BILL NUMBER: SB 1847 CHAPTERED 08/23/04 CHAPTER 283 FILED WITH SECRETARY OF STATE AUGUST 23, 2004 APPROVED BY GOVERNOR AUGUST 23, 2004 PASSED THE SENATE AUGUST 10, 2004 PASSED THE ASSEMBLY AUGUST 4, 2004 AMENDED IN ASSEMBLY JULY 6, 2004 AMENDED IN SENATE MAY 11, 2004 INTRODUCED BY Senator Perata FEBRUARY 20, 2004 An act to amend Section 121360.5 of the Health and Safety Code, relating to communicable diseases. LEGISLATIVE COUNSEL'S DIGEST SB 1847, Perata. Omnibus Tuberculosis Control and Prevention Act. Existing law establishes the Omnibus Tuberculosis Control and Prevention Act of 2002 which, among other things, until January 1, 2006, permits any local health department to provide for certification, by the local health officer, of tuberculin skin test technicians. This bill would extend the repeal date of these provisions, until January 1, 2011. This bill would require each city or county that elects, on or after January 1, 2005, to certify tuberculin skin test technicians to submit a survey and an evaluation of its findings, including a review of the aggregate report, to the California Tuberculosis Controllers Association annually, to and including January 1, 2011. This bill would, until January 1, 2011, require a participating local health officer who determines that an adverse event resulted from improper tuberculin test technician training or performance to report that information to the Tuberculosis Control Branch within the State Department of Health Services. THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS: SECTION 1. It is the intent of the Legislature only to extend the authorization, as amended by this act, for local health departments to certify tuberculin skin test technicians to place and measure tuberculin skin tests. (b) It is not the intent of the Legislature to make tuberculin skin test technicians responsible for followup or completion of therapy for tuberculosis patients. SEC. 2. Section 121360.5 of the Health and Safety Code is amended to read: 121360.5. (a) Any city or county health department that elects to participate in this program shall provide for one-year certification of tuberculin skin test technicians by local health officers. (b) For purposes of this section, a "certified tuberculin skin test technician" is an unlicensed public health tuberculosis worker employed by, or under contract with, a local public health department, and who is certified by a local health officer to place and measure skin tests in the local health department's jurisdiction. (c) A certified tuberculin skin test technician may perform the functions for which he or she is certified only if he or she meets all of the following requirements: (1) The certified tuberculin skin test technician is working under the direction of the local health officer or the tuberculosis controller. (2) The certified tuberculin skin test technician is working under the supervision of a licensed health professional. For purposes of this section, "supervision" means the licensed health professional is immediately available for consultation with the tuberculin skin test technician through telephonic or electronic contact. (d) A certified tuberculin skin test technician may perform intradermal injections only for the purpose of placing a tuberculin skin test and measuring the test result. (e) A certified tuberculin skin test technician may not be certified to interpret, and may not interpret, the results of a tuberculin skin test. (f) In order to be certified as a tuberculin skin test technician by a local health officer, a person shall meet all of the following requirements, and provide to the local health officer appropriate documentation establishing that he or she has met those requirements: (1) The person has a high school diploma, or its equivalent. (2) (A) The person has completed a standardized course approved by the California Tuberculosis Controllers Association (CTCA), which shall include at least 24 hours of instruction in all of the following areas: Didactic instruction on tuberculosis control principles and instruction on the proper placement and measurement of tuberculin skin tests, equipment usage, basic infection control, universal precautions, and appropriate disposal of sharps, needles, and medical waste, client preparation and education, safety, communication, professional behavior, and the importance of confidentiality. (B) A certification of satisfactory completion of this CTCA-approved course shall be dated and signed by the local health officer, and shall contain the name and social security number of the tuberculin skin test technician, and the printed name, the jurisdiction, and the telephone number of the certifying local health officer. (3) The person has completed practical instruction including placing at least 30 successful intradermal tuberculin skin tests, supervised by a licensed physician or registered nurse at the local health department, and 30 correct measurements of intradermal tuberculin skin tests, at least 15 of which are deemed positive by the licensed physician or registered nurse supervising the practical instruction. A certification of the satisfactory completion of this practical instruction shall be dated and signed by the licensed physician or registered nurse supervising the practical instruction. (g) The certification may be renewed, and the local health department shall provide a certificate of renewal, if the certificate holder has completed in-service training, including all of the following: (1) At least three hours of a CTCA-approved standardized training course to assure continued competency. This training shall include, but not be limited to, fundamental principles of tuberculin skin testing. (2) Practical instruction, under the supervision of a licensed physician or registered nurse at the local health department, including the successful placement and correct measurement of 10 tuberculin skin tests, at least five of which are deemed positive by the licensed physician or registered nurse supervising the practical instruction. (h) The local health officer or the tuberculosis controller may deny or revoke the certification of a tuberculin skin test technician if the local health officer or the tuberculosis controller finds that the technician is not in compliance with this section. (i) Each county or city participating in the program under this section using tuberculin skin test technicians, that elects to participate on or after January 1, 2005, shall submit to the CTCA a survey and an evaluation of its findings, including a review of the aggregate report, by July 1, 2006, and by July 1 of each year thereafter to, and including, July 1, 2011. The report shall include the following: (1) The number of persons trained and certified as tuberculin skin test technicians in that city or county. (2) The estimated number of tuberculin skin tests placed by tuberculin skin test technicians in that city or county. (j) By July 1, 2008, the CTCA shall submit a summary of barriers to implementing the tuberculosis technician program in the state to the department and to the appropriate policy and fiscal committees of the Legislature. (k) The local health officer of each participating city or county shall report to the Tuberculosis Control Branch within the department any adverse event that he or she determines has resulted from improper tuberculin skin test technician training or performance. (l) (1) This section, except subdivision (i), shall remain operative only until January 1, 2011. (2) This section shall remain in effect only until January 1, 2012, and as of that date is repealed, unless a later enacted statute, that is enacted before January 1, 2012, deletes or extends that date.