Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) Risk Assessment

Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) Risk Assessment and Testing A. All DMH-certified substance use services must document and follow written policies and procedures that ensure: 1. People who are infected with HIV or TB are provided priority admission. 2. People who are infected with HIV or TB are placed in treatment services identified as the best modality by the assessment within 48 hours. 3. If an agency provider is unable to admit a person who is infected with HIV or TB due to being at capacity or any other appropriate reason, the agency provider must assess, refer, and place the person in another DMH-certified agency provider within 48 hours. 4. If unable to complete the entire process as outlined, DMH must be notified immediately by fax or email using standardized forms provided by DMH. The time frame for notifying DMH of inability to place a person who uses IV drugs cannot exceed 48 hours from the initial request for treatment from the person. B. All providers must provide and document that all people receiving substance use disorder treatment services receive a risk assessment for HIV at the time of intake. For people determined to be high risk by the HIV assessment, testing options are determined by level of care and must be provided as follows: 1. Outpatient and Intensive Outpatient Services: People must be offered on-site HIV Rapid Testing by the organization or informed of available HIV testing resources within the community. 2. High-Intensity Residential Services: People must be offered and encouraged to participate in on-site HIV Rapid Testing. If HIV Rapid Testing is not immediately available, then testing must be offered using other methodology on-site or the person must be transported to a testing location in the community only until such time as a Rapid Testing Program can be implemented. 3. Low-Intensity Residential and Recovery Support Services: People must be offered and encouraged to participate in on-site HIV Rapid Testing unless the service can provide documentation that the person received the risk assessment and was offered testing within the last six (6) months. If testing was refused, the agency provider should encourage further testing. If HIV Rapid Testing is not immediately available, then testing must be offered using other methodology on-site or the person must be transported to a testing location in the community only until such time as a Rapid Testing Program can be implemented. C. All service locations must have and follow written policies and procedures for ensuring maximum participation from people in HIV testing to include: 1. Standardized procedures for conducting an HIV Risk Assessment. 2. Utilization of an “opt-out” methodology for documenting people who decline to be tested. 3. Standardized protocol for explaining the benefits of testing. D. All services offering HIV Early Intervention Testing should provide at a minimum: 1. A minimum of 30 minutes up to one (1) hour of pre-test counseling which must include a risk assessment if one has not been previously conducted. 2. Offer appropriate post-test counseling as needed. If preliminary testing is reactive (positive) then a minimum of 60 minutes of post-test counseling is required. 3. All services providing on-site testing must have the following: (a) A Clinical Laboratory Improvements Amendments (CLIA) Waiver; (b) Relevant employee training; (c) A written protocol for HIV testing; and (d) Agreements with the Mississippi State Department of Health or other relevant agency providers to obtain HIV test kits, where applicable. E. Services providing on-site testing must have policies and procedures that include but are not limited to: 1. Standardized procedures for conducting an HIV test and delivering results; 2. Standardized procedures for obtaining a confirmatory test in the case of a reactive “preliminary positive” test result; 3. Documentation and standardized procedures for providing linkage to care; and 4. Quality control procedures to include: (a) Proper storage of HIV test kits and controls; and (b) Documentation of when and how often controls are run to verify test accuracy. F. All Level 3 Clinically Managed Residential and Medically Monitored Intensive Inpatient providers must document that all people received a risk assessment for TB at the time of intake. Any person determined to be at high-risk cannot be admitted into a treatment service until testing confirms the person does not have TB.