105 CMR 365.200 - Case Management
(A) Case management
for tuberculosis is defined as the coordination of the medical, nursing,
outreach, adherence support, and social service systems that will ensure that
all persons with confirmed and clinically suspected tuberculosis are started on
appropriate therapy, and that all persons with confirmed tuberculosis complete
an appropriate and effective course of treatment.
(B)
(1) All
persons with confirmed or clinically suspected tuberculosis shall have a nurse
case manager designated by the local board of health who will work in
consultation and cooperation with the Tuberculosis Program, as necessary. This
case management is required regardless of the source of health care (public or
private) and the ability to pay for the services or medications. The
Tuberculosis Program shall assign Tuberculosis Surveillance Nurses and
epidemiologists, as necessary, to work cooperatively and in consultation with
local board of health authorities and the nurse case manager designated by the
local board of health, to ensure that a case management system is in place for
every confirmed or clinically suspected case of tuberculosis.
(2) In consultation with the treating health
care provider, the nurse case manager, designated by the local board of health,
determines that a medical treatment plan is in place and is in accordance with
the current American Thoracic Society (ATS), CDC, and the Infectious Disease
Society of America (IDSA) treatment standards.
(3) The initial case assessment and contact
investigation by the local board of health shall begin within three working
days of notification of a potential case of infectious tuberculosis. Contacts
to the case shall be identified and categorized for their risk of tuberculosis
infection as determined by their level of exposure and the person's potential
for infectiousness. Contacts shall be investigated according to current ATS,
CDC, and the IDSA standards and the policies of the Tuberculosis Program.
Contact investigation reports shall be prepared and updated in accordance with
the Tuberculosis Program policies and procedures.
(4) An individualized nursing care plan shall
be developed by the nurse case manager designated by the board of health to
advance the individual needs of the person who has confirmed or clinically
suspected tuberculosis. The nursing care plan content, and standards of care
management, shall be consistent with standards established by the Tuberculosis
Program.
Notes
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