For more than 60 years, A.G. Holley State Hospital in Lantana served countless patients who suffered from tuberculosis (TB). The Department of Health staff, nurses and physicians who worked at A.G. Holley were unwavering in their service and commitment to public health. They took care of tuberculosis patients when most chose not to do so. With the closing of the campus last month, we are reminded that it was not the facility that made the difference: It was the people, care-givers and patients alike.
Dedicated on July 16, 1950, A.G. Holley was the Southeast Tuberculosis Hospital, the second of four TB hospitals built in Florida, and one of more than 600 tuberculosis hospitals in the United States. In 1969, when the State Tuberculosis Board was dissolved, the hospital was renamed Adrian Glenn “AG” Holley, in honor of the prominent hardware store owner and long-term chair of the tuberculosis board.
Built to serve 500 patients daily and house the staff who cared for them, the A.G. Holley Hospital campus was, in its day, a community for managing tuberculosis. By the 1970s, the daily census at A.G. Holley had already dropped to less than half of the original 500. In 2011, there were 77 patients for the entire year. Across our state that same year, we witnessed a 10 percent reduction in active tuberculosis cases, from 837 to 753, with more than 90 percent of patients being managed in their communities.
A.G. Holley Hospital was an expression of public health that reminds us of Florida’s efforts to control infectious disease by protecting the healthy from the sick while eliminating infection. For tuberculosis, we relied on one model during the past century, focused initially on confinement of tuberculosis patients and moving to treatment in isolation as medications were discovered.
A.G. Holley health professionals transformed TB from a disease to be feared, marked by a death rate of 30 per 100,000 before it opened, to a disease to be cured, with a case rate of four per 100,000 last year.
The success of A.G. Holley brought us to the present, when tuberculosis care rarely requires confinement, and treatment regimens can “assure the cure” with proper case management. We manage tuberculosis patients in a system of care that protects the public health while allowing most TB patients to receive care where they want — in their communities.
A.G. Holley represented one way to serve TB patients, yet today, our integrated state health department and clinical care system are able to provide the highest level of care to tuberculosis patients within our own communities. For the few TB patients requiring hospitalization, premier academic medical centers can provide specialized care.
Our commitment to tuberculosis patients remains as strong as it has ever been, and we have set clear goals: to reduce by half the case rate of tuberculosis in our state by 2020 — this means that 380 Floridians will never have tuberculosis — as we work to eliminate tuberculosis in Florida.
A.G. Holley hospital made a profound difference in the lives of tuberculosis patients and their families, moving them from isolation to integration, from despair to hope, and from a sentence to a healthier future.
The closure of A.G. Holley hospital, the last TB sanitarium in the United States, is a milestone for Florida’s public health system, and reminds us that there is no finish line until we eliminate TB in Florida.
Dr. John Armstrong is state surgeon general and Florida secretary of health.