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