John Bernardo

1. Minutes from the NTCA John Bernardo John Bernardo President 2006

2. Time Spent NTCA • Mission: Partnerships with CDC, NTNC • Immigrant/refugee screening and B-notification • Budget and Advocacy • Laboratory • Education and Research • Working groups • Program Representation to NTCA • Annual Meeting

3. NTCA Mission … to advance the elimination of tuberculosis in the U.S. through the collective, concerted action of the officials of state, local, and territorial government who are empowered by their jurisdiction with the responsibility for carrying out programs to prevent and control TB NTNC Carol Pozsik, RN, MPH Executive Director

4. Overseas Screening • Hmong resettlement, 2004 - • Missed cases • High burdens of disease (MDR) to Domestic Programs • Technical Instructions for Panel MD’s Revised, 2006 • CDC Division of Migration and Quarantine (DGMQ) • NTCA role (proposed) • Follow-up of arrivals: evaluation of screening/feedback • Burmese resettlement 2006 - (anticipate n > 150,000/~10yr) • Electronic Disease Notification (EDN) • Process in-development (DGMQ) • NTCA panel (M. Arbese, D. Sodt; DGMQ staff) to work start-up • Proposed changes to screening criteria • To expand screening to most 6 month-or-longer stays • Capacity overseas? • Roles and capacity of local TB programs? • Proposed revision of CDC Guideline for TB Control in Foreign-Born

5. Budget and Advocacy • Budgetary crisis • DTBE level funding 1993-2005 • Reduction in real dollars • 5% (appr.) cut to TB Programs COAG in 2006 • Late arrival of funds • Current program challenges to maintain services • Anticipate another 5% cut for 2007 • NTCA responses • Prioritization to essential program activities: DTBE, ACET • IMPACT of FUNDING CUTS • Discussions with DTBE re funds distribution • “Formula committee” – morbidity-based/non-punitive • Advocacy • Results: Domestic TB issues now agenda item • Support Comprehensive TB Elimination Act of 2006, reincarnate (HR5836)

6. Laboratory • Association of Public Health Laboratories Task Force: NTCA • Systems Approach to Laboratory Services (MMWR 2005) • Revision of Laboratory Self Assessment Manual • Education and training for Clinicians and Public Health • Collaborations on Diagnostics working groups • QFT (TBESC), NAA (TBTC) • Concurrent regional meetings • Concurrent National meetings

7. Education and Research • Participation in educational activities at all levels • RTMCC’s • Regional TB Control and Program conferences • Assessment of program relevance of CDC Clinical and Epidemiologic Research activities • Turning Research into Practice working group, TBESC • Program participation in new TBESCSTAR process • To define TBESC research agenda • External review of TBTC agenda

8. Working Groups/Surveys • QuantiFERON-G • Communicate among users/potential users • Advocate for implementation of testing • Explore operational performance of QFT testing (?TBESC) • TB Nurses’ Manual Committee • Revision of popular manual for TB Nurses • Genotyping Database … • Surveys • Impact of federal funding cuts • Use of Medicaid waiver for TB treatment • Adverse events from treatment of LTBI …

9. Program Representation • To define channels of communication between NTCA Board and Constituents • Board members assigned to constituent programs • Mechanism … tbd • Purpose: to facilitate identification of program issues • Directly engage NTCA and CDC leadership • Provide dialog/program participation in new/ongoing activities

10. Eliminating TB: Fighting the Enemy 2006 National TB Controllers Workshop

11. Annual Meeting • Collaborate with CDC to create agenda of value to program staff • Confront relevant issues, identified by programs • Provide education • Encourage communication/networking • Utilize programs, their staff and their experiences • Expand understanding of TB control • Engage partners (laboratories, RTMCC’s, research groups) • Satisfy mission of NTCA/NTNC

12. Enjoy the Ride !!! Just Don’t Hit Bottom!!