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
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   4-53  Name:  Susan Steeg                                             x
   4-54  Representing:  TDH
   4-55  City:  Austin
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   4-57  Name:  Jim Allison                                             x
   4-58  Representing:  Co Judges & Comm Asso of Tx
   4-59  City:  Austin
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