Florida’s surgeon general on Monday announced new protocols for treating TB patients in the state’s post-sanatorium era. The Legislature earlier this year required that Florida’s last TB hospital, A.G. Holley State Hospital in Lantana, be closed as part of a broader effort reorganizing the state Department of Health.
“The real issue with A.G. Holley isn’t so much why is it closing,” said Dr. John Armstrong during a teleconference outlining the treatment protocols. “It is closing because of legislative mandate. The issue is why did it take Florida so long?”
Under the new system, TB patients will be divided into three groups. Most will be in tier one, receiving care at home from county nurses. A middle tier will direct people who otherwise might have been hospitalized to one of eight regional area networks, where injectable drugs will be administered by specialists in a clinic setting. Patients needing housing will be kept isolated, not in expensive hospitals, but rather in “appropriate transitional housing.” A third tier will be for the most severe and expensive-to-treat cases requiring a hospital stay.
Transitional housing will be identified on a case-by-case basis, said Dr. Doug Holt, an infectious-diseases specialist. “The type of facilities will be single-occupancy facilities that do not have common areas and provide no shared air,” he said. “They will have controlled or limited access.”
The state surgeon general’s plan for TB emphasizes standardized care and accountability, with the goal of cutting Florida’s TB rate in half by 2020. The state’s 4.0 TB infections per 100,000 population last year was its lowest rate in decades.
“We recognized years ago that if you wanted to improve the care of patients in complex systems, you have to document and evaluate outcomes at every level,” Armstrong said.
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