BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 1038|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
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CONSENT
Bill No: SB 1038
Author: Allen (D), et al.
Introduced:2/12/16
Vote: 21
SENATE EDUCATION COMMITTEE: 8-0, 3/30/16
AYES: Liu, Block, Huff, Leyva, Mendoza, Monning, Pan, Vidak
NO VOTE RECORDED: Hancock
SUBJECT: Community colleges: employees
SOURCE: Author
DIGEST: 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.
ANALYSIS:
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 (CDC) and licensed by the federal Food and Drug
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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 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 )
This bill:
1) Replaces current mandatory 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.
Comments
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 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,
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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 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."
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:
1) People who have spent time with someone who has TB disease;
2) People with HIV infection or another medical problem that
weakens the immune system;
3) People who have symptoms of TB disease (fever, night sweats,
cough, and weight loss);
4) People from a country where TB disease is common (most
countries in Latin America, the Caribbean, Africa, Asia,
Eastern Europe, and Russia);
5) People who live or work somewhere in the United States where
TB disease is more common (homeless shelters, prison or
jails, or some nursing homes); and,
6) People who use illegal drugs.
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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 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.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:NoLocal: No
SUPPORT: (Verified3/30/16)
County Health Executives Association of California
Health Officers Association of California
OPPOSITION: (Verified3/30/16)
None received
Prepared by:Lenin DelCastillo / ED. / (916) 651-4105
3/31/16 15:46:03
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