Chicago Tribune - July 28, 2004
Mickey Ciokajlo and Judith Graham, Tribune staff reporters

Questions have swirled for years about the continuing need for the Suburban Cook County Tuberculosis Sanitarium District in an era in which modern medicine has largely brought the disease under control in the United States.

Though public health experts agree Cook County needs a comprehensive tuberculosis program, a rift has developed over how to best achieve that goal.

Officials at the Cook County Department of Public Health say it makes more sense to fold the tuberculosis district's duties into its existing infrastructure, which handles more than 65 communicable diseases, ranging from AIDS to West Nile virus to meningitis.

The Civic Federation, a Chicago-based tax watchdog group, has called for the dissolution of the agency and its tax levy on suburban properties. A bill pending in Springfield would do just that.

A team of consultants hired by the tuberculosis district is expected to lay out its case Wednesday for why it would be a mistake to dissolve the agency.

According to a summary of selected comments from the consultants' report, the team said funding for tuberculosis control would decline in Cook County's massive health-care system if the tax is ended and the agency is dissolved.

"TB control would most likely be sharply curtailed, which as demonstrated in the United States in the late 1970s and mid-1980s, led to a resurgence of TB, which then proved extremely difficult and costly to reverse," the summary said. "Experience in the United States and other countries has shown that the need to fund problems perceived as being `more acute' wins out over the need to fund TB control activities."

The summary noted that a national trend replicated in suburban Cook County has shown an increase in cases involving foreign-born individuals.

A separate report issued by the tuberculosis district in March said 14 percent of suburban Cook County residents are foreign-born and thus at higher risk of contracting TB.

Cook County officials disputed the consultants' conclusions and said they are ready to take on its duties.

The county would develop an integrated concept already used in larger jurisdictions across the country, said Sean McDermott, the department's director of public policy, planning and government relations.

"It's archaic the way it's currently functioning," McDermott said. "We are a professional public health department that could do the job, and we could do the job tomorrow."

Though consultants suggested that valuable experience could be lost if the district is eliminated, pending legislation calls for Cook County to retain the tuberculosis district's employees and clinics.

The legislation would abolish the district's tax levy, which next year is proposed to generate $1.8 million from suburban taxpayers.

Tuberculosis control responsibilities would be funded initially using the district's existing fund reserves, which at the end of 2002 exceeded $9 million.

The county could also save money through increased efficiencies and also raise revenue by charging patients' insurance programs, which the district currently declines to do, McDermott said.

Cook County already treats tuberculosis cases through its health services bureau, which also runs three hospitals containing specially-equipped rooms where patients can be isolated if necessary, McDermott said.

The tuberculosis district treated 130 new active cases in 2002, down from 168 in 1992 and 184 in 1982.

Large numbers of people are thought to be infected with a form of the disease that isn't active but is still potentially dangerous, known as latent tuberculosis.

Based on a suburban Cook County population of 2.5 million, the district estimates the number of latent cases could range from 124,000 to 248,000.
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