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To keep TB out of homeless shelters, many TB control programs resort to photo IDs. Before they can get a bed, homeless people must go to the health department and get a card attesting they’re disease-free. Sometimes, though, the cards become black-market commodities.
Oklahoma City solved that problem by switching to photo IDS. Unlike regular IDs, they can’t be traded for a bottle of alcohol. Apparently as a result of the photo ID system, TB in city shelters is down from a high of 10% of the case total to just one shelter-associated case in the past two years. Plus, homeless people like the photo IDs, says H.R. Holman, TB control bureau spokesman. "Few of them have a driver’s license, so this comes in handy," Holman says. "The card says in big letters Not an official ID,’ but they’re able to use it anyway."
Cardholders wax creative when it comes to providing a name, Holman adds. "We have a guy out there calling himself Human,’ and several men whose cards say they’re Jack Daniel, and about 10 John Does. But there’s only one of each face."
Getting city shelters to sign onto the system wasn’t hard, says Holman. "They want to make sure their staff doesn’t get exposed." Nor are the cards expensive; by using a digital photo ID machine the health department already had, the bureau produces the cards for 20 cents apiece.
So far, there’s only one hitch. For anyone without a photo ID, shelters issue a temporary card, a privilege some abuse by hopping from shelter to shelter. "Nothing’s perfect," says Holman. "But this system still works pretty well."