BILL ANALYSIS �
AB 1667
Page 1
ASSEMBLY THIRD READING
AB 1667 (Williams)
As Amended May 23, 2014
Majority vote
HEALTH 18-0 EDUCATION 7-0
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|Ayes:|Pan, Maienschein, Atkins, |Ayes:|Buchanan, Olsen, Ch�vez, |
| |Bonilla, Rendon, Ch�vez, | |Gonzalez, Nazarian, |
| |Chesbro, Gomez, Gonzalez, | |Weber, Williams |
| |Roger Hern�ndez, Mansoor, | | |
| |Nazarian, Nestande, | | |
| |Patterson, Ridley-Thomas, | | |
| |Wagner, Wieckowski, | | |
| |Bocanegra | | |
| | | | |
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APPROPRIATIONS 16-0
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|Ayes:|Gatto, Bigelow, |
| |Bocanegra, Bradford, Ian |
| |Calderon, Campos, Eggman, |
| |Gomez, Holden, Jones, |
| |Linder, Pan, Quirk, |
| |Ridley-Thomas, Wagner, |
| |Weber |
|-----+--------------------------|
| | |
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SUMMARY : Replaces current mandatory tuberculosis (TB) testing
for school employees and volunteers with a TB risk assessment
administered by a health care provider. Requires, upon initial
employment, individuals under contract by a school district in a
certified or classified position to undergo a TB risk assessment
and for current employees who have no identified risk factors or
who test negative to undergo a TB risk assessment at least once
every four years. Requires further examinations for individuals
identified with a TB risk factor, as specified. Clarifies that
a governing board of a school district or the governing
authority of a private school may require more extensive or
frequent physical exams, and that the cost of the TB risk
assessment to employees be reimbursable, as specified.
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FISCAL EFFECT: According to the Assembly Appropriations
Committee:
1)Minor staff costs to the Department of Public Health to
develop a TB risk assessment questionnaire.
2)Unknown, potentially significant annual state reimbursable
mandate costs if schools are successful in filing mandate
claims for the addition of contractors to the TB requirements.
As many school districts are choosing to receive a block
grant in lieu of filing mandate claims, actual potential
mandate costs are unknown, but costs could easily exceed
$150,000 annually.
COMMENTS : According to the author, the best public health and
medical evidence suggests that universal TB testing is neither
necessary nor cost-effective. School employees and volunteers
are not considered high-risk populations. The number of
certificated and classified staff TB cases is low, and universal
testing results in a number of false positives. The author also
states that this can result in persons being unnecessarily
placed on potentially toxic treatment regimens.
According to the Centers for Disease Control and Prevention
(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 tuberculin skin test 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 human immunodeficiency virus infection or another
medical problem that weakens the immune system;
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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.
Currently five states (Florida, Texas, New Mexico, Nebraska, and
North Dakota) do not require teachers to be tested for TB.
The Health Officers Association of California, the sponsor of
this bill, writes that school employees and volunteers are not
considered high-risk populations and replacing mandated
universal testing of school personnel with targeted screening
will be more cost effective while still protecting the state's
teachers, volunteers, school employees, and children from TB.
The California Tuberculosis Controllers Association supports the
bill and references an American Academy of Family Physicians
statement noting, "Routine screening outside?high-risk groups
dissipates resources and leads to high false-positive test
rates." The California School Nurses Association supports this
bill because it has been demonstrated that school staff and
volunteers are a low risk population and thus the revised policy
and protocol for universal TB risk assessment and testing, if
warranted, is more efficacious and efficient.
There is no opposition to this bill.
Analysis Prepared by : Paula Villescaz / HEALTH / (916)
319-2097
FN: 0003745
AB 1667
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