South Carolina Code of Regulations
Chapter 61 - DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL
Subchapter 61-122 - Standards for Licensing In-Home Care Providers
Appendix - ANNUAL TUBERCULOSIS RISK ASSESSMENT

Provider TB Risk Classification

Low Risk Setting

Less than 3 TB cases/year (see Part A)

AND

No risk factors are present (See Part B)

Low Risk TB Screening

Baseline two step TST or single BAMT upon hire or contract/eligible for referral and prior to client contact.

* If TST is positive or employee or caregiver is symptomatic, obtain chest X-ray and refer to Health Department for a symptom assessment and medical evaluation.

* NO ANNUAL TST or BAMT required.

* Perform/obtain annual symptom assessment if documented prior positive TST or has documentation of prior active TB disease.

* Persons identified as a contact to an infectious case and having unprotected exposure will be evaluated in accordance with the Health Department's contact investigation policies and procedures.

Medium Risk Setting

3 or more TB cases/year (see Part A)

OR

Other risk factors apply (see Part B)

Medium Risk TB Screening

* Baseline two step TST or single BAMT upon hire contract/eligible for referral and prior to client contact.

* If TST is positive or employee or caregiver is symptomatic, obtain chest X-ray and refer to Health Department for a symptom assessment and medical evaluation.

* Perform/obtain ANNUAL TB screening test (TST, BAMT or symptom assessment) for each employee and caregiver.

* Perform/obtain annual symptom assessment if documented prior positive TST or has documentation of prior active TB disease treatment.

* Persons identified as contact to an infectious case and having unprotected exposure will be evaluated in accordance with the Health Department's investigation policies and procedures.

Potential Ongoing Transmission Setting

Evidence of ongoing M. tuberculosis transmission

This is a temporary classification only, warranting immediate investigation. After the ongoing transmission has ceased, the setting will be reassessed for classification.

Potential Ongoing Transmission TB Screening

* Report to local health department immediately.

* Persons identified as a contact to an infectious case and having unprotected exposure will be evaluated in accordance with the Health Department's contact investigation policies and procedures.

* Baseline two-step TST for TB or single BAMT for any new hire or any caregiver newly contracted or newly eligible for referral and prior to client contact while in this category.

* Consult and coordinate with the Health Department for guidance as to when transmission has ceased and a new risk assessment can be completed.

Employee & Client TST Situation

Recommended TST Testing

1. No previous TST or BAMT result.

1. Two-step baseline TST or single BAMT completed upon hire or contract/eligible for referral and prior to client contact.

2. Previous negative TST or BAMT result > 12 months before new employment or contract/eligible for referral.

2. Two-step baseline TST or single BAMT completed upon hire or contract/eligible for referral and prior to client contact.

3. a. Previous documented negative TST result within 12 months before employment or contract/eligible for referral. b. Previous documented negative BAMT.

3. a. Single TST needed for baseline testing; this will be the second step.

b. Single BAMT needed.

4. Previous documented positive TST result in millimeters.

4. No TST or BAMT; need TB symptom assessment.

5. Undocumented history of prior positive TST result.

5. Two-step baseline or single BAMT upon hire or contract/eligible for referral and prior to client contact.