Att B: B2 Sample Education Materials

B2 Sample Education Materials

These are the draft materials that will be evaluated by participants for their feedback.

B2 Education Script (for use in Mexico)

Hello, good morning / afternoon, and welcome. My name is _______________ and I am here to explain the results of your child’s medical evaluation for tuberculosis, also known as TB. I am working with health officials in the United States to make sure you know what you need to do to keep your child healthy.

First, I will explain what your child's results mean and the things you need to do before and after entering the United States. Then I will give you information to read and take with you, which includes a diagram of the steps you will take and answers to common questions people have about their TB results. If you have any other questions, please ask me at the end of my presentation.

The medical tests for TB that your child has just completed are required for immigration to the United States for all children aged 2 to 14. The results do not affect your child’s immigration process.

Your child had a TB skin test (some call it a PPD test), which showed a small bump on their skin that indicates TB infection. However, their x-ray showed no evidence of TB disease in their lungs. Right now your child has the germs of tuberculosis in their body, and the TB germs are not yet active but could wake up at any time in the future. This means your child has TB infection, sometimes called latent TB infection, or LTBI, but is not sick with tuberculosis disease, which is why the child has no symptoms. Because of the results of these medical tests, your child’s immigration paperwork will indicate a B2 latent TB infection classification (show example). In order to protect your child’s health, we will teach you about additional steps to follow once they get to the United States

TB is caused by bacteria that can attack the lungs, and sometimes other parts of the body. You get TB by breathing it when you are near someone who has TB in their lungs, usually from someone who spreads the bacteria into the air by coughing. Most people don’t know who infected them, but some can recall family members or friends with TB, especially if they were coughing a lot.

Most people who get infected, like your child, do not become sick right away. Their TB germs are “sleeping.” But if the germs “wake up” and start to multiply, your child will get sick. If your child develops TB disease, it will take many months and several antibiotics to cure. Also, if it develops in your child’s lungs, your child can pass TB to other family members.

When you get to the United States, the local health department will be notified of your child’s arrival. It is important that you make contact with the health department when your child arrives. The health department will want to give your child treatment for TB infection to prevent them from getting sick in the future. In most places in Mexico, this prevention treatment is not available.

So – how will the process work for your child, and what can you do to help them stay healthy? [Distribute the flow chart]. This flow chart shows the steps to follow. I will explain the steps:

1. The clinic already handed you an envelope and a compact disc (CD). You have to present the unopened envelope to the consulate during your child's interview. This envelope contains information about your child’s medical exam, including the B2 TB infection classification (show example). Make sure your child keeps the CD with them when they go to the United States. It contains a copy of your child’s x-ray.

2. During your child’s interview, tell the consular officer the correct address and phone in the United States where your child can be reached, and an e-mail address if you have one. It is important that you provide the most accurate information you have. The address, phone number, and e-mail will be how the local health department will contact you to help with your child's TB care in the United States.

3. When your child is cleared for immigration, the consulate will give you a sealed envelope that contains many immigration documents including your child’s health information.

4. When your child enters the US.. for the first time and you are at the entry point:

   1. You will give the immigration officer the envelope from the consulate. Do not give them the CD with the x-ray results – that is yours to keep. If they ask you about the TB classification, you can tell them that B2 TB means latent TB infection and not TB disease, and that your child was cleared for entry. You can also show them the flow sheet to help explain what you were told.

   2. When the officer asks about the address, phone, and e-mail information on your child’s immigration documents, be sure to update information about their US address and phone number if it has changed. Again, this does not affect the immigration process, but it is very important to help your child continue their care for TB in the United States.

   3. The address you provide will be used to send your child’s TB information to the correct local health department in the United States. If you give the wrong address, the information will be sent to the wrong health department, and it will be harder for the child to get care.

   4. The officer should give you a copy of your child’s health information, which includes the TB information. If they don’t, you can ask them for a copy. Other copies are sent to the health department that serves the address you provided.

5. It is very important that when your child arrives at their destination in the United States, someone contacts the local health department to schedule an appointment. Not all of the health departments have someone who speaks Spanish, so get help from someone you trust who speaks English and will call on your behalf. It is not recommended that you contact a private health provider, because the health system in the United States is different than in Mexico. The correct people to help with TB care after immigration are in the health department. In some places, the health department may contact you, but it is best that you call them as soon as your child arrives.

6. The health department may already have a copy of your child’s medical evaluation, but it is important that you bring your own copy as well. Also, bring the CD with the x-ray results.

7. The health department may repeat some of the TB tests (TB skin test and x-ray) and may perform other tests (blood tests). When those tests are completed, they can recommend the best treatment or follow-up for your child. Remember, this will not change or affect your child’s immigration status.

8. We strongly recommend that you follow all the instructions of the health department. Your goal is to keep your child, your family, and your community healthy.

Thanks for your time and attention. Any questions?

B2 Frequently Asked Questions (for use in Mexico and U.S.)

1. What is LTBI?

Not everyone infected with TB bacteria becomes sick right away. As a result, they could have either of two TB conditions: latent TB infection or TB disease. TB bacteria can live in the body without making you sick: This is called latent TB infection, or LTBI. In most people who become infected, the body is able to fight the bacteria to stop them from growing. People with LTBI:

• Have no symptoms

• Do not feel sick

• Cannot spread the TB bacteria to other people

• Usually have a positive TB skin test or positive TB blood test

• Are at risk of developing TB disease in the future

Being diagnosed with LTBI means the person is infected with TB germs but is not sick with TB disease. Some people will develop TB disease if they do not receive treatment for LTBI.

2. What is a B2 LTBI classification?

A B2 LTBI classification means a visa applicant has a positive tuberculosis skin test or blood test and a normal x-ray of their lungs, which indicates that they have LBTI. The immigration system uses this classification to notify US health departments. It does not affect your child’s immigration status. It is important that your child receive treatment for LTBI to prevent their tuberculosis infection from making them sick with TB disease.

3. My child has no symptoms. How could he/she have TB infection?

Someone with latent TB infection will not have any symptoms. Treatment can prevent the infection from turning into TB disease and making your child sick. If you wait, and your child does become sick with TB, it is more difficult to treat, and it can spread to others.

4. What happens now that my child is classified as B2 LTBI?

See the attached chart that shows the next steps. The clinic will give you a copy of your child's evaluation and send another one to the consulate. If your lawyer needs additional information, you should call the consulate.

Their B2 LTBI classification does not affect your child’s immigration status. It is important that the local health department examines your child soon after they arrive in the United States to determine if they would benefit from treatment.

5. Does having TB infection or taking TB treatment in the past change my child’s immigration status or ability to become a citizen?

No. Your child’s immigration status will not be affected by an LTBI diagnosis or treatment.

6. My child was “cleared” for active TB during their medical examination in Mexico. Why does he/she need another examination?

Having an examination in the United States will tell you more about your child’s risk of developing TB disease and whether your child needs treatment to prevent them from getting sick later. You will also get an updated medical record at the exam that will be helpful when your child goes to the doctor in the future or enters school.

7. How do I find the right health department for my child´s examination?

Every local government jurisdiction in the US has a health department that provides services to the community. Health departments are different from community health centers or private clinics. You can find the health department by searching online. When you contact the health department, tell them you need a TB examination for your child because during their immigration exam they were given a B2 LTBI classification.

8. What if the officers do not give me any paperwork when we enter the US for the first time?

Ask the officer for one of the copies of your medical evaluation that are in the sealed envelope. If they still do not give you a copy, go on to your US residence and contact your local health department.

9. What happens if I was not given, or I lost, my child´s medical evaluation paperwork or x-ray before they can be examined in the US?

It is your responsibility to take care of your child's documents. The health department should have electronic access to your child´s examination if you are going to the address you gave to consular/border officers. If you are going to a different location, the health department can get access if you tell them your previous intended address.

10. What should I do if I change my address from the one I gave the consulate?

You should contact the local health department in your new location, tell them of your child’s B2 classification, and tell them the previous address so they can gather the necessary medical information.

11. Will I need to pay for my child´s examination in the U.S.?

Policies vary, but in most locations, you will get your first visit even if you or your family are unable to pay.

12. Do U.S. health departments have someone who speaks Spanish?

Many health departments have staff who speak Spanish, but some don’t. It is best if you have someone who speaks English help you make the first appointment and come with you to that appointment.

B2 Flow Chart