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Description

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G Holley State Hospital part of the Florida Department of Health is a center of excellence in the diagnosis treatment and cure of tuberculosis a disease the World Health Organization has declared to be a worldwide epidemic killing a human being every ten seconds

The Florida Department of Health is statutorily required to treat and cure patients with tuberculosis a disease that is a real threat to the health of the public One infectious patient not receiving treatment can infect up to 30 others in the community

The hospital serves all 67 counties in the state treating and curing patients with the most difficult dangerous and resistant forms of tuberculosis those strains that cannot be treated in the community

The hospital is a center of excellence in the education and treatment of TB and coinfections Serving as the education and clinical site for the Southeastern National Tuberculosis Center the hospital provides a Comprehensive Clinical Tuberculosis Course and Grand Rounds quarterly providing the best in education and training to healthcare professionals from around the state the country and from countries hardest hit with this highly infectious disease Additionally the hospital is a major partner with the Florida Public Health Institute in sponsoring and facilitating quotA Master Course An Introduction to Applied Public Healthquot an intensive two week course presented by eight of Floridas universities the Florida Department of Health the Bureau of State Laboratories the Bureau of STD Prevention and Control AG Holley and County Health Departments The course is designed to increase and enhance the public health workforce in Florida

Situated in Lantana a lovely small town in Southern Florida a major gateway into Florida and the United States AG Holley partners with the surrounding communities who recognize the need for the treatment and cure of tuberculosis to continue protecting the health of the citizens and visitors to the state


MISSION

GOAL To be a center of excellence for the treatment of TB and HIV

METHOD To provide State of the Art diagnostic and therapeutic care to those individuals who have failed traditional outpatient therapy

AG Holley is the only public health hospital in Florida Its current mission is to provide successful treatment of tuberculosis for patients who have failed therapy in community settings Today AG Holley cures over 90 percent of its patients that previously had less than a 50 percent chance of cure by traditional means The intricacies of the new therapies for HIV now being developed predict that appropriate management of these patients will be of utmost importance to the publics health The more complex cases of HIV with their attending psychological and social issues will necessitate a more intense center of treatment As TB cases decrease the AG Holley facility must position itself to have the flexibility expertise and facilities to meet the needs that will come with the future

The design and use of the hospital must accomplish the following

Expand hospital mission to address future specialized diagnosis and treatment of communicable diseases consistent with the changing public health environment

Finish 4th floor patient care renovations to maintain a proper patient care environment that will provide a flexible capacity for a minimum of 50 to a maximum of 77 patients

Renovate and utilize nonpatient care space to provide a capacity for public health teaching and research

computerize all departments to ensure maximum revenue generation cost control and overall operating efficiencies

Maintain a legal consultation capability to assist communities health care professionals in the area of involuntary examination and treatment statutes

Develop an outpatient capacity to assist local communities in the treatment of communicable diseases

Utilize current administrative services capabilities to support other DOH entities within the region

Utilize existing buildings to provide a source of revenue that will offset the cost of ongoing grounds and building maintenance

MEDICAL DEPARTMENT

1 Provide State of the Art TBHIV inhouse therapy
2 Apply State of the Art diagnostic modalities to TBHIV

PSYCHOSOCIAL DEPARTMENT

1 Expand psychosocial program to deal with psychological and social needs of HIV infected individuals
2 Hire fulltime psychiatrist
3 Develop and maintain a drugfree and smokefree environment Develop smoking cessation program for staff and patients

LEGAL DEPARTMENT

1 Provide expert legal consultation to private and public healthcare facilities judges and legislators
2 Continue to maintain jurisdiction over FS392
3 Continue to update FS392 as needed

PHARMACY DEPARTMENT

1 Develop State of the Art inpatient and outpatient pharmaceutical services for TB and HIV patients

OUTPATIENT DEPARTMENT

1 Develop Outpatient Department to provide resources that currently do not exist in local communities ie expert consultation diagnostic testing monitoring and pharmacologic intervention
2 Statewide physician consultation services Provide expert physician consultation to counties that do not or cannot provide this for themselves

EDUCATION DEPARTMENT

1 Continue State of the Art Grand Rounds for both TB and HIV
2 Continue to provide training courses for all levels of health professionals in the state both private and public in TB and HIV education
3 Continue the TB Hotline
4 Continue the Clinical Case Conferences
5 Develop the newsletter
6 Continue fellowship programs in nursing social work dietary pharmacy and physician training programs

Administration Department

1 Maximize reimbursement and decrease expenditures while still providing State of the Art patient care
2 Develop wing for private patients
3 Regionalization of Hospital

Laboratory

1 Work with State Lab to develop and provide necessary diagnostic and monitoring tools to the clinician ie therapeutic serum drug levels for both TB and HIV drugs and phenotypic and genotypic sensitivity patterns for both TB and HIV
2 Work with State Lab to develop State of the Art diagnostic genetic testing and therapeutics

REASERCH

1 Coordinate with State Lab and Bureau of Disease Intervention statewide research projects in TB and HIV
2 Acquire grants to fund research
3 Develop research coalitions with the medical schools in the state

STAFFING

1 Improve recruitment and retainment of current staffing
2 Have adequate number of FTE positions to meet needs of patient care

FACILITY

1 Rebuild 4th floor to provide modern hospital facility for patient care
2 Maintain strong infection control program
3 Develop 3rd floor for new HIV treatment center
4 Modernize ventilation systems
5 Enlarge and improve staff offices
6 Automate hospital operations
7 Modernize communication systems
8 Create area for outpatient services

PUBLIC RELATIONS

1 Continue to educate the community judges and law enforcement in issues pertinent to TB and HIV

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History

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A G Holley State Hospital AGH was opened in 1950 as the Southeast Tuberculosis Hospital It was originally built to serve 500 patients with living accommodations for the physicians nurses and administrative staff It was the second of four state tuberculosis hospitals built in Florida between 1938 and 1952 The other hospitals have since closed A G Holley is the last of the original American sanatoriums that continues to be dedicated to tuberculosis
With the discovery of drugs to treat tuberculosis patients outside of the hospital setting the daily census at the hospital by 1971 dropped to less than half of the original 500 By 1976 the beds and staff at AG Holley were reduced to serve a maximum of 150 patients As space became available other agencies were invited to move onto the complex to utilize the unique environment

As the incidence of TB declined so did the number of beds Although the hospital is currently licensed for 100 beds it is only funded for 50 As the rate of tuberculosis continued to decline the hospital was faced with closure

Tuberculosis in the United States and especially in Florida began to increase in the mid 80s This was due to the emergence of HIV an increase in homelessness drug addiction immigration from areas of high tuberculosis the spread in institutional settings and the spread of drugresistant tuberculosis