Illinois Administrative Code
Title 77 - PUBLIC HEALTH
Part 2060 - ALCOHOLISM AND SUBSTANCE ABUSE TREATMENT AND INTERVENTION LICENSES
Subpart D - REQUIREMENTS - TREATMENT LICENSES
Section 2060.415 - Infectious Disease Control
Universal Citation: 77 IL Admin Code ยง 2060.415
Current through Register Vol. 48, No. 12, March 22, 2024
a) Licensees shall be in compliance with:
1)
guidelines issued by the U.S. Centers for Disease Control and Prevention in
"Recommendations for Prevention of HIV Transmission in Health Care Settings":
and "Update: Universal Precautions for Prevention of Transmission of Human
Immunodeficiency Virus, Hepatitis B Virus, and other Bloodborne Pathogens in
Healthcare Settings", both known as "Universal Precautions"; and
2) the U.S. Department of Labor rules for
Occupational Exposure to Bloodborne Pathogens, 29 CRF
1910.1030(2000).
b) Tuberculosis Control and Services
1) Any
organization providing treatment services shall have its medical director or
other designated staff be responsible for developing, reviewing annually and
evaluating the effectiveness of a tuberculosis infection control plan based on
a tuberculosis risk assessment of the facility following the protocol for
conducting a tuberculosis (TB) risk assessment in a health care facility in
"Guidelines for Preventing the Transmission of Mycobacterium Tuberculosis in
Health Care Facilities", referred to as CDC Tuberculosis Guidelines, which
should, at a minimum, include:
A) a medical
screening of each patient for infectious, communicable tuberculosis as required
in Section
2060.413(b)
of this Part;
B) identification of
patients at increased risk of being infected with tuberculosis, using a
standardized screening tool, and provision of tuberculosis services, either
directly or through referral with other public, nonprofit or private
entities;
C) procedures for the
immediate reporting of patients with, or suspected of having, active,
infectious tuberculosis to the local tuberculosis control agency and a process
for isolation of such patients from the general population until the patient is
determined to be non-infectious. Provisions shall be made for respiratory
isolation (by linkage with other health care providers and the local
tuberculosis control agency) for substance abuse treatment if and when possible
and appropriate;
D) procedures for
providing prompt and appropriate curative therapy directly by the organization
or by referral. Such medical care provided shall be consistent with standards
specified by the Centers for Disease Control and Prevention, Treatment of
Tuberculosis and Tuberculosis Infection in Adults and Children (American
Thoracic Society, Medical Society of the American Lung Association and U.S.
Department of Health and Human Services). Am. J. Respir. Crit. Care Med. vol.
149, pp. 1359-1374, 1994 (no later amendments or editions included);
E) procedures (by way of linkage with other
health care providers and with the local health department) for isolation of
patients who may have active infectious tuberculosis;
F) procedures for lessening the risk of
environmental transmission within the facility; and
G) procedures for meeting State reporting
requirements while adhering to confidentiality requirements specified in
Section
2060.319
of this Part and in 42 CFR 2.
2) Employee Skin Testing and Management
A) All staff shall have a tuberculin skin
test using the Mantoux method (5TU, PPD) when hired, annually and as indicated
in the CDC Tuberculosis Guidelines (or authentic documentation of a skin test
within the past three months, or of completion of previous medical treatment of
the disease, or of preventive therapy). The test shall be read within 48 to 72
hours by personnel trained in accordance with guidance from the local
tuberculosis agency.
B) The
organization shall establish procedures requiring medical evaluation for
personnel with positive skin tests or with signs and symptoms of active
tuberculosis disease; requiring preventive therapy for personnel with
tuberculosis infection, unless medically contraindicated; and requiring leave
and/or restriction from the patient population as necessary in cases of active
infectious tuberculosis.
C) Staff
who have an initial negative skin test result but who have not had a documented
negative skin test result during the 12 preceding months shall be retested
using the Mantoux method within one to three weeks after the initial test. If
the second test is positive, the person should be considered previously
infected.
D) Staff with negative
tests shall be retested at least every 12 months and upon a known or suspected
exposure to tuberculosis.
E) The
organization shall document and have available for review by the Department the
results of all staff tuberculin testing.
3) Patient Skin Testing and Management
A) The medical director of any organization
providing treatment services shall develop a tuberculosis skin testing policy
and procedure based on the tuberculosis risk assessment and tuberculosis
infection control plan required in subsection (b)(1) of this Section.
B) Patient Testing
i) Each organization providing inpatient
services (except for residential extended care) and/or providing opioid
maintenance therapy shall either directly or through arrangements with other
public, nonprofit or private entities, provide each patient with medical
tuberculosis screening services including at a minimum a PPD skin test (5TU,
PPD), placed within seven calendar days after admission and read within 48 to
72 hours after placement by personnel trained in accordance with guidance from
the local tuberculosis agency. If a patient is known to be immunosuppressed, a
chest x-ray, energy battery, sputum smear and/or sputum culture/sensitivity
study for tuberculosis may be used instead of a PPD skin test.
ii) Patients with prior positive skin tests
or diagnoses who have not completed treatment or prevention therapy shall be
medically evaluated for symptoms of infectious tuberculosis.
C) The result of the Mantoux skin
test in mm of induration, the date given and the date read shall be recorded in
the patient's medical file.
D)
Patients who have a positive reaction of 5 mm or more to the skin test or who
have signs and symptoms compatible with tuberculosis disease shall be medically
evaluated for tuberculosis or shall be referred for such evaluation. Admission
of patients with symptoms of active tuberculosis may be delayed until there is
adequate documentation that the person is not infectious.
E) Organizations shall follow the CDC
Tuberculosis Guidelines regarding appropriate testing after the initial test
(i.e., in determining appropriate retesting, the need for anergy testing,
testing required upon exposure and additional considerations for interpreting
test results). Patients with negative reactions to the initial tuberculin test
shall be retested using the Mantoux method (5TU PPD) at least annually or after
any known exposure to infectious tuberculosis.
F) Procedures shall be established for
providing prompt and appropriate curative and preventive therapy directly by
the organization or by referral. Medical care provided shall be consistent with
the CDC's Treatment of Tuberculosis and Tuberculosis Infection in Adults and
Children.
4) Facility
Environment-Transmission Prevention
A) An
organization that provides respiratory isolation at a facility shall assure
that it has consulted engineers or other professionals with expertise in
ventilation engineering to ensure that its facility ventilation systems meet
applicable federal, State and local standards.
B) Persons with suspected or known infectious
tuberculosis shall not be allowed to enter living or work areas of a treatment
facility. The process for handling persons prior to and while screening for
infectious tuberculosis shall be done as to avoid environmental exposure to
other patients and staff.
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