Supplies, Materials, and Services

Contents

<Your State>Tuberculosis program Manual Supplies, Materials, and Services15.1

Revised 08/11/08

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 Supplies, Materials, and Services15.1

Revised 08/11/08

Introduction

Use this section to find out what resources are available and how to access them.

The<Your State> TuberculosisProgram 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.

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 formby <fax, land mail, e-mail> to <fax number, land mail address, e-mail address>.

Time / TST supplies can be delivered<number of days> business days from the receipt of the request.

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 formby <fax, land mail, e-mail> to <fax number, land mail address, e-mail address>.

Time / IGRA supplies can be delivered<number of days> business days from the receipt of the request.

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 formby <fax, land mail, e-mail> to <fax number, land mail address, e-mail address>.

Time / CXRs can be approved<number of days> business days from the receipt of the request.

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 formby <fax, land mail, e-mail> to <fax number, land mail address, e-mail address>.

Time / Supplies can be delivered<number of days> business days from the receipt of the request.

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.
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, e-mail 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.

Incentives and Enablers

<Add, edit, or delete the directions below to reflect your state’s practices.>

Table6: 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
  • Automotive supplies
  • Hobby/craft items
  • Household items
  • Laundry services
  • Seasonal/holiday treats
  • Movie passes
  • Restaurant/fast food vouchers
  • Toys
  • Personal care items
/ Enablers
  • Transportation (bus pass, cab fare, car battery, gas)
  • Rent assistance
  • Childcare
  • Obtaining and shipping specimens for the patient
  • 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

How to Obtain / 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 formby <fax, land mail, e-mail> to <fax number, land mail address, e-mail address>.

Time / If approved, funds will be provided <number of days> business days from the receipt of the request.

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:
  • Yellow pages under "Translators & Interpreters"
  • Medicaid-funded interpreters
  • State refugee services program
  • Local community organizations

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 Supplies, Materials, and Services15.1

Revised 08/11/08