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TB Diagnostics

A.G. Holley Hospital 

Court Committed Patients

CHAPTER 392, Florida Statutes, states in part that "active tuberculosis is a highly contagious infection that is sometimes fatal and constitutes a serious threat to public health", therefore it is "unlawful for any person who has active tuberculosis and who knows or has been informed of that fact to willfully expose other persons to the disease".  An individual must follow the prescribed regimen of medication for the time period necessary for "treatment to cure" or he is in violation of the law, and has committed a second degree misdemeanor.  He is also subject to commitment proceedings.  Although most people are responsible and will take their medications as directed some, have trouble remembering to do so due to mental illness, drug or alcohol addiction, homelessness or other problems.

For these individuals a Health Department representative will go out to the home and watch the person taking his medication.  This is called directly observed therapy (DOT) and can be voluntary or court ordered.  If a patient fails directly observed therapy by not being home at medication time, or by continuing to drink or take drugs with the medicine, or any number of other problems, the health department can petition the court and the judge will commit the patient to A.G. Holley Hospital.   The sheriff will serve the commitment papers and deliver the patient to the hospital.  This is when the real work begins.

Upon admission, the patient has a complete medical workup, a Psychosocial evaluation, and a psychiatric evaluation if necessary.  The patient is detoxified if needed, and placed in respiratory isolation until three sputum samples in a row are negative.  Daily TB treatment is started from admission.  While at the hospital, the patient can also chose to participate in the Psychosocial program, which includes drug and alcohol group therapy, individual therapy, AA and NA meetings, and other therapeutic activities.

The patient also receives psychotropic medication if necessary.   The purpose of all of this is to give the patient the opportunity to change the psychosocial factors in his life which brought him to A.G. Holley in the first place.   If able to make these changes, the patient is less likely to return to the hospital with reactivated TB, but more importantly, is less likely to infect others in the future.   Often, the easiest part is to cure the patient medically of TB.  The real difficulty is in trying to help motivate patients to make lifestyle changes which are permanent and which will ultimately help protect you and me.

All patients are referred to A. G. Holley by the local health department.  Patients remain at A. G. Holley anywhere from 4 to 18 months, depending on the severity of their infection and complicating factors, like cancer, HIV, cirrhosis, etc.  Once a patient has completed their course of therapy, they are returned to their county of origin.