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The Cook County Tuberculosis Sanitarium District (TB District) has hired a new medical director who officials hope will take the agency in a new direction and help it recover from damage to its image endured during a push among legislators to dissolve the district in 2004.

Susan Marantz, a pulmonary physician who was formerly the TB director for the State of Illinois, said she hopes to bring a more hands-on approach to the position of director, participating in clinics provided by the district and working “in the trenches” alongside nurses.

She said that the district’s mission is especially vital at this time due to a recent reemergence of TB in the United States. The district, which treated 62 new active TB cases, has already treated 102 cases in 2005.

The hike, she said, is likely due to an increase in immigration as the United States has begun to reopen its borders to immigrants in the years following 9/11. “When the disease was quiet, people stopped funding it ” it was treated like a stepchild ” now it’s beginning to come back,” she said.

Marantz noted that the number of TB cases in the district, which consists of all of Cook County outside Chicago, has also been escalated by the movement of poor immigrant families from the city to the suburbs in response to high rents and the elimination of Chicago’s public housing projects.

Still, she said, the majority of the district’s patients are there for routine TB tests often required by schools and other organizations, especially in areas with large immigrant populations. The district also tracks down and tests families and friends of those infected with TB.

The district operates two treatment centers in Harvey and Desplaines aside from the Forest Park location, and also operates a mobile clinic in Evanston and Skokie. It has 55 employees, including 17 registered nurses and eight physicians.

The nurses, according to Marantz, visit patients at home and provide free medication paid for by the district.

A more focused approach

Ray McDonald, president of the district’s board, said the district, often criticized for wasteful spending, is working to streamline both its expenses and its approach to treatment of the disease.

McDonald said the reduction in costs has been achieved through a drastically decreased tax levy. “We’ve cut our levy on alternate years to practically nothing,” he said. “We levied $100,000 this year, next year we’ll levy maybe $3.5 million, and the next year we’ll be back to $100,000.”

The district is able to afford the cuts due to the surplus created when its Hinsdale site was sold several years ago.

McDonald said that the district is also rethinking its medical approach with the help of newly appointed board member and Chief Operating Officer of the Illinois Department of Public Health Stephen Martin.

He said the district’s goal is to “coordinate the work we do in a sensible fashion with the Department of Public Health.”

The district, according to McDonald, is focusing on “aggressive, targeted testing” in communities with high immigrant populations.

Battle not over

“I think for the time being, the majority of the political powers have decided to leave us be,” said McDonald. The political powers that McDonald refers to, however, warn that the push to eliminate the district has not ended.

Cook County Commissioner Tony Peraica led the movement to close the district’s doors after a report from the Civic Federation, a private organization, criticized the district for maintaining its tax levy despite a $9 million surplus.

“They wouldn’t have (reduced their levy) unless we put pressure on them. The forced reduction of the tax levy shows they are not needed,” said Peraica, who is challenging John Stroger for Cook County president in 2006.

“(The public health department) spends $1 billion a year and employs 9,000 people ” if it’s not able to take care of 130 suburban TB cases, that’s a problem,” he said.

Peraica said that though the district was temporarily saved through political connections to Stroger, he would revive legislation to close it if elected.

McDonald said that closing the district would likely lead to higher taxes by placing strain on the Department of Public Health, which he said is “bursting at the seams.”

He said that district officials are entertaining the idea of a possible expansion to treat other respiratory diseases besides TB.

Sen. Don Harmon (D-39), who in the past supported the abolishment of the center, said he has briefly discussed the expansion idea with district officials.

“I’m supportive of an effort to make it a more holistic place to treat a variety of diseases, especially with the fear of diseases like avian flu,” he said.

“I would never want fights over political jurisdiction to interfere with public health.”