The document provides background information for a capstone course project involving a situation at a home health care agency. A home health aide, Sara, contracted tuberculosis (TB) and faced isolation from coworkers upon returning from medical leave. Another aide is now displaying similar symptoms. The student has been tasked with investigating how the agency handled the situation. The first steps outlined are: 1) research TB and ensure education materials are available for staff, 2) research disclosure requirements to ensure protocol was followed, and 3) interview Sara, coworkers, supervisors, and HR to determine if a privacy violation or disparate treatment occurred. Researching TB will help address staff fears and interviews will provide facts from all perspectives to compile an accurate

1. Module 1 - Home
PUBLIC HEALTH, EPIDEMIOLOGY, AND HEALTH
STATISTICS
Modular Learning Outcomes
Upon successful completion of this module, the student will be
able to satisfy the following outcomes:
· Case
· Describe epidemiology of a communicable disease..
· SLP
· Research literature for relevant information including health
and disease statistics to assess significance of a communicable
disease..
· Discussion
· Identify steps for gathering relevant information to determine
disease outbreak.
Module Overview
Background and Context
The BHS499 capstone course challenges you to synthesize what
you have learned in your BSHS program’s core courses to
develop a plan that addresses a "real-world" topic in health
care. As you proceed through the assignments, you will have an
opportunity to apply the knowledge and skills gained from your
previous coursework while conducting research to interpret the
issues and implications of a health/healthcare topic from the
perspective of a health professional, and developing a plan to
address the issue.
Throughout the course, you will be expected to incorporate
several information resources from different media (such as
professional and scholarly sources, educational videos, news
broadcasts and articles, consumer information sources, and
interviews with health professionals) to this project and to
evaluate the relative merits of competing resources with respect
to the expectations of this project.
Foundation for this Project

2. Congratulations! You have been hired as Assistant Manager of a
Home Health Care Agency. The agency offers a wide range of
skilled medical services such as nursing care, physical therapy,
occupational therapy from qualified medical professionals. The
agency also provides home health aide services including
assistance with activities of daily living, such as bathing and
eating.
Your supervisor told you that she recently received a call from
an advocate whom an employee consulted via the Employee
Assistance Program because the employee felt that she had been
treated unfairly after contracting an illness. She explained that a
few months ago, one of your agency’s home health aides, Sara,
became ill. Sara had been coughing for approximately six
weeks, lost weight without trying, had no appetite, was having
difficulty sleeping, and had an intermittent fever. She became
concerned and went to see a healthcare professional who
diagnosed her with active tuberculosis (TB).
Sara missed a lot of time from work while completing treatment
for TB. Her physician cleared her to return to work after she
was no longer contagious. Upon returning to work, Sara felt
isolated because her boss and co-workers refused to spend time
with her. She heard that someone from the agency’s Human
Resources Department told her co-workers her diagnosis. The
stressful circumstances at work became even worse when
another home health aide started to display the same symptoms
Sara had.
Your supervisor has asked you to review the entire situation and
how it was handled by the agency. Each module includes
information about epidemiology, health statistics, public health,
health communication and advocacy, health literacy, healthcare
delivery systems, the Affordable Care Act, ethical
considerations, human resources management, legal aspects,
cultural and global perspectives, and financial considerations
for the organization.
Your methodology over the next few weeks will be to arrange
interviews with the relevant individuals, departments, and

3. agencies, in addition to researching professional and scholarly
sources, educational videos, and news articles. You will
evaluate the information you gather throughout the course of
your investigation in order to determine the best course of
action. Ultimately, the information will be used to formulate
policies and create an employee education presentation.
Module 1 - Background
PUBLIC HEALTH, EPIDEMIOLOGY, AND HEALTH
STATISTICS
Required Reading
Byron, P. (2016, July 11). History of tuberculosis in the United
States to be explored in unprecedented depth. Virginia Tech.
Retrieved from https://vtnews.vt.edu/articles/2016/07/clahs-
tuberculosisforum.html
Centers for Disease Control and Prevention
(2016). Tuberculosis (TB). Division of Tuberculosis
Elimination, U.S. Department of Health & Human Services.
Accessed at http://www.cdc.gov/tb/
Miramontes, R., Hill, A. N., Woodruff, R. S. Y., Lambert, L.
A., Navin, T. R., Castro, K. G., & LoBue, P. A. (2015).
Tuberculosis infection in the United States: Prevalence
estimates from the national health and nutrition examination
survey, 2011-2012. PLoS One, 10(11)
doi:http://dx.doi.org/10.1371/journal.pone.0140881
Yuen, C. M., Kammerer, J. S., Marks, K., Navin, T. R., &
France, A. M. (2016). Recent transmission of tuberculosis --
United States, 2011-2014. PLoS One, 11(4)
doi:http://dx.doi.org/10.1371/journal.pone.0153728
initial post for each module discussion:
· At the beginning of each module, address the discussion topic,
making sure to meet all of the criteria on the rubric.
· A substantive comment should be approximately 200 words or
more.
· Cite sources within your comment to support your statements.

4. · Include at least one reference, properly formatted, not just a
link.
· You will only be able to view other discussion comments after
you post your own. Your first comment will be graded.
Second post for each module discussion:
· Read the initial comments posted by your classmates and
reflect upon them.
· Formulate one new comment of your own. It must be a logical
and thoughtful response that synthesizes the comments of at
least 3 classmates into one comment. Be sure to synthesize; do
not simply reply to each of the 3 classmates.
· If the class is small, the discussion will be with your
professor.
· NOTE: You are not required to cite sources and include a
reference list for the second post if it is simply your opinion.
However, if your opinion is based on facts (as it should be), it
is good practice to strengthen your position by citing sources.
· Be sure to meet all of the criteria on the rubric, as noted in the
instructions above.
Third post for each module discussion:
· Read the initial and secondary comments posted by your
classmates and reflect upon them.
· Directly respond to at least one classmate in a way that
extends meaningful discussions, adds new information, and/or
offers alternative perspectives.
Respond to the following
Gathering of Relevant Information-post 1
Actions for Gathering of Relevant Information-post 1
Sheila Chase posted Oct 19, 2016 11:45 AM
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The first three steps as I begin my investigation would be to:
-Conduct research on tuberculosis and if there are education
materials in the facility for the staff
-Conduct research on disclosure requirements for those who

5. came in contact to ensure protocol was followed
-Conduct interviews to determine privacy violation and
disparate treatment
-Interview Sara
-Interview Co-workers and Supervisor
-Interview Human Resource Staff
-Interview Aide with similar symptoms
I would conduct research on tuberculosis and provide
educational materials to ensure that the staff understood
contraction after treatment and to deter further ostracizing of
Sara. This may also be conducive to the staff to alleviate any
fear that they may have of contraction. I would want to
understand the process of notification of individuals who came
in to contact with Sara prior to conducting any interviews. Once
I understand the process I would conduct interviews to
determine how the information was disclosed and if it was
within protocol or violation of Health Insurance Portability and
Accountability Act (HIPPA).
Centers for Disease Control and Prevention (2016).
Tuberculosis (TB).
Menu of Suggested Provisions For State Tuberculosis
Prevention and Control Laws. Mandated Reporting. Retrieved
fromhttp://www.cdc.gov/tb/programs/Laws/menu/caseid.htm
U.S. Department of Health and Human Services (2016). HIPPA
for Professionals. Summary of the HIPPA Privacy Rule.
Retrieved fromhttp://www.hhs.gov/hipaa/for-
professionals/privacy/laws-regulations/index.html
Respond to the following
Gathering Relevant Information-post 2
Actions for Gathering Relevant Information-post 2
Sheila Chase posted Oct 25, 2016 11:41 AM

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Since it has been months we could presume that the Home
Health Care Agency reported the TB case to the Health
Department because the timeframe for reporting is within 24
hours of any suspected or confirmed case of tuberculosis (CDC,
2016).
I agree with Clay that conducting interviews will allow
interviewers to receive the facts from both sides, including the
newly sick employee and to compile an accurate timeline and
gain a better understanding of the possible PHI breach. The
authorized disclosure of information is when the health care
provider must report any screening of contacts, with the names
and addresses and results of the screening tests of the contacts,
to the local health department (CDC, 2016). Castor states that
The U.S. Department of Health and Human Services outlines the
policy for employers that allows them to ask for information if
it pertains to an employee’s health that may require them to take
sick leave for an extended period. However, employers will not
be able to receive information directly from an employee’s
primary care provider unless that employee has authorized their
physician to disclose information to their employer. Sonya adds
that since another employee is reportedly having the symptoms
as Sara I would then involve a neighboring local or state health
department to assist with the outbreak response. The Health
Department would determine whether to conduct a contact
investigation (CDC, 2016).
The education portion provided to the employees at the Home
Health Agency would be to refer them to the [Health & Safety]
Code § 121361 where it states, that a healthcare facility shall
not discharge or release a person known to have active
tuberculosis disease, or who the medical staff of the health
facility or of the penal institution has reasonable grounds to
believe has active tuberculosis disease, unless notification and a
written treatment plan pursuant to [statutory provision requiring
disease notification report to local health officer, including an
individual treatment plan] has been received by the local health

7. officer. When prior notification would jeopardize the person’s
health, the public safety, or the safety and security of the penal
institution, the notification and treatment plan shall be
submitted within 24 hours of discharge, release, or transfer”
(CDC, 2016).
Centers for Disease Control and Prevention (2016).
Tuberculosis (TB). Menu of Suggested Provisions For State
Tuberculosis Prevention and Control Laws. Mandated
Reporting. Retrieved
from http://www.cdc.gov/tb/programs/Laws/menu/caseid.htm
Foundation for this Project
Congratulations! You have been hired as Assistant Manager of a
Home Health Care Agency. The agency offers a wide range of
skilled medical services such as nursing care, physical therapy,
occupational therapy from qualified medical professionals. The
agency also provides home health aide services including
assistance with activities of daily living, such as bathing and
eating.
Your supervisor told you that she recently received a call from
an advocate whom an employee consulted via the Employee
Assistance Program because the employee felt that she had been
treated unfairly after contracting an illness. She explained that a
few months ago, one of your agency’s home health aides, Sara,
became ill. Sara had been coughing for approximately six
weeks, lost weight without trying, had no appetite, was having
difficulty sleeping, and had an intermittent fever. She became
concerned and went to see a healthcare professional who
diagnosed her with active tuberculosis (TB).
Sara missed a lot of time from work while completing treatment
for TB. Her physician cleared her to return to work after she
was no longer contagious. Upon returning to work, Sara felt
isolated because her boss and co-workers refused to spend time
with her. She heard that someone from the agency’s Human

8. Resources Department told her co-workers her diagnosis. The
stressful circumstances at work became even worse when
another home health aide started to display the same symptoms
Sara had.
Your supervisor has asked you to review the entire situation and
how it was handled by the agency. Each module includes
information about epidemiology, health statistics, public health,
health communication and advocacy, health literacy, healthcare
delivery systems, the Affordable Care Act, ethical
considerations, human resources management, legal aspects,
cultural and global perspectives, and financial considerations
for the organization.
Your methodology over the next few weeks will be to arrange
interviews with the relevant individuals, departments, and
agencies, in addition to researching professional and scholarly
sources, educational videos, and news articles. You will
evaluate the information you gather throughout the course of
your investigation in order to determine the best course of
action. Ultimately, the information will be used to formulate
policies and create an employee education presentation.
Privacy Po
Answer the following post discussion question:
outline the first three things/steps you will do as you begin your
investigation. For example, will you begin by doing some
research about the disease? Or would you begin by interviewing
Sara? Would you interview someone at the agency? If so, who?
Or would you do something else? Please explain your rationale.
Your comments will be graded on how well they meet the
Discussion Requirements posted under “Before You Begin.”