481—59.6 (135B,135C) Serial TB screening procedures for health care facilities and hospitals.
	 59.6(1) Health care facilities or hospitals classified as low risk. After baseline testing of HCWs for infection with M. tuberculosis, additional TB screening of HCWs is not necessary unless an exposure to M. tuberculosis occurs.
	 59.6(2) Health care facilities or hospitals classified as medium risk.
	  a.   	 After undergoing baseline testing for infection with M. tuberculosis, HCWs should receive TB screening annually (i.e., symptom screen for all HCWs and testing for infection with M. tuberculosis for HCWs with baseline negative test results).
	  b.   	 HCWs with a baseline positive or new positive test result for M.	tuberculosis infection or documentation of previous treatment for LTBI or TB disease shall receive one chest radiograph result to exclude TB disease. Instead of participating in serial testing, HCWs should receive a symptom screen annually. This screen should be accomplished by educating HCWs about symptoms of TB disease and instructing HCWs to report any such symptoms immediately to the occupational health unit. Treatment for LTBI should be considered in accordance with CDC guidelines.
	 59.6(3) Health care facilities or hospitals classified as potential ongoing transmission. Testing for infection with M. tuberculosis may need to be performed every eight to ten weeks until lapses in infection control have been corrected and no additional evidence of ongoing transmission is apparent. The potential ongoing transmission classification should be used only as a temporary classification. This classification warrants immediate investigation and corrective steps. After a determination that ongoing transmission has ceased, the setting shall be reclassified as medium risk for a minimum of one year.
[ARC 0484C, IAB 12/12/12, effective 1/16/13]