https://armypubs.army.mil/epubs/DR_pubs/DR_a/pdf/web/ad2015_20.pdf
SECRETARY OF THE ARMY
WASHINGTON
MEMORANDUM FOR SEE DISTRIBUTION
2 1 AP R 2015
SUBJECT: Army Directive 2015-20 (Tuberculosis (TB) Screening and Testing
Procedures for Child, Youth and School (CYS) Services Personnel)
1. References:
a. Army Regulation (AR) 608-10 (Child Development Services), 15 July 1997.
b. AR 40-5 (Preventive Medicine), 25 May 2007.
c. U.S. Army Medical Command (MEDCOM) Regulation No. 40-64 (The
Tuberculosis Surveillance and Control Program) , 26 November 2013.
d. Centers for Disease Control and Prevention (CDC), Core Curriculum on
Tuberculosis: What the Clinician Should Know, Sixth Edition 2013.
e. CDC Targeted Tuberculin Testing and Treatment of Latent Tuberculosis
Infection, Morbidity and Mortality Weekly Report Recommendations and Reports,
June 9, 2000 , Vol. 49, No. RR-6.
2. Purpose. This directive issues policy for the routine TB screening and testing for
CYS Services personnel.
3. Policy
a. AR 608-10 currently requires all prospective CYS employees to undergo a
tuberculin skin test or chest x-ray to test for TB. This directive revises the TB testing
requirement. Both the CDC and the Assistant Secretary of Defense (Health Affairs)
recommend changing TB testing policy to target individuals at high risk and discourage
the testing of those at low risk.
b. Effective immediately, all CYS Services personnel will have a preemployment
medical evaluation. CYS Services personnel are not considered at high risk for TB;
therefore, routine TB skin testing and/or a chest x-ray are not recommended . Targeted
TB testing will only be performed for those CYS Services personnel known to have
been exposed to the disease as identified during the preemployment evaluation. The
preemployment evaluation for those applicants with a known TB exposure will include a
tuberculin skin test or chest x-ray and other tests the occupational health service deems
appropriate.
SUBJECT: Army Directive 2015-20 (Tuberculosis (TB) Screening and Testing
Procedures for Child, Youth and School (CYS) Services Personnel)
c. The occupational health service staff and health consultant should also consider
the requirements for immunization against other significant vaccine-preventable
diseases among caregiving employees, Family Child Care providers and children.
4. Process. The updated TB screening procedures that follow replace the TB testing
requirement in AR 608-10.
a. The MEDCOM Initial Entry TB Risk Assessment will be used to screen all
prospective CYS Services personnel before their employment or certification .
Diagnostic tests will be used in accordance with CDC guidance.
b. A TB risk assessment will be used for CYS Services personnel who report
exposure to TB.
c. Diagnostic tests, including tuberculin skin tests and chest x-rays, will only be
conducted based on a medical provider's evaluation and determination.
d. Installations should request authority to solicit services from private practitioners
when long wait times for preemployment physical examinations at occupational health
or military treatment facilities (MTFs) result in critical delays in onboarding
nonappropriated fund employees. The examinations will be at no cost to the individuals
until wait times meet established metrics (30 days). In these cases, nonappropriated
fund employees must provide copies of the completed TB assessment and proof of any
needed diagnostic tests to the MTF's occupational health services.
5. U.S. Army Installation Management Command will :
a. ensure compliance with updated TB screening and testing procedures and
disseminate this information to all installation CYS Services programs no later than
30 April 2015. Notify the point of contact in the Office of the Assistant Chief of Staff for
Insta ll ation Management, Installation Services Directorate, Soldier and Family
Readiness Division, of installation compliance by 15 May 2015.
b. provide installations with operational guidance to ensure compliance with this
policy and procedures.
c. ensure that CYS Service employees who receive TB-related healthcare services
from private practitioners provide copies of the completed TB assessment as required in
reference 1c and proof of any diagnostic test(s) to MTF occupational health services in
accordance with the guidance in paragraph 4d.
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SUBJECT: Army Directive 2015-20 (Tuberculosis (TB) Screening and Testing
Procedures for Child , Youth and School (CYS) Services Personnel)
6. This directive is effective immediately and supersedes existing policy for the
tuberculin skin test in AR 608-10. However, implementation of the requirements in this
directive is subject to the satisfaction of applicable labor relations obligations.
7. The Assistant Chief of Staff for Installation Management is the proponent for this
policy and will incorporate the provisions of this directive into AR 608-10. This directive
is rescinded upon publication of the revised regulation.
8. This policy applies to all CYS Services employees.
DISTRIBUTION:
Principal Officials of Headquarters, Department of the Army
Commander
U.S. Army Forces Command
U.S. Army Training and Doctrine Command
U.S. Army Materiel Command
U.S. Army Pacific
U.S. Army Europe
U.S. Army Central
U.S. Army North
U.S. Army South
U.S. Army Africa/Southern European Task Force
U.S. Army Special Operations Command
Military Surface Deployment and Distribution Command
U.S. Army Space and Missile Defense Command/Army Strategic Command
U.S. Army Medical Command
U.S. Army Intelligence and Security Command
U.S. Army Criminal Investigation Command
U.S. Army Corps of Engineers
U.S. Army Military District of Washington
U.S. Army Test and Evaluation Command
U.S. Army Installation Management Command
Superintendent, United States Military Academy
Director, U.S. Army Acquisition Support Center
Executive Director, Arlington National Cemetery
Commander, U.S. Army Accessions Support Brigade
CONT
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SUBJECT: Army Directive 2015-20 (Tuberculosis (TB) Screening and Testing
Procedures for Child , Youth and School (CYS) Services Personnel)
DISTRIBUTION : (CONT)
Commandant, U.S. Army War College
Commander, Second Army
CF:
Director, Army National Guard
Director of Business Transformation
Commander, Eighth Army
Commander, U.S. Army Cyber Command
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