Menu of Suggested Provisions For State Tuberculosis Prevention and Control Laws
1. Express Legal Authority to Screen
Descriptive Note: Public health officials interrupt transmission of TB by preventing, identifying, and treating persons with TB. TB screening may include screening for latent TB infection, active TB, or both. Broad screening programs are an intervention of the past and scarce TB funds are now appropriately allocated to screening high-risk populations. This section contains examples of provisions that authorize public health officials to screen for TB.
- A health officer may conduct screening programs of populations that are at increased risk of developing tuberculosis or having latent tuberculosis infection and offer treatment as appropriate. Such screening programs may be implemented by a local health officer with the approval of the state chief medical officer. Colo. Rev. Stat. § 25-4-506 (2009).
- Each local health department shall assure the provision of a comprehensive program for the prevention, treatment, and control of tuberculosis. Services shall include: Prevention and screening, with emphasis on screening of high risk populations. Wash. Admin. Code § 246-170-031 (2009).
2. Specific Individuals/Populations to be Screened
Descriptive Note: Workshop participants recommended that this section focus on innovative provisions on TB screening, rather than provisions that run the gamut of high-risk populations that may be screened. The first bullet was drafted by the APHL TB Steering Committee and relates to screening laboratory personnel for latent TB infection. Finally, the provisions below on screening students of postsecondary educational institutions have recently been enacted by the Kansas state legislature. States considering adoption of this type of TB screening law may consider defining “postsecondary educational institution” broadly to include all relevant institutions.
- Laboratory workers conducting tests on clinical specimens suspected to be positive for Mycobacterium tuberculosis complex(MTB) are deemed at risk for exposure to MTB. Accordingly, laboratorians should undergo baseline screening for MTB using the tuberculin skin test, interferon gamma release assay test, or other test for tuberculosis infection approved by the U.S. Food and Drug Administration upon commencement of employment. After baseline testing for MTB, the laboratorian should receive MTB screening annually. Laboratorians who have a baseline positive or newly positive test result for MTB should receive a medical examination, a chest radiograph and other testing as needed to exclude TB disease.
Students of Postsecondary Educational Institutions:
- The [state public health official] is hereby authorized and directed to adopt rules and regulations establishing guidelines for a tuberculosis prevention and control plan for any postsecondary educational institution. The tuberculosis prevention and control plan shall be designed to reduce the risk of tuberculosis transmission and shall be based on the recommendations by the American Thoracic Society, the Centers for Disease Control and Prevention and the Infectious Diseases Society of America. These rules and regulations shall be in compliance with the best practice standards as recommended by the Division of Tuberculosis Elimination of the Centers for Disease Control and Prevention.
- Each postsecondary educational institution shall develop and implement a tuberculosis prevention and control plan with assistance of the department of health and environment. Each postsecondary educational institution shall designate a person who is responsible for the oversight and implementation of the plan. Such person shall maintain the records created or collected in accordance with this section for at least five years and allow the department of health and environment to review and inspect the records upon request.
- The [state public health official] is hereby authorized and directed to adopt rules and regulations establishing tuberculosis evaluation requirements for certain students entering classrooms of a postsecondary educational institutionin [state] who are considered as high risk for tuberculosis as defined by the department of health and environment. These rules and regulations shall establish evaluation criteria in compliance with best practice standards as recommended by the Division of Tuberculosis Elimination of the Centers for Disease Control and Prevention.
- Each postsecondary educational institution shall develop and implement tuberculosis evaluation requirements with assistance of the department of health and environment. Each postsecondary educational institution shall designate a person who is responsible for the oversight and implementation of the requirements. Such person shall maintain the record for at least five years and the department of health and environment shall have the right to review and inspect the records upon request. Such person shall report immediately the positive findings of tuberculosis infection or disease to the department of health and environment.
- Each student entering classrooms of a postsecondary educational institution in [state] shall comply with the tuberculosis evaluation requirements implemented by such institution where the student is enrolled by providing requested information in accordance with a screening and evaluation through an enrollment process. Any student who is not in compliance with the requirements shall not be attending classes or eligible to enroll for a subsequent semester or term or to obtain an official academic transcript or diploma until the student is compliant with the requirements.
- Nothing in this section and section 1, and amendments thereto, shall be construed as applying to individuals who are not attending the classes regularly but participating in the continuing education programs or any other seminar or function at the postsecondary educational institution.
- ‘‘Postsecondary educational institution’’ used in this section and section 1, and amendments thereto, means any public or private university, municipal university, community college or technical college.
- All costs associated with the evaluation requirements of the prevention and control plan shall be the responsibility of the student.
- Any person found to be infected with tuberculosis infection or tuberculosis disease will be provided treatment and ongoing monitoring in accordance with [state TB prevention and control laws]. Kan. Stat. Ann. § 65-129e (2010).