DBB(EXHIBIT) - EMPLOYMENT REQUIREMENTS AND RESTRICTIONS: MEDICAL EXAMINATIONS AND COMMUNICABLE DISEASES

See the following pages for exhibits regarding:

EXHIBIT A

KATY INDEPENDENT SCHOOL DISTRICT

HIV INFECTION EMPLOYEE FORM FOR EMPLOYEES

Iam the employee/guardian/person legally authorized to consent to medical care for (Employee's name)

I authorize the medical professional assigned to: (Campus/Department)

in the Katy Independent School District, to release the information that the employee named above has HIV infection to the following person(s) or classification of person(s):

This release of information to the above-named person(s) or classification of person(s) is in effect until I revoke it.

Signature of Authorized Person:

Date:

EXHIBIT B

KATY INDEPENDENT SCHOOL DISTRICT

STATEMENT OF CONFIDENTIALITY ON HIV INFECTION

I, (Employee's Name),

have received confidential information on (Employee's Name),

who has HIV infection.

I understand this information is strictly confidential and protected by the Texas Health and Safety Code 81.103. An offense under this subsection is a Class A misdemeanor.

Employee's Signature (who is receiving the information)

Date

Section 81.103, Health and Safety Code, makes an HIV test result confidential and prohibits the release of the "test result" by a person who possesses or has knowledge of the results except in a limited number of instances to the health authority as required in other sections of the Act, to the physician who ordered the test, to health care personnel who have a legitimate need to know in order to care for a patient, to the spouse of a person who tests positive, to the person tested, and in certain other limited instances. Violation is a Class A misdemeanor (up to one year in jail or a fine of $1,000 or both).

Section 81.104, Health and Safety Code, provides for Civil penalties against anyone who releases "test results" in violation of Section 81.103. If disclosed by negligence, the person is liable for actual damages, a civil penalty of $1,000, and court costs and reasonable attorney's fees. The civil penalty may be increased $5,000 where the disclosure was willful.

Katy ISD

DBB(EXHIBIT)-X

LDU-20-00

DATE ISSUED: 5/15/2000