Title
Agreement with the Kansas Department of Health and Environment (KDHE) to bill for laboratory analysis services for QuantiFeron-TB Gold (QFT) blood tests for the Tuberculosis (TB) Control Program at the Health Department.
Body
Recommended Action: Approve the agreement; and authorize the Chairman to sign this document and any other documents associated with this agreement containing substantially the same terms and conditions; and approve establishment of budget authority at the time the documents are executed.
Background: Control of Tuberculosis is a core public health function provided by the Health Department. The TB Control program has 3 major components: 1) providing treatment for TB disease cases, 2) preventing active disease in those with latent TB Infection through contact investigations and treatment, and 3) coordinating TB Control in the county with other community entities. Latent TB infection can be identified through different testing methods, including skin tests and collecting and analyzing blood specimens. The QFT testing method, developed in 2005, is performed on blood specimens and is a more precise method of TB testing.
The Health Department began using QFT testing in 2008 to comply with new TB standards and reduce the number of clients incorrectly diagnosed with TB infection needing preventive treatment. In 2009, the first full year QFT was used, this protocol resulted in a decreased demand for chest X-rays and follow-up medical and nursing care by 30% compared to when no QFT testing was used.
In 2011, the Health Department conducted 250 QFT tests on previously skin-test positive patients resulting in 138 negative tests. In the past, all of those 138 clients would have received a chest X-ray and most would have been placed on preventive therapy for nine months based on doctor's recommendations.
Through the use of QFT, the lower number of latent TB infection cases frees staff to focus on cases with active disease, investigations to prevent outbreaks, and community education.
Analysis: The proposed agreement is annually renewed. The $47 cost per test remains the same as that of the current fiscal year. Adequate funds for these billed services were budgeted in 2012, fund center 38013-110.
Alternatives: This agreement simply formalizes a mechanism necessary for business between KDHE and the Health Department. To utilize an external laboratory for this testing would cost approximately three times more per test. The alternative is to go back to skin testing only which would increase the client base unnecessarily.
Financial Considerations: This agreement will be managed through Fund Center #38013-110, Local TB Control Fund. This agreement is effective for the period of July 1, 2012 to June 30, 2013.
Legal Considerations: Legal authority for TB control is established by the following Kansas Statutes: K.S.A. 65-116a, et. seq., -119, 129a, et. seq., and -202. The agreement with KDHE may be entered into pursuant to K.S.A. 19-101. Approval is by simple majority vote.
Policy Considerations: None.