Who is covered: Health care facilities (hospitals, skilled nursing, clinics, outpatient medical offices, home health, hospice, paramedic/EMS); high-risk facilities (correctional facilities, homeless shelters, drug-treatment programs); public-health operations (contact tracing, screening); police during transport/detention of suspected ATD cases; laboratories handling aerosol-transmissible pathogens; cadaver-handling operations (pathology labs, medical examiners, coroners, mortuaries); and contaminated air-handling maintenance. Limited exceptions for certain outpatient dental/specialty practices with screening — 8 CCR 5199(a).
Evaluation performed by: PLHCP knowledgeable in occupational TB/ATD evaluation (TB management referrals to a PLHCP knowledgeable in TB diagnosis/treatment)
🩺 Baseline / Pre-Placement
On hire/assignment into an ATD exposure-risk classification — 8 CCR 5199(h)
- Baseline TB screening/testing for new hires in exposure-risk job classifications (TB skin test or IGRA blood test, per the facility's program) — 8 CCR 5199(h)
- Vaccines listed in Appendix E (e.g., for susceptible exposed workers) made available at no cost within 10 working days of assignment — 8 CCR 5199(h)(5)
- Medical-history/screening as part of program enrollment
🕒 Periodic / Routine
Interval-based for exposed employees — NOT result-triggered
Schedule: Annual TB testing/assessment for all exposed employees — 8 CCR 5199(h)(3)
- Annual TB testing/assessment (symptom screen and/or TB test per program and risk level) for exposed employees — 8 CCR 5199(h)(3)
Abnormal results & exposure-event protocols
Abnormal Results & Exposure-Event Protocols
- Employee TB test conversion (new positive) 8 CCR 5199(h)(3): Provide a medical evaluation and refer the employee to a PLHCP knowledgeable in the diagnosis/treatment of TB for further evaluation and management. Tests: Medical evaluation of the TB conversion, Referral to a PLHCP knowledgeable in TB diagnosis and treatment, Symptom assessment and chest imaging as clinically indicated by the PLHCP
- Significant exposure incident / suspected or confirmed ATD case exposure 8 CCR 5199(h)(6): Conduct an exposure analysis within 72 hours; provide a post-exposure MEDICAL EVALUATION within 96 hours of the exposure; report suspected reportable ATD cases to the local health officer; notify other potentially exposed employers within 72 hours. Tests: Exposure incident analysis within 72 hours, Post-exposure medical evaluation within 96 hours, Reporting of suspected case to the local health officer, Notification of other potentially exposed employers within 72 hours, Post-exposure prophylaxis/treatment as recommended by the PLHCP
Reporting Requirements
| Who performs the evaluation | PLHCP (referrals for TB conversion to a PLHCP knowledgeable in TB diagnosis/treatment) — 8 CCR 5199(h). |
|---|---|
| Reported to employer | Employer receives the PLHCP's written opinion/recommendation on work status and any work restrictions related to ATD exposure; clinical details remain confidential. |
| Reported to / for the employee | Employee informed of TB test results, conversion status, exposure-incident findings, and any need for further evaluation/treatment; copy of the written opinion provided. |
| Time limits | Exposure analysis within 72 hours; post-exposure medical evaluation within 96 hours; suspected-case report to the local health officer; notification of other potentially exposed employers within 72 hours — 8 CCR 5199(h)(6). |
| Recordkeeping | Confidential ATD medical records retained per 8 CCR 3204 (duration of employment plus 30 years); may be combined with the 5193 medical record — 8 CCR 5199(j)(1)(A). |
Medical Removal Protection
No MRP. Program is baseline + annual TB surveillance plus event-triggered TB-conversion evaluation and post-exposure response (see abnormal_protocols). Medical records may be combined with the 5193 (bloodborne) medical record — 8 CCR 5199(j)(1)(A) — though the two standards cover non-overlapping disease routes (airborne vs. bloodborne).