ATTACHMENT E Advance Notification Email

ATTACHMENT E: Advance Notification Email

Send message 1 week prior to opening [Date TBD pending OMB approval]

From: Ken Castro and Sapna Bamrah Morris

To: TB control program directors or their designees

Subject: Assessment of Local Health Departments’ Interventions to Address TB among Persons Experiencing Homelessness

Dear [TB Program Controller or Staff name]

In recent TB outbreaks investigated by CDC, 20% of the persons were homeless or unstably housed. In one outbreak, all 31 persons with TB were linked to a single homeless shelter. Analysis has shown that if even one of the first three persons in a TB cluster is homeless, the risk that the cluster will grow is 92%. These findings are not surprising, given that the high prevalence of substance use and the crowded conditions in congregate settings, like shelters, are conducive to explosive transmission of TB and that persons experiencing homelessness often lack ready access to the medical care required to make an early diagnosis of TB.

Implementing effective TB control interventions among homeless persons is challenging, but several success stories prove that the challenges can be overcome. The Outbreak Investigations Team in the Division of Tuberculosis Elimination is working to better understand the interventions of local health departments on addressing TB among the homeless. Understanding current practices can assist the Division in providing the best recommendations in responding to recent transmission among this vulnerable population.

The Division of TB Elimination requests your feedback on an assessment of interventions to address TB among persons experiencing homelessness. We have developed a short online data collection form (25 questions) to determine if TB control programs have specific interventions targeted to addressing TB among persons experiencing homelessness. The data collection should take approximately 15 minutes to complete.

Completion of the data collection form is entirely voluntary and your responses will not be shared in an identifiable form. Information from the data collection instrument will provide the basis for implementing improvements to addressing TB among homeless persons. Links to the data collection instrument including additional instructions will be sent on [Enter date]. We ask you return the completed data collection instruments by [actual date TBD pending OMB approval].

Your participation is greatly appreciated.

Sincerely,

Kenneth G. Castro, MD, MPH Sapna Bamrah Morris, MD

RADM, Division Chief Principal Investigator

Division of TB Elimination Outbreak Investigations Team

Centers for Disease Control and Prevention Division of Tuberculosis Elimination

Email: [email protected] Email: [email protected]

Telephone: 404-639-8289