Oregon Bulletin
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.
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