BILL ANALYSIS Ó
SENATE COMMITTEE ON EDUCATION
Senator Carol Liu, Chair
2015 - 2016 Regular
Bill No: SB 1038
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|Author: |Allen |
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|Version: |February 12, 2016 Hearing |
| |Date: March 30, 2016 |
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|Urgency: |No |Fiscal: |No |
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|Consultant:|Lenin Del Castillo |
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Subject: Community colleges: employees
SUMMARY
This bill replaces current mandatory tuberculosis (TB) testing
for community college employees with a TB risk assessment
developed by the State Department of Public Health and the
California Tuberculosis Controllers Association.
BACKGROUND
Existing law:
1) Prohibits a person from being initially employed by a
community college district in an academic or classified
position unless the person has had a TB test within the
past 60 days to determine if he or she has TB, as
specified.
2) Requires the TB test to consist of an approved
intradermal TB test or any other test for TB infection that
is recommended by the federal Centers for Disease Control
and Prevention and licensed by the federal Food and Drug
Administration, and requires if the test is positive, that
the test be followed by an X-ray of the lungs.
3) Allows a district superintendent to exempt a pregnant
employee who tests positive for TB from the requirement for
an X-ray of the lungs for up to 60 days following
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termination of the pregnancy.
4) Requires employees who test negative for TB to be tested
at least once every four years.
5) Requires that once an employee has been documented as
having TB, the test is no longer required, and requires the
employee to be referred within 30 days to the local health
officer to determine the need for follow-up care.
6) Requires employees, after the test, to file a
certificate from the physician showing the employee was
examined and found free from active TB.
(Education Code § 87408.6 )
ANALYSIS
This bill:
1) Replaces current mandatory tuberculosis (TB) testing for
school employees with a TB risk assessment developed by the
State Department of Public Health and the California
Tuberculosis Controllers Association.
2) Prohibits a person from being initially employed by a
community college school district unless the person has had
a TB risk assessment within the past 60 days.
3) Specifies that if no risk factors are identified by a TB
risk assessment, an examination is not required.
4) Requires that if TB risk factors are identified by a TB
risk assessment, employees are to be examined by a
physician to determine if they are free of infectious TB.
5) Requires employees who have no identified risk factors,
or who test negative, to undergo a TB risk assessment at
least once each four years.
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6) Specifies that once an employee has been documented as
having TB, the risk assessment is no longer required.
7) Requires employees, after a TB risk assessment and, if
necessary, an examination, to file with the district
superintendent, a certificate from the physician and
surgeon showing the employee was examined and found free
from infectious TB.
8) Makes the risk assessment and, if indicated, the TB test
a condition of employment and requires the cost to be borne
by the applicant. Allows schools or districts to reimburse
applicants once they are hired.
9) Requires existing employees to be reimbursed for the
expense of the TB assessment and examination.
10) Provides that if a person who transfers his or her
employment from one campus or community college district to
another or who transfers employment from a private or
parochial elementary school, secondary schools, or nursery
school to the community college district, he or she may be
employed if he or she can produce a certificate that shows
he or she had a tuberculosis risk assessment in the last
four years that showed no risk factors were present or was
examined.
11) Requires all drivers, as a condition of contract
providing the transportation of pupils, to have a TB risk
assessment and, if indicated, the examination for TB within
60 days of initial hire and be found free of infectious TB.
STAFF COMMENTS
1) Need for the bill. According to the author's office, "SB
1038 will help alleviate the reoccurring shortage of TB
tests by eliminating mandated universal TB testing for
community college administrators, faculty, and classified
employees and replace these testing requirements with
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universal TB screening and testing only when indicated.
The most common test for TB infection is the tuberculin
skin test. Purified protein derivative is injected into
the inner surface of the forearm, and the test is read two
to three days later by measuring the diameter of swelling
at the injection site. Though the tuberculin skin test
(TST) is often a valuable tool in determining the presence
of tuberculosis (TB) infection, the tuberculin used for TB
skin testing is frequently in short supply. As one
approach to combat the recurring national shortage of
tuberculin, the Centers for Disease Control and Prevention
(CDC), among numerous other expert bodies, recommend
allocating TSTs only to those who are a high-risk for TB."
2) Tuberculosis. According to the CDC, TB is a disease that
is spread through the air from one person to another.
There are two kinds of tests that are used to determine if
a person has been infected with TB bacteria: the TST and TB
blood tests. A positive TB skin test or TB blood test only
tells that a person has been infected with TB bacteria. It
does not tell whether the person has latent TB infection or
has progressed to TB disease. Other tests, such as a chest
X-ray and a sample of sputum, are needed to see whether the
person has TB disease. According to the CDC, TB tests are
generally not needed for people with a low risk of
infection with TB bacteria. Certain people should be
tested for TB bacteria because they are more likely to get
TB disease, including:
a) People who have spent time with someone who
has TB disease;
b) People with HIV infection or another medical
problem that weakens the immune system;
c) People who have symptoms of TB disease (fever,
night sweats, cough, and weight loss);
d) People from a country where TB disease is
common (most countries in Latin America, the
Caribbean, Africa, Asia, Eastern Europe, and Russia);
e) People who live or work somewhere in the
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United States where TB disease is more common
(homeless shelters, prison or jails, or some nursing
homes); and,
f) People who use illegal drugs.
The two purified protein derivatives licensed by the Food
and Drug Administration that serve as antigens for TB tests
have been experiencing nationwide shortages since April
2013. In their September 4, 2013 health update, the CDC
recommends allocating TB tests to priority usages as
determined by public health authorities. Since 2000, the
Centers for Disease Control and Prevention (CDC) has stated
that screening of low-risk persons and testing for
administrative purposes should be replaced by targeted
testing. In 2006, the California Department of Public
Health and the Cancer Treatment Centers of America issued
joint guidelines, Targeted Testing and Treatment of Latent
Tuberculosis Infection in Adults and Children, which state
that tuberculin skin testing of low risk populations will
result in unnecessary treatment because of false-positive
test results. Currently, five states (Florida, Texas, New
Mexico, Nebraska, and North Dakota) do not require teachers
to be tested for TB.
3) No double referral. This bill addresses substantially
similar policy issues as that of AB 1667 (Williams, Chapter
329, Statutes of 2014), which replaced TB testing for K-12
school employees and volunteers with a TB risk assessment
and was heard by the Senate Health Committee during the
2013-14 legislative session. The application of those
provisions to community college employees, as this measure
proposes, is consistent with the prior action of the Senate
Health Committee.
4) Related legislation. AB 1667 (Williams, Chapter 329,
Statutes of 2014), similar to this bill, replaced TB
testing for K-12 school employees and volunteers with a TB
risk assessment, as specified.
SUPPORT
County Health Executives Association of California
Health Officers Association of California
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OPPOSITION
None received.
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