Continuity of TB Therapy for US Immigration and Customs

1、Continuity of TB Therapy for U.S. Immigration and Customs Enforcement (ICE) DetaineesAn Update,Advisory Council for the Elimination of Tuberculosis March 20, 2007 Diana Schneider, DrPH, MA CDR, US Public Health Service U.S. Department of Health and Human Services Health Resources and Services Admini

2、stration Bureau of Primary Health Care Division of Immigration Health Services,2,3,ICE Custody,ICE detention is to facilitate removal Criminal charges resolved before admission to ICE custody ICE must remove individual as soon as possible following Final Order of Removal Must remove within 90 days b

3、y statute Post Order Custody Review if removal cannot be accomplished within 180 days If otherwise can be deported, cannot keep people in custody because of illness,4,Service Processing Centers and Contract Detention Facilities that House U.S. Immigration and Customs Enforcement (ICE) Detainees*,ICE

4、 Service Processing Center and ICE Staging Facility, DIHS staffing, digital radiography screening ICE Service Processing Center, DIHS staffing, TST screening Contract Detention Facility or IGSA, DIHS staffing, digital radiography screening Contract Detention Facility or IGSA, DIHS staffing, TST scre

5、ening Contract Detention Facility or IGSA, Contractor staffing, TST screening * Locations without symbols have ICE detainees housed in local jails nationwide,5,TB among ICE Detainees,Intake Medical Screening/TB Screening Infection control Maintain a safe detention and working environment Case detect

6、ion Continue or initiate treatment as indicated Detainees with active TB often deported prior to completion of treatment ICE does not deport patients while contagious Patients often deported before culture results are available,6,U.S. Immigration and Customs Enforcement Detainees Active Tuberculosis

7、 Cases Reported to Immigration Health Services, by Country and Release Status*, 2005,*Classified as a TB case by treating physician; not verified as meeting CDC criteria for national surveillance,Release Status,7,TB Continuity of Care Processes,Notification to DIHS Epidemiology Unit Short-term medic

8、al holds Referral for treatment and case management TBNet Program CureTB Program Binational TB Card Coordinated Removal / Medical “meet and greet” Requests for stays of removal,8,Stays of Removal,Stays of removal may be considered MDR, medically complicated, nonadherence, concomitant mental health c

9、onditions, frequent border crossers Do not ensure continued custody ICE may require other secure environment (U.S.) State and local jurisdictions have authority to compel isolation and treatment,9,Challenges,Notification before release Differing diagnostic and treatment norms U.S. vs. other Adherenc

10、e Authorities to compel isolation and treatment are unclear Information-sharing across jurisdictional boundaries If stays of removal are granted, case management may become health department responsibility Department of Homeland Security initiatives Secure Border Initiative Increasing detention capa

11、city Expedited removals,10,Workgroup Recommendations (1),Engage the foreign national health authorities and the U.S.-Mexico Border Health Commission to: Establish mechanisms to foster binational and international collaborations regarding TB case management, including electronic information sharing/h

12、ealth record sharing of expertise and resources treatment, medication availability laboratory support adherence contact investigations,11,Workgroup Recommendations (2),Convene a public health legal forum to better facilitate binational/international case management Engage the foreign National TB Pro

13、grams to promote collaboration with coordinated removals / TB meet and greets Recommend to CDC that a mechanism be established to count all TB cases that are managed by state and local TB control programs for determining federal funding,12,Next Steps,Evaluation initiated Assess outcomes Stakeholder

14、interviews Continue education and outreach State and regional TB meetings NTCA breakout session Planning webinar with Southeast Regional TB Training and Medical Consultation Center Educational materials Workgroup conference calls,13,Acknowledgements,DIHS Staff: Aguadilla, PR: CDR Karen Dorse, CDR Wa

15、nda Gonzalez Batavia, NY: CDR Jeri McGinnis, LT Deborah Doody, Dr. Brenda Bailey El Centro, CA:, LCDR Eileen Falzini, LCDR Upeng Demske, Dr. Carlos Duchesne El Paso, TX : LCDR Erik Hierholzer, LCDR Zita Guerrero, Dr. Rosa Colon, LCDR Chiara Rodriguez Elizabeth, NJ:, LCDR Rusty Waldron, LT Jonee Mear

16、ns, LT Raymond de la Pea, Dr. Chang Park Eloy, AZ: LCDR Melissa George Florence, AZ: CDR Claire Karlson, Dr. Elizabeth Fleming, LT Marc Winoker Harlingen, TX: LCDR William Rekward Houston, TX: CAPT Christine Williams, LT, Monique Frazier, LT Cynthia Beard Los Angeles, CA: LCDR Jason Ortiz, LTJG Kath

17、erine Maye Miami, FL: CDR Kirsten Warwar, CDR Jaime Muiz, Dr. Abelardo Montalvo, LCDR Andrew Ganzon Pearsall, TX: CAPT BuJean Jenkins, Dr. Erik Johnson, LCDR Gina Chacon Port Isabel, TX: CAPT Marian Moe, LT Maria Morel, CDR Adolfo Zorilla, Dr. Luz Peredo-Berger San Diego, CA: LCDR Steve Gonsalves, D

18、r. Ester Hui, LCDR Bonnie Saylor San Pedro, CA: LCDR Chris Henneford, LT Shelly Hollandsworth Stewart, GA: CDR Lynn Harris, CDR Sherlene Jacques, CDR Betty Shaw Tacoma, WA: LCDR Deanna Gephart, LT Christine Chang, Dr. Phil Farabaugh Taylor, TX: LCDR Tom Hochberg, CDR Peggy Mathis, LCDR Angel LaSanta

19、 Willacy, TX: CDR Dawn Anderson-Gary Headquarters: Mr. Neil Sampson, Dr. Tim Shack, LCDR Alice Fike, Ms. Jennifer Cheng,14,Acknowledgements,ICE/DHS: Jay Brooks; Joan Lieberman; Tim Perry, Nina Dozoretz CDC: Ken Castro, Mark Lobato, Kayla Laserson, Stephen Waterman, Maureen Wilce, Miguel Escobedo, St

20、eve Harris, Todd Wilson, Steve Benoit, Bill MacKenzie DHHS/OGC: Jocelyn Mendelsohn Arizona Dept. of Health Services: Karen Lewis, Angelito Bravo, Patty Gast, Ayesha Bashir Arizona Attorney Generals Office: Kevin Ray, Don Schmidt CA Dept. of Health Services: Sarah Royce, Anne Cass, Stephanie Spencer

21、Colorado Department of Health: Barb Stone, Gayle Schack Denver TB Control: Randall Reves Florida Dept. of Health: Halsey Rhodes, Toni Johns Georgia Department of Human Resources: Beverly Devoe-Payton, Karen Buford New Mexico: Gary Simpson, Cliff Rees TX Dept. of State Health Services: Charles Wallac

22、e, Phyllis Cruise, Sandra Morris, Mike Greenburg, Walter Erhesman, Jose Moreira, Maria Rodriguez San Diego County Health Dept/CureTB: Kathy Moser, Alberto Colorado, Florencia Sisterson, Francisco Velasco, Rafael Garcia Migrant Clinicians Network: Jeanne Laswell, Del Garcia, Ed Zuroweste, Bertha Arme

23、ndariz, Nora Martinez, Karen Mountain Public Health Institute (CA): Samantha Graff Pan American Health Organization: Kam Suan Mung, Guillermo Mendoza, Mirtha del Granado U.S.-Mexico Border Health Commission: Dan Reyna National TB Programs: El Salvador, Guatemala, Honduras, Nicaragua,15,Contacts and Information,Division of Immigration Health Services Diana Schneider, DrPH, MA phone: (202) 732-0070 e-mail: Dian