Montana Laboratory Sentinel

Updates from the MT Laboratory Services Bureau
Phone: 800-821-7284 Fax: 406-444-1802
Lab Website

Lab Manual 

(Please reference this for testing or submission questions.)

March, 2025

News and Updates

Serology

• Tickborne diseases: Colorado Tick Fever

  • MTPHL was recently notified of a change to the CDC's Colorado Tick Fever (CTFV) assays.  Currently, only acute serum samples (0-14 days post onset) will be accepted for testing by RT-PCR.  Since no antibody test is available, samples >14 days post onset will not be tested, and will be resulted as “Test Not Performed” 

  • When submitting samples for tickborne diseases, please remember to include additional information required for appropriate testing: date of onset, brief clinical summary (signs, symptoms, underlying illness if known, labs), travel locations and dates (3 months prior to symptom onset), history of potential tick exposure and antibiotic treatment with date administered.

IT Corner

• Transition to OKTA for Lab Portal Authentication

  • As announced in the last newsletter, we are onboarding users to OKTA for authentication to the lab portal. OKTA is the authentication method used by the State for access to all state applications. All users will need to create an OKTA account. So far over 130 users have made the transition, but we have many more to go.

  • We will be sending emails to the remaining users who have not transitioned to OKTA over the next several weeks in hopes to get everyone switched over.  But you don’t have to wait!  You can take the initiative to create your OKTA account now using the instructions found here.

  • Once you have an OKTA account, please notify us by sending an email to HHSLIMS@mt.gov from the email address used for your OKTA account. Each week we will be giving a list to our IT department, and they will add lab portal access to those OKTA accounts. We will then notify you by email. Until you receive that email, you can continue to sign in to the portal the way you do now.

  • Eventually access to the system will be limited to the OKTA authentication method only so it is in your best interest to make the transition now to avoid the risk of losing access when the transition is complete.

  • Also, once you have an OKTA account, you can also pay your MTPHL bill online with that same account! Similarly, for those who have already set up an OKTA account to pay your bill online, you can use that account for lab portal authentication. Just let us know you already have an OKTA account by sending an e-mail to HHSLIMS@mt.gov and we will get your OKTA account linked to the lab portal.

• Medicaid Billing

  • It is important to enter Medicaid information BEFORE adding tests and saving an order. If an order gets saved and the insurance information is added afterwards, it does not get properly attached to the order for billing.

  • If you enter an order that should be billed to Medicaid and accidentally save it prior to adding the insurance information, please open a ticket from the order using the “create ticket” button and select “Billing Issue or Inquiry” as the reason. Let us know in the ticket it should be billed to Medicaid but was saved prior to the insurance information being added.

  • Instructions for how to enter Medicaid information can be found on page 15 of the order entry instructions which are found on our website.

Upcoming Trainings

• Packaging and Shipping: Save the Date!!

  • Please mark the date for packaging and shipping training on March 6th!

  • This intermediate-level course will be held virtually from 9:00 AM to 4:00 PM on March 6, 2025. A one-hour lunch break will be allowed.

  • Description of Session:

    • Through several facilitated learning activities, participants will mark, label, package, and complete documentation for various infectious substance shipments (Category A, Category B, Exempt Human Specimens). To demonstrate competency, participants will complete an online exam and practical exercises. This course provides a certificate of completion but does not certify individuals in the packing and shipping of dangerous goods. Individuals can be certified by their employer after all training requirements have been met.

  • Objectives:

    • List applicable regulations for transporting Division 6.2 infectious substances and dry ice.

    • Recognize training requirements for transporting Division 6.2 infectious substances and dry ice.

    • Summarize the potential risks associated with packing and shipping infectious substances.

    • Determine the proper action for packing and shipping Division 6.2 infectious substances.

    • Apply the key components of packing instructions 620 and 650, and properly mark, label, and document Division 6.2 infectious substances and dry ice.

  • Participants must pass the examination within one week of course completion to qualify for 5.5 P.A.CE. continuing education hours.

    “ASCLS-MT is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E. ® Program.”

  • If interested in attending, please fill out the short form found here, so I will know where to send the workshop link and course resources.

• Biosafety Training: Save the Date

  • Please mark the date for biosafety and risk assessment training on March 20th!

  • This intermediate-level course will be held virtually from 1:00 PM to 3:00 PM on March 20, 2025.

  • Description of Session:

    • The possibility of exposure to dangerous pathogens is very real in the laboratory, and creating a safety culture is essential. No matter a person's position or authority, all laboratory employees must adhere to policies and procedures to protect themselves, each other, and those outside this working environment.

  • During this session, participants will learn the purpose and principles of biosafety and the factors to consider before, during, and after a risk assessment. This training will be a combination of lectures, slides, and discussion.

  • At the end of this session, the participant will be able to:

    • Describe the difference between a risk and a hazard and how they apply to risk assessment.

    • Define organism risk groups and biosafety Levels

    • Describe the portals of entry and how safety mitigations and personal protective equipment can be used to prevent infection

    • List the five biosafety controls and give an example of each

  • Participants who complete this course will qualify for 2 P.A.C.E. continuing education hours. “ASCLS-MT is approved as a provider of continuing education programs in the clinical laboratory sciences by the ASCLS P.A.C.E. ® Program.”

  • If interested in attending, please fill out the short form found here, so I will know where to send the workshop link and course resources.

• Please contact Crystal Fortune for more information on either of these trainings. 

  • Phone: 406-444-0930
  • email: cfortune@mt.gov

Preparedness

• LPX-A Survey

  • The 2025 CAP LPX-A Preparedness Survey is to be sent to Sentinel Laboratories on March 31, 2025.

  • An important aspect of this Preparedness Exercise is the Packaging & Shipping Exercise component.

  • Organisms that Sentinel Labs cannot rule out as Select Agents should be referred to the Montana Public Health Laboratory.

  • Remember to contact the MT Public Health Laboratory with any questions and before referring your cultures for confirmation: 1-800-821-7284 or 1-406-444-5251.

  • More guidance on LPX-A survey.

     

Dear Lab-by I am concerned about infection control after seeing gloves and lab coats in the regular trash. My last laboratory had very strict rules: Everything that came in contact with blood and body fluids had to go into red bags. But at my new laboratory, they even throw urine cups into the regular trash! I don’t want to get into trouble for doing the wrong thing and risk someone getting sick as a result. Thanks, Lab-bey, Hello, writer! Waste management is a hot topic in many laboratories. Many people have contacted me about gloves or lab coats being in the regular trash or gauze being in sharps containers. As laboratorians, we treat everything as potentially infectious and are inclined to throw all laboratory waste in biohazard bags. One possible concern your new laboratory is considering is the cost of the extra weight generated by waste that is not “regulated”. The Bloodborne Pathogen Standard (29 CFR 1910.1030) defines contaminated as the presence or reasonably anticipated presence of blood or other potentially infectious materials and regulated waste as liquid or semi-liquid blood or other potentially infectious materials; contaminated items that would release blood or other potentially infectious materials in a liquid or semi-liquid state if compressed; items that are caked with dried blood or other potentially infectious materials and are capable of releasing these materials during handling; contaminated sharps; and pathological and microbiological wastes containing blood or other potentially infectious materials. There is lots of information you can wade through to find clarification on the issue, but here is one oldie but goodie that I like to refer to: Guidelines for Safe Work Practices in Human and Animal Medical Diagnostic Laboratories Recommendations of a CDC-convened Biosafety Blue Ribbon Panel, available online at https://www.cdc.gov/mmwr/pdf/other/su6101.pdf. This document discusses general safety in the laboratory, such as electrical safety, ergonomics, waste management, and routes of exposure. It also goes into further detail regarding hazards and risks in the different laboratory sections, such as hematology, chemistry, blood banking, virology, and tuberculosis. Section 3.5 of the document goes more in-depth into waste management, discussing the laboratory’s need to establish a waste management plan that designates the categories of waste generated and the applicable federal, state, and local regulations for each category. If you have concerns about your laboratory doing things incorrectly to save money, you have the right to report. However, first, look over resources such as these to clarify the issue with your facility. You can always reach out to me to search for answers if you can’t find what you need. If I don’t know the answer, I have a network of safety professionals who can help. Best, Lab-by

Reminders:

• Lab Portal Information

  • All of our lab portal procedures and access paperwork can be found on our website. Here is the link to the direct page with all of our forms and procedures: https://dphhs.mt.gov/publichealth/LaboratoryServices/onlineorderingandresults.

  • There is also a link in our lab portal that will take you directly to this page. This link can be found under quick links. "MT PHL Lab Portal Procedures and Forms". 

• Courier 

  • Please click here for our full courier schedule.

• Previous Laboratory Sentinels 

  • All previous Laboratory Sentinels can be found on our website on the column on the left hand side by selecting "Public Health Laboratory Newsletter". Here is a link to all our previous Laboratory Sentinels.