Arizona-Sonora Meet & Greet Program

12/5/2012 Arizona-Sonora Meet & Greet Program Robert Guerrero, MBA Chief Office of Border Health Arizona Department of Health Services azdhs.gov Hea...
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12/5/2012

Arizona-Sonora Meet & Greet Program Robert Guerrero, MBA Chief Office of Border Health Arizona Department of Health Services azdhs.gov

Health and Wellness for all Arizonans

Abbreviations • ADHS-TB- Arizona Department of Health Services-TB Control Program • ADHS-OBH- Arizona Department of Health Services – Office of Border Health • LHD- Local Health Department • CF- Correctional Facility • ICE- Immigration and Customs Enforcement • IHSC- ICE Health Service Corps • ASPHL- Arizona State Public Health Laboratory • MDR- multi-drug resistant tuberculosis • M&G-Meet and Greet

azdhs.gov

Health and Wellness for all Arizonans

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12/5/2012

What is the Arizona Meet and Greet Program? • Informal agreement between Arizona and Sonora, Mexico for cases repatriated to Mexico • Process to provide the opportunity for continuity of care for patients returning to Mexico with active TB or suspected TB on medications • Protocol established in 2007 and updated in 2010

azdhs.gov

Health and Wellness for all Arizonans

Why a M&G? • Long duration of TB treatment

• Education concerning TB and treatment • Possibility of return and public health threat • Threat of emerging drug resistance • Completion rate

azdhs.gov

Health and Wellness for all Arizonans

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Goals of the Program • Continuity of care for TB active/suspects cases • Completion of TB treatment for confirmed cases • This program is primarily for inmates/detainees in correctional facilities who are being repatriated to Mexico but has been used for high risk community cases

azdhs.gov

Health and Wellness for all Arizonans

Agencies Involved • IHSC • ADHS-OBH • ADHS-TB • Secretaria de Salud Publica de Sonora • Consulate Mexicano / Cancilleria de Protecciones /Instituto de Mexicanos en el Exterior (Tucson & Nogales) •Instituto Nacional de Migracion

•U.S. Marshals Service •U.S. Border Patrol • Hospital General de Nogales* • LHDs • CureTB • TBNet • CBP • CFs

azdhs.gov

Health and Wellness for all Arizonans

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Role of Correctional Facilities Complete medical screening

• Provide case management for inmate/detainee • Notify ADHS-TB at least 24-72 hours prior to departure • Complete and submit binational referral form • Submit lab reports and all pertinent medical information • Coordinate with referral agency for patient interview • Coordinate contact investigation with LHD, if necessary • Arrange resources for departure • Confirm status with ADHS-OBH 1 hour prior to departure

Notify LHD/ADHS-TB of all active/suspect TB cases

azdhs.gov

Health and Wellness for all Arizonans

Role of ADHS-TB Receive notifications from CFs and LHDs

• Notify LHD if not already aware • Ensure patient is enrolled with referral agency • Contact ICE/IHCS for departure status • Contact ADHS-OBH for coordination with Sonora, Mexico • Provide surveillance on all cases • Serve as consultation to agencies • Organize communication for M&G • Coordinate laboratory testing at ASPHL • Communicate with ADHS-OBH and referral agency for follow-up on patient

azdhs.gov

Health and Wellness for all Arizonans

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Role of ADHS-OBH Receive notification from ADHS-TB

• Notify Hospital General de Nogales •TB Program Physician •TB Nurse • Notify Secretaria de Salud de Sonora in Hermosillo •Director of Disease Control and Prevention •Director of TB Program • Coordinate and confirm date of M&G for Sonora • Coordinate with Consulado de Mexico for possible nonmedical assistance •IME •Cancilleria de Protecciones •Notify Instituto Nacional de Migración • Contact TB Physician/Nurse on day of deportation to ensure patient is met at the border • Provide follow-up of M&G to ADHS-TB

azdhs.gov

Health and Wellness for all Arizonans

Bus/van leaves from correctional facility

Day of Departure

Correctional officers call ADHS-OBH 1 hour from the border

ADHS-OBH notifies the Sonoran health officials

Bus arrives at Lane 1 at the border where they meet Sonoran health officials Sonoran health officials take patient to Hospital General de Nogales Patient is interviewed and either stays in Nogales or other arrangements are made for transportation to their destination azdhs.gov

Health and Wellness for all Arizonans

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Active TB Cases, Meet & Greets, Arizona, 2009 - 2011 2009 4 1 5

2010 6 3 9

2011 15 0 15

Returned to Mexico on anti-TB drugs

5

9

15

Number of AFB positive smear/ negative culture TB cases Number of AFB positive smear/ positive culture TB cases Number of AFB negative smear / negative culture TB cases Number of AFB negative smear / positive culture TB cases

0 2 2 1

1 3 4 1

1 4 8 2

Completed treatment Treatment continued in Mexico Treatment discontinued in Mexico (Medical provider) Lost (Documented) Unknown outcome Restarted treatment in the U.S. after Meet & Greet

0 1 0 3 1 0

1 0 2 2 2 2

1 4 2 2 5 1

Successful Meet & Greets Failed Meet & Greet Attempts Total Meet & Greets

azdhs.gov

Health and Wellness for all Arizonans

Gracias

THANK YOU azdhs.gov

Health and Wellness for all Arizonans

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