Increasing Engagement in HIV Care through Health Department

Increasing Engagement in HIV Care through Health Department and Community Health Center Collaboration Pam Kurowski, LCSW Special Projects Director Infectious Disease Prevention and Care Services Bureau Prevention and Health Promotion Administration -

MISSION AND VISION MISSION The mission of the Prevention and Health Promotion Administration is to protect, promote and improve the health and well-being of all Marylanders and their families through provision of public health leadership and through communitybased public health efforts in partnership with local health departments, providers, community based organizations, and public and private sector agencies, giving special attention to at-risk and vulnerable populations. VISION The Prevention and Health Promotion Administration envisions a future in which all Marylanders and their families enjoy optimal health and well-being. Prevention and Health Promotion Administration - 2

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Maryland Adult/Adolescent 2013 HIV Diagnosis Rates by Jurisdiction Reported Adult/Adolescent (age 13+ at HIV Diagnosis) HIV Cases with or without an AIDS diagnosis, per 100, 000 population 50+ 25 – 49. 9 15 – 24. 9 10 – 14. 9 0 – 9. 9 State Rate = 28. 1 per 100, 000 Using data as reported through 12/31/2014

Maryland Adult/Adolescent Persons Living with HIV by Region, 2013 Using data as reported through 12/31/2014

Maryland Adult/Adolescent New HIV Diagnoses by Region, 2013 Using data as reported through 12/31/2014

Health Centers Prevention and Health Promotion Administration - 8

Ryan White Program Prevention and Health Promotion Administration - 9

Case Study: Community Clinic Health & Wellness A RW/HIV-Naïve Health Center Prevention and Health Promotion Administration - 10

Program Considerations v Number of sites v Number of providers/support staff v Training needs v Provider capacity/attitudes v Testing options v Incorporating HIV testing into clinic flow v Will they cover their costs? Prevention and Health Promotion Administration - 11

Program Implementation v HIV Testing v Utilizing EMR & i 2 i for tracking v Pre-visit planning v Rapid & lab-based testing v Develop P&P v Goal: Implement routine HIV testing Prevention and Health Promotion Administration - 12

Program Implementation Con’d v HIV Care v Create HIV care team v Gain staff buy-in v Set up referral systems v Market to outside agencies v Goal: 100 patients by December 2016 Prevention and Health Promotion Administration - 13

Program Implementation Con’d v HIV Treatment v Primary diagnosis drives PCP selection v Associate Care Providers consult with HIV specialist v Goal: Expand HIV care to all sites Prevention and Health Promotion Administration - 14

Key Points v Could other health centers replicate this model? v Funding v Issue of uninsured v HIV testing and care costs v EMR modifications v Who is the expert? Prevention and Health Promotion Administration - 15

Prevention and Health Promotion Administration Pam Kurowski, LCSW Pamela. kurowski@maryland. gov http: //phpa. dhmh. maryland. gov Prevention and Health Promotion Administration - 16