1-1 By: Moncrief S.B. No. 57 1-2 (In the Senate - Filed December 7, 1992; January 13, 1993, 1-3 read first time and referred to Committee on Health and Human 1-4 Services; May 5, 1993, reported adversely, with favorable Committee 1-5 Substitute by the following vote: Yeas 6, Nays 0; May 5, 1993, 1-6 sent to printer.) 1-7 COMMITTEE VOTE 1-8 Yea Nay PNV Absent 1-9 Zaffirini x 1-10 Ellis x 1-11 Madla x 1-12 Moncrief x 1-13 Nelson x 1-14 Patterson x 1-15 Shelley x 1-16 Truan x 1-17 Wentworth x 1-18 COMMITTEE SUBSTITUTE FOR S.B. No. 57 By: Moncrief 1-19 A BILL TO BE ENTITLED 1-20 AN ACT 1-21 relating to the screening and treatment for tuberculosis of 1-22 employees, volunteers, and inmates in county jails and other 1-23 correctional facilities. 1-24 BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS: 1-25 SECTION 1. Subtitle D, Title 2, Health and Safety Code, is 1-26 amended by adding Chapter 89 to read as follows: 1-27 CHAPTER 89. SCREENING AND TREATMENT FOR TUBERCULOSIS 1-28 IN JAILS AND OTHER CORRECTIONAL FACILITIES 1-29 SUBCHAPTER A. GENERAL PROVISIONS 1-30 Sec. 89.001. DEFINITIONS. In this chapter: 1-31 (1) "Community corrections facility" means a facility 1-32 established under Article 42.13, Code of Criminal Procedure. 1-33 (2) "County jail" means a facility operated by or for 1-34 a county for the confinement of persons accused or convicted of an 1-35 offense and that has a capacity of 100 beds or more and includes: 1-36 (A) a facility operated by or for a county for 1-37 the confinement of persons accused or convicted of an offense; 1-38 (B) a county jail or a correctional facility 1-39 authorized by Subchapter F, Chapter 351, Local Government Code; and 1-40 (C) a county corrections center authorized by 1-41 Subchapter H, Chapter 351, Local Government Code. 1-42 (3) "Health authority" has the meaning assigned by 1-43 Section 121.021. 1-44 (4) "Local health department" means a health 1-45 department created under Subchapter D, Chapter 121. 1-46 (5) "Physician" means a person licensed to practice 1-47 medicine in a state of the United States. 1-48 (6) "Public health district" means a health district 1-49 established under Subchapter E, Chapter 121. 1-50 (7) "Screening test" means a rapid analytical 1-51 laboratory or other procedure to determine the need for further 1-52 diagnostic evaluation. 1-53 (8) "Tuberculosis" means a disease caused by 1-54 Mycobacterium tuberculosis or other members of the Mycobacterium 1-55 tuberculosis complex. 1-56 (Sections 89.002 to 89.010 reserved for expansion 1-57 SUBCHAPTER B. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS 1-58 Sec. 89.011. SCREENING OF JAIL EMPLOYEES AND VOLUNTEERS. 1-59 (a) The commissioners court of each county and the district 1-60 judges governing a community corrections facility, through the 1-61 community supervision and corrections department, shall require 1-62 that each employee or volunteer working or providing services in a 1-63 county jail or a community corrections facility, who meets the 1-64 screening guidelines prescribed by board rule, present to the court 1-65 or judicial district a certificate signed by a physician that 1-66 states that: 1-67 (1) the employee or volunteer has been tested for 1-68 tuberculosis infection in accordance with board rules; and 2-1 (2) the results of the test indicate that the person 2-2 does not have tuberculosis. 2-3 (b) In lieu of a screening test, an employee or volunteer 2-4 with a history of a positive screening test may provide: 2-5 (1) documentation of that positive test result and of 2-6 any diagnostic and therapeutic follow-up; and 2-7 (2) a certificate signed by a physician that states 2-8 that the person does not have tuberculosis. 2-9 (c) The health authority may require an employee or 2-10 volunteer to have an additional screening test or medical 2-11 examination if the department determines that an additional test or 2-12 examination is necessary and appropriate to protect the public 2-13 health. 2-14 Sec. 89.012. FOLLOW-UP EVALUATIONS AND TREATMENT. (a) An 2-15 employee or a volunteer with a positive screening test result must 2-16 obtain a diagnostic evaluation from the person's own physician to 2-17 determine if the person has tuberculosis. 2-18 (b) If the employee or volunteer has tuberculosis, the 2-19 commissioners court or the judicial district, as appropriate, may 2-20 not permit the person to begin or continue the person's employment 2-21 duties or volunteer services unless the person is under treatment 2-22 for the disease by a physician and the person provides to the court 2-23 or judicial district a certificate signed by the attending 2-24 physician stating that the patient is noninfectious. 2-25 Sec. 89.013. CERTIFICATE REQUIRED. (a) The commissioners 2-26 court, judicial district, or a designee of either shall confirm 2-27 that each employee or volunteer required to be screened under this 2-28 subchapter has the required certificate. 2-29 (b) The commissioners court or judicial district may not 2-30 permit an employee or volunteer to carry out the person's duties if 2-31 the person does not have the required certificate. 2-32 Sec. 89.014. COST OF TESTS, FOLLOW-UP, AND TREATMENT. The 2-33 employee or volunteer shall pay the expense of a screening test, 2-34 diagnostic evaluation, or other professional medical service 2-35 required under this subchapter unless the commissioners court or a 2-36 local health department or public health district elects to provide 2-37 the service. 2-38 (Sections 89.015 to 89.050 reserved for expansion 2-39 SUBCHAPTER C. INMATE SCREENING AND TREATMENT 2-40 Sec. 89.051. INMATE SCREENING REQUIRED. (a) Each inmate in 2-41 a county jail or community corrections facility shall undergo a 2-42 screening test for tuberculosis infection approved by the board if: 2-43 (1) the inmate will probably be confined in jail or a 2-44 community corrections facility for more than 14 days; and 2-45 (2) the inmate meets the screening guidelines 2-46 prescribed by board rules. 2-47 (b) The inmate must be tested on or before the 14th day 2-48 after the day the inmate is first confined. 2-49 (c) An inmate listed by Subsection (a) is not required to be 2-50 retested at each rebooking if the inmate is booked into a jail or a 2-51 community corrections facility more than once during a 12-month 2-52 period unless the inmate shows symptoms of tuberculosis or is known 2-53 to have been exposed to tuberculosis. 2-54 Sec. 89.052. RESCREENING; DIAGNOSTIC EVALUATIONS. The 2-55 department or a health authority may require the commissioners 2-56 court or the judicial district to provide an additional screening 2-57 test or a diagnostic evaluation if the health authority determines 2-58 that an additional screening test or a diagnostic evaluation is 2-59 necessary and appropriate to protect the health of the jail 2-60 inmates, employees, volunteers, or the public. 2-61 Sec. 89.053. FOLLOW-UP EVALUATIONS. (a) If an inmate has a 2-62 confirmed positive screening test result, the commissioners court 2-63 or judicial district shall provide a diagnostic evaluation to 2-64 determine whether the inmate has tuberculosis. 2-65 (b) The sheriff, jail administrator, or director of the 2-66 community corrections facility shall provide appropriate 2-67 accommodations to an inmate who has tuberculosis or is suspected of 2-68 having tuberculosis, including respiratory isolation, if necessary, 2-69 and adequate medical care and treatment that meet the accepted 2-70 standards of medical practice. 3-1 (c) The county jail or community corrections facility shall 3-2 provide preventive therapy to an infected inmate if the preventive 3-3 therapy is prescribed by the attending physician and the inmate 3-4 consents to the treatment. 3-5 Sec. 89.054. INMATE TRANSFER AND RELEASE. A copy of an 3-6 inmate's medical records or documentation of screenings or 3-7 treatment received during confinement must accompany an inmate 3-8 transferred from one jail or community corrections facility to 3-9 another and be available for medical review on arrival of the 3-10 inmate. 3-11 (Sections 89.055 to 89.070 reserved for expansion 3-12 SUBCHAPTER D. REPORTING; RULEMAKING; MINIMUM STANDARDS 3-13 Sec. 89.071. REPORTING. (a) A case of tuberculosis shall 3-14 be reported to the appropriate health authority or to the 3-15 department not later than the third day after the day on which the 3-16 diagnosis is suspected. 3-17 (b) The results of a screening test shall be reported to the 3-18 department monthly in a manner approved by the department. 3-19 Sec. 89.072. RULEMAKING. The department shall recommend to 3-20 the Commission on Jail Standards and the Texas Department of 3-21 Criminal Justice rules to carry out this chapter, including rules 3-22 describing: 3-23 (1) the types of screening tests and diagnostic 3-24 evaluations and the scope of the professional examinations that may 3-25 be used to meet the requirements of this chapter; 3-26 (2) the categories of employees, volunteers, or 3-27 inmates who must have a screening test under this chapter; 3-28 (3) the form and content of the certificate required 3-29 under Subchapter B for employees and volunteers; 3-30 (4) the deadlines for filing a certificate; 3-31 (5) the transfer of employee or volunteer certificates 3-32 and inmate records between county or judicial district facilities; 3-33 (6) the frequency of screening tests for employees, 3-34 volunteers, and inmates; 3-35 (7) the criteria for requiring an additional screening 3-36 test or a diagnostic evaluation or examination; and 3-37 (8) the reporting of a screening test or an evaluation 3-38 or examination result to the appropriate health authority or to the 3-39 department. 3-40 Sec. 89.073. ADOPTION OF LOCAL STANDARDS. (a) The 3-41 standards prescribed by this chapter and the rules adopted by the 3-42 board relating to screening tests or examinations for tuberculosis 3-43 required for certain employees and volunteers are minimum 3-44 standards. 3-45 (b) With the prior approval of the department: 3-46 (1) a commissioners court or a judicial district may 3-47 adopt and enforce standards for carrying out this chapter if the 3-48 standards are compatible with and equal to or more stringent than 3-49 the standards prescribed by this chapter and the board's rules; and 3-50 (2) a private facility may adopt and enforce standards 3-51 for carrying out this chapter if the standards are compatible with 3-52 and equal to or more stringent than the standards prescribed by 3-53 this chapter and the board's rules. 3-54 (c) The board shall adopt substantive and procedural rules 3-55 to govern the submission of county, judicial district, or private 3-56 jail standards. At a minimum these rules must contain: 3-57 (1) a procedure for the submission of standards for 3-58 departmental review; and 3-59 (2) an internal departmental appeal process by which a 3-60 county, judicial district, or private entity may seek a review of 3-61 the department's decision to reject the entity's proposed 3-62 standards. 3-63 SECTION 2. (a) The Texas Department of Health shall supply 3-64 the materials, drugs, and laboratory service to jails and community 3-65 corrections facilities that are necessary to accomplish the 3-66 screening required by this Act. The department is not required to 3-67 supply a private jail, but a private jail may receive reimbursement 3-68 under its contract with a county. 3-69 (b) The Texas Department of Criminal Justice shall provide 3-70 funds for administering screenings, evaluating inmates, and 4-1 administering drugs to inmates suspected of having an active case 4-2 of tuberculosis, for inmates whose paperwork and processing 4-3 required under Subsection (a), Section 8, Article 42.09, Code of 4-4 Criminal Procedure, has been completed, and inmates in a community 4-5 corrections facility. The department shall reimburse a county or 4-6 judicial district in the same manner as provided for reimbursements 4-7 under Section 499.123, Government Code. 4-8 (c) A county or judicial district shall provide funds for 4-9 administering screenings, evaluating inmates, and administering 4-10 drugs to inmates suspected of having an active case of 4-11 tuberculosis, for inmates who are pretrial, inmates whose paperwork 4-12 and processing under Subsection (a), Section 8, Article 42.09, Code 4-13 of Criminal Procedure, is incomplete, or inmates who are not to be 4-14 transferred to a Texas Department of Criminal Justice facility. 4-15 (d) It is the intent of the legislature that the county 4-16 provide only 33 percent of the cost of the program required under 4-17 this Act. The Texas Department of Health is authorized to provide 4-18 grants to counties which require assistance to fulfill this 4-19 expression of intent. 4-20 SECTION 3. (a) Except as provided by Subsection (b), this 4-21 Act takes effect September 1, 1993. 4-22 (b) Each county commissioners court and governing body of a 4-23 judicial district shall begin the screening activities prescribed 4-24 by Chapter 89, Health and Safety Code, as added by this Act, not 4-25 later than March 15, 1994. 4-26 SECTION 4. The importance of this legislation and the 4-27 crowded condition of the calendars in both houses create an 4-28 emergency and an imperative public necessity that the 4-29 constitutional rule requiring bills to be read on three several 4-30 days in each house be suspended, and this rule is hereby suspended. 4-31 * * * * * 4-32 Austin, 4-33 Texas 4-34 May 5, 1993 4-35 Hon. Bob Bullock 4-36 President of the Senate 4-37 Sir: 4-38 We, your Committee on Health and Human Services to which was 4-39 referred S.B. No. 57, have had the same under consideration, and I 4-40 am instructed to report it back to the Senate with the 4-41 recommendation that it do not pass, but that the Committee 4-42 Substitute adopted in lieu thereof do pass and be printed. 4-43 Zaffirini, 4-44 Chair 4-45 * * * * * 4-46 WITNESSES 4-47 FOR AGAINST ON 4-48 ___________________________________________________________________ 4-49 Name: Mary Ellen Schattman x 4-50 Representing: TX Asso of Public & Non-Profit 4-51 City: Fort Worth 4-52 ------------------------------------------------------------------- 4-53 Name: Susan Steeg x 4-54 Representing: TDH 4-55 City: Austin 4-56 ------------------------------------------------------------------- 4-57 Name: Jim Allison x 4-58 Representing: Co Judges & Comm Asso of Tx 4-59 City: Austin 4-60 -------------------------------------------------------------------