Division of HIV, STD and TB Services (DHSTS) CTR Coordinator’s Meeting April 20, 2011

1. New Jersey Department of Health & Senior Services Division of HIV, STD and TB Services (DHSTS) CTR Coordinator’s Meeting April 20, 2011

2. Agenda • Introductions • Statistical Overview • EvaluationWeb • SAGE Update • DHSTS Training Update • Attachment C Requirements • Workgroup Meeting Update • State Laboratory Update • Syringe Access Program Update – ARCH Nurses • RWJ Update

3. Welcome & Introductions • Welcome • Maureen Wolski • Assistant Commissioner • Connie F. Meyers • Director, Prevention and Education Unit • Steve Saunders, M.S. • Unit Staff Introductions

4. Statistical Overview

5. CTR Data Processing Overview • DHSTS receives 80,000 – 100,000 data forms annually • Thank you for submitting these forms in a timely manner • Forms are processed through the following stages: • Sorting • Scanning • Interpretation • Verification • Review • Validation • Submission to CDC • Analysis and Reporting

6. CTR Data Challenges • Coordinators: • Continue to: • Review the data forms prior to mailing • Send the data forms on time • Follow instructions for positive results • Complete – Parts 1 (front & back), 2 and 3 • Mail to the Surveillance Program, PO box 363, 4th Floor, Trenton, NJ 08625-0363 • Provide DHSTS with 3 weeks notice when requesting data forms • DHSTS • Data forms received vs. data forms reported (Monthly Progress Report) • Data forms received vs. clients tested (Robert Word Johnson Report)

7. EvaluationWeb • Direct Entry (internet) Data Collection and Reporting System • User-Friendly • Real Time Access to Data • Customized Reports – easily generated • Electronic Authentication – Identity proofed by CDC • Staff using the system will: • Go thru the authentication process • Be required to have an active e-mail address • Have to have a valid identification – drivers license • Pilot Programs have been identified • 1 Emergency Department, 1 CTR – with ED & MU, 1 County Jail, 2 Community Health Centers, 1 Planned Parenthood (10 sites) • Technical Assistance Provided – implementation, system requirement assessments, electronic authentication of staff, on-going assistance

8. Rollover of New Grant Amendment/Revision Process SAGE Update

9. Training Update

10. HIV Basic Facts • A new direction – Ecourses • Benefits of Ecourses • Registration and Completion Process • Website – http://hpcpsdi.rutgers.edu • Computer System Requirements • Present – • HIV/AIDS Basic Facts • Launch Date – Summer 2010 • Future – • Other courses being developed

11. Training Opportunity • Town Hall Meetings – Nationally & Locally • What consumers are saying • How we are responding • “Creating Safe Spaces & Places: A Primer for Increasing Provider Skills in the Reduction of HIV/AIDS Stigma, Bias and Discrimination” • Designed to focus on stigmatization & discrimination surrounding HIV/AIDS • Strategies will include individual reflection, group sharing and environmental scans and analyses • Develop plan that can be introduced into the workplace

12. Registration Process • Required to attend: • All coordinators & counselors • Training Dates & Locations (2 day course) • May 26 & June 15 – Rutgers – New Brunswick • May 27 & June 16 – Rutgers – Newark • June 10 & July 8 – Rutgers – Newark Registration Process Rutgers – http://hpcpsdi.rutgers.edu E-mail to PMO Registration closes – 1 week prior or when 35 individuals have registered *** Register by May 10th ***

13. Attachment C Requirements

14. Linkage Agreements Establish and maintain written linkage agreements with a variety of service programs for the purpose of client referrals. Written linkage agreements must include: the services provided, the location where services are provided, the overall time period of the agreement, the method for verifying if the client has kept the appointment, and signatures of the responsible individuals from each agency. Client referrals will be documented in the client’s chart. Verification if client kept the appointment will be documented in the client’s chart and on Reporting Form Linkage agreements should be maintained with, but are not limited to: HIV/AIDS treatment, prevention service agencies, crisis intervention, health center, family planning/planned parenthood, prenatal, financial/legal aide, substance abuse treatment, STD clinics, mental health treatment and support groups (HIV, battered women, grieving/bereavement, MSM, gay/lesbian/transgender).

15. Personnel Changes • Report to PMO within 2 days • Written Justification Required to Fill a Vacancy • Recommendation by PMO • Approval by DHSTS

16. Resource Directory • DHAS Resource Directory • Maintained by Rutgers • Website – http://hpcpsdi.rutgers.edu • Update Directory: • On Website Page • Resource Directory • Search Database • Div of HIV/AIDS Services • Planning Bodies • National Organizations • Resource Index • Download Directory • Directory Update Form • Complete Form • Fax or E-Mail Update Every July

17. Workgroup Meetings by Initiative • Purpose • Bring Agencies Providing Similar Services Together to Identify Site Specific Issues & Concerns (i.e., security, promoting testing, access to patients) • Goal • Thru Networking - Address Issues/Concerns and Explore Ways to Minimize Problems

18. Laboratory Update • New Division Name • Public Health Infrastructure, Laboratories and Emergency Preparedness – PHILEP • Moving to New Facility • Courier Service Update • Update • Problems or Issues • Specimen Collection • Gold top tube for primary sampling • Requisition form/sample ID mismatches • What do you need from us? • Supplies • Blood Collection Tubes • Requisitions • Shipping containers • Martha Smith – • Director, Policy Planning and Regulatory Compliance • 609-292-7783 • Mary Efstathiou – • PHILEP – HIV Coordinator • 609-984-9318 or 609-292-7013

19. Syringe Access Program Access to Reproductive Care and HIV Services (ARCH) Nurses Dr. Sindy Paul

20. Access to Reproductive Care and HIV Services (ARCH) • Medical outreach nurses to provide primary care and harm reduction services • Target population: IDUs • CBOs in association with SAP • Atlantic City • Camden • Jersey City • Newark • Paterson

21. Collaborative Program • Funding from multiple sources • CDC HIV Prevention Cooperative Agreement • STD Program - Infertility Prevention Program • TB Program • Collaboration with NJDHSS, FXBC, and CBOs

22. Program Development • Educational process for nurses • Didactic educational sessions & problem solving • Development of educational materials • Template medical record • Standing orders • Data collection tool –Weekly Report • Web-site – in progress

23. Services Provided – Harm Reduction • Sexual risk reduction • Safer injection education • Reproductive health counseling • Including preconception counseling • Overdose prevention counseling • Nutritional counseling • Food bags available • Other educational support

24. Services Provided – Lab Testing • Pregnancy (point-of-care) • HBV • HCV • Chlamydia • GC • HIV testing by CTR (RTA) • Referral for treatment for all positive tests • Note: on-site Chlamydia and GC treatment

25. Services Provided – Adult Immunizations • Twinrix (hepatitis A & B) • Diptheria, tetanus, pertussis • Flu • Pneumococcal • Gardisil

26. Other Services • Wound assessment and care • Drug treatment referral • TB screening • Narcan

27. Results 2010 • Number persons seen – 2,495 • Female 1,157 • Male 1,336 • Transgender 2 • Harm reduction visits • Safer injection 1,255 • Sexual risk reduction 629 • Overdose prevention 336

28. Results 2010 • Wound care 542 • Other educational support 799 • Pregnancy tests 137 • Positive 23 • Referred for prenatal care 32 • Drug treatment referral 31 • Other referrals 405 • Twinrix 1 • Other vaccines 27

29. Anecdotes Numbers Don’t Tell The Whole Story • At one site, the nurse reported that male SEP participants are bringing their pregnant girlfriends in to speak with the nurse, presenting an opportunity to link pregnant women at HIV risk to prenatal care. • At another site, a past SAP client returned to confirm her pregnancy and discuss options for prenatal care.

30. Anecdote • A woman tested positive for pregnancy and expressed fear, which turned into excitement when she learned about methadone maintenance. Client had been unaware of the resources available for pregnant women, and reported that she could not wait to begin treatment the following morning, since “it is not just me anymore!” Client reported that she had wanted to get pregnant, but she and her boyfriend had believed that they could not get pregnant due to possible fertility issues. Client reports that she has missed one period, which was due at the beginning of February. Client was admitted for methadone treatment and prenatal care.

31. ARCH Summary • ARCH nurses established ongoing patient relationships with very high-risk persons. • Often, the nurses’ teaching safer injection practices opened the initial door to this relationship. • The harm reduction environment supported clients’ return visits to the nurses for health education & to the SAP.

32. RWJ Update Report Card Project Update