La. Admin. Code tit. 51 § II-503

Current through Register Vol. 50, No. 11, November 20, 2024

Section II-503 - Mandatory Tuberculosis Testing

A. [formerly paragraph 2:022] All persons, including employees, students or volunteers, having no history of latent tuberculosis infection or tuberculosis disease, prior to or at the time of employment, beginning clinical rotations in the healthcare profession, or volunteering at any hospital or nursing home (as defined in Parts XIX and XX of the Sanitary Code, respectively, herein, and including intermediate care facilities for the developmentally disabled) requiring licensing by the Louisiana Department of Health or at any Louisiana Department of Health, Office of Public Health (LDH-OPH) parish health unit or an LDH-OPH outpatient health care facility, whose duties include direct patient care, shall be free of tuberculosis in a communicable state as evidenced by either:

1. a negative purified protein derivative skin test for tuberculosis, 5 tuberculin unit strength, given by the Mantoux method or a blood assay for Mycobacterium tuberculosis approved by the United States Food and Drug Administration;

2. a normal chest X-ray, if the skin test or a blood assay for Mycobacterium tuberculosis approved by the United States Food and Drug Administration is positive; or

3. a statement from a licensed physician certifying that the individual is non-infectious if the X-ray is other than normal. The individual shall not be denied access to work solely on the basis of being infected with tuberculosis, provided the infection is not communicable.

B. [formerly paragraph 2:023] Any employee, student or volunteer at any medical or 24-hour residential facility requiring licensing by the Louisiana Department of Health or at any LDH-OPH parish health unit or an LDH-OPH outpatient health care facility who has a positive purified protein derivative skin test for tuberculosis, 5 tuberculin unit strength, given by the Mantoux method, or a positive blood assay for Mycobacterium tuberculosis approved by the United States Food and Drug Administration; or a chest X-ray other than normal, in order to remain employed, remain in clinical rotations, or continue work as a volunteer, shall complete an adequate course of medical treatment for tuberculosis as prescribed by a Louisiana licensed physician, or shall present a signed statement from a Louisiana licensed physician stating that medical treatment for tuberculosis is not indicated.

C. [formerly paragraph 2:024] All persons with a history of latent tuberculosis infection or tuberculosis disease prior to or at the time of employment, including employment as a student in clinical rotations, or volunteering at any medical or 24-hour residential facility requiring licensing by the LDH, at any hospital or nursing home (as defined in Parts XIX and XX of the Sanitary Code, respectively, herein, and including intermediate care facilities for the developmentally disabled) requiring licensing by the LDH, at any LDH-OPH parish health unit, or at any LDH-OPH out-patient health care facility, whose duties include direct patient care, must present a statement from a Louisiana licensed physician that he or she has been satisfactorily treated for tuberculosis and is non-infectious or, for persons with a history of untreated latent tuberculosis infection, a statement that he or she is non-infectious.

1. Further, for persons with a history of untreated latent tuberculosis infection an annual symptom screen shall be done, including, but not limited to, the following questions.

a. Do you have a productive cough that has lasted at least 3 weeks? (Yes or No)

b. Are you coughing up blood (hemoptysis)? (Yes or No)

c. Have you had unexplained weight loss recently? (Yes or No)

d. Have you had fever, chills, or night sweats for 3 or more days? (Yes or No)

2. Any employee, student, or volunteer with a history of untreated latent tuberculosis infection giving a positive response to any one of the questions under Paragraph 1 of this Subsection shall be referred to a physician for medical evaluation as soon as possible.

3. All initial screening test results and all follow-up screening test results shall be kept in each employee's, student's, or volunteer's health record or facility's personnel record.

D. Annually, but no sooner than 6 months since last receiving tuberculosis educational information (more fully described at the end of this sentence) or symptom screening, all employees, students in the healthcare professions, or volunteers at any medical or 24-hour residential facility requiring licensing by LDH or at any hospital or nursing home (as defined in Parts XIX and XX of the Sanitary Code, respectively, herein, and including intermediate care facilities for the developmentally disabled) requiring licensing by the LDH or at any LDH-OPH parish health unit or and LDH-OPH out-patient health care facility shall receive, at a minimum, educational information explaining the health concerns, signs, symptoms, and risks of tuberculosis.

E. [formerly paragraph 2:033] All persons with acquired immunodeficiency syndrome (AIDS) or known to be infected with the human immunodeficiency virus (HIV), in the process of receiving medical treatment related to such condition, shall be screened for tuberculosis, with screening to include a chest X-ray. Sputum smear and culture shall be done if the chest X-ray is abnormal or if the patient exhibits symptoms of tuberculosis disease. Screening for tuberculosis shall be repeated as medically indicated.

La. Admin. Code tit. 51, § II-503

Promulgated by the Department of Health and Hospitals, Office of Public Health, LR 28:1220 (June 2002), amended LR 32:98 (January 2006), LR 33:93 (January 2007), LR 37:598 (February 2011), LR 401942 (10/1/2014), Amended by the Department of Health, Office of Public Health, LR 47744 (6/1/2021).

AUTHORITY NOTE: Promulgated in accordance with the provisions of R.S. 40:4(A)(2) and R.S. 40:5.