The LENOWISCO Health District (LHD) is located in the heart of the beautiful Appalachian mountains of southwest Virginia, extending east from the
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2 The LENOWISCO Health District (LHD) is located in the heart of the beautiful Appalachian mountains of southwest Virginia, extending east from the Cumberland Gap, and bordering Kentucky and Tennessee. Much of our district is closer to at least seven other state capitals than to Virginia s own capital, Richmond. LHD serves three counties Lee, Wise and Scott, and the independent City of Norton. LHD serves a population of approximately 92,000.
3 Rates of Acute HBV by District and Year Virginia, Rates of Chronic HBV by District and Year Virginia, Rates per 100,000 Persons Rates Per 100,000 Persons Year Year LENOWISCO Cumberland Plateau Virginia
4 7.0 Rates of Acute HCV by District and Year Virginia, Rates of Chronic HCV by District and Year Virginia, Rates per 100,000 Persons Rates per 100,000 Persons Year Year LENOWISCO Cumberland Plateau Virginia
5 Rates of Hepatitis per 100,000 population 2016 US 2017 VA 2017 LENOWISCO 2017 Cumberland Plateau Acute Hepatitis B Chronic Hepatitis B Acute Hepatitis C Chronic Hepatitis C
6 Rates of Fatal Prescription Opioid Overdoses by Locality of Residence, 2016 *Excluding Fentanyl
7 County Opioid Prescribing Rate by Locality of Residents, per 100 persons, 2016 < > Missing Data
8 CDC County-level Vulnerability Assessment for Rapid Dissemination of HIV or HCV Infections among PWID IN WIS E LE E DICKENSON BUCHANA N TAZEWELL RUSSEL L WYTHE PATRICK KY Vulnerable Counties and National Ranks (from 1-220) Buchanan 28 Lee 73 Patrick 166 Dickenson 29 Wise 78 Wythe 210 Russell 61 Tazewell 96 Notes: Map and Analysis provided by the Geospatial Research, Analysis, and Services Program (GRASP), DIV of Toxicology and Human Health Sciences, ATSDR (2015). Data Sources: American Community Survey, ; DEA ARCOS 2013; NCHS/NVSS ; SAMHSA DATA 2000 Program Info 2014.
9 APPALACHIAN H.E.A.R.T. TABLETOP EXERCISE
10 Exercise Objectives Discuss outbreak prevention and mitigation. Discuss viral hepatitis/hiv outbreak response needs. Examine information sharing processes with community partners. Discuss laws, regulations, and procedure for viral hepatitis/hiv outbreak.
11 Reviewed key components of draft plan Obtained feedback from town hall participants Town hall participants received a copy of draft executive summary of the response plan Feedback from participants at the 4 meetings was used to inform and refine the final plan
12 Response Phases Community Prevention Community Response Community Recovery Targeted education; partnering with community/agencies Targeted prevention; BBP surveillance & testing; communitywide education & training efforts Messaging; training; treatment; continued community status analysis
13 Clinical Strategies Testing Sterile Injection Equipment Referral & Navigation Used Injection Equipment Disposal Access to Supplies SUD Treatment PrEP, npep, HEP Vaccine Overdose Prevention Risk Reduction Counseling Benefits & Insurance Navigation
14 LENOWISCO PrEP Program Overview Provides PrEP throughout the LENOWISCO Health District Enrolled 17 6 Currently Active Participants 1 Referral from Syringe Services Program Expanded through 4 additional neighboring counties
15 LENOWISCO Hepatitis C Tx Program Overview Partnership with Virginia Department of Health, LENOWISCO Health District, University of Virginia Health System, and Stone Mountain Health Svcs Telemedicine Services (I.D. clinician mentoring local providers) 11 Referrals from Wise County Health Dept. 6 Referrals from Syringe Services Program 1 Co-Infected with HIV
16 LENOWISCO Syringe Exchange Program Overview Participants: 23 Total Visits: 47 Syringes Dispensed: 810 Syringes Returned: 971 Syringe Return Rate: 120% Narcan Trained: 17 HCV/HIV Tx Referral: 6 PrEP Referral: 1 Recovery Referral: 4 Drug Use Behavior Average Injections/Day: 4 Substances Injected 1. Rx Opioids (17) 2. Meth (7) 3. Heroin (2) 4. Other (Suboxone 9; Adderall 1) Current as of August 2018
17 Thank You
April 10, Audio Access Dial-in: Participant Access Code: #
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