AGING AND DISABILITY SERVICES ADMINISTRATION

 

November 1, 2001

 

AASA:? AFH #2001-024
Tuberculosis Screening

 

Dear Adult Family Home Provider:

The purpose of this letter is to clarify the requirements for tuberculosis (TB) screening for AFH employees and ensure that the screening requirements are applied consistently across Residential Care Services (RCS) programs.? ??????????????

Information about TB screening and infection

The purpose of TB skin testing is to identify persons who may have TB disease.? However, a positive TB skin test does not mean that a person definitely has TB disease.? Many persons with a positive skin test are simply infected with TB germs, or have been exposed to TB germs, but do not have any active disease.? A positive TB skin test needs to be followed by other tests, such as chest x-ray, to determine whether a person has active disease.?

Who Sets the Standards and Guidelines for TB Screening?

RCS looks to the Washington State Department of Health (DOH), TB Control Program, for guidance on TB standards and also consults with the Department of Labor and Industries (L&I) to make sure that our regulations are consistent with the Washington Industrial Safety & Health Act (WISHA).?

AFH Rules for TB Screening

The AFH rule for TB screening of employees is WAC 388-76-680(3) and (3)(b) states:

?The individual provider, entity representative, resident manager and caregiver must have, upon employment, tuberculosis skin testing to establish tuberculosis status.??

After consultation with DOH and L&I we have determined that a reasonable interpretation of ?upon employment?, is that TB skin testing must be initiated within 3 days of employment.? Beginning with the date of this letter, licensors will be use ?within 3 days? as the standard for when you must initiate TB screening for your new employees.? In the future, we will amend our rules and use the ?within 3 days? language.?

Using the ?within 3 days? standard to initiate TB screening of new employees should not place residents or other staff at greater risk of contracting tuberculosis because generally, infection with TB requires extended periods of close contact for at least several hours per day over the course of a few weeks.? However, to ensure the health and safety of your residents, it is very important that you follow WAC 388-76-680(3)(f) carefully regarding follow-up on any positive TB tests.? We remind you that your local health department is one place where your staff can go to have their TB tests given, read, and followed up if follow up is necessary.?

If you have questions about the information in this letter, please contact your field manager.

Sincerely,

Patricia K. Lashway, Director
Residential Care Services