By: Moncrief S.B. No. 57 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.