Regulations for TB Control in Minnesota Health Care Settings - Minnesota Dept. of Health

Regulations for TB Control in Minnesota Health Care Settings

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Many health care settings that are state-licensed or are federally-certified in Minnesota have specific state and/or federal TB prevention and control requirements. In addition, all health care settings in Minnesota must follow the requirements of the Minnesota Occupational Safety & Health Administration (MN-OSHA). Occupational safety and health standards are under Minnesota Statute 182.655. (Subdivision 10a details protective equipment, monitoring exposure levels, and medical exams).

Effective June 10, 2019:

  • MDH no longer uses a Minnesota-specific algorithm to determine setting TB risk level.
  • Settings licensed by MDH will no longer be required to do annual TB screenings of health care personnel to remain in regulatory compliance with MDH, regardless of facility TB risk classification.

This is in accordance with new guidance:

Much of the new guidance remains unchanged compared with the previous CDC recommendations from 2005.

Important new changes and caveats to these changes include the following:

  • Discontinue serial (e.g. annual) screening and testing of TB infection after the baseline screening for most health care personnel.
    • Consider continuing serial TB screenings for personnel at increased occupational risk of TB exposure. These groups include, but are not limited to:
      • Pulmonologists or respiratory therapists.
      • Settings in which there is ongoing exposure to Mycobacterium tuberculosis complex, such as TB clinics or laboratories.
      • Settings in which screening requirements are outlined by state statute, such as correctional facilities.
      • Settings where there was evidence of transmission (either in staff, volunteers, residents, or guests) that occurred in the past, such as emergency departments, homeless shelters, home care agencies, nursing homes, and hospices.
    • Post-exposure screening and testing is still required whenever health care personnel have had known exposure to a person with potentially infectious TB disease without the use of adequate personal protection.
  • Conduct a new baseline (preplacement) individual TB risk assessment to accompany previously required baseline TB screening test (for those without documented prior TB disease or latent TB infection) and TB symptom assessment.
    • The new risk assessment assists in test interpretation.
  • A new emphasis on TB exposure risks (both inside and outside of health care facilities), and symptoms of TB as part of previously required annual TB education for all health care personnel.
    • Personnel who feel they may have had an occupational or nonoccupational exposure to TB following their baseline screening should be encouraged to discuss possible exposures with their primary care provider or occupational health clinician.
  • A new strong recommendation to treat all health care personnel with untreated latent TB infection unless medically contraindicated.

Manual

This manual is in the process of being updated to reflect changes to the recommendations. Most notably, annual screenings for medium-risk settings are no longer required. (June 2019)

Resources

Chapter One - Background

  • Minnesota OSHA's Enforcement Policy and Procedures for Occupational Exposure to Tuberculosis is not currently available online. Contact osha.compliance@state.mn.us or 651-284-5050 with questions about MN-OSHA's TB requirements and to obtain a copy of the document.

Chapter Two - Infection Control Program

  • Fundamentals of TB Infection Control, CDC (PDF)
    Description of the three-level hierarchy of TB infection control. Pages 6 – 7 of Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005 (CDC).

Chapter Three - Screening Health Care Workers

Chapter Four - Screening Residents

Updated Wednesday, 12-Jun-2019 15:17:07 CDT