J-5_Employee_Health.pdf

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J-5

J-5 Employee Health

Employee Health

Employee Health File

Employee health files for each employee must be maintained on site, by the Health Services Administrator or the employer’s designee. Health files are maintained in a locked cabinet in accordance with DHS and ICE Privacy Policies, the Privacy Act of 1974, and contain the following documents:

Initial and annual TB infection screening results

Vaccination records including results, titers and Immunization Declination Form(s)

OSHA 301 Incident forms

Blood borne pathogen exposure documentation

Annual respirator medical clearance

Annual respirator fit test results

Other employee health documents

Prior to performing any duties, all contract personnel must provide documentation regarding the following:

1. History of testing for tuberculosis (TB) within the last 12 months:

a. chest x-ray if employee has a history of LTBI, treatment history for LTBI or TB disease, if applicable;

b. Additionally, on an annual basis and at own expense, contractor shall provide a current TST or IGRA test result if the employee previously tested negative for LTBI, evaluation for TB symptoms if the employee previously tested positive for LTBI, and follow up as appropriate in accordance with Centers for Disease Control and Prevention (CDC) guidelines.

2. Hepatitis B The Occupational Safety and Health Administration (OSHA) Blood borne pathogens (BBP) Standard requires employers to provide employees at risk of occupational exposure to blood and other potentially infectious material (OPIM) with the Hepatitis B vaccination series. Health staff must do one of the following:

a. Complete the Hepatitis B vaccination series prior to performing work on the contract; and provide documentation of the vaccination series or titer results that confirm immunity to HBV; or

b. Refuse the vaccination series for medical reasons and complete the Immunization Declination Form.

Highly Recommended Vaccinations for Health Care Workers

On the basis of documented nosocomial transmission, health care workers are considered to be at significant risk for acquiring or transmitting Hepatitis B, measles, mumps, rubella, varicella and seasonal influenza. All of these diseases are vaccine-preventable. Therefore, the following vaccinations are highly recommended for health staff. If staff decline or refuse any of these recommended vaccines, an Immunization Declination Form is required.

Hepatitis A

Hepatitis B

Varicella

Measles, Mumps, Rubella (MMR)

Diphtheria, tetanus, a-cellular pertussis (DTAP)

Annual seasonal influenza

Health staff provides immunization documentation or titer results for these diseases to the HSA or the employer’s designee for placement in the employee health file. For more details refer to:

CDCs Immunization of Health-Care Workers: Recommendations of the Advisory Committee on Immunization Practices (ACIP) and the Hospital Infection Control Practices Advisory Committee (HICPAC)

Immunization Declination Form

I understand that my risk of exposure due to lack of immunizations may place me at risk with the following vaccine-preventable diseases, puts me at risk of acquiring the disease. I have had the opportunity to be vaccinated, however, I choose to decline the vaccination(s) checked below at this time. I understand that by declining vaccine protection, I continue to be at risk of acquiring the disease and I hold the government harmless in the event of infection.

In the event of exposure I understand that I may be required to not enter the facility for at least the incubation period of the disease to which I have been exposed. In some cases that may be for a period of up to a month or longer.

Type Reason

□ Measles, Mumps, Rubella (MMR)

□ Varicella (VZW)

□ Hepatitis A

□ Hepatitis B

□ Influenza

□ H1N1

□ Tetanus / Pertussis / Tdap

□ Other

Signed: Date:

Printed Name:

Title: