Situation Report | December 21, 2020
In case you missed it (ICYMI) in our member alert last week, the state Department of Health (DOH) has finalized an HCA-supported rule (see page 26) easing tuberculosis (TB) testing requirements.
The now-final rule changes the annual TB testing requirement with an annual assessment that includes education, individual risk assessment, and follow-up tests as indicated.
The rule change is accompanied by a Dear Administrator Letter (DAL) updating the requirements for baseline and annual TB assessments of home care, hospice, and other health care personnel.
The changes are effective December 16, 2020.
HCA submitted comments and separately urged DOH to finalize this rule, which was delayed by the COVID-19 pandemic.
This change should be helpful for home care and hospice agencies who have encountered difficulties in meeting the requirement that their aides receive an annual health assessment, including a TB test, by December 31, 2020, now that the annual test is no longer required unless the risk assessment indicates otherwise.
DOH had previously suspended this health assessment requirement in its regulatory changes for the public health emergency but then reinstated it in a November 23 DAL. That DAL also stated that an RN may complete the health assessment subject to certain policies and procedures and a finding that the RN “is qualified to carry out the assessment process.”
In its most recent DAL, the Department states that an individual risk assessment is the primary screening tool (for TB), with repeat testing (by tuberculin skin test or interferon-gamma release assay blood test) only when indicated. Any diagnosis of TB should be followed up with appropriate clinical referral and documentation of treatment, including completion of treatment for latent TB infection.
Please read the DAL closely for additional information and guidance.
Note that pre-employment health assessments for all personnel, including an initial individual TB risk assessment, symptom evaluation, and TB test screening, is still required.
Also, please note that the annual health assessment is still suspended for Consumer Directed Personal Assistance Program (CDPAP) personal assistants. This suspension was included in an April 8, 2020 DOH guidance.
Questions about TB testing can be directed to the state’s Bureau of Tuberculosis Control at email@example.com.