WI State Report RVIPP, Indianapolis, IN June 9-10, 2010

Wisconsin State Report RVIPP Meeting Indianapolis: June 9-10, 2010 Timeliness to Treatment Update State Report Update Status of Re-testing for Chlamydia

Timeliness to Treatment Update  Status on Wisconsin Action Items Reported Morbidity Positives vs. RVIPP Positives  To be addressed by December 2010 Treatment Rates vs. Data Collection Issues  To be addressed through Tx Audits in PPW, FP and STD clinics WI Planned Parenthood Chart Audit  To be completed July 2010 Family Planning & STD Clinic Chart Audits  To be completed by December 2010

Timeliness to Treatment  WI Planned Parenthood STD Tx Audit STD Treatment Audit Tool to be completed by the end of June 2010  Will field test tool in one PPW clinic in early June  25 charts to be reviewed: (20 females, 5 males) Positive CT and/or GC test results for males and females

Timeliness to Treatment  Conduct Chart Audit July 2010 in all PPW Sites Statewide (27 clinics) using STD Tx Audit Tool WSLH will generate a line list of positive female and male patients for CT and GC for each clinic site from SLH laboratory positives  Select date range for positive patients to allow 120 days for quality assurance check on practice of re-test High volume clinics: randomly select maximum of 25 positives from 4 th quarter 2009 Medium volume clinics: randomly select maximum of 25 positives from 4 th quarter 2009 Low volume clinics: select positives from 2009 up to a maximum of 25 positives

Timeliness to Treatment  Evaluation of Chart Audit for STD Tx Rate PPW sites will complete the audit tool electronically from chart review HCET will compile electronic forms into an STD TX audit database Results available for STD Grant application August 2010

Wisconsin State Report Update  April GYT 2010 Update  School Based Clinics in Milwaukee Update  Male FP Medicaid Waiver  EPT Update  Rural Screening Project  Status of Re-screening in Wisconsin

April GYT 2010 Update  Universal testing on 4 days in April 2010 offered at 27 PPW clinics for CT (& GC in Milwaukee clinics only)  In 2009, we were able to offer “free” CT-GC testing for entire month; used data in lieu of planned “Universal Screening” study. Identified approximately 1200 “extra” tests based on average month.

GYT 2010 PPW Data  Criteria for noting “GYT” on lab slip not consistently defined  Similar proportion met SSC (74 vs. 81%)  Higher number reached via GYT?  Possibly higher risk patients? Numbers are small… Met Selective Screening Criteria Did NOT meet SSC # Pos# Tested% Pos# Pos# Tested% Pos “GYT” on LRF % % “GYT” not on LRF % %

Milwaukee School Based Clinics Update 2010  Testing in 15 SBC began Jan 2009 Low volume of testing/positivity at first Volume and positivity picking up Higher-risk kids more comfortable with health center presence? Staff efforts? # Tested#/% Pos CT#/%Pos GC 1-2 Q ‘ / 9.3%0/0% 3-4 Q ‘ /14.2%6/3.5% 1-2Q ’10* 18538/20.5%10/5.4%

Male FP Waiver Update  Male FP Waiver Effective May 1, 2010 Covers office visit, STD tests, treatment, condoms for year olds, up to 200% poverty, with 30 days to complete enrollment application following presumptive eligibility enrollment

EPT Update  EPT signed into Wisconsin Law May 11, 2010  Becomes effective May 26, 2010  EPT allowed for one dose therapy for CT, GC, Trichomoniasis No name prescription allowed if partner name not obtainable, in which case, ‘EPT’ required to be written on prescription  An information sheet for patient/partner developed by the Wisconsin DPH must be delivered by the provider with EPT, as required by the new law ready for distribution June 1  WEB site and official DPH letter of announcement to providers launched June 1  Guidance for providers under development, ready for distribution June 15 th  Training for implementation for Family Planning Providers scheduled for July and September WFPRHA meetings  Plans for evaluation under development

Rural Screening Project  4 sites in Northern Wisconsin participated in Universal screening for the months of April and May Objective: to estimate CT prevalence in rural clinic populations Determine if there are risk criteria outside of the evidence based SSC currently in use in WI FP which add greater sensitivity to the risk assessment for CT and GC infection in men and women attending these clinics

Rural Screening Project  Preliminary Findings Nuances of interviewing patients important  Consider the consistency and how questions are asked and perceived by the patient Numbers are small, but prevalence appears to be under 3% threshold Final analysis pending  Will present at Winter RVIPP meeting

Status of Re-Screening  Plan to evaluate rates of re-screening in FP as a quality assurance measure in FP clinics Plan to include ‘Re-screened?’ field in STD Tx Audit Tool in PPW in July 2010  PPW will add a required field for ‘Re-screened?’ to Electronic Medical Record when ready in July 2011  Re-screening will be discussed during annual WFPRHA meeting in September 2010 as part of Quality Assurance discussion  Specific guidance on writing in re-screened information on the LRF until a permanent field is in place on the LRF will be provided during a November SLH and STD Update Teleconference Recommendations in guidance to re-screen will include males (any input from RVIPP group during June 2010 meeting?) and females  When have SSC changes from prevalence evaluations finalized, will add these changes and ‘Re-screened?’ field to laboratory request form at SLH