The Committee on Medical Affairs proposes the following amendment (SR-819.KM0002S):

Amend the bill, as and if amended, by striking all after the enacting words and inserting:

SECTION 1. Chapter 31, Title 44 of the S.C. Code is amended by adding:

 Section 44-31-45. (A) For the purposes of this section:
 (1) "Authorized healthcare provider" means a physician, nurse practitioner, physician assistant, or registered nurse acting under written standing orders or a protocol approved by a physician.
 (2) "Blood assay for mycobacterium tuberculosis" means an interferon-gamma release assay or other blood tests for tuberculosis infection approved by the FDA.
 (B)(1) Prior to an applicant for employment having resident contact at a nursing home or community residential care facility, as defined in Section 44-7-130, a facility shall:
   (a) conduct an annual tuberculosis risk assessment using a high, medium, or low risk standard in accordance with CDC guidelines to determine the facility's risk classification and appropriate screening measures;
   (b) request and receive from an authorized healthcare provider a signed, a written declaration that the applicant:
    (i) has received a negative tuberculosis screening test, either a single skin test or a single blood assay for mycobacterium tuberculosis within three months prior to resident contact; or
    (ii) documentation of a negative tuberculosis screening test with the previous twelve months; and
    (iii) exhibits no signs or symptoms of active tuberculosis disease.
  (2) Upon receipt of documentation from an authorized healthcare provider that the applicant satisfied the provisions contained in subsection (B)(1)(b), the applicant may begin work at the nursing home or residential care facility subject to the following conditions:
   (a) If the documented negative tuberculosis test was a tuberculin skin test, the nursing home or community residential care facility must place and read the second step skin test within the first fourteen days of resident contact.
   (b) No further testing is required if the applicant received a negative blood assay for mycobacterium tuberculosis within three months prior to resident contact, no further testing is required. If the applicant received a negative blood assay for mycobacterium more than three months prior to resident contact, a single tuberculin skin test or single blood assay for mycobacterium tuberculosis can be administered within the first fourteen days of resident contact to serve as the baseline.
 (C) Applicants with a prior positive or newly positive tuberculosis test result or who exhibits symptoms of tuberculosis, including, but not limited to cough, weight loss, night sweats, or fever, shall immediately undergo a chest radiograph to exclude tuberculosis disease. If a physician is unable to exclude tuberculosis disease after the chest radiograph, then the applicant must be excluded from work until he is cleared by the department's tuberculosis control program. The applicant must also be evaluated for treatment of tuberculosis disease or latent tuberculosis infection pursuant to the department's and CDC's guidelines.

SECTION 2. This act takes effect upon approval by the Governor.

Renumber sections to conform.

Amend title to conform.