Laws and Guidelines


Reporting Notifiable Conditions

Civil Surgeons LTBI Reporting

The Tuberculosis Technical Instructions for Civil Surgeons requires reporting of patients who have Latent TB Infection (LTBI) to the patients' county of residence.*

The Civil Surgeons LTBI Reporting Form (docx) is only for patients meeting the following criteria: has a positive IGRA test (T-Spot, QFT-GIT, or QFT Plus) and has a normal chest x-ray/CT or an abnormal one not consistent with TB disease.

* King County Residents: Civil surgeon patients who are diagnosed with LTBI and reside in King County should be reported to Public Health Seattle & King County using this online survey For King County residents it is not necessary to also fax the above Civil Surgeons LTBI Reporting Form.

Laws and Regulations

Guidelines for Congregate Settings

Guidelines for Employers

Health Care Personnel Screening and Testing

The Centers for Disease Control and Prevention (CDC) and the National Tuberculosis Controllers Association (NTCA) released recommendations titled, Tuberculosis Screening, Testing, and Treatment of U.S. Health Care Personnel, 2019. These recommendations update the health care personnel screening and testing section of the 2005 CDC Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health Care Settings, however the facility risk assessment and infection control practice sections remain unchanged from the 2005 guidelines.

While the Washington State Department of Health TB Program supports the implementation of these new recommendations, facilities should first contact their licensing authority to determine the TB screening requirements they need to follow. It will take some time for licensing authorities to consider updating codes related to TB screening and treatment. If you need help determining which code or licensing authority your facility operates under, please refer to this reference guide (PDF) or contact the TB Program for assistance.

  • New 9-9-2019: The Department of Health has issued a policy statement allowing residential treatment facilities to implement these updated guidelines. Read policy statement (pdf).

More information about the TB screening and treatment recommendations for health care personnel can be found on the CDC website. Additional resources include:

  • Health Care Personnel Baseline Individual TB Risk Assessment Form (PDF)
    Used to assess health care personnel upon hire. Health care personnel who have a new positive TB test should receive a symptom evaluation and chest x-ray to rule out TB disease. Additional workup may be needed depending on results. Health care personnel with a documented history of a prior positive TB test should receive a baseline TB risk assessment and TB symptom screening at hire. A repeat TB test is not necessary.
  • Tuberculosis Symptom Screening (PDF)
    Used when performing baseline or annual symptom screening for employees with untreated TB infection or to assess for TB disease. According to the new recommendations, annual TB testing of health care personnel is not recommended unless there is a known exposure or ongoing transmission at a healthcare facility.
  • Tuberculosis Risk Assessment Worksheet (MMWR, Appendix B, page 128)
    Facilities can use this form to determine the risk of TB transmission and frequency of TB screenings for employees. Health care facilities might consider using serial TB screening for certain groups at increased occupational risk for TB exposure (e.g., pulmonologists or respiratory therapists) or in certain settings if transmission has occurred in the past (e.g., emergency departments).
  • Home Health Agencies
    Licensing rules for in-home service agencies were updated and took effect April 6, 2018 (Chapter 246-335 WAC). Guidance about the new rules, and how to use the Tuberculosis (TB) Risk Assessment Form (PDF), can be found on the Home Health Agencies webpage. For questions about the rule or the form, contact Health Systems Quality Assurance customer service: 360-236-4700 or

Guidelines for Health Professionals