AFL 21-05 From the California Department of Public Health
TO: Skilled Nursing Facilities
SUBJECT: Process for Fit-testing Resource Requests
All Facilities Letter (AFL) Summary
This AFL informs Skilled Nursing Facilities (SNFs) of the process for requesting resources through Salesforce to assist in the fit-testing of respiratory protection for staff.
Effective January 13, 2021, the State of California has introduced a new process for SNFs to request fit-testing assistance for staff respiratory protection. The State has contracted with Concentra to provide training and fit-testing for SNF staff who must wear respiratory protection to safely perform their essential duties. Facilities will now have the ability to enter fit-testing requests into Salesforce for their Medical Health Operational Area Coordinator (MHOAC) to consider and coordinate. For additional information on the Salesforce platform, please refer to AFL 20-79 on Access to Salesforce for Resource Requests.
Requesting Fit-testing Services
Facilities requesting fit-testing through Concentra can submit a Salesforce request and will subsequently receive an authorization form that they will distribute to their staff who require fit-testing.
Facility staff obtaining fit-testing through Concentra are responsible for locating their nearest Concentra facility through Concentra’s website and calling the location to schedule an appointment for fit-testing. Facility staff will need to bring the following to their fit-testing appointment:
- at least two respirator models or sizes,
- their medical clearance forms (outlined below), and
- their authorization form.
Concentra will administer a medical evaluation to facility staff prior to their fit testing appointment, including a Respirator Medical Evaluation Questionnaire that staff must complete before their visit. The medical evaluation and questionnaire must be consistent with the requirements of the Cal/OSHA respirator standard, Title 8 California Code of Regulations section 5144. When a facility staff person gives a positive response to questions 1-8 on the medical questionnaire or when the initial medical evaluation or subsequent examination demonstrates a need for a follow-up medical examination, Concentra will provide a follow-up medical examination. Concentra will provide facility staff with an opportunity to discuss the questionnaire and examination results with the physician or other licensed health care professional (PLHCP) during the clinic appointment.
Fit-testing Requirements and Documentation
Concentra will verify that each employee is clean-shaven in the area where the sealing surface of the respirator contacts the skin or they will not perform the fit test. An employee may need to be fit tested for one or more types of respirators depending on their job tasks.
Concentra will document for each employee upon fit testing the respirator size, type, model, and the approved brand that adequately fit the employee. The type(s) of respirator, e.g. N95 filtering facepiece respirator, for which the employee is to be fit tested will be based on the type indicated on the master list of all respirators provided by CDPH.
Concentra will provide a report of the fit test result to each employee showing whether they passed or failed the fit test for each respirator fit tested. The report will include information on the brand, model, size of the respirator that fit the employee, in addition to the employee’s first and last name and date of the fit test.
Additionally, Concentra will provide training to staff persons at the time of fit-testing on proper usage of the respirator and explain how improper usage and maintenance can compromise the protective effectiveness of the respirator. This training will include information about how to properly inspect, put on and remove, use, and check the seals of the respirator.
Original signed by Heidi W. Steinecker
Heidi W. Steinecker