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36 <br /> N.C. Department of Environment, Health, and Natural Resources Page 2 of <br /> _ _ Division of General Services- FY 03 <br /> CONTRACT ADDENDUM <br /> Communicable Disease Control Section 93 4510 068 <br /> Office, Section or Branch Contract Number <br /> Orange County Health Department Communicable Disease <br /> Contractor Activity <br /> 4) provide HIV counseling and testing services to 90% of those requesting <br /> testing within one week of request; <br /> 5) provide immunizations as an integral part of child health and family <br /> planning clinics without referral or rescheduling; <br /> 6) provide required immunizations within one week by appointment and on a <br /> walk-in basis; <br /> 7) -physical exams will not be required prior to immunization unless there <br /> is an acute illness or a neurologic condition that is evolving or has <br /> not been fully evaluated; <br /> 8) provide communicable disease control services regardless of patients' <br /> county of residence; <br /> 9) suspected TB cases should be evaluated within one working day and <br /> started on therapy within 72 hours; <br /> • 10) contacts of suspected TB cases should be interviewed for <br /> symptoms and screened within 7 days of recognition of <br /> suspected case. <br /> j B. Quality of Services: . <br /> 1) local health departments should have current standing orders which are <br /> consistent with control measures for: <br /> a) giving immunizations and avoiding inappropriate contraindications; <br /> b) diagnosing and testing for uncomplicated gonorrhea, syphilis, <br /> . chlamydia, and NGU on-site; <br /> c) beginning preventive therapy for tuberculosis for patients at low <br /> risk for side effects; <br /> d) investigation and management of cases and contacts of reportable <br /> communicable diseases; <br /> e) providing HIV counseling, testing, and .referral. <br /> 2) Staff at local health departments who routinely provide communicable <br /> disease services should have sufficient training to: <br /> • a) conduct an investigation to:identify the source of infection and <br /> those at risk for spread of all reportable communicable diseases; <br /> b) conduct STD evaluation, including performance of physical <br /> examinations and laboratory work (gram stain, wet prep, <br /> *- urinalysis, stat RPR, and "stat" or "dry" dark field) , and provide <br /> treatment under standing orders; . <br /> c) monitor TB patients on medications, recognize and provide initial <br /> management for side effects or complications of TB disease; <br /> 3) local health departments- should have: <br /> a) back-up from a physician knowledgeable about public health <br /> communicable disease control needs for each facet of its <br /> communicable disease control Program; and <br /> rJ • . Reviewed by <br /> r 1 <br /> Dec 33D0 (Revised 2/90) (� 0 - t;, c(� <br /> General Services Division (Review 1/95) Initials Date <br />