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Oregon Bulletin

January 1, 2012

 

Oregon Health Authority,
Public Health Division
Chapter 333

Rule Caption: Requires correctional facilities to test inmates with risk factors for tuberculosis when incarcerated 15 days.

Adm. Order No.: PH 12-2011

Filed with Sec. of State: 12-14-2011

Certified to be Effective: 12-14-11

Notice Publication Date: 11-1-2011

Rules Adopted: 333-019-0042

Rules Amended: 333-019-0041

Subject: The Oregon Health Authority, Public Health Division is permanently adopting and amending rules in chapter 333, division 19 related to tuberculosis (TB) screening. OAR 333-019-0042 is being adopted to replace subsection (2)(a) of OAR 333-019-0041, which requires correctional facilities to follow inmate TB screening recommendations as outlined in the Centers for Disease Control Guideline “Prevention and Control of Tuberculosis in Correctional Facilities: Recommendations from the CDC”. The proposed rule provides specific guidance that inmates should be screened for symptoms of TB disease at intake and tested for latent TB infection if TB risk factors are present at 15 days of consecutive incarceration. This rule change is being made to provide correctional facilities with
better clarity as to when TB screening should take place and which populations need TB screening.

Rules Coordinator: Brittany Sande—(971) 673-1291

333-019-0041

Tuberculosis

(1) Each health care facility shall formally assess the risk of tuberculosis transmission among staff (professional and volunteer), residents, and patients at least annually and shall follow tuberculosis screening recommendations outlined in “Guidelines for preventing the transmission of Mycobacterium tuberculosis in Health-Care Settings,” published by the Centers for Disease Control and Prevention (Morbidity and Mortality Weekly Report, Vol. 54, Number RR-17: 1-141; December 30, 2005) or otherwise approved by the Authority. For the purposes of this rule “health care facility” has the meaning given that term in ORS 442.015.

(2) Each facility specified below shall formally assess the risk of tuberculosis transmission among staff (professional and volunteer), residents, and patients at least annually and shall follow appropriate tuberculosis screening recommendations as outlined in the relevant publication or as otherwise approved by the Authority:

(a) Long Term Care Facilities for the Elderly: “Prevention and control of tuberculosis in facilities providing long-term care to the elderly. Recommendations of the Advisory Committee for Elimination of Tuberculosis,” published by the Centers for Disease Control and Prevention (Morbidity and Mortality Weekly Report, Vol. 39, RR-10, pp. 7-20; July 13, 1990) and “Guidelines for preventing the transmission of Mycobacterium tuberculosis in Health-Care Settings,” published by the Centers for Disease Control and Prevention (Morbidity and Mortality Weekly Report, Vol. 54, Number RR-17: 1-141; December 30, 2005).

(b) Homeless Shelters: “Prevention and control of tuberculosis among homeless persons,” published by the Centers for Disease Control and Prevention (Morbidity and Mortality Weekly Report, Vol. 41, RR-5, pp. 13-23; April 17, 1992)

[Publications: Publications referenced are available from the agency.]

Stat. Auth.: ORS 431.110, 432.060, 433.001–433.035, 433.110–433.220 & 437.030

Stats. Implemented: ORS 431.150, 431.155, 431.170, 433.001–433.035, 433.110–433.220 & 437.030

Hist.: OHD 4-2002, f. & cert. ef. 3-4-02; PH 10-2005, f. 6-15-05, cert. ef. 6-21-05; PH 9-2009, f. & cert. ef. 9-22-09; PH 7-2011, f. & cert. ef. 8-19-11; PH 12-2011, f. & cert. ef. 12-14-11

333-019-0042

Tuberculosis Screening in Correctional Facilities

(1) For purposes of this rule:

(a) “Correctional facility” means a facility operated by the Oregon Department of Corrections or a local correctional facility as that is defined in ORS 169.005; and

(b) “Symptoms of TB disease” means a cough longer than 3 weeks and/or coughing up blood in conjunction with fever, fatigue, night sweats or weight loss.

(2) A correctional facility shall screen all inmates upon admission for symptoms of tuberculosis (TB) disease. This screening and any follow-up shall be documented.

(3) Any inmate suspected of having TB disease or who has TB disease shall be isolated as appropriate and provided medical care and treatment that meets accepted standards of practice.

(4) Inmates detained or confined for 15 consecutive days or more in a correctional facility shall be screened for the following TB risk factors:

(a) HIV/AIDS;

(b) Immigration within the past five years from a country that has a high incidence of TB, including but not limited to immigration from Africa, Asia, Middle East, Latin America, Eastern Europe and South Pacific regions;

(c) Close contact to a person with infectious TB disease;

(d) History of injection drug use;

(e) History of homelessness; and

(f) Taking immunosuppressive medication.

(5) Inmates screened under section (4) of this rule who have TB risk factors and no documented history of prior positive screening tests for TB shall be screened with either a TB skin test or interferon gamma release assay (IGRA). Inmates with a documented previously positive TB skin test or IGRA, or a new positive result upon testing, shall receive a chest X-ray.

(6) Exceptions:

(a) A correctional facility is not required to retest an inmate at each admission under section (5) of this rule if:

(A) There is a documented record of a negative TB skin test or negative IGRA or normal chest X-ray within the past year; or

(B) There is a documented record of adequate TB treatment or compliance with a currently prescribed TB treatment.

(b) This exception does not apply if the inmate has symptoms of TB, evidence of new exposure to a person with infectious TB disease or a diagnosis of HIV/AIDS.

(7) Nothing in these rules prohibit any correctional facility from having more stringent TB screening requirements.

Stat. Auth.: ORS 431.110, 432.060, 433.001–433.035, 433.110–433.220 & 437.030

Stats. Implemented: ORS 431.150, 431.155, 431.170, 433.001–433.035, 433.110–433.220 & 437.030

Hist.: PH 12-2011, f. & cert. ef. 12-14-11

Notes
1.) This online version of the OREGON BULLETIN is provided for convenience of reference and enhanced access. The official, record copy of this publication is contained in the original Administrative Orders and Rulemaking Notices filed with the Secretary of State, Archives Division. Discrepancies, if any, are satisfied in favor of the original versions. Use the OAR Revision Cumulative Index found in the Oregon Bulletin to access a numerical list of rulemaking actions after November 15, 2011.

2.) Copyright 2012 Oregon Secretary of State: Terms and Conditions of Use

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