1. Appropriate CT/GC Screening & Factors to Consider Becky McCoy MSN, RN, CEN STD Nurse Consultant

2. Infertility Prevention Project “IPP”  The CDC in collaboration with the Office of Population Affairs of the Department of Health and Human Services supports the program.  Promotes (and funds!) women's reproductive & sexual health via chlamydia/gonorrhea screening & treatment.  Services are intended for low-income, sexually active women attending public clinics (family planning) to prevent infertility.

3. Who Do We Need To Screen ? Females age 25 and younger:  Does FP clinic have high positivity (> 3%) ?  If so, perform routine CT/GC screening Females age 26 and older:  Do not conduct routine screening  Test if sx are reported or observed  Test if there is a new partner or multiple partners in previous 60 days  Test if exposure to an infected individual

6. Screening Statistics ~ What Do We Look At ?? Essentially divided into 2 groups of data:  Females 25 years and younger  Females 26 years and older

7. Data ~ 25 and Younger We look at:  Total number tested  Number of “positives” from those tested  Positivity rate Sites identified with low positivity (< 3 %) should cease routine screening & perform targeted screening, i.e. pt complaint of sx, observation of sx, new or multiple partners within previous 60 days or exposure to infected individual

8. Data ~ 26 and Older We look at:  Total number tested  Number of “positives” from total number tested  Positivity rate Testing should be conducted only if patient is determined to be “at-risk” based on previously indicated criteria, i.e. symptoms, new or multiple partners in previous 60 days or exposure to infected individual

9. Fiscal Impact STD Program in Frankfort contributes approximately $400,000 annually via CDC-STD grant to support the program, i.e. purchase test kits. Current contract price for each CT/GC test kit is approximately $9.60 per kit. Keep in mind that this is the kit only – does not include labor nor costs at the state lab for actual testing

10. Local Effect  Decreasing public health dollars  Competing priorities  Recent updates from CDC emphasizing federal goal of avoiding duplication, stating CDC funding should not be used to provide clinical services  Increased emphasis on cost-effective screening, screening rates and timely treatment

11. Factors to Consider  Are we using test kits / IPP services to process testing for patients with health insurance, Medicaid, etc?  What type of billing systems or process is in place to recover such funds?  What screening tool is in place to assess need for testing prior to collection of specimens ~ use of test kit?  Need for education of all staff regarding significance of appropriate screening & testing

12. What’s Next?  Be proactive instead of reactive!  Identify as a team what will work best for your individual facilities and implement appropriate interventions.