1. M. Frances Vasquez, M.S. Tuberculosis Case Manger Stanford Public Health Office Albuquerque, NM

2. Initial Situation Phone call, we have a new client at Lovelace Hospital Help him apply for General Assistance Apply for Institutional level care He may qualify for D&E Waiver

3. First DOT on 11-03-2008. Age: 51 History of Alcoholism and Homelessness

4. First Visit Met client on 12-22-08 wearing my endearing ensemble of N-95 mask, gown and gloves I am one of 3 or 4 people in the room talking to him. He receives lots of information but speaks very little.

5. Homework GA is $266 per month Needs photo ID for Food Stamps Needs Birth Certificate – no record in NM system Ageing and Long Term Services stated wait list is over 2 years; do not think my client would qualify If found incompetent, check out guardianship. Homeless shelters may be best option for persons w/o an income. GA is $266 per month Needs photo ID for Food Stamps Needs Birth Certificate – no record in NM system Ageing and Long Term Services stated wait list is over 2 years; do not think my client would qualify If found incompetent, check out guardianship. Homeless shelters may be best option for persons w/o an income.

6. Surprise! On visit to client on 11-12-08, he told Dr. Burgos that he finished his TB medicine in 1994 in Eugene, OR. Stated he started treatment in Ogden, UT., then moved to Boise Idaho and then completed treatment in Oregon. Arrived in ABQ two weeks ago from Kingman AZ and before that he lived in Phoenix. BAC was.325 when admitted. On visit to client on 11-12-08, he told Dr. Burgos that he finished his TB medicine in 1994 in Eugene, OR. Stated he started treatment in Ogden, UT., then moved to Boise Idaho and then completed treatment in Oregon. Arrived in ABQ two weeks ago from Kingman AZ and before that he lived in Phoenix. BAC was.325 when admitted.

7. 04-23-09 Phone call received from sister. Reported that mother had active TB in 1950s and was treated in a sanatorium in Albuquerque.

8. a Around this time client given neuropsychological evaluation. Found incompetent. Makes our job easier. Sister calls and complains that the neuropsych eval needs to be in Navajo, his native language. Navajo interpreter difficult to find. Finally I recruit our WIC clerk from Cuba to come and interpret. Client refuses to use her! Client is more cooperative and responsive during second evaluation and is found to be competent.

9. Building Rapport and Trust 01-07-09 Inquired about ID. Client stated that he has no documents on his person or in his wallet. Began to stop in when time permitted to spend time with client and make small talk. I asked him if there was anything he was craving. Began to bring burritos from home or snacks. One day he told me he had an AZ ID and a Social Security card. 01-07-09 Inquired about ID. Client stated that he has no documents on his person or in his wallet. Began to stop in when time permitted to spend time with client and make small talk. I asked him if there was anything he was craving. Began to bring burritos from home or snacks. One day he told me he had an AZ ID and a Social Security card.

10. I felt like...

11. Isolation Client was in isolation about 4 months Had lots of time to think about his situation and his life Decided to quit drinking.

12. Upon Release Was set up in hotel to complete DOT. Set up with a few utensils for cooking. When no long infectious used local services for homeless for food, bus passes, clothes, etc. Eventually received GA Eventually received Social Security Found low-income housing for client. Has been clean and sober since he was hospitalized at the end of 2008.

13. Good Outcome!

14. Continue to have a good relaltionship with him. Meeting with hospital staff, DOH attorneys, IHs,