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EXHIBIT C <br />REQUIREMENT GUIDELINES <br />REOUIRED: <br />Schedule <br />Interpretation <br />Hepatitis B <br />2 doses, 4 weeks apart; Yd <br />Agency's policy follows CDC recommendations. <br />dose, 5 months after 2nd; <br />Documentation of 3 doses of Hepatitis B vaccination (at <br />booster not necessary <br />appropriate intervals), serologic proof of immunity or <br />declination of the series of vaccines signed by the <br />healthcare worker. <br />MMR (Measles, <br />2 doses, 4 weeks apart <br />Agency's policy follows CDC recommendations for <br />Mumps, Rubella) <br />healthcare personnel (HCP) born in 1957 or later without <br />serologic evidence of immunity or prior vaccination give 2 <br />doses of MMR, 4 weeks apart. For HCP born prior to <br />1957, is considered acceptable evidence of measles, <br />mumps and rubella immunity, however Agency follows <br />CDC recommendation that a HCP get a titer but it is not <br />required (unless a work site requirement.) <br />Varicella (chicken <br />2 doses, 4 weeks apart <br />Agency follows CDC recommendation all HCP who have <br />pox) <br />no serologic proof of immunity, prior vaccination, or <br />history of varicella disease, give 2 doses of varicella <br />vaccine, 4 weeks apart; all HCP be immune to varicella <br />with proof of Titer. <br />HIGHLY <br />[Not Required] <br />Employee must obtain if required by their work site. <br />RECOMMENDED: <br />Influenza <br />Annual influenza vaccine <br />Highly recommended by Agency (must be obtained if <br />required by employee's work site.) <br />Tetanus, diphtheria, <br />Td booster every 10 years <br />Agency follows CDC recommendation all HCP get a Td <br />pertussis <br />after one Tdap <br />booster does every 10 years, following the completion of <br />the primary 3 -dose series. Also, All HCP younger than 65 <br />get a 1 -time does of Tdap, if they have direct patient <br />contact. <br />Tuberculosis Skin <br />Upon Hire —Two step <br />Agency's policy for Tuberculosis screening follows CDC <br />Test Screening <br />TST; Annual TB skin test <br />recommendations. <br />for settings classified as <br />medium risk for HCWs <br />who have the potential for <br />exposure to M. <br />Tuberculosis through air <br />space shared with persons <br />with TB disease <br />State license, <br />Per state board of nursing <br />Agency contacts the State Board or other licensing agency <br />registration or <br />or other licensing agency <br />prior to the Assigned Employee's start date to confirm that <br />certification (when <br />the license, registration or certification is active and in <br />required) <br />good standing. Agency will not knowingly employ a <br />professional that has an action against their license. <br />