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

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

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

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

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

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

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

9. Program Representation To define channels of communication between NTCA Board and Constituents To define channels of communication between NTCA Board and Constituents Board members assigned to constituent programs Board members assigned to constituent programs Mechanism … tbd Mechanism … tbd Purpose: to facilitate identification of program issues Purpose: to facilitate identification of program issues Directly engage NTCA and CDC leadership Directly engage NTCA and CDC leadership Provide dialog/program participation in new/ongoing activities 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 Collaborate with CDC to create agenda of value to program staff Confront relevant issues, identified by programs Confront relevant issues, identified by programs Provide education Provide education Encourage communication/networking Encourage communication/networking Utilize programs, their staff and their experiences Utilize programs, their staff and their experiences Expand understanding of TB control Expand understanding of TB control Engage partners (laboratories, RTMCC’s, research groups) Engage partners (laboratories, RTMCC’s, research groups) Satisfy mission of NTCA/NTNC Satisfy mission of NTCA/NTNC

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