1. UTMB/CMC MEDICALLY FOCUSED HIV DISCHARGE PLANNING

2. STAFF INTRODUTIONS Director of Virology Jessica Khan, MD
Coordinator II
Jan Johns
Medically Focused HIV Discharge Planners
Marie Shaffner
Ashlee Hall

3. PROGRAM OVERVIEW
Our program began in 2007 when Dr. David Parr the director of the Virology Department at that time recognized a need for HIV discharge planning for positive patient/offenders releasing from TDCJ. Our contract started with DSHS MAI program in In 2011 TDCJ/TCOOMMI joined us taking over the transitional (ADAP application, First medical appointment) part of the program. UTMB/CMC continues to take care of the medical part. As Medically Focused discharge planners we strive to help our patient’s release back into the free-world as their own best healthcare advocates. We will continue to empower them with the knowledge they will need to maintain a healthy lifestyle and the ability to recognize and reduce their risky behavior post-release.

4. HIV Medication Certification Form
Chart reviews are required for each MC requested.
Included in each review:
Is patient followed by INFDS?
Is ART a complete regimen?
Is viral load Not Detectable prior to discharge?
Is prophylaxis needed for a CD-4 count under 200.
This process can be labor intensive. Once the med cert is completed it is faxed to the Physician Specialist for review and signature. The MC is then faxed to TCOOMMI. The med cert is used both by UTMB and TCOOMMI at our scheduled HIV discharge planning sessions.
Requested by TCOOMMI

5. Education - HIV HEALTH HIV disease process Modes of transmission
Explain labs – CD-4 and Viral Load
Safe Sex- ABC strategy a) Abstinence, b) Being faithful to one partner, c) CONDOM USE .
Talk about their ART medications , compliance, missed doses, and side effects.
Opportunistic Infections
HEP-C and HEP-B co infections
Remind how and when to activate their ADAP applications.

6. Risk Profile Assessed Assess risk profile of patient/offender
Previous sexual history
Infectious disease history
Substance abuse history
Mental health history
RELEASED (NOW WHAT)
Basic needs
Housing
Transportation
Employment
Support System

7. Risk Reduction Plan
We help the patient establish a personal risk reduction plan to reduce risks of:
Drug/alcohol relapse
New diagnosis of STI/Strain of HIV
Returning to TDCJ
The plan should be realistic yet challenging, and should address the specific behaviors identified by the patient during the risk assessment phase of the session. It should also remind them to never get to:
HUNGRY
ANGRY
LONELY
TIRED
HALT can serve as a reminder that they need to take care of their basic
Needs everyday.

8. Are there any questions?
CONCLUSION
This presentation is a brief summary of how UTMB/CMC fits into the MAI program. Our role in the program has changed over the years, but we continue to make each day/session with the patient count!
Are there any questions?
CONCLUSION