SOUTH CAROLINA DEPARTMENT OF MENTAL HEALTH
Columbia, South Carolina

OFFICE OF THE STATE COMMISSIONER OF MENTAL HEALTH

DIRECTIVE NO. 426-77

(8-100)

TO:              All Organizational Components

SUBJECT:   Procedure for Treating Patients with Tuberculosis

I.        Purpose

It is the purpose of this directive to establish a policy and procedure for treating patients of the Department of Mental Health who have tuberculosis. It is essential that all members of the Medical Staff and other treatment personnel understand this policy and follow the procedure outlined in this directive.

II.     Policy

Tuberculosis is an infectious disease which can be spread to others in a number of ways. It is an especially important concern where groups of people reside together such as in mental health facilities. It has been established through the years that the tuberculosis patient is the most important factor in the control of the disease. Consequently, it is the policy of this Department that careful attention shall be given to the diagnosis and treatment of patients with tuberculosis.

III.     Procedures

A.      Diagnosis

When it is suspected that a person in a facility of the Department of Mental Health has tuberculosis, the patient shall be isolated in a private room and the necessary precautions and techniques immediately implemented. Additionally, the necessary clinical procedures and tests which are used to diagnose tuberculosis should be ordered. If a facility is not equipped or does not have personnel trained in isolation techniques, the patient should be transferred immediately to the Byrnes Clinical Center or the McLendon Clinical Center in accordance with Section III, paragraph 2b.

B.      Arrangements for Treatment:

If it is established that the patient has active tuberculosis, the following procedures shall be followed.

1.      (a)      A patient who is in need of treatment for tuberculosis but no longer needs
         treatment at a facility of the South Carolina Department of Mental Health
         shall be discharged and admitted to the State Park Health Center.

(b)     Physicians from the Crafts-Farrow State Hospital will provide psychiatric consultation for patients admitted to State Park Health  Center.

(c)     Patients who are admitted to State Park Health Center will become  the responsibility of that facility. When the patient completes the course of treatment for tuberculosis at State Park Health Center, it will be the responsibility of that facility to discharge the patient or initiate proceedings to have the person admitted to Department of Mental Health facilities.

2.       (a)     Patients who are in need of further treatment at facilities of the South
          Carolina Department of Mental Health and cannot be discharged will be
          treated in facilities of the Department of Mental Health.

(b)     Patients at the South Carolina State Hospital, William S. Hall Psychiatric Institute, C. M. Tucker Human Resources Center and Village "A" will be treated at the James F. Byrnes Clinical Center. Patients at Crafts-Farrow State Hospital and the Earle E. Morris, Jr. Alcohol and Drug Addiction Treatment Center will be treated at the Sol B. McLendon Clinical Center.

(c)     It will be the responsibility of the Director of the facility at which the patient is located to make the necessary arrangements with the Superintendent of the facility at which the patient will be transferred.

(d)    When patients are transferred to Byrnes or McLendon Clinical Centers, it will be the responsibility of the receiving facility to provide psychiatric consultation for the patient while under treatment for tuberculosis.

(e)     As soon as a patient completes the course of treatment for tuberculosis at Byrnes Clinical Center or McLendon Clinical Center, the patient will be transferred back to the facility from which the patient was received.

IV.      Recessions:

This directive rescinds all previous directives and memorandums pertaining to this subject.

                                                                                                hall.GIF (6886 bytes)

May 12, 1977