1. Prevention and Health Promotion Administration - 1 Increasing Engagement in HIV Care through Health Department and Community Health Center Collaboration Pam Kurowski, LCSW Special Projects Director Infectious Disease Prevention and Care Services Bureau Prevention and Health Promotion Administration

2. Prevention and Health Promotion Administration - 2 MISSION AND VISION MISSION The mission of the Prevention and Health Promotion Administration is to protect, promote and improve the health and well-being of all Marylanders and their families through provision of public health leadership and through community- based public health efforts in partnership with local health departments, providers, community based organizations, and public and private sector agencies, giving special attention to at-risk and vulnerable populations. VISION The Prevention and Health Promotion Administration envisions a future in which all Marylanders and their families enjoy optimal health and well-being.

3. Prevention and Health Promotion Administration - 3

4. Prevention and Health Promotion Administration - 4

5. Reported Adult/Adolescent (age 13+ at HIV Diagnosis) HIV Cases with or without an AIDS diagnosis, per 100,000 population 50+ 25 – 49.9 15 – 24.9 10 – 14.9 0 – 9.9 Maryland Adult/Adolescent 2013 HIV Diagnosis Rates by Jurisdiction State Rate = 28.1 per 100,000 Using data as reported through 12/31/2014

6. Maryland Adult/Adolescent Persons Living with HIV by Region, 2013 Using data as reported through 12/31/2014

7. Maryland Adult/Adolescent New HIV Diagnoses by Region, 2013 Using data as reported through 12/31/2014

8. Prevention and Health Promotion Administration - 8 Health Centers

9. Prevention and Health Promotion Administration - 9 Ryan White Program

10. Prevention and Health Promotion Administration - 10 Case Study: Community Clinic Health & Wellness A RW/HIV-Naïve Health Center

11. Prevention and Health Promotion Administration - 11 Program Considerations  Number of sites  Number of providers/support staff  Training needs  Provider capacity/attitudes  Testing options  Incorporating HIV testing into clinic flow  Will they cover their costs?

12. Prevention and Health Promotion Administration - 12 Program Implementation  HIV Testing  Utilizing EMR & i2i for tracking  Pre-visit planning  Rapid & lab-based testing  Develop P&P  Goal: Implement routine HIV testing

13. Prevention and Health Promotion Administration - 13 Program Implementation Con’d  HIV Care  Create HIV care team  Gain staff buy-in  Set up referral systems  Market to outside agencies  Goal: 100 patients by December 2016

14. Prevention and Health Promotion Administration - 14 Program Implementation Con’d  HIV Treatment  Primary diagnosis drives PCP selection  Associate Care Providers consult with HIV specialist  Goal: Expand HIV care to all sites

15. Prevention and Health Promotion Administration - 15 Key Points  Could other health centers replicate this model?  Funding  Issue of uninsured  HIV testing and care costs  EMR modifications  Who is the expert?

16. Prevention and Health Promotion Administration - 16 Prevention and Health Promotion Administration Pam Kurowski, LCSW Pamela.kurowski@maryland.gov http://phpa.dhmh.maryland.gov