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DOH Issues Guidance and FAQ Regarding Annual TB Testing for Home Care

The Department of Health (DOH) recently issued Dear Administrator Letter (DAL) DHCBS 21-03 and related Frequently Asked Questions (FAQ) clarifying the Dec. 16, 2020 guidance and new regulations regarding annual tuberculosis (TB) testing for health care employees. This DAL and FAQ are intended for Certified Home Health Agencies (CHHAs), Long Term Home Health Care Programs (LTHHCPs), AIDS home care programs, Hospices, and Licensed Home Care Services Agencies (LHCSAs). The regulations, though not this guidance, also apply to hospitals, nursing homes, and assisted living residences. Currently, the Department is working to revise the regulations to include personnel of adult care facilities (ACFs) and assisted living programs, which were inadvertently omitted from the adopted regulations.

On Dec. 16th, the Department adopted regulatory changes to 10 NYCRR 763.13, 766.11, and 794.3 (among other regulatory sections) and issued DAL DHCBS 20-14, “Annual TB Testing,” announcing the changes in requirements for pre-employment TB testing and annual TB assessments of health care personnel in a variety of health care settings. The regulations and guidance are here.

The DAL outlines the updates to the requirements for pre-employment TB testing and annual TB assessment and advises that current, active employees are no longer required to have an annual tuberculin skin test (TST) or interferon-gamma release assay (IGRA) blood test, unless medically indicated, but must be screened by a Registered Nurse (RN) annually through an individual risk assessment.

The guidance reminds providers that policies and procedures must be updated, TB annual assessments must be in place for current personnel when their annual health assessments become due, and staff education regarding TB is required.

The regulatory amendments and related guidance became effective on Dec. 16, 2020, and health care providers are expected to implement these regulatory changes as soon as practicable and to have annual TB assessments in place for current personnel as annual health assessments become due based on the personnel’s date of hire. DOH urges agencies to not delay in the creation of new policies and procedures to comply with the guidance and will cite providers if appropriate.

The FAQ should be carefully reviewed. Unfortunately, it does not address the inquiries LeadingAge New York submitted regarding how this change impacts the assisted living progrm (ALP), as the ALP is comprised of a home care agency and adult care facility.  Many topics are addressed, including: overview of risk assessment, inclusion of risk assessment in the annual health assessment, licensed practitioners authorized to perform testing, screening and education, clarification regarding testing requirements, remote screenings, and guidance regarding TB testing and COVID-19 vaccination.

Questions related to TB testing should be directed to tbcontrol@health.ny.gov; other questions should be addressed to homecare@health.ny.gov.

Contact: Meg Everett, meverett@leadingageny.org, 518-929-9342