As of October 1, 2018, new 2018 Civil Surgeons TB Technical Instructions state that IGRA testing is required for all applicants screened for status adjustment to lawful permanent residents in the US who are aged 2 years or older and are now required to report LTBI to the health department. A chest X-ray is required for all applicants with a positive IGRA result, known human immunodeficiency virus (HIV) infection, or signs/symptoms of TB disease. Civil surgeons should not refer applicants to the health department for IGRA testing or chest X-ray; all IGRAs and chest x-rays ordered by civil surgeons must be performed independently of a health department. Applicants requiring an evaluation for active TB disease (abnormal chest X-ray or HIV infected) should continue to be reported to TB Control.
Civil surgeons should complete the Confidential Morbidity Report to report LTBI to the SFDPH TB Prevention and Control Program and fax this to (628) 206-4565. For those applicants that live outside of San Francisco City and County, the civil surgeon should report to the applicant’s county of residence. At this time, we are not using the CalREDIE Provider Portal.
Download the 2018 SF Civil Surgeons Toolkit
| Category | Definition | Reporting requirements |
|---|---|---|
| Latent TB Infection (LTBI) | Positive IGRA Normal chest x-ray No known HIV No signs / symptoms of active TB disease | The applicant's name, contact information, IGRA results, chest x-ray, and treatment results must be reported to the San Francisco Department of Public Health (SFDPH) Tuberculosis Control Program using the Confidential Morbidity Report Form Fax to (628) 206-4565. Civil surgeons should offer LTBI treatment or refer patients to primary care for LTBI treatment. |
| All HIV-infected applicants | History of HIV infection | If the applicant has known HIV infection, an IGRA and a chest x-ray must be performed and they must be referred to the health department of jurisdiction for sputum testing (regardless of above results). The patient will be contacted to schedule an appointment to come to the clinic once the following is faxed: - Civil Surgeon Checklist - Confidential Morbidity Report - Chest x-ray results - IGRA results Please ID yourself as a referring Civil Surgeon Provider and fax the documents to (628) 206-4565. |
| Active TB disease (Suspected or confirmed) | Abnormal Chest X-ray (including chest X-rays) May or may not have signs / symptoms of active TB disease | Any confirmed or suspected case of active TB disease is required by law to be reported within one business day to the TB Prevention and Control Section by telephone at (628) 206-8524, or by fax at (628) 206-4565. This will also act as a referral and we will work with you to set up an appointment. The patient will be contacted to schedule an appointment to come to the clinic once the following is faxed: - Civil Surgeon Checklist - Confidential Morbidity Report - Chest X-ray results - IGRA results Please ID yourself as a referring Civil Surgeon Provider and fax the documents to (628) 206-4565. |