Background: To examine the effects of a community program on tuberculosis incidence, prevalence,and transmission requiring users of public facilities to carry cards certifying theircompliance with a tuberculosis screening, prophylaxis, and treatment program. Communityknowledge of tuberculosis and costs and benefits of the program are described.Setting: A West Coast “skid row” community with historically high rates of tuberculosis, homelessness,poverty, and use of drugs and alcohol.De ...