WSR 06-19-086

EXPEDITED RULES

DEPARTMENT OF

SOCIAL AND HEALTH SERVICES
(Aging and Disability Services Administration)

[ Filed September 19, 2006, 12:27 p.m. ]

     Title of Rule and Other Identifying Information: WAC 388-78A-2480 Tuberculosis (TB) tests.

NOTICE

     THIS RULE IS BEING PROPOSED UNDER AN EXPEDITED RULE-MAKING PROCESS THAT WILL ELIMINATE THE NEED FOR THE AGENCY TO HOLD PUBLIC HEARINGS, PREPARE A SMALL BUSINESS ECONOMIC IMPACT STATEMENT, OR PROVIDE RESPONSES TO THE CRITERIA FOR A SIGNIFICANT LEGISLATIVE RULE. IF YOU OBJECT TO THIS USE OF THE EXPEDITED RULE-MAKING PROCESS, YOU MUST EXPRESS YOUR OBJECTIONS IN WRITING AND THEY MUST BE SENT TO Rules Coordinator, Department of Social and Health Services, P.O. Box 45850, Olympia, WA 98504-5850, or deliver to Blake Office Park East, 4500 10th Avenue S.E., Lacey, WA 98503, e-mail fernaax@dshs.wa.gov, fax (360) 664-6185 , AND RECEIVED BY 5:00 p.m. on November 20, 2006.


     Purpose of the Proposal and Its Anticipated Effects, Including Any Changes in Existing Rules: The proposed amendment will eliminate a numbering/typographical error that exists in the current rule. Presently, there are two subsections (1)(d). The proposed amendment will renumber the second subsection (1)(d) and correctly identify it as subsection (1)(e).

     Persons affected by this proposed amendment are boarding home licensees, boarding home residents, boarding home staff, and other persons who have an interest in the operation of boarding homes.

     RCW 34.05.353 (1)(c) allows the use of expedited rule making to correct typographical errors that do not change the effect of the rule.

     Reasons Supporting Proposal: Amending the rule will eliminate confusion regarding which subsection of WAC 388-78A-2480 is being referenced.

     Statutory Authority for Adoption: RCW 18.20.090.

     Statute Being Implemented: Chapter 18.20 RCW.

     Rule is not necessitated by federal law, federal or state court decision.

     Name of Proponent: Department of social and health services, governmental.

     Name of Agency Personnel Responsible for Drafting: Denny McKee, 4500 10th Avenue S.E., Lacey, WA 98503, (360) 725-2590, mckeedd@dshs.wa.gov; Implementation and Enforcement: Joyce Pashley Stockwell, 4500 10th Avenue S.E., Lacey, WA 98503, (360) 725-2401.

September 13, 2006

Andy Fernando, Manager

Rules and Policies Assistance Unit

3793.1
AMENDATORY SECTION(Amending WSR 06-01-047, filed 12/15/05, effective 1/15/06)

WAC 388-78A-2480   TB tests.   (1) The boarding home must ensure each staff person, except for volunteers and contactors, is screened for tuberculosis, as follows:

     (a) Except when a staff person provided the boarding home with documentation of a previous positive Mantoux skin test, a staff person hired before September 1, 2004 must have had:

     (i) A tuberculin skin test by the Mantoux method within six months preceding the date of employment in the boarding home; and

     (ii) A second tuberculin skin test within one to three weeks after a negative Mantoux test if the staff person was thirty-five years of age or older at the time of hiring.

     (b) A staff person hired on or after September 1, 2004 must have a baseline two-step skin test initiated within three days of being hired unless the staff person meets the requirements in (c) or (d) of this subsection. The skin tests must be:

     (i) Given no less than one and no more than three weeks apart;

     (ii) By intradermal (Mantoux) administration of purified protein derivative (PPD);

     (iii) Read between forty-eight and seventy-two hours following administration, by trained personnel; and

     (iv) Recorded in millimeters of induration.

     (c) A staff person needs to have only a one-step skin test within three days of being hired if:

     (i) There is documented history of a negative result from previous two-step testing; or

     (ii) There was a documented negative result from one-step skin testing in the previous twelve months.

     (d) A staff person does not need to be skin tested for tuberculosis if he/she has:

     (i) Documented history of a previous positive skin test consisting of ten or more millimeters of induration; or

     (ii) Documented evidence of adequate therapy for active disease; or

     (iii) Documented evidence of adequate preventive therapy for infection.

     (((d))) (e) If a skin test results in a positive reaction, the boarding home must:

     (i) Ensure that the staff person has a chest X ray within seven days;

     (ii) Report positive chest X rays to the appropriate public health authority; and

     (iii) Follow precautions ordered by a physician or public health authority.

     (2) The boarding home must:

     (a) Keep in the boarding home for the duration of the staff person's employment, and at least two years following termination of employment, records of:

     (i) Tuberculin test results;

     (ii) Reports of X-ray findings; and

     (iii) Physician or public health official orders.

     (b) Provide staff persons with a copy of the records specified in (a) of this subsection:

     (i) During the time the staff person is employed in the boarding home, limited to one copy per report; and

     (ii) When requested by the staff person.

     (3) The boarding home must ensure that caregivers caring for a resident with suspected tuberculosis comply with the WISHA standard for respiratory protection.

[Statutory Authority: RCW 18.20.090. 06-01-047, § 388-78A-2480, filed 12/15/05, effective 1/15/06. Statutory Authority: RCW 18.20.090 (2004 c 142 § 19) and chapter 18.20 RCW. 04-16-065, § 388-78A-2480, filed 7/30/04, effective 9/1/04.]

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