Presentation on theme: "Linkage and Retention Interventions selected for dissemination"— Presentation transcript:
1 Linkage and Retention Interventions selected for dissemination Steven Sawicki, MHSA Program Manager, AIDS Institute SPNS Lead, NY-LINKS September, 20131
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4 Looking Back Creation of UMRG, WNYS and Q&SI collaboratives in NYS Involvement of more than 60 individual provider organizations in the establishment of base line data and individual testing of interventions12 face to face learning sessions used to network, share information, and further improve linkage and retention
5 Looking Back Development of regionally based cascades Involvement of county health departments and multiple state departments and divisionsWork done shared through international program and with QAC, CAC, QOC, the other 5 states involved, and the national evaluators.Incredible amount of change going on within individual organizations and systems
6 Where we are UMRG—6th learning session WNYS—4th learning session Q&SI—3rd learning sessionMid and Lower Hudson—1st learning sessionLong Island—1st meeting 11/13/13Central and Eastern NYBronxBrooklyn
7 Where we are going Dissemination of work Adding in a menu of evidence based interventions to the IAPAC Guidelines previously presentedSolidifying gains made
8 Interventions Selection process The 5 interventions Summary of each interventionHow to Pick an Intervention to ImplementTimeline
9 Intervention Selection Process Meeting on June 20 to discuss intervention workFollow up meeting to pare down list of dozens of identified interventions to 6 or fewerInterventions were selected based on the following criteria:Number of existing providers utilizing interventionWhere impact of intervention fell on continuumResources required to implement interventionDiversity of target population impactedEvidence base supporting interventionProvider type associated with intervention
10 Intervention selection teams Each intervention had a teamTeams were assigned to each intervention to:Develop a summary of the interventionDevelop an intervention packageTeams were comprised of:NYS DOH staffNYC DOH MH staffNYLinks staffConsumersProvidersMembers of each team were selected based on experience with the particular intervention they were assigned toSummaries and packages produced by the teams were submitted to HRSA and to the national evaluation team for SPNS--ETAC
11 The 5 InterventionsArtas (Anti-Retroviral Treatment and Access to Services)Appointment ProceduresConsistent MessagingOutreach/Return to CarePeers
12 Summary of Each Intervention Brief DescriptionIntervention Impact AreaTarget populationBest for agencies who provide…Core ElementsDuration—how long for each client/patientResource requirementsTraining needed
13 Anti-Retroviral Treatment and Access To Services (ARTAS) Brief Description--ARTAS is an individual-level, multi-session, time-limited intervention utilizing a strengths based case management model.Impact Area—Linkage to Care/Retention in Care.Target Population--Newly diagnosed individuals or those returning to care after more than a 6 month lapse.For Agencies that Provide—HIV testing, clinical, supportive services.Core Elements—1-5 structured sessions with each person, Focus on strengths of the individual, Development of step by step plan to connect to care, Service takes place in the environment of the individual, Advocacy of individual needs related to return to care.
14 Anti-Retroviral Treatment and Access To Services (ARTAS) Duration—1 to 90 daysResource requirements—Staff trained in case management/engagement.Training needed—ARTAS, Motivational Interviewing suggested
15 Appointment Procedures Brief Description—Standardization of procedures to facilitate making appointments, reminding patients of appointments, and providing follow up after missed appointments.Impact Area—Linkage to Care/Retention in Care.Target Population—All individuals who are HIV+. Limited resources may require prioritization—New diagnoses, Out of Care, frequency of no show, last lab status.For Agencies that Provide—HIV testing, clinical, supportive services.Core Elements—Patient enrollment, expanded patient contact info acquired, appointment reminders instituted, missed appointment follow up procedures developed, documentation of efforts.
16 Appointment Procedures Duration—ongoing.Resource requirements—Staff, time for training.Training needed—Field safety training if outreach is to be used.
17 Consistent Team Based Messaging Brief Description—Positively phrased and action oriented messages are delivered by all members of the care team.Impact Area—Linkage to Care/Retention in Care.Target Population—All HIV+ individuals who are newly engaging or re-engaging in care.For Agencies that Provide—HIV testing, clinical, supportive services.Core Elements—List of newly engaging and re-engaging patients, brief care message delivered by all staff on care team, longer care message developed and delivered by specifically indicated members of care team, tool to track messages and delivery process.
18 Consistent Team Based Messaging Duration—ongoing.Resource requirements—Staff, time for training.Training needed—Use of scripted messaging, teachback, motivational interviewing suggested.
19 Outreach/Return to Care Brief Description—Systematic search for individuals who have been out of care for longer than 6 months. Engagement of those individuals back to care.Impact Area—Retention in Care.Target Population—HIV+ individuals with at least one HIV medical visit within the last two years who have not been seen in primary care for 9 months or longer.For Agencies that Provide—Clinical, supportive services.Core Elements—Maintained care roster to identify out of care patients, case finding efforts, field outreach, care determination process, re-engagement and case closure process.
20 Outreach/Return to Care Duration—ongoing.Resource requirements—Staff, time for training.Training needed—Field safety training for outreach, Case finding training.
21 Peer SupportBrief Description—Utilizing the skills of peers to better engage patients in the system.Impact Area—Linkage to Care/Retention in Care.Target Population—HIV+ individuals who are newly diagnosed, transferring their care, or returning to care after not being seen for 6 months or longer.For Agencies that Provide—HIV Testing, Clinical, supportive services.Core Elements—Identification of new, transferring or returning patients, Peers trained in engagement, Use of standardized, consistent messages, Contact schedule and process recording.
22 Peer Support Duration—1 to 90 days. Resource requirements—Staff, time for training.Training needed—Confidentiality, engagement and communication.
23 Key Components to consider in Intervention Selection Current statusUse of regional cascade along with individual organization data related to linkage and retention.Awareness of competing interventions.Organizational resources.Commitment and ability to track required data.Ability to test and measure change and outcomes.Ability to run intervention through August of 2015 and participate in statewide evaluation process
25 Next Steps Introductory Webinars Pilot Phase Revision and finalization of interventionsAssessment package developedIndividual webinars for each intervention ?????Process within each learning session to look at best way to impact the regional cascadesProviders select interventions and receive TABeginning of evaluationStatewide dissemination process begins—Webinars, workshops, presentations, conferences.
26 Timeline Pilot Phase begins November through February Sites that meet minimal criteria volunteer, choose intervention, receive TA around implementation, and report processAdjustments made to interventions as needed during this periodBy end of pilot, in February, interventions have been revised and are ready for full dissemination.6 to 8 sites to be involved in PilotWhile Pilot phase is running.Introductory webinars will be heldSites not involved in Pilot prepare for dissemination
27 Upcoming Webinars Tuesday, November 12th, 2013, 11:00 AM Wednesday, November 13th, 2013, 3:00 PMThursday, November 14th, 2013, 10:00 AM, 2:00 PMFriday, November 15th, 2013, 1:00 PM
28 Upcoming Stakeholder MEetings December 4th, 2013, Western New York State—Batavia, NYDecember ?? th, Mid and Lower Hudson—Newburgh (date is tentative)December 17th, Upper Manhattan—TBDDecember 20th, 2013, Queens and Staten Island—90 Church St., Manhattan
29 Contact InformationSteven Sawicki, NYSDOH, SPNS LeadClemens Steinbock, NYS Director of Quality InitiativesBruce D. Agins, Medical Director,Website atBlog at