Public Health Department Policy & Procedure Manual Example

Procedure for Enabler/Incentive Program

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Procedure for Enabler/Incentive Program

  1. Purchase incentive items for tuberculosis clients using the money provided. Types of items that can be purchased may be as far reaching as your imagination with the exception of cigarettes, alcohol, and health services such as x-rays and any over-the-counter medications. Usual incentives cost under $10. Remember that an incentive need not be expensive to be meaningful to a client. Typical items include pill minders, food, beverages, school supplies, plants, bus tickets, gas vouchers, flowers, birthday cards, even fishing lures. It is important to base incentive purchases on your knowledge of the client and to make them as personally meaningful to the client as possible. Listen to your clients, and as you build rapport with them, learn their interests. This will enable you to choose meaningful incentives for them. Begin right away with small items while the nurse-client bond is forming.

Sometimes, it may be appropriate to spend a bit more on a client if they have a particular need (they are contagious and need help paying rent so as not to become homeless), or have reached an important milestone in treatment (they have completed one year of therapy for multidrug-resistant TB). If such special cases arise, clear your purchase first. Call the American Lung Association’s TB Control Incentive Program Coordinator at (262) 703-4845 to ensure the availability of funding to fulfill your request. General questions without client names can also be submitted to the American Lung Association email address at:

  1. Fill out the purchase log (Appendix J) for each set of items you purchase and attach your receipts to the log for the items purchased. Make a separate entry in the log for each receipt you submit.
  2. Fill out the disbursement record (Appendix K) each time you provide an incentive to a client. First, record the date the incentive was provided to the client. Then record the confidential client identification information (client’s name, initials or identification number assigned by the Wisconsin TB Program) and the client’s date of birth for client tracking purposes (clients need not sign the record themselves). Make one check in either the “Suspect/Active TB Case” or the “Latent TB Infection” column to indicate what type of tuberculosis the client has. Indicate what type of incentive was used, and finally, its value or approximate value.

  3. Fill out the reimbursement request (Appendix L) at the time you decide to request reimbursement from the American Lung Association of Wisconsin. Indicate to whom/what agency the check should be made payable, to whom the check should be mailed to the attention of, your agency name, and the correct address the check should be mailed to. Indicate the total amount you are requesting to be reimbursed (which should match the total amount on the purchase log and be equal to the attached receipts). Sign and date the request.

  4. You may submit the purchase log with attached receipts, the disbursement record, and the reimbursement request to the American Lung Association of Wisconsin at any time you would like to be reimbursed. You need not wait until you have spent the entire $100, as is it is intended to form a base for your incentive account from which you may draw. When the American Lung Association receives the forms, they will process them and send you a check for the amount of money you have used within three weeks.

  5. Submit all forms and receipts before December 15th of each calendar year so that the American Lung Association of Wisconsin can track the clients served within that year. Activity for December 15th to 31st may be carried over to the following year.
  6. You may discontinue participation in the Tuberculosis Control Incentive Program at any time. Resignation from the program requires that the $100 used as a base for the incentive account be returned to the American Lung Association of Wisconsin accompanied by a letter clearly stating your agency’s desire to resign from participation in the program. Lack of activity in the Tuberculosis Control Incentive Program does not mandate resignation from the program, as it is understood that significant time periods may be experienced between tuberculosis clients

Annual review of implementation of policy and procedure to assess the need for modifications to improve quality or efficiency of program.


  • American Academy of Pediatrics. Red Book 2000, Report of the Committee on Infectious Disease, 25th Edition, 2000.

  • American Thoracic Society and Centers for Disease Control and Prevention. Diagnostic Standards and Classification of Tuberculosis in Adults and Children. American Journal of Respiratory and Critical Care Medicine, April, 2000, 161:1376-1395.

  • American Thoracic Society. Treatment of tuberculosis and tuberculosis infection in adults and children. American Journal of Respiratory and Critical Care Medicine,
    1994; 149: 1359-74.

  • Centers for Disease Control and Prevention. Core Curriculum on Tuberculosis: What the Clinician Should Know. Fourth Edition, 2000.

  • Centers for Disease Control and Prevention. Improving Client Adherence to Tuberculosis Treatment. 1994.

  • Centers for Disease Control and Prevention. Morbidity & Mortality Weekly Report, Volume 44/No. RR-11. Elements of a Treatment Plan for TB Clients.

  • Centers for Disease Control and Prevention. Targeted Tuberculin Testing and Treatment of Latent Tuberculosis Infection. MMWR April, 2000;49 (No. RR-6).

  • Division of Public Health, Bureau of Communicable Diseases. EPINET, Wisconsin Disease Surveillance Manual [Updated periodically on the Health Alert Network (HAN).]

  • National Tuberculosis Controllers Association. Tuberculosis Nursing: A Comprehensive Guide to Client Care, 1997.

  • Pickering, L.K., ed. Tuberculosis. In: 2000 Red Book: Report of the Committee on Infectious Diseases. 25th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2000, 593-613.

  • TB Fact Sheet Series found at

  • Sputum Conversion during TB Treatment, (POH 7131)

  • Rifater and Rifamate in the Treatment of TB (POH 7133)

  • Tuberculin Skin Testing for Suspected TB (POH 7134)

  • False-Positive Cultures for Mycobacterium tuberculosis (POH 7137)

  • “Tuberculosis” DPH Disease Fact Sheet Series, POH 4432. (

  • Wisconsin Department of Health and Family Services. Wisconsin Administrative Rule, Control of Communicable Diseases, Chapter 145.

  • Wisconsin Division of Public Health. Infection Control Plan for Local Health Departments (developed as a template for local health departments). 1998.

  • Wisconsin Statutes and Administrative Code Relating to the Practice of Nursing, ss. 441 Wis. Stats., & Chapter N6 - Standards of Practice for Registered Nurses and Licensed Practical Nurses.

  • Wisconsin Statutes, Communicable Diseases; ss. 252.07 – 252.10; 1999.

  • Wisconsin TB Program Strategic Plan for Elimination of TB in Wisconsin, 2001.

  • World Wide Web addresses, National Model TB Centers & CDC:
    Harlem Model Center –

      • New Jersey Model Center –

      • San Francisco Model Center –

  • Centers for Disease Control and Prevention, CDC, Atlanta –

POLICY TITLE: TB – Isolation



AUTHORIZED BY: Heidi Stewart, BSN, Health Officer / Director
To assure the containment of tuberculosis through measures to protect the public when an individual is suspected or known to have infectious or high-risk tuberculosis.

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