Priority activities for State X's TB Control Program include
- identifying and treating cases of active TB disease,
- identifying, testing, and applying preventive treatment for the contacts of active cases, and
- conducting screenings among groups that are at high risk.
TB-control staff is also involved in public education efforts to inform health-care providers, public officials and the general public about TB.
The TB Control Program operates at the county, health district, and state levels
- County health departments are the direct providers of TB services. Eighteen full-time nurses (17 RNs and 1 LPN) as well as a number of part-time RNs and LPNs are employed directly by the program.
Other nursing positions are funded directly by districts and counties. In some counties, nurses responsible for TB-control are also responsible for other disease-control activities (e.g., HIV and STDs).
- The district level structure is responsible for overseeing and coordinating the work of the counties in all matters related to disease control. This level includes a health director, a physician, a nursing administrator, an administrator, professional office directors (health education, social work, and nutrition), and county supervisors.
- At the state level, the program operates within the parameters listed below.
- The program's central office provides consultation, training, and funding, and develops policies and procedures.
- Nurses, assisted by administrative staff, manage the program.
- A physician has been contracted on a part-time basis to supervise state-level activities.
At all levels, TB-control staff members spend a substantial amount of time in the field. Certain staff rely on fleet vehicles for transportation, but many use their personal vehicles and are reimbursed for mileage. Because of liability issues, the program does not directly provide transportation to clients. Medicaid-eligible patients can use Medicaid transportation. Funds from the Lung Association are also used to reimburse qualified patients for their transportation costs.
Basic items and standard medical equipment and supplies necessary to provide TB services are listed in the table below.
||Standard Medical Equipment
||Disposable surgical masks
|PPD antigen (for skin testing)
|Rulers (to measure the size of skin reactions)
||Latex and vinyl gloves
|Sputum collection/mailing kits
|Hypertonic saline for sputum induction
|Sputum induction machines and nebulizers (one per district)
||1 weight scale
|Tissues and paper bags for sputum disposal
||1 sphygmomanometer and stethoscope
||Skin preparation solutions
|Visual acuity charts
Diagnosis and clinical laboratory services are provided by the state's public health laboratories, or if necessary, by CDC or the National Jewish Medical and Research Center in Colorado.
To facilitate access to services for non-English speaking patients, a contract for translation services has been signed with the state university. A hotline is also available for persons who speak Spanish and for disabled patients. In some counties, programs rely on the foreign language skills of staff members to communicate with patients, or the programs have developed relationships with local ethnic organizations that help with translating.
All services, including drug treatment for active TB disease and for latent TB infection, are provided to patients free-of-charge. The program does not bill any third-party payers.