49406
. (a) (1) (A) Except as provided in subdivision (j), a person
shall not be initially employed by a school district, or employed
under contract, in a certificated or classified position unless the
person has submitted to a tuberculosis risk assessment within the
past 60 days, and, if tuberculosis risk factors are identified, has
been examined to determine that he or she is free of infectious
tuberculosis by a physician and surgeon licensed under Chapter 5
(commencing with Section 2000) of Division 2 of the Business and
Professions Code, a physician assistant practicing in compliance with
Chapter 7.7 (commencing with Section 3500) of Division 2 of the
Business and Professions Code, or a nurse practitioner practicing in
compliance with Chapter 6 (commencing with Section 2700) of Division
2 of the Business and Professions Code. If no risk factors are
identified, an examination is not required. A person who is subject
to the requirements of this subdivision may submit to an examination
that complies with subparagraph (B) instead of submitting to a
tuberculosis risk assessment.
(B) The examination required by this subdivision 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 (FDA). If the test is positive, the test
shall be followed by an X-ray of the lungs in accordance with
subdivision (f) of Section 120115 of the Health and Safety Code.
(2) The X-ray may be taken by a competent and qualified X-ray
technician if the X-ray 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.
(3) The district superintendent of schools 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 test for tuberculosis infection be followed by an X-ray of
the lungs.
(b) Thereafter, an employee who has no identified risk factors or
who tests negative for the tuberculosis infection shall be required
to undergo the tuberculosis risk assessment and, if risk factors are
identified, the examination, at least once each four years or more
often if directed by the governing board of the school district upon
recommendation of the local health officer. Once an employee has a
documented positive test for tuberculosis infection conducted
pursuant to this subdivision that has been followed by an X-ray, the
tuberculosis risk assessment is no longer required. 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.
(c) After the tuberculosis risk assessment and, if indicated, the
examination, the employee shall file with the district superintendent
of schools a certificate from the examining physician and surgeon,
physician assistant, or nurse practitioner showing the employee was
examined and found free from infectious tuberculosis. The county
board of education may require, by rule, that the certificates be
filed in the office of the county superintendent of schools or
maintained in the office of the county superintendent of schools if a
majority of the governing boards of the school districts within the
county petition the county board of education. A school district, or
school districts with a common governing board, having an average
daily attendance of 60,000 or more may elect to maintain the files
for its employees in that school district.
(d) As used in this section, "certificate" means a certificate
signed by the examining physician and surgeon licensed under Chapter
5 (commencing with Section 2000) of Division 2 of the Business and
Professions Code, a physician assistant practicing in compliance with
Chapter 7.7 (commencing with Section 3500) of Division 2 of the
Business and Professions Code, or a nurse practitioner practicing in
compliance with Chapter 6 (commencing with Section 2700) of Division
2 of the Business and Professions Code, or a notice from a public
health agency that indicates freedom from infectious tuberculosis.
The latter, regardless of form, shall constitute evidence of
compliance with this section.
(e) Nothing in this section shall prevent the governing board of a
school district, upon recommendation of the local health officer,
from establishing a rule requiring a more extensive or more frequent
physical examination than required by this section. The rule shall
provide for reimbursement on the same basis as required in this
section.
(f) The tuberculosis risk assessment and, if indicated, the
examination is a condition of initial employment and the expense
shall be borne by the applicant unless otherwise provided by rules of
the governing board of the school district. However, the governing
board of a school district may, if an applicant is accepted for
employment, reimburse that person in a like manner prescribed in this
section for employees.
(g) The governing board of a school district shall reimburse the
employee for the cost, if any, of the tuberculosis risk assessment
and the examination. The governing board of a school district may
provide for the tuberculosis risk assessment and examination required
by this section or may establish a reasonable fee for the
examination that is reimbursable to employees of the school district
complying with this section.
(h) At the discretion of the governing board of a school district,
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.
(i) If the governing board of a school district determines by
resolution, after hearing, that the health of pupils in the school
district would not be jeopardized, this section shall not apply to an
employee of the school district who files an affidavit stating that
he or she adheres to the faith or teachings of a well-recognized
religious sect, denomination, or organization and, in accordance with
its creed, tenets, or principles, depends for healing upon prayer in
the practice of religion, and that to the best of his or her
knowledge and belief, he or she is free from infectious tuberculosis.
If at any time there is probable cause to believe that the affiant
is afflicted with infectious tuberculosis, he or she may be excluded
from service until the governing board of the school district is
satisfied that he or she is not afflicted.
(j) A person who transfers employment from one school or school
district to another school or school district shall be deemed to meet
the requirements of subdivision (a) if that person can produce a
certificate that shows he or she was found to be free of infectious
tuberculosis within 60 days of initial hire, or the school previously
employing the person verifies that the person has a certificate on
file showing that the person is free from infectious tuberculosis.
(k) A 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 was found to be free of
infectious tuberculosis within 60 days of initial hire, or if the
school previously employing the person verifies that the person has a
certificate on file showing that the person is free from infectious
tuberculosis.
(l) A 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 tuberculosis risk assessment and,
if indicated, the examination for infectious tuberculosis within 60
days of initial hire, as provided by subdivision (a), of all drivers
transporting pupils. At the discretion of the governing board or
county superintendent of schools, this subdivision shall not apply to
a private contracted driver who transports pupils infrequently
without prolonged contact with the pupils.
(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.
(n) The State Department of Public Health, in consultation with
the California Tuberculosis Controllers Association, shall develop a
risk assessment questionnaire, to be used to conduct tuberculosis
risk assessments pursuant to this section. The risk assessment
questionnaire shall be administered by a health care provider, which
shall be specified on the questionnaire. This risk assessment
questionnaire shall be exempt from the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).