant payments if the
8-2 final determination is in favor of the grant award recipient.
8-3 (d) Notice and hearing requirements under this section do
8-4 not apply if a grant:
8-5 (1) is canceled by the department because of
8-6 exhaustion of funds or because insufficient funds require the board
8-7 to adopt award priorities; or
8-8 (2) expires according to its own terms.
8-9 Sec. 89.025. EXEMPTION. The board may not adopt a rule to
8-10 require a county or municipality to participate in inmate screening
8-11 for tuberculosis if the department does not award the county or
8-12 municipality a grant under this subchapter, unless:
8-13 (1) the county or municipality has a history of
8-14 providing inmate screening for tuberculosis on September 1, 1993,
8-15 and voluntarily terminated the screening program after that date;
8-16 or
8-17 (2) a federal or private grant or contract has been
8-18 awarded to the county or municipality that includes within its
8-19 provisions the authority to provide an inmate tuberculosis
8-20 screening program.
8-21 (Sections 89.026 to 89.030 reserved for expansion
8-22 SUBCHAPTER D. INMATE SCREENING
8-23 Sec. 89.031. INMATE SCREENING REQUIRED. (a) If the
8-24 department awards a screening grant to a county or municipality as
8-25 a part of the jail intake procedure, the commissioners court of a
9-1 county or the governing body of a municipality must require each
9-2 inmate to undergo screening tests approved by the board for the
9-3 detection of tuberculosis infection on or before the 14th day of
9-4 detention in jail if:
9-5 (1) the inmate will be confined in jail for more than
9-6 14 days; and
9-7 (2) the inmate is in a category of persons identified
9-8 by the board.
9-9 (b) If an inmate is booked into a jail more than one time
9-10 during a calendar year, it is not necessary to retest the inmate at
9-11 each rebooking during that year unless the inmate shows symptoms of
9-12 tuberculosis or is known to have been exposed to tuberculosis.
9-13 Sec. 89.032. RESCREENING; DIAGNOSTIC EVALUATIONS. The
9-14 department or a health authority may require the commissioners
9-15 court to provide additional screening tests or a diagnostic
9-16 evaluation if the department or health authority determines that
9-17 additional screening tests or a diagnostic evaluation is necessary
9-18 and appropriate to protect the health of inmates, employees,
9-19 volunteers, or the public.
9-20 Sec. 89.033. FOLLOW-UP EVALUATIONS. (a) If an inmate has a
9-21 confirmed positive screening test result, the commissioners court
9-22 or governing body must provide a diagnostic evaluation to determine
9-23 whether the inmate has tuberculosis.
9-24 (b) If an inmate has tuberculosis or is suspected of having
9-25 tuberculosis, the sheriff or jail administrator shall provide
10-1 appropriate accommodations, including respiratory isolation when
10-2 necessary, and adequate medical care and treatment that meet the
10-3 accepted standards of medical practice during the inmate's
10-4 confinement in the county or municipal jail.
10-5 (c) With the consent of the inmate, the county or municipal
10-6 jail must provide preventive therapy to an infected inmate if the
10-7 preventive therapy is prescribed by the attending physician.
10-8 Sec. 89.034. INMATES FROM OTHER JURISDICTIONS. (a) An
10-9 inmate under the jurisdiction of an entity other than a
10-10 municipality or county located in the State of Texas who is
10-11 incarcerated, by agreement or contract, in a county or municipal
10-12 jail or other confinement facility operated by a county or
10-13 municipality located in Texas must be shown to be free from
10-14 infectious tuberculosis before being booked into a county or
10-15 municipal jail.
10-16 (b) The expenses of administering screening tests,
10-17 diagnostic tests, preventive care, or treatment for tuberculosis
10-18 must be borne by the transferring entity.
10-19 Sec. 89.035. INMATE TRANSFER AND RELEASE. Documentation of
10-20 an inmate's treatment must accompany the transfer of an inmate and
10-21 be available for medical review on arrival of the inmate if:
10-22 (1) the inmate is considered to have tuberculosis or
10-23 is suspected of having tuberculosis; and
10-24 (2) the inmate has not finished his or her course of
10-25 therapy.
11-1 (Sections 89.036 to 89.040 reserved for expansion
11-2 SUBCHAPTER E. CASE REPORTING; RULEMAKING; MINIMUM STANDARDS
11-3 Sec. 89.041. CASE REPORTING. (a) Cases of tuberculosis
11-4 must be reported to the health authority or the department not more
11-5 than three days after the diagnosis is suspected.
11-6 (b) The results of screening tests must be reported to the
11-7 department monthly in a manner approved by the department.
11-8 Sec. 89.042. RULEMAKING. After consulting with the
11-9 Commission on Jail Standards, the board shall adopt rules to carry
11-10 out this chapter, including rules describing:
11-11 (1) the type or types of screening and diagnostic
11-12 tests and the scope of the professional examinations that may be
11-13 used to fulfill the requirements of this chapter;
11-14 (2) the categories of employees, volunteers, or
11-15 inmates who must have a screening test;
11-16 (3) the form and content of the certificate for
11-17 employees and volunteers;
11-18 (4) the closing dates for filing the individual
11-19 certificates;
11-20 (5) the transfer of employee or volunteer certificates
11-21 and inmate records between county or municipal facilities;
11-22 (6) the frequency of screening tests for employees,
11-23 volunteers, and inmates;
11-24 (7) the criteria for additional screening tests or a
11-25 diagnostic examination; and
12-1 (8) the reporting of screening test or examination
12-2 results to the health authority or the department.
12-3 Sec. 89.043. MINIMUM STANDARDS. The standards set forth in
12-4 this chapter and the rules adopted by the board to carry out this
12-5 chapter are the minimum standards for the screening tests or
12-6 examination for tuberculosis of the named categories of employees
12-7 and volunteers.
12-8 Sec. 89.044. ADOPTION OF LOCAL STANDARDS. (a) With the
12-9 prior approval of the department:
12-10 (1) a commissioners court or the governing body of a
12-11 municipality may adopt and enforce standards for carrying out this
12-12 chapter if the standards are compatible with and equal to or more
12-13 stringent than the standards set forth in this chapter and board
12-14 rules; and
12-15 (2) a private facility may adopt and enforce standards
12-16 for carrying out this chapter if the standards are compatible with
12-17 and equal to or more stringent than the standards set forth in this
12-18 chapter and board rules.
12-19 (b) The board shall adopt substantive and procedural rules
12-20 to govern the submission of county, municipal, and private jail
12-21 standards that differ from those adopted by the board. At a
12-22 minimum these rules must contain:
12-23 (1) procedures for the submission of standards for
12-24 departmental review; and
12-25 (2) an internal departmental appeal process by which
13-1 counties, municipalities, and private entities may seek a review of
13-2 the department's decision to reject the entities' proposed
13-3 standards.
13-4 SECTION 2. If the Texas Board of Health establishes a grant
13-5 program under Subchapter C, Chapter 89, Health and Safety Code, the
13-6 Texas Department of Health may accept applications for grant awards
13-7 until November 15, 1993. Grants must be awarded not later than
13-8 January 1, 1994, and the screening of grant award recipients must
13-9 begin not later than March 15, 1994.
13-10 SECTION 3. This Act takes effect September 1, 1993.
13-11 SECTION 4. EMERGENCY. The importance of this legislation
13-12 and the crowded condition of the calendars in both houses create an
13-13 emergency and an imperative public necessity that the
13-14 constitutional rule requiring bills to be read on three several
13-15 days in each house be suspended, and this rule is hereby suspended.