DOH Proposes Updated TB Testing Guidelines for Health Care Workers

January 31, 2020

The New York State Department of Health (DOH) published a proposed rule in yesterday’s State Register that would reduce annual tuberculosis (TB) testing for health care workers. This update aligns with recent guidance from the Centers for Disease Control and Prevention (CDC) and the National Tuberculosis Controllers Association that discourages routine serial testing of health care workers.

The proposed rule would require hospitals, certified home health agencies, and hospices to revise facility policies for TB testing to ensure adequate baseline assessments and annual individual risk assessment and education, with further testing as indicated. This is a change from the current requirement to screen health care workers no less than every year after a baseline screening upon employment. DOH recommends that health care facilities consider maintaining serial TB screening for certain groups that might be at increased occupational risk for TB exposure. These groups could include respiratory therapists, pulmonologists, and others, based on each facility’s determination. Provider policies should also include processes for offering and documenting treatment of TB infection.

GNYHA and its members have encouraged DOH to update its rules on TB testing for health care workers to align with the CDC’s new recommendations. US health care workers have a low rate of tuberculin skin test conversions. Furthermore, improved infection control, diagnostic testing, and treatment have resulted in a decrease of TB incidence overall. GNYHA has advocated for the update largely due to last year’s nationwide shortage of purified protein derivative solution for tuberculin testing. The reduced testing will also allow health care facilities to focus their efforts on effective risk assessment and infection control.

DOH will accept comments on the proposed rule through March 29.