With the closing of Florida’s only hospital dedicated to tuberculosis, Jackson Memorial has taken all of the state’s TB patients that health officials believe need hospitalization — a mere 21.
Jackson and county health officials say the transition has gone smoothly, despite reports of a virulent strain of TB in Jacksonville that has received intense publicity.
“I can’t tell you how proud I am of Jackson,” said Lillian Rivera, administrator of the Miami-Dade Department of Health, a state agency. “They have the expertise and are providing excellent care.”
She said the state is temporarily paying for several employees from the closed TB hospital to help train the Jackson staff.
A.G. Holley State Hospital, which had been treating tuberculosis patients for a half-century, was closed earlier this month in a cost-cutting move passed by the Legislature and signed into law by Gov. Rick Scott. On a 140-acre campus in Lantana, the facility had a capacity for 500 beds, one of several large TB state hospitals. As the number of TB patients shrank, the other facilities closed. When Holley was shut down, it had about 35 patients supported by a staff of 130.
The Florida Department of Health decided 17 of the patients still needed hospitalization, so they were transferred to Jackson. The others were allowed to go home, with careful monitoring by health officials, Rivera said. Since then, four other TB patients have been sent to Jackson — from Orlando, Jacksonville, South Broward and the Panhandle.
A.G. Holley was almost the last of its kind. Records of the American Hospital Association list only one remaining TB hospital in the country, the Texas Center for Infectious Disease in San Antonio.Because of vaccinations, better nutrition and better drugs, tuberculosis in America has been trending downward for decades, including each of the last 19 years. The Centers for Disease Control and Prevention report that the TB rate in 2011 was 3.4 cases per 100,000 people — an all-time low.
“What’s important is the patients are getting good, dependable care,” said James Howell, a physician on the faculty of Nova Southeastern who recently headed a discussion on TB at a South Florida Hospital and Healthcare Association meeting. He called A.G. Holley “a big old battleship when you needed a state-of-the art cruiser.”
Tuberculosis is a highly contagious airborne disease that can endanger the public if a patient is untreated, and nine of the patients transferred to Jackson are hospitalized under court order because they refused to take needed medications. Howell said the noncompliant patients tend to be homeless, alcoholic or have drug problems.
Marc J. Yacht, a retired physician and longtime public health officer, said he still had many doubts about the closing of Holley. He wonders whether Jackson will be committed to long-term care for TB patients. “I have concerns if they’re going to release them quickly and they go to hotels, motels and under bridges. These patients require ongoing attention.”
The Jackson patients are in a locked unit with “negative air flow” that prevents the air in the unit from circulating to other areas, said Jackson spokesman Edwin O’Dell. He said Jackson is being adequately compensated for the care by the state.