Interjurisdictional Continuity of Care Policy Statement

Transcription

1 Interjurisdictional Continuity of Care Policy Statement revised November of 5

2 Table of Contents Preface 2 Purpose 2 Correctional Inmates/Parolees 2 Laboratory 2 Health Care Facilities 3 Special Circumstances 4 Health Care Facilities Algorithm 5 revised November of 5

3 Preface The following guidelines have been developed by the California Department of Public Health (CDPH), Centers for Infectious Diseases, Tuberculosis Control Branch (TBCB), and the California Tuberculosis Controllers Association (CTCA). These guidelines provide statewide recommendations for tuberculosis (TB) control in California. If these Guidelines are altered for local use, then the logo should be removed and adaptations from this source document acknowledged. No set of guidelines can cover all individual situations that can and will arise. When questions arise on individual situations not covered by these guidelines, consult your local TB Controller or CDPH, TBCB. Purpose As TB Controllers, our goal is to ensure the continuity of care of all patients with known or suspected TB. We are committed to following each patient to completion of therapy and to providing needed information to other TB Controllers or providers when a patient who has not completed the recommended course of therapy, moves/transfers to another jurisdiction. To meet this goal, we commit to the following: Correctional Inmates/Parolees Upon notification by a correctional facility in the local jurisdiction, the sending TB control program will notify the TB control program of the jurisdiction that will be receiving the patient, when any correctional facility including juvenile facilities in the sending jurisdiction, transfers or paroles/releases an inmate with known or suspected TB to another jurisdiction. The receiving TB Controller will notify the Chief Medical Officer of the receiving facility. The National TB Controllers Association Interjurisdictional Tuberculosis (TB) Notification (ITN) form should be used to notify the receiving local health jurisdiction. This can be found at Health and Safety Code Section requires the local jurisdiction to notify the parole agent or regional administrator when a parolee with active TB ceases TB treatment prior to completion of therapy. The receiving TB Controller of the jurisdiction in which the parolee resides will notify parole officials. Laboratory The local TB Controller will forward, as soon as possible, to the appropriate TB Controller, any mycobacteriology laboratory reports received where patient address revised November of 5

4 indicates residence in another jurisdiction. Positive AFB smears on sputum results will be reported immediately by phone and fax. Health Care Facilities (see attached Health Care Facilities Algorithm) Sending Health Department (jurisdiction where patient is hospitalized) When a TB Control Program receives notification that a TB suspect or case is hospitalized at a facility within its jurisdiction, and the patient resides in another jurisdiction, the sending health department will forward the ITN report (found at by phone and fax to the receiving health department within one working day. The care provider will submit a written discharge plan to the sending health department. To expedite interjurisdictional discharge approvals, providers should be encouraged to submit discharge plans two working days prior to the anticipated discharge date. Within four working hours of receipt of the discharge plan, the sending health department will phone and fax the discharge plan to the receiving jurisdiction. The sending health department will follow established CDPH/CTCA Guidelines for the Assessment of Tuberculosis Patient Infectiousness and Placement into High and Lower Risk Settings (2009) when evaluating a request for discharge approval. The sending jurisdiction should use reasonable judgment and diligence in informing and working cooperatively with the receiving jurisdiction, providing updated information when it is received or requested. Within one working day after consultation with the receiving jurisdiction, the sending department will notify the provider and the receiving jurisdiction of discharge approval, or the need for additional information/action that is required prior to discharge approval. In the event a discharge approval is requested on a holiday, weekend, or after business hours, the sending jurisdiction will attempt to contact the TB duty officer (if one is designated) for the receiving jurisdiction. The same criteria for discharge approval will be followed. Receiving Jurisdiction (jurisdiction to which the patient will be discharged) When the TB Control Program receives notification of a TB suspect/case, staff should begin preparing for discharge at that time by initiating an evaluation of the home and household contacts to determine if the environment is suitable for discharge. revised November of 5

5 The receiving jurisdiction will review the TB discharge plan within one working day of when it was received, and will contact the sending jurisdiction and/or provider to discuss the plan when necessary. If it has not previously done so, the receiving jurisdiction will assess the proposed placement/home environment and report to the sending jurisdiction within two working days. The assessment will be based on CDPH/CTCA Guidelines for the Assessment of Tuberculosis Patient Infectiousness and Placement into High and Lower Risk Settings (2009). The receiving jurisdiction should use reasonable diligence in expediting the evaluation process so that the patient discharge is not unnecessarily delayed. Receiving jurisdictions without a response plan for holidays, weekends or after normal hours will receive notification on the next business day. Special Circumstances In the event there is a disagreement between the sending and receiving jurisdictions on the appropriateness of a placement, the TB Controllers or their designees, will review the case and arrive at a mutually agreeable plan of action. Unusual circumstances, such as a previously unexposed high risk contacts in the home, MDR-TB, or high risk for non-adherence, may necessitate a delay in discharge approval until special arrangements can be made. revised November of 5

6 Health Care Facilities Algorithm Hospitalized TB suspect/case reported to local health department; patient s residence or discharge address (if known) located outside local jurisdiction. Sending Jurisdiction* notifies Receiving Jurisdiction** ** of pending discharge by phone and fax within four (4) working hours of receipt of hospital discharge request. Sending Jurisdiction Receiving Jurisdiction Must update Receiving Jurisdiction as additional information is received via phone and fax. Receiving Jurisdiction, upon receipt, will review plan information within one working day. If required, the Receiving Jurisdiction will contact the Sending Jurisdiction and hospital. Evaluation of Discharge Plan: The Sending Jurisdiction retains authority to approve or deny discharge plans from health care facilities within their local jurisdiction. The Sending Jurisdiction will follow established CDPH/CTCA Guidelines for the Assessment of Tuberculosis Patient Infectiousness and Placement into High and Lower Risk Settings (2009) when evaluating request for discharge. Sending Jurisdiction should notify Receiving Jurisdiction of plan approval. Assessment of Placement and Recommendations: Upon receipt of the discharge plan, the receiving jurisdiction will make an assessment of the proposed placement/home and forward information and recommendations to the Sending Jurisdiction within two (2) working days. The assessment will be based upon the CDPH/CTCA Guidelines for the Assessment of Tuberculosis Patient Infectiousness and Placement into High and Lower Risk Settings (2009). Holiday, weekend or after normal business hours: The Sending Jurisdiction will attempt to contact the TB Duty Officer of the Receiving Jurisdiction, if known. Receiving Jurisdictions without a response place for holiday, weekend or after normal business hours will receive phone and fax notification on the next business day. In the event of unusual circumstances or disagreement between jurisdictions regarding discharge or placement, the Tuberculosis Controllers of the two jurisdictions will review the individual case and arrive at a mutually agreeable plan of action. * Sending Jurisdiction: Jurisdiction in which health care facility with in-house TB suspect or case is located. ** Receiving Jurisdiction: Jurisdiction in which TB suspect or case plans to locate immediately following discharge from health care facility. revised November of 5