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Supplies, Materials, and Services CONTENTS Introduction ........................................... 15.2 Mantoux Tuberculin Skin Testing Supplies .......................... 15.3 Interferon Gamma Release Assay Supplies ..................................... 15.4 Chest Radiographs ............................... 15.5 Specimen Collection and Shipment Supplies ........................ 15.6 Antituberculosis Medications ............. 15.7 Incentives and Enablers ...................... 15.9 Medical Interpretation Services ........ 15.10 Healthcare Staff Training and Education ..................................... 15.11 <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.1 Introduction Use this section to find out what resources are available and how to access them. The <<Your State>> Tuberculosis Program has resources available to assist local agencies. The following tables explain the resources that are available and how to obtain them: Table 1: Mantoux Tuberculin Skin Testing Supplies Table 2: Interferon Gamma Release Assay Supplies Table 3: Chest Radiographs Table 4: Specimen Collection and Shipment Supplies Table 5: Antituberculosis Medications Table 6: Incentives and Enablers Table 7: Medical Interpretation Services Table 8: Healthcare Staff Training and Education For information on obtaining laboratory tests, see the Laboratory Services section. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.2 Mantoux Tuberculin Skin Testing Supplies <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 1: MANTOUX TUBERCULIN SKIN TESTING SUPPLIES Availability and Cost In the following circumstances: <<Insert the criteria describing circumstances in which free Mantoux tuberculin skin testing (TST) supplies are provided.>> <<Criterion>> <<Criterion>> The state TB program provides the following TST supplies at no charge: <<Item>> <<Item>> How to Obtain To order these supplies from the state TB program: <<If your state processes orders by telephone, edit the following steps.>> Call <<position>> at <<telephone number>>. <<If your state uses a form, edit the following steps.>> Complete this required form: <<form name>> Send the form by <<fax, land mail, e-mail>> to <<fax number, land mail address, email address>>. Time TST supplies can be delivered <<number of days>> business days from the receipt of the request. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.3 Interferon Gamma Release Assay Supplies <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 2: INTERFERON GAMMA RELEASE ASSAY SUPPLIES Availability and Cost In the following circumstances: <<Insert the criteria describing circumstances in which interferon gamma release assay (IGRA) supplies are provided.>> <<Criterion>> <<Criterion>> The state TB program provides the following IGRA specimen collection and shipment supplies at no charge: <<Item>> <<Item>> How to Obtain To order these supplies from the state TB program: <<If your state processes orders by telephone, edit the following steps.>> Call <<position>> at <<telephone number>>. <<If your state uses a form, edit the following steps.>> Complete this required form: <<form name>> Send the form by <<fax, land mail, e-mail>> to <<fax number, land mail address, email address>>. Time IGRA supplies can be delivered <<number of days>> business days from the receipt of the request. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.4 Chest Radiographs <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 3: CHEST RADIOGRAPHS Availability and Cost In the following circumstances: <<Insert the criteria describing circumstances in which free chest radiographs (CXRs) are provided.>> <<Criterion>> <<Criterion>> How to Obtain To order CXRs from the state TB program: <<If your state processes orders by telephone, edit the following steps.>> Call <<position>> at <<telephone number>>. <<If your state uses a form, edit the following steps.>> Complete this required form: <<form name>> Send the form by <<fax, land mail, e-mail>> to <<fax number, land mail address, email address>>. Time CXRs can be approved <<number of days>> business days from the receipt of the request. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.5 Specimen Collection and Shipment Supplies <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 4: SPECIMEN COLLECTION AND SHIPMENT SUPPLIES Availability and Cost In the following circumstances: <<Insert the criteria describing circumstances in which free specimen collection and shipment supplies are provided.>> <<Criterion>> <<Criterion>> The state TB program provides the following specimen collection and shipment supplies at no charge: Specimen containers Packaging for shipment How to Obtain To order these supplies from the state TB program: <<If your state processes orders by telephone, edit the following steps.>> Call <<position>> at <<telephone number>>. <<If your state uses a form, edit the following steps.>> Complete this required form: <<form name>> Send the form by <<fax, land mail, e-mail>> to <<fax number, land mail address, email address>>. Time Supplies can be delivered <<number of days>> business days from the receipt of the request. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.6 Antituberculosis Medications <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 5: ANTITUBERCULOSIS MEDICATIONS Availability and Cost In the following circumstances: <<Insert the criteria describing circumstances in which the state TB program pays for antituberculosis medications.>> <<Criterion>> <<Criterion>> The state TB program provides the following antituberculosis medications at no charge: <<Add or delete medications below.>> Isoniazid (INH) Rifampin (RIF) Rifapentine (RPT) Ethambutol (EMB) Pyrazinamide (PZA) Note: Pyridoxine (vitamin B-6) is also provided to patients who have conditions associated with neuropathy such as nutritional deficiency, diabetes, human immunodeficiency virus (HIV) infection, renal failure, alcoholism, and pregnant/ breastfeeding women. Second-line antituberculosis medications are provided for patients with drug-resistant TB. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.7 How to Obtain To order antituberculosis medications from the state TB program: <<If your state processes orders by telephone, edit the following steps.>> Call <<position>> at <<telephone number>>. <<If your state uses a form, edit the following steps.>> Complete this required form: <<form name>> Send the form(s) by <<fax, land mail, e-mail>> to <<fax number, land mail address, email address>>. <<If your state distributes medications through pharmacies, edit the following information; otherwise, delete it.>> Medications will only be provided to approved pharmacies. Minimum inventories will be maintained at each pharmacy to allow sufficient access for patients. Note: Local healthcare agencies should establish a relationship with a local pharmacy to provide dispensing services. Time Medications can be delivered <<number of days>> business days from the receipt of the request. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.8 Incentives and Enablers <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 6: INCENTIVES AND ENABLERS Availability and Cost In the following circumstances: <<Insert the criteria describing circumstances in which incentives and/or enablers are funded by the state TB program.>> <<Criterion>> <<Criterion>> The state TB program provides the funds for the following incentives and enablers: <<Add or delete incentives and enablers below.>> Incentives Food and beverages Clothing Enablers Transportation (bus pass, cab fare, car battery, gas) Automotive supplies Rent assistance Hobby/craft items Childcare Household items Obtaining and shipping specimens for the patient Laundry services Seasonal/holiday treats Movie passes Restaurant/fast food vouchers Toys Personal care items How to Obtain Assisting the patient with getting medication refills Assisting the patient with completing paperwork to get food/housing assistance Assisting the patient with getting substance treatment To request funds for incentives and enablers from the state TB program: <<If your state processes orders by telephone, edit the following steps.>> Call <<position>> at <<telephone number>>. <<If your state uses a form, edit the following steps.>> Complete this required form: <<form name>> Send the form by <<fax, land mail, e-mail>> to <<fax number, land mail address, email address>>. Time If approved, funds will be provided <<number of days>> business days from the receipt of the request. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.9 Medical Interpretation Services <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 7: MEDICAL INTERPRETATION SERVICES Availability and Cost In the following circumstances: <<Insert the criteria describing circumstances in which medical interpretation services are provided by the state TB program.>> <<Criterion>> <<Criterion>> The state TB program provides medical interpretation services at no charge. For other patients, other agencies may fund interpretation services, or interpretation services may be obtained on a fee-for-service basis. How to Obtain To secure preapproval of funds for a medical interpreter, call <<position>> at <<telephone number>>. To arrange for a medical interpreter (state-funded or not), contact one of the following: <<Below, list medical interpretation resources recommended by your state.>> <<Title>> <<Title>> <<To create your state’s list of medical interpretation services, it may be helpful to review resources from the following:>> Diversity Rx page on Interpreter Associations: http://diversityrx.org/HTML/MOASSO.htm Yellow pages under "Translators & Interpreters" Medicaid-funded interpreters State refugee services program Local community organizations <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.10 Healthcare Staff Training and Education <<Add, edit, or delete the directions below to reflect your state’s practices.>> Table 8: HEALTHCARE STAFF TRAINING AND EDUCATION Availability and Cost In the following circumstances: << List training and education services and resources provided by the state TB program and their costs.>> <<Service/resource>> <<Service/resource>> How to Obtain For more information, call <<position>> at <<telephone number>>. <<YOUR STATE>> TUBERCULOSIS PROGRAM MANUAL Revised 08/11/08 Supplies, Materials, and Services 15.11