1. Tuberculosis Follow up Care PA Department of Health Role Maxine Kopiec Community Health Nursing Supervisor April 24, 2015

2. TB Program Objectives Program Overview Program Goals Staffing State and Local

3. TB Program The Pennsylvania Department of Health Tuberculosis (TB) Control Program has the overall responsibility for statewide tuberculosis control efforts which include:

4. TB Program Role Ensuring the provision of effective and efficient surveillance Diagnostic, treatment and prevention services

5. TB Program Staffing Central Staff in Harrisburg works with: Six (6) District Offices of the Department of Health Ten (10) county and municipal health departments Private sector and other public community based agencies

6. TB Program Goal Provide and support a variety of TB related services

7. TB Program Services TB related training and education at state, district, and local levels Comprehensive diagnostic and treatment services for patients including:

8. TB Program Services Suspected or confirmed TB disease Latent TB infection (LTBI) Investigation of close contacts Provision of epidemiological oversight and guidance to public health field staff

9. TB Care Process Referrals for suspect, active, and LTBI cases Referral sources: ICPs at hospital Physicians NEDSS reporting system Self-referral

10. Initial Care Community Health Nurse: Obtains/reviews information Patient assessment Office, hospital or home visit Consults/notifies TB clinician Initiates standing orders

11. Ongoing Care LTBI cases Obtain history, assess patient Provide education on disease vs. infection Provide HIV testing Obtain chest x-ray Clinician office visit

12. Ongoing Care Suspect and Active TB Cases Obtain history, assess patient Provide HIV testing Initiate and continue treatment per standing orders and protocol DOT visits Contact testing

13. Ongoing Care Monitoring of patients Daily, monthly Laboratory testing per protocol per MD request

14. Evaluation of Care Reporting to TB Program NEDSS Monthly update Consult for care, legal issues TB Cohort reviews

15. Summary Contact your local health department for any assistance and guidance. TB is manageable with adequate care and treatment.