Ryan White Enrollment within the CAPUS Demonstration Project Virtual Administrative Reverse Site Visit February 5, 2016 Tonya King Jalesa Sutton Veronica Calvin
Objectives At the end of this presentation you will learn HIV/AIDS demographics of Tennessee CAPUS demonstration project CAPUS efforts to re-engage in Tennessee Ryan White enrollment within CAPUS 2
HIV/AIDS Prevalence in TN (CDC) 2010 Data 18 th in U.S. 15,331 cases Rates (per 100,000) Overall 293 Black 1060 White 143 Hispanic 265 48% MSM 2013 Data 15 th in U.S. 16,206 cases Rates (per 100,000) Overall 295 Black 1042 White 139 Hispanic 306 47% MSM 3
What is CAPUS? Care and Prevention in the United States (CAPUS) CDC funded demonstration project 3 years; one year extension Purpose: reduce morbidity and mortality related to HIV/AIDS National HIV AIDS Strategy alignment TN Department of Health (HIV/STD Section) proposal 4
CAPUS and TN Department of Health Goals Ac)vi)es 1) Earlier identification of HIV 4 th Generation testing in labs 2) Immediate linkage to care (new diagnosis) Social Network Strategy (MSM & AA) 3) Retention/Re-engagement in care Corrections Navigation 4) Identify/Address key barriers to care Re-engage HIV+ pts lost to care (those > 1 year out of care); Identify/inform barriers to care 5
Goal of CAPUS Identify/address key barriers to care Focus on areas with highest HIV prevalence Out of care for at least one year Address barriers to care Resources Disease Intervention Specialists (DIS) Person locating software Community-based organization (CBO) collaboration 6
CAPUS in TN Regions for CAPUS DIS Shelby County (Memphis) (12) Davidson County (Nashville) (7) Mid-Cumberland Region (8) East Grand Region (1, 2, 3, 5, 6, 14) 7
Disease Intervention Specialist (DIS) DIS skill set STD notification, education, referral Interview for medical, social, sexual history Discuss preventive behaviors Refer to resources 8
CAPUS DIS CAPUS DIS skill set Trained additionally in HIV linkage techniques (i.e., ARTAS) Case management/patient navigation techniques Collaborates with HIV providers, medical case managers & CBOs Builds rapport with patients Guide Educate & Empower Transport 9
Re-engagement to Care Process 1. Assigned names Utilizing Accurint 2. Verification of Care Status Investigation by DIS 3. Contact those out of care Phone calls House visits Letters 4. Re-engage persons into medical care & social services 10
CAPUS Re-engagement Challenges Locating information Average time to re-engage Limited providers in area Fear of stigma Other physical needs Housing Medical issues Work
CAPUS Re-engagement Successes Comfort of pts. Collaborations Medical staff Ryan White MCMs CBOs Assistance with transportation Prep and enrollment to Ryan White 12
CAPUS Snapshot: Oct. 2014 Sept. 2015 Assigned names: 880 Initially found In Care: 292 Eligible cases for CAPUS: 464 Unable to Locate: 212 Linked in Care via CAPUS: 88 Pending appointments: 6 Refused CAPUS services: 23 13
CAPUS Snapshot: Oct. 2014 Sept. 2015 Linked to Care via CAPUS (n=88) Race Black 62 (70%) White 10 (11%) Hispanic 2 (2%) Other 14 (16%) Risk Category MSM 25 (28%) IDU 6 (7%) High risk heterosexual 31 (35%) Other 14 (16%) Unknown risk 12 (14%) Gender Male 52 (59%) Female 36 (41%) Transgender 0 14
Linked to Care via CAPUS and Ryan White CAPUS DIS and Ryan White Relationships with Medical Case Managers (MCMs) Prepare patient to enroll Overcome barriers (i.e., unfamiliar with eligibility criteria, care facility info, locations, hours of operation, etc.) 15
CAPUS & Ryan White; Oct. 2014 Sept. 2015 Linked to Care via CAPUS and RWES Status (n=88) Active 37 (42%) Inactive 23 (26%) No utilization of RWES 28 (32%) Note on Inactive Status Majority of ineligibility due to other health insurance source 16
Linked to Care via CAPUS and Ryan White Linked to Care via CAPUS AND Active Enrollment in Ryan White Eligibility Services (n=37) Race Black 31 (84%) White 4 (11%) Hispanic 1 (3%) Other 1 (3%) Risk Category MSM 10 (27%) IDU 1 (3%) High risk heterosexual 15 (41%) Other 5 (14%) Unknown risk 6 (16%) Gender Male 24 (65%) Female 13 (35%) Transgender 0 17
Conclusion Benefits of CAPUS DIS and MCMs collaboration Increased awareness of eligibility criteria Assistance in obtainment of required documentation Increase staff familiarity Further Investigations Viral Suppression and RWES enrollment Access to dental services 18
Questions??? 19
Contact Information Tonya King, MPA Director, Ryan White Part B Program Tonya.King@tn.gov Jalesa Sutton, MPH CAPUS DIS for Davidson County Jalesa.Sutton@tn.gov Tennessee Department of Health HIV/STD/Viral Hepatitis Nashville, TN 615.741.7500 Veronica Calvin, MPH, CHES CAPUS DIS for Mid-Cumberland Region, CAPUS Program Coordinator Veronica.Calvin@tn.gov 20