California Legislature—2013–14 Regular Session

Assembly Bill No. 1667

Introduced by Assembly Member Williams

February 12, 2014

An act to amend Section 49406 of the Education Code, and to amend Sections 121525, 121535, 121545, and 121555 of the Health and Safety Code, relating to tuberculosis testing.

LEGISLATIVE COUNSEL’S DIGEST

AB 1667, as introduced, Williams. Tuberculosis testing in schools.

Existing law prohibits a person being initially employed by a school district in a certificated or classified position, or who is employed or volunteering at a private or parochial school or nursery school, unless the person has submitted to a tuberculosis examination within the past 60 days, and requires the person to undergo an examination to determine that he or she is free of active tuberculosis at least once every 4 years thereafter. Existing law requires the governing board of a school district to reimburse the employee for the cost of the examination.

This bill would instead require a person to submit to a tuberculosis risk assessment, and if risk factors are identified, would then require the person to submit to a tuberculosis examination to determine that the person is free of infectious tuberculosis. The bill would also make those provisions applicable to persons under contract in any school, or volunteering in a public school. To the extent that this bill imposes a new duty on a school district, the bill would impose a state-mandated local program. The bill would delete requirements for followup care when an employee has tested positive for tuberculosis infection, and would make other conforming and nonsubstantive changes.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: yes.

The people of the State of California do enact as follows:

SECTION 1.  

Section 49406 of the Education Code is amended
to read:

49406.  

(a)  begin insert (1) end insert begin insert   end insert Except as provided in subdivision begin delete (h), no end delete begin insert (g),
a end insert person shall begin insert not end insert be initially employed by a school district begin insert , or
employed under contract, end insert in a certificated or classified position
unless the person has submitted to begin delete an examination end delete begin insert a tuberculosis
risk assessment end insert within the past 60 days begin insert , and if tuberculosis risk
factors are identified, has been end insert begin insert examined end insert to determine that he or
she is free of begin delete active tuberculosis, end delete begin insert infectious end insert begin insert tuberculosis end insert by a
physician and surgeon licensed under Chapter 5 (commencing
with Section 2000) of Division 2 of the Business and Professions
Code or a physician assistant practicing in compliance with Chapter
7.7 (commencing with Section 3500) of Division 2 of the Business
and Professions Code. begin delete This end delete begin insert If no risk factors are identified, an
examination is not required. The end insert examination shall consist of either
an approved intradermal tuberculin test or any other test for
tuberculosis infection that is recommended by the federal Centers
for Disease Control and Prevention (CDC) and licensed by the
federal Food and Drug Administration begin delete (FDA), which, if end delete begin insert (FDA).
If the test is end insert positive, begin insert the test end insert shall be followed by an X-ray of the
lungs in accordance with subdivision (f) of Section 120115 of the
Health and Safety Code. begin delete The end delete

begin insert (2) end insert begin insert   end insert begin insert The end insert X-ray begin delete film end delete may be taken by a competent and qualified
X-ray technician if the X-ray begin delete film end delete is subsequently interpreted by
a physician and surgeon licensed under Chapter 5 (commencing
with Section 2000) of Division 2 of the Business and Professions
Code.

begin delete

The

end delete

begin insert (3) end insert begin insert   end insert begin insert The end insert district superintendent begin insert of schools end insert or his or her designee
may exempt, for a period not to exceed 60 days following
termination of the pregnancy, a pregnant employee from the
requirement that a positive begin delete intradermal tuberculin end delete test begin insert for
tuberculosis infection end insert be followed by an X-ray of the lungs.

(b) Thereafter, begin delete employees who are test end delete begin insert an employee who has
no identified risk factors or who tests end insert negative begin delete by either the
tuberculin skin test or any other test end delete for begin insert the end insert tuberculosis infection
begin delete recommended by the CDC and licensed by the FDA end delete shall be
required to undergo the begin delete foregoing end delete begin insert tuberculosis risk assessment
and, if risk factors are identified, the end insert examination begin insert , end insert at least once
each four years or more often if directed by the governing board
begin insert of the school district end insert upon recommendation of the local health
begin delete officer for so long as the employee’s test remains negative. end delete begin insert officer. end insert
Once an employee has a documented positive test for tuberculosis
infection conducted pursuant to this subdivision begin delete which end delete begin insert that end insert has
been followed by an X-ray, the begin delete foregoing examination end delete begin insert tuberculosis
risk assessment end insert is no longer begin delete required, and a referral shall be made
within 30 days of completion of the examination to the local health
officer to determine the need for followup care. end delete begin insert required. end insert

(c) After the begin insert tuberculosis risk assessment and, if indicated, the end insert
examination, begin delete each end delete begin insert the end insert employee shall begin delete cause to be on end delete file with the
district superintendent of schools a certificate from the examining
physician and surgeon or physician assistant showing the employee
was examined and found free from begin delete active end delete begin insert infectious end insert tuberculosis.
The county board of education may require, by rule, that begin delete all their end delete
begin insert the end insert certificates be filed in the office of the county superintendent
of schools or begin delete shall require their files be end delete maintained in the office
of the county superintendent of schools if a majority of the
governing boards of the begin insert school end insert districts within the county begin delete so end delete
petition the county board of begin delete education, except that in either case
a end delete begin delete district or end delete begin insert education. A school district, or school end insert districts with a
common begin insert governing end insert board begin insert , end insert having an average daily attendance of
60,000 or more may elect to maintain the files for its employees
in that begin insert school end insert district. begin delete “Certificate,” as used in this section, means
a end delete

begin insert (d) end insert begin insert   end insert begin insert As used in this section, “certificate” means a end insert certificate
signed by the examining physician and surgeon or physician
assistant practicing in compliance with Chapter 7.7 (commencing
with Section 3500) of Division 2 of the Business and Professions
Code or a notice from a public health agency begin delete or unit of the
American Lung Association end delete that indicates freedom from begin delete active end delete
begin insert infectious end insert tuberculosis. The latter, regardless of form, shall
constitute evidence of compliance with this section. begin delete Nothing end delete

begin insert (e) end insert begin insert   end insert begin insert Nothing end insert in this section shall prevent the governing board begin insert of
a school district end insert , upon recommendation of the local health officer,
from establishing a rule requiring a more extensive or more
frequent physical examination than required by this begin delete section, but
the end delete begin insert section. The end insert rule shall provide for reimbursement on the same
basis as required in this section.

begin delete

(d) This

end delete

begin insert (f) end insert begin insert   end insert begin insert The tuberculosis risk assessment and, if indicated, the end insert
examination is a condition of initial employment and the expense
begin delete incident thereto end delete shall be borne by the applicant unless otherwise
provided by rules of the governing board begin insert of the school district end insert .
However, the begin insert governing end insert board begin insert of a school district end insert may, if an
applicant is accepted for employment, reimburse that person in a
like manner prescribed in this section for employees.

begin delete

(e)

end delete

begin insert (g) end insert  The governing board of begin delete each end delete begin insert a school end insert district shall reimburse
the employee for the cost, if any, of begin delete this end delete begin insert the tuberculosis risk
assessment and the end insert examination. The begin insert governing end insert board begin insert of a school
district end insert may provide for the begin insert tuberculosis risk assessment and end insert
examination required by this section or may establish a reasonable
fee for the examination that is reimbursable to employees of the
begin insert school end insert district complying with begin delete the provisions end delete of this section.

begin delete

(f)

end delete

begin insert (h) end insert  At the discretion of the governing board begin insert of a school district end insert ,
this section shall not apply to those employees not requiring
certification qualifications who are employed for any period of
time less than a school year whose functions do not require frequent
or prolonged contact with pupils.

begin delete

The governing board may, however, require an examination
described in subdivision (b) and may, as a contract condition,
require the examination of persons employed under contract, other
than those persons specified in subdivision (a), if the board believes
the presence of these persons in and around school premises would
constitute a health hazard to pupils.

(g)

end delete

begin insert (i) end insert  If the governing board of a school district determines by
resolution, after hearing, that the health of pupils in the begin insert school end insert
district would not be jeopardized begin delete thereby end delete , this section shall not
apply to begin delete any end delete begin insert an end insert employee of the begin insert school end insert district who files an
affidavit stating that he or she adheres to the faith or teachings of
begin delete any end delete begin insert a end insert well-recognized religious sect, denomination, or organization
and begin insert , end insert in accordance with its creed, tenets, or principles begin insert , end insert depends
for healing upon prayer in the practice of religion begin insert , end insert and that to the
best of his or her knowledge and belief begin insert , end insert he or she is free from
begin delete active end delete begin insert infectious end insert tuberculosis. If at any time there begin delete should be end delete begin insert is end insert
probable cause to believe that the affiant is afflicted with begin delete active end delete
begin insert infectious end insert tuberculosis, he or she may be excluded from service
until the governing board begin delete of the employing district end delete begin insert of the school
district end insert is satisfied that he or she is not begin delete so end delete afflicted.

begin delete

(h)

end delete

begin insert (j) end insert  A person who transfers begin delete his or her end delete employment from one
school or school district to another begin insert school or school district end insert shall
be deemed to meet the requirements of subdivision (a) if that
person can produce a certificate begin delete which end delete begin insert that end insert shows begin delete that end delete he or she
begin delete was examined within the past four years and end delete was found to be free
of begin delete communicable end delete begin insert infectious end insert tuberculosis begin insert within 60 days of initial
hire end insert , or begin delete if it is verified by end delete the school previously employing begin delete him or
her end delete begin insert the person verifies end insert that begin delete it end delete begin insert the person end insert has a certificate on file
begin delete which contains that showing. end delete begin insert showing that the person is free from
infectious tuberculosis. end insert

begin delete

A

end delete

begin insert (k) end insert begin insert   end insert begin insert A end insert person who transfers his or her employment from a private
or parochial elementary school, secondary school, or nursery school
to a school or school district subject to this section shall be deemed
to meet the requirements of subdivision (a) if that person can
produce a certificate as provided for in Section 121525 of the
Health and Safety Code that shows that he or she begin delete was examined
within the past four years and end delete was found to be free of
begin delete communicable end delete begin insert infectious end insert tuberculosis begin insert within 60 days of initial
hire end insert , or if begin delete it is verified by end delete the school previously employing begin delete him or
her end delete begin insert the person verifies end insert that begin delete it end delete begin insert the person end insert has a certificate on file
begin delete which contains that showing. end delete begin insert showing that the person is free from
infectious tuberculosis. end insert

begin delete

(i) Any

end delete

begin insert (l) end insert begin insert   end insert begin insert A end insert governing board or county superintendent of schools
providing for the transportation of pupils under contract authorized
by Section 39800, 39801, or any other provision of law shall
require as a condition of the contract the begin insert tuberculosis risk
assessment and, if indicated, the end insert examination for begin delete active
tuberculosis, end delete begin insert infectious end insert begin insert tuberculosis within 60 days of initial hire, end insert
as provided by subdivision (a), of all drivers transporting begin delete these
pupils, provided that private end delete begin insert pupils. Private end insert contracted drivers who
transport begin delete these end delete pupils begin delete on an infrequent basis, not to exceed once
a month, end delete begin insert infrequently without prolonged contact end insert shall be excluded
from this requirement.

begin insert

(m) A volunteer in a school shall also be required to have on
file with the school a certificate showing that, upon initial volunteer
assignment, the person submitted to a tuberculosis risk assessment
and, if tuberculosis risk factors were identified, was examined and
found to be free of infectious tuberculosis. If no risk factors are
identified, an examination is not required. At the discretion of the
governing board of a school district, this section shall not apply
to a volunteer whose functions do not require frequent or prolonged
contact with pupils.

end insert

SEC. 2.  

Section 121525 of the Health and Safety Code is
amended to read:

121525.  

(a) Except as provided in Section 121555, begin delete no end delete begin insert a end insert person
shall begin insert not end insert be initially employed begin insert , or employed under contract, end insert by a
private or parochial elementary or secondary school, or any nursery
school, unless that person produces or has on file with the school
a certificate showing that within the last 60 days the person has
begin insert submitted to a tuberculosis risk assessment and, if tuberculosis
risk factors are identified, has end insert been examined and has been found
to be free of begin delete communicable end delete begin insert infectious end insert tuberculosis. begin insert If no risk
factors are identified, an examination is not required. end insert

(b) Thereafter, begin delete those employees who are skin test negative, or
negative by end delete begin insert an employee who has no identified risk factors or who
tests negative for the tuberculosis infection by either the tuberculin
skin test or end insert any other test for tuberculosis recommended by the
federal Centers for Disease Control and Prevention (CDC) and
licensed by the federal Food and Drug Administration (FDA), shall
be required to undergo the foregoing begin delete examination end delete begin insert tuberculosis
risk assessment and, if risk factors are identified, the examination, end insert
at least once each four years, or more often if directed by the begin delete school end delete
begin insert governing authority end insert upon recommendation of the local health
begin delete officer, for so long as the employee remains test negative by any
test for tuberculosis infection that has been recommended by the
CDC and licensed by the FDA. end delete begin insert officer. end insert Once an employee has a
documented positive begin delete tuberculin test or any other test for
tuberculosis infection that has been recommended by the CDC
and licensed by the FDA, end delete begin insert test for the tuberculosis infection
conducted pursuant to this subdivision, end insert the begin delete foregoing examination end delete
begin insert tuberculosis risk assessment end insert is no longer begin delete required, and a referral
shall be made within 30 days of completion of the examination to
the local health officer to determine the need for followup care end delete
begin insert required end insert .

(c) At the discretion of the governing authority of a private
school, this section shall not apply to employees who are employed
for any period of time less than a school year whose functions do
not require frequent or prolonged contact with pupils. begin delete The
governing authority may, however, require the examination and
may as a contract condition require the examination of persons
employed under contract if the governing authority believes the
presence of the persons in and around the school premises would
constitute a health hazard to students. end delete

(d) The governing authority of a private school providing for
the transportation of pupils under authorized contract shall require
as a condition of the contract that every person transporting pupils
produce a certificate showing that within the last 60 days the person
has begin insert submitted to a tuberculosis risk assessment, and if tuberculosis
risk factors are identified, has end insert been examined and has been found
to be free of begin delete communicable end delete begin insert infectious end insert tuberculosis begin delete , except that
any end delete begin insert . A end insert private contracted driver who transports pupils begin delete on an
infrequent basis, not to exceed once a month, end delete begin insert infrequently without
prolonged contact end insert shall be excluded from this requirement.

(e) The examination attested to in the certificate required
pursuant to subdivision (d) of this section shall be made available
without charge by the local health officer.

begin delete

“Certificate,”

end delete

begin insert (f) end insert begin insert   end insert begin insert “Certificate,” end insert as used in this chapter, means a document
signed by the examining physician and surgeon who is licensed
under Chapter 5 (commencing with Section 2000) of Division 2
of the Business and Professions Code, or a notice from a public
health agency begin delete or unit of the Tuberculosis Association end delete that indicates
freedom from begin delete active end delete begin insert infectious end insert tuberculosis.

begin delete

(f)

end delete

begin insert (g) end insert  Nothing in this section shall prevent the governing authority
of a private, parochial, or nursery school, upon recommendation
of the local health officer, from establishing a rule requiring a more
extensive or more frequent examination than required by this
section.

SEC. 3.  

Section 121535 of the Health and Safety Code is
amended to read:

121535.  

The X-ray begin delete film end delete may be taken by a competent and
qualified X-ray technician if the X-ray begin delete film end delete is subsequently
interpreted by a licensed physician and surgeon.

SEC. 4.  

Section 121545 of the Health and Safety Code is
amended to read:

121545.  

(a)  begin delete All volunteers end delete begin insert A volunteer end insert in begin delete schools covered
under end delete begin insert a school end insert begin insert subject to end insert this chapter shall also be required to have
on file with the school a certificate showing that begin delete within the last
four years the person has been examined and has been found to
be end delete begin insert , upon initial volunteer assignment, the person submitted to a
tuberculosis risk assessment, and, if tuberculosis risk factors were
identified, the person was examined and found to be end insert free of
begin delete communicable end delete begin insert infectious end insert tuberculosis. begin insert If no risk factors are
identified, an examination is not required. end insert

(b) At the discretion of the governing authority of a begin delete private
school, end delete begin insert school end insert begin insert subject to this chapter end insert this section shall not apply
to begin delete volunteers end delete begin insert a volunteer end insert whose functions do not begin delete necessitate end delete
begin insert require end insert frequent or prolonged contact with pupils.

SEC. 5.  

Section 121555 of the Health and Safety Code is
amended to read:

121555.  

(a) A person who transfers his or her employment
from one of the schools specified in subdivision (a) of Section
121525 to another shall be deemed to meet the requirements of
subdivision (a) of Section 121525 if the person can produce a
certificate that shows that he or she was begin delete examined within the past
four years and was end delete found to be free of begin delete communicable end delete begin insert infectious end insert
tuberculosis begin insert within 60 days of initial hire end insert , or begin delete if it is verified by end delete the
school previously employing begin delete him or her end delete begin insert the person verifies end insert that begin delete it end delete
begin insert the school end insert has a certificate on file begin insert showing that the person is free
from infectious tuberculosis end insert .

(b) A person who transfers his or her employment from a public
elementary school or secondary school to any of the schools
specified in subdivision (a) of Section 121525 shall be deemed to
meet the requirements of subdivision (a) of Section 121525 if that
person can produce a certificate as provided for in Section 11708
of the Education Code that shows that he or she was begin delete examined
within the past four years and was end delete found to be free of
begin delete communicable end delete begin insert infectious end insert tuberculosis begin insert within 60 days of initial
hire end insert , or if begin delete it is verified by end delete the school district previously employing
begin delete him or her end delete begin insert the person verifies end insert that begin delete it end delete begin insert the school district end insert has a
certificate on file begin insert showing that the person is free from infectious
tuberculosis end insert .

SEC. 6.  

If the Commission on State Mandates determines that
this act contains costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division
4 of Title 2 of the Government Code.