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The Latest Column
Questions are from the latest Standards Q&A column, posted in March 2017.
TIMING OF TB TESTS
I have reviewed the 2014 NCCHC Standards but I cannot locate the time line for a tuberculosis test to be completed from the date of booking. Am I missing it, or is it the facility’s preference?
The answer varies depending on whether you are referring to a jail or a prison.
For jails, this is addressed in standard E-04 Initial Health Assessment. Whether you are using the full population assessment or individual assessment when clinically indicated, it is expected that TB testing is done at the time of the health assessment unless there is documentation from the health department that the prevalence rate does not warrant it (see compliance indicators #2e and #6e). The health assessments must be conducted within 14 calendar days after admission for facilities that conduct full population assessments, and within two days for facilities that choose the individual health assessment option.
For prisons, the Receiving Screening standard (E-02) states that a tuberculosis test must be completed during the screening (see compliance indicator #11).
HEALTH CARE LIAISON
Our facility has health staff on-site 19 hours per day, seven days a week. Does the Health Care Liaison standard (C-08) apply to us?
No. According to the standard, a designated, trained health care liaison coordinates the health services delivery in the facility on those days when no qualified health care professionals are available for 24 hours. The intent of this standard is that health care service continues to be coordinated when health staff are not available for an extended period of time. The presence of a qualified health care professional for any part of 24 hours eliminates the need for a designated health care liaison post for those 24 hours. However, there still must be a plan in place that tells custody staff what to do when a health situation arises when health staff are not present (compliance indicator #2).
Dental exam for newly admitted juveniles
If a juvenile is already under the care of a community dentist, has seen the dentist recently and then is admitted to a detention center, does the youth still need a dental exam within 60 days?
Yes, an oral examination by a licensed dentist would still be required. The E-06 Oral Care standard for juvenile detention and confinement facilities states that an oral examination is performed by a dentist within 60 days of admission. An oral examination by a licensed dentist includes taking or reviewing the patient’s oral history, an extraoral head and neck examination, charting of teeth and examination of the hard and soft tissue of the oral cavity with a mouth mirror, explorer and adequate illumination.
However, if a juvenile who has received an oral examination in the correctional system within the past year is readmitted, a new exam is not required except as determined by the supervising dentist. The intent of this standard is that juvenile’s serious dental needs are met. Oral care is an important component of an individual’s overall health care. Poor oral health has been linked to numerous systemic diseases.