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QUESTION: Will anyone share their policy on New Hires and previous Chest X-Rays? If a potential new hire has had a chest x-ray previously, within what time frame do you accept it? Policy 1: Every employee is required to receive the Mantoux TB test when hired and annually thereafter. If an employee experiences a positive reaction (greater than or equal to 10 mm) to the test, or for some reason cannot take the Mantoux TB test, the employee will be required to obtain and supply proof of a chest x-ray and results. Following successful completion of the three month training period BRS will reimburse the employee for out of pocket expenses for the cost of the test or x-ray, subject to agency reimbursement limits. Should the chest x-ray indicate the presence of active Tuberculosis, the employee must undergo treatment at their own expense. Any reports this agency receives of active Tuberculosis will be reported to the Health Department in the employee’s county of residence and county of employment. The employee must submit a written statement from the physician indicating that the chest x-ray was negative or that treatment has been received and the employee is no longer an active carrier of the virus in order to return to work. Individuals who have known reactions to the skin test will have the option of having a chest x-ray or a TB Quantiferon Gold blood test. These individuals will be required to submit a new x-ray or blood test every 5 years and must submit a TB Questionnaire, signed by a physician or RN, every year between X-rays or blood test. The agency does not reimburse employees for mileage incurred to obtain TB test. TB test results for new hires from previous employers will be accepted as long as test results show a 0 mm reading and have signature of an RN or physician within the past 12 months prior to hire date. (In regard to X-Ray, they would need to present an X-Ray within the 5 year period to the Health Dept RN to complete our TB questionnaire.) Policy 2: We look at changing our policy of TBs/Xray every 2 years. One of the Work Comp providers we use have stopped doing them every 2 years due to over exposure so we have put their letter in the file of the employee along with a questioner the nurse reviews TB Testing TB testing will be done upon hire and annually thereafter. If a person cannot medically take this test, the Agency will pay for chest x-rays to be taken. This will be done at a C.A.R.S. Worker’s Compensation Medical Provider or a provider designated by C.A.R.S. Chest x-rays are necessary once in a two-year period, or following recommendation of the physician. An employee who tests positive for tuberculosis and is in a contagious state will be put on medical leave until they are no longer contagious. Sick days may be used if the employee has accrued sick days. Policy 3: We accept if done within prior 12 months only. Policy 4: We allow new hires to submit any TB test documentation that is within the previous 6 months of their hire date. Policy 5: Here is an excerpt from our Communicable Disease Control Policy; 4.5. Employees 4.5.1. A physical examination shall be required for those employees who are subject to specific guidelines of Department of Transportation (DOT), Head Start regulations or other specific regulations. All employees, except CCI home workers, shall receive a Mantoux test, using the Mantoux (5TU, PPD), unless a previously significant reaction (10 mm or more) can be documented. The result shall be recorded in mm of induration with the date given, date read, and by whom administered. 4.5.1.1. All employees who have a significant reaction (10 mm or more) to the skin test (or documentation of previous treatment for LTBI or TB disease shall be required to have a chest x-ray and other physical and laboratory examinations in order to complete a diagnosis. Employees with no finding of active pulmonary Tuberculosis who have completed preventive treatment or adequate therapy for disease as prescribed by a physician and have completed a baseline chest x-ray shall have annual symptom screenings performed by a medical professional in lieu of annual radiograph screening. Screenings for Kosciusko County employees will be conducted at the Cardinal Clinic. Screenings for Cass, Fulton, and Marshall Counties employees may be conducted at the Cardinal Clinic, or by the nurse in those counties. 4.5.1.2. All employees who have a non-significant reaction to the tuberculin skin test shall be retested annually using the Mantoux (5TU, PPD). So, if a new hire were to have had a significant reaction as defined above to the skin test, and they could provide documentation of this reaction, we would require them to have a baseline chest X-ray for their new hire evaluation and then symptoms screening annually thereafter. Policy 6: We accept Chest X-ray on new hires, but it cannot be over one year old. We also involve our RN. This information is a compilation of suggestions, ideas, and opinions shared by INARF Members in response to the featured question. This information should not be considered official interpretation or guidance of State or Federal Policy. Additionally, statements within this document do not necessarily reflect an official position or opinion of INARF.
QUESTION: Will anyone share their policy on New Hires and previous Chest X-Rays? If a potential new hire has had a chest x-ray previously, within what time frame do you accept it?