Current through Register Vol. 56, No. 18, September 16, 2024
(a) The policy and procedure manual shall include
policies and procedures to ensure that physical examinations of staff are performed upon initial employment
and at subsequent intervals. Policies and procedures shall specify the circumstances under which other
persons providing direct client care services shall receive a physical examination. Policies and procedures
shall specify the content and the frequency of the examination.
(b) The program shall require all staff employed as of June 1, 2009, and
all staff hired thereafter, to submit to screening tests for rubella and measles, subject to the following:
1. If an employee can document seropositivity from a previous rubella
screening or inoculation with rubella vaccine, the employee shall not be required to submit to any additional
rubella screening.
2. If an employee cannot provide documentation
required by (b)1 above, the employee shall be given a rubella hemagglutination inhibition test or other
rubella-screening test approved by DOH as equivalent or better, on a case by case basis.
3. Only employees born in 1957 or later shall be required to submit to a
measles screening test.
i. If the employee can document receipt of a live
measles vaccine on or after his or her first birthday, physician diagnosed measles, or serologic evidence of
immunity to measles, the employee shall not be required to submit to a measles screening test.
ii. If the employee cannot provide the documentation required in (b)3i
above, the employee shall submit to a measles hemagglutination inhibition test, or other measles screening
test.
4. All employees hired after June 1, 2009
required to submit to screening tests shall do so upon employment.
5. All employees employed as of June 1, 2009 required to submit to
screening tests shall do so by June 1, 2009.
(c) The
program shall inform each employee of the results of each screening test, record all tests performed and the
results thereof in each employee's personnel record, and maintain a list of all employees who are
seronegative and unvaccinated.
(d) The program shall require all
employees, including medical staff members, to submit to tuberculosis testing using a two-step Mantoux in
accordance with the Tuberculosis Surveillance Procedures for Substance Abuse Treatment Facilities, published
by DMHAS, and incorporated herein by reference as chapter Appendix A.
1.
Employees hired after June 1, 2009 shall be required to submit to Mantoux testing upon employment, while
employees employed as of June 1, 2009 shall submit to the Mantoux test by July 31, 2009, if the employee has
not been tested within the past year.
2. If the Mantoux test
result is negative (less than 10 millimeters of induration or less than five millimeters of induration if
immunosuppressed), the employee shall submit to a repeat Mantoux skin test within three weeks of the initial
test.
3. If either the initial or subsequent test result is
positive (10 or more millimeters of induration, or five millimeters if immunosuppressed), the employee shall
submit to a chest x-ray and be referred for chemoprophylaxis or treatment for tuberculosis, as
appropriate.
4. Employees who can document a negative Mantoux
test within the prior 12 months would only need one Mantoux skin test.
5. The following employees shall not be required to submit to a Mantoux
test:
i. Employees who can document a positive Mantoux skin test (10
millimeters or more of induration or five millimeters or more of induration if immunosuppressed) regardless
of treatment; or
ii. Employees who have received and completed
treatment for tuberculosis disease and latent tuberculosis infection.
6. The Mantoux skin test shall be repeated on an annual basis for all
employees unless contraindicated.
7. All symptomatic employees
shall have a chest x-ray and be medically cleared regardless of the skin test result.
(e) The program shall establish policies and procedures regarding employee
safety and shall include procedures for the care of employees who become ill or who are injured at the
facility.
(f) The program shall establish policies and procedures
that provide for pre-employment drug screening, and shall include the random drug screening of staff
including the screening of staff suspected of substance abuse. The policies and procedures shall address the
program's response to positive drug screening results.
