University of Florida officials are backing a plan to move the state's only remaining tuberculosis hospital to the Gainesville area.
A.G. Holley State Hospital in Lantana has treated the state's tuberculosis patients for more than 60 years. As the state considers options for closing the hospital, UF is supporting the construction of a new facility within 50 miles of campus, staffed by university physicians and managed by Shands HealthCare.
"It brings it to a point where they can have closer interaction with the Emerging Pathogens Institute and the research capabilities that are here at UF," said Dr. Glenn Morris, director of the UF institute.
Lawmakers have sought to close the Lantana hospital because of its cost, problems there and calls to develop its 140-acre site in Palm Beach County for other uses. UF initially proposed building a new hospital and infectious disease center at Florida Atlantic University's Jupiter campus, but that plan fell through.
Now UF, home to one of four U.S. centers designated to the study of tuberculosis, is discussing the alternative of building a hospital closer to the university at an expected cost of $10 million to $20 million. The project might be funded through the sale of the property in Lantana, which the town recently rezoned for other uses.
Morris said the state would continue to own the hospital and be responsible for choosing a new site. It is not planned for the UF campus, he said.
Tuberculosis is an infectious disease that can be spread by coughing or even breathing. It usually attacks the lungs and, if left untreated, can kill half of its victims with a year. It once was the leading cause of death in the U.S. and remains the leading cause of death by infectious disease in the world as a whole.
"The deep pool of people who have tuberculosis around the world is a big challenge,"said Dr. Mike Lauzardo, director of the Southeastern National Tuberculosis Center.
The Centers for Disease Control and Prevention designated four tuberculosis centers in the U.S, each dedicated to a particular region, to provide training, education and medial consultation. The Southeastern center is housed in UF's Emerging Pathogens Institute, with the Lantana hospital serving as a clinical training site.
The hospital is the only one that remains of four built by the state from 1938 to 1952. It was built to care for 500 patients but has 50 beds today and currently houses 37 patients. Most of its patients have been ordered there by the courts for failing to adhere to treatment, while other patients have drug-resistant strains.
State lawmakers have pushed to privatize the hospital, an effort fueled by a 2009 inspector general's report. It found the hospital's former interim CEO had used a state credit card to pay for home improvements and allowed a plumber to live with a crack-smoking prostitute in an RV on the hospital site.
A state law passed last year ordered the Florida Department of Health to develop a plan to treat patients in private and non-state hospitals. A study issued by the department in November found a lack of isolated rooms at private hospitals and security to manage court-ordered patients.
Morris said private treatment would increase costs and create other challenges, as private hospitals lack physicians with the expertise to treat tuberculosis patients.
"These patients just don't fit into your standard acute care hospital," he said.
He said a rising number of cases outside the U.S. continue to make it a problem here. About half of the tuberculosis cases in Florida originated in foreign countries, mostly in Haiti and Mexico, according to the state Department of Health.
"We are going to have people coming into Florida all the time who are restarting the brush fires," Morris said.
There were 821 tuberculosis cases and 38 deaths in 2009, the most recent year of available data, according to the Florida Department of Health. Lauzardo said there are typically about 1,000 cases in the state annually, 10 percent of which result in death.
He said a big problem with tuberculosis is the failure of patients to take drugs, creating resistant strains that are more difficult and expensive to treat. The cost of treating the average patient is about $20,000 compared with as much as $500,000 for one with a drug-resistant strain, Morris said.
The Department of Health study also outlined other options such as moving patients to a tuberculosis hospital in San Antonio or building a new hospital on the Lantana site. Morris said building a new hospital closer to UF would allow for better access to facilities here and might attract biotechnology research to the area.
Lauzardo said the hospital would pose no threat to the community or its employees, as transmission of the disease is less common in a specialty facility than other hospitals. In the end, he said, treating those with the disease only benefits public health.
"This is protecting all of us," he said. "This is not just protecting the patients that have the disease."
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