S.B. No. 57 AN ACT 1-1 relating to the screening and treatment for tuberculosis of 1-2 employees, volunteers, and inmates in county jails and other 1-3 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 AND TREATMENT FOR TUBERCULOSIS 1-8 IN JAILS AND OTHER CORRECTIONAL FACILITIES 1-9 SUBCHAPTER A. GENERAL PROVISIONS 1-10 Sec. 89.001. DEFINITIONS. In this chapter: 1-11 (1) "Community corrections facility" means a facility 1-12 established under Article 42.13, Code of Criminal Procedure. 1-13 (2) "County jail" means a facility operated by or for 1-14 a county for the confinement of persons accused or convicted of an 1-15 offense and that has a capacity of 100 beds or more and includes: 1-16 (A) a facility operated by or for a county for 1-17 the confinement of persons accused or convicted of an offense; 1-18 (B) a county jail or a correctional facility 1-19 authorized by Subchapter F, Chapter 351, Local Government Code; and 1-20 (C) a county corrections center authorized by 1-21 Subchapter H, Chapter 351, Local Government Code. 1-22 (3) "Health authority" has the meaning assigned by 1-23 Section 121.021. 1-24 (4) "Local health department" means a health 2-1 department created under Subchapter D, Chapter 121. 2-2 (5) "Physician" means a person licensed to practice 2-3 medicine in a state of the United States. 2-4 (6) "Public health district" means a health district 2-5 established under Subchapter E, Chapter 121. 2-6 (7) "Screening test" means a rapid analytical 2-7 laboratory or other procedure to determine the need for further 2-8 diagnostic evaluation. 2-9 (8) "Tuberculosis" means a disease caused by 2-10 Mycobacterium tuberculosis or other members of the Mycobacterium 2-11 tuberculosis complex. 2-12 (Sections 89.002 to 89.010 reserved for expansion 2-13 SUBCHAPTER B. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS 2-14 Sec. 89.011. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS. 2-15 (a) The commissioners court of each county and the district 2-16 judges governing a community corrections facility, through the 2-17 community supervision and corrections department, shall require 2-18 that each employee or volunteer working or providing services in a 2-19 county jail or a community corrections facility, who meets the 2-20 screening guidelines prescribed by board rule, present to the court 2-21 or judicial district a certificate signed by a physician that 2-22 states that: 2-23 (1) the employee or volunteer has been tested for 2-24 tuberculosis infection in accordance with board rules; and 2-25 (2) the results of the test indicate that the person 2-26 does not have tuberculosis. 2-27 (b) In lieu of a screening test, an employee or volunteer 3-1 with a history of a positive screening test may provide: 3-2 (1) documentation of that positive test result and of 3-3 any diagnostic and therapeutic follow-up; and 3-4 (2) a certificate signed by a physician that states 3-5 that the person does not have tuberculosis. 3-6 (c) The health authority may require an employee or 3-7 volunteer to have an additional screening test or medical 3-8 examination if the department determines that an additional test or 3-9 examination is necessary and appropriate to protect the public 3-10 health. 3-11 (d) An employee or volunteer is exempt from the screening 3-12 test required by this section if: 3-13 (1) the screening test conflicts with the tenets of an 3-14 organized religion to which the individual belongs; or 3-15 (2) the screening test is medically contraindicated 3-16 based on an examination by a physician. 3-17 Sec. 89.012. FOLLOW-UP EVALUATIONS AND TREATMENT. (a) An 3-18 employee or a volunteer with a positive screening test result must 3-19 obtain a diagnostic evaluation from the person's own physician to 3-20 determine if the person has tuberculosis. 3-21 (b) If the employee or volunteer has tuberculosis, the 3-22 commissioners court or the judicial district, as appropriate, may 3-23 not permit the person to begin or continue the person's employment 3-24 duties or volunteer services unless the person is under treatment 3-25 for the disease by a physician and the person provides to the court 3-26 or judicial district a certificate signed by the attending 3-27 physician stating that the patient is noninfectious. 4-1 Sec. 89.013. CERTIFICATE REQUIRED. (a) The commissioners 4-2 court, judicial district, or a designee of either shall confirm 4-3 that each employee or volunteer required to be screened under this 4-4 subchapter has the required certificate. 4-5 (b) The commissioners court or judicial district may not 4-6 permit an employee or volunteer to carry out the person's duties if 4-7 the person does not have the required certificate. 4-8 Sec. 89.014. COST OF TESTS, FOLLOW-UP, AND TREATMENT. The 4-9 employee or volunteer shall pay the expense of a screening test, 4-10 diagnostic evaluation, or other professional medical service 4-11 required under this subchapter unless the commissioners court or a 4-12 local health department or public health district elects to provide 4-13 the service. 4-14 (Sections 89.015 to 89.050 reserved for expansion 4-15 SUBCHAPTER C. INMATE SCREENING AND TREATMENT 4-16 Sec. 89.051. INMATE SCREENING REQUIRED. (a) Each inmate in 4-17 a county jail or community corrections facility shall undergo a 4-18 screening test for tuberculosis infection approved by the board if: 4-19 (1) the inmate will probably be confined in jail or a 4-20 community corrections facility for more than 14 days; and 4-21 (2) the inmate meets the screening guidelines 4-22 prescribed by board rules. 4-23 (b) The inmate must be tested on or before the 14th day 4-24 after the day the inmate is first confined. 4-25 (c) An inmate listed by Subsection (a) is not required to be 4-26 retested at each rebooking if the inmate is booked into a jail or a 4-27 community corrections facility more than once during a 12-month 5-1 period unless the inmate shows symptoms of tuberculosis or is known 5-2 to have been exposed to tuberculosis. 5-3 (d) An inmate is exempt from the screening test required by 5-4 this section if: 5-5 (1) the screening test conflicts with the tenets of an 5-6 organized religion to which the individual belongs; or 5-7 (2) the screening test is medically contraindicated 5-8 based on an examination by a physician. 5-9 Sec. 89.052. RESCREENING; DIAGNOSTIC EVALUATIONS. The 5-10 department or a health authority may require the commissioners 5-11 court or the judicial district to provide an additional screening 5-12 test or a diagnostic evaluation if the health authority determines 5-13 that an additional screening test or a diagnostic evaluation is 5-14 necessary and appropriate to protect the health of the jail 5-15 inmates, employees, volunteers, or the public. 5-16 Sec. 89.053. FOLLOW-UP EVALUATIONS. (a) If an inmate has a 5-17 confirmed positive screening test result, the commissioners court 5-18 or judicial district shall provide a diagnostic evaluation to 5-19 determine whether the inmate has tuberculosis. 5-20 (b) The sheriff, jail administrator, or director of the 5-21 community corrections facility shall provide appropriate 5-22 accommodations to an inmate who has tuberculosis or is suspected of 5-23 having tuberculosis, including respiratory isolation, if necessary, 5-24 and adequate medical care and treatment that meet the accepted 5-25 standards of medical practice. 5-26 (c) The county jail or community corrections facility shall 5-27 provide preventive therapy to an infected inmate if the preventive 6-1 therapy is prescribed by the attending physician and the inmate 6-2 consents to the treatment. 6-3 Sec. 89.054. INMATE TRANSFER AND RELEASE. A copy of an 6-4 inmate's medical records or documentation of screenings or 6-5 treatment received during confinement must accompany an inmate 6-6 transferred from one jail or community corrections facility to 6-7 another or the Texas Department of Criminal Justice and be 6-8 available for medical review on arrival of the inmate. 6-9 (Sections 89.055 to 89.070 reserved for expansion 6-10 SUBCHAPTER D. REPORTING; RULEMAKING; MINIMUM STANDARDS 6-11 Sec. 89.071. REPORTING. (a) A case of tuberculosis shall 6-12 be reported to the appropriate health authority or to the 6-13 department not later than the third day after the day on which the 6-14 diagnosis is suspected. 6-15 (b) The results of a screening test shall be reported to the 6-16 department monthly in a manner approved by the department. 6-17 Sec. 89.072. RULEMAKING. The department shall recommend to 6-18 the Commission on Jail Standards and the Texas Department of 6-19 Criminal Justice rules to carry out this chapter, including rules 6-20 describing: 6-21 (1) the types of screening tests and diagnostic 6-22 evaluations and the scope of the professional examinations that may 6-23 be used to meet the requirements of this chapter; 6-24 (2) the categories of employees, volunteers, or 6-25 inmates who must have a screening test under this chapter; 6-26 (3) the form and content of the certificate required 6-27 under Subchapter B for employees and volunteers; 7-1 (4) the deadlines for filing a certificate; 7-2 (5) the transfer of employee or volunteer certificates 7-3 and inmate records between county or judicial district facilities; 7-4 (6) the frequency of screening tests for employees, 7-5 volunteers, and inmates; 7-6 (7) the criteria for requiring an additional screening 7-7 test or a diagnostic evaluation or examination; and 7-8 (8) the reporting of a screening test or an evaluation 7-9 or examination result to the appropriate health authority or to the 7-10 department. 7-11 Sec. 89.073. ADOPTION OF LOCAL STANDARDS. (a) The 7-12 standards prescribed by this chapter and the rules adopted by the 7-13 board relating to screening tests or examinations for tuberculosis 7-14 required for certain employees and volunteers are minimum 7-15 standards. 7-16 (b) With the prior approval of the department: 7-17 (1) a commissioners court or a judicial district may 7-18 adopt and enforce standards for carrying out this chapter if the 7-19 standards are compatible with and equal to or more stringent than 7-20 the standards prescribed by this chapter and the board's rules; and 7-21 (2) a private facility may adopt and enforce standards 7-22 for carrying out this chapter if the standards are compatible with 7-23 and equal to or more stringent than the standards prescribed by 7-24 this chapter and the board's rules. 7-25 (c) The board shall adopt substantive and procedural rules 7-26 to govern the submission of county, judicial district, or private 7-27 jail standards. At a minimum these rules must contain: 8-1 (1) a procedure for the submission of standards for 8-2 departmental review; and 8-3 (2) an internal departmental appeal process by which a 8-4 county, judicial district, or private entity may seek a review of 8-5 the department's decision to reject the entity's proposed 8-6 standards. 8-7 SECTION 2. Subchapter B, Chapter 501, Government Code, is 8-8 amended by adding Section 501.059 to read as follows: 8-9 Sec. 501.059. TUBERCULOSIS SCREENING. The board will 8-10 establish requirements for tuberculosis screening of department 8-11 employees and volunteers in a manner similar to that established 8-12 for jail employees and volunteers as outlined in Subchapter B, 8-13 Chapter 89, Health and Safety Code. 8-14 SECTION 3. (a) The Texas Department of Health shall supply 8-15 the materials, drugs, and laboratory services to jails and 8-16 community corrections facilities that are necessary to accomplish 8-17 the screening required by this Act. The department is not required 8-18 to supply a private jail, but a private jail may receive 8-19 reimbursement under its contract with a county. 8-20 (b) The Texas Department of Criminal Justice shall provide 8-21 funds for administering screenings, evaluating inmates, and 8-22 administering drugs to inmates suspected of having an active case 8-23 of tuberculosis, for inmates whose paperwork and processing 8-24 required under Subsection (a), Section 8, Article 42.09, Code of 8-25 Criminal Procedure, has been completed, and inmates in a community 8-26 corrections facility. The department shall reimburse a county or 8-27 judicial district in the same manner as provided for reimbursements 9-1 under Section 499.123, Government Code. 9-2 (c) A county or judicial district shall provide funds for 9-3 administering screenings, evaluating inmates, and administering 9-4 drugs to inmates suspected of having an active case of 9-5 tuberculosis, for inmates who are pretrial, inmates whose paperwork 9-6 and processing under Subsection (a), Section 8, Article 42.09, Code 9-7 of Criminal Procedure, is completed, or inmates who are not to be 9-8 transferred to a Texas Department of Criminal Justice facility. 9-9 (d) It is the intent of the legislature that the county 9-10 provide not more than 33 percent of the cost of the program 9-11 required under this Act. The Texas Department of Health is 9-12 authorized to provide grants to counties for this program. 9-13 (e) If the Texas Department of Health and the Texas 9-14 Department of Criminal Justice fail to provide 67 percent of the 9-15 costs of the program assistance to a county as prescribed under 9-16 this Act, the county is not required to continue the tuberculosis 9-17 testing and screening programs mandated under Chapter 89, Health 9-18 and Safety Code. 9-19 SECTION 4. (a) Except as provided by Subsection (b), this 9-20 Act takes effect September 1, 1993. 9-21 (b) Each county commissioners court and governing body of a 9-22 judicial district shall begin the screening activities prescribed 9-23 by Chapter 89, Health and Safety Code, as added by this Act, not 9-24 later than March 15, 1994. 9-25 SECTION 5. The importance of this legislation and the 9-26 crowded condition of the calendars in both houses create an 9-27 emergency and an imperative public necessity that the 10-1 constitutional rule requiring bills to be read on three several 10-2 days in each house be suspended, and this rule is hereby suspended.