Pristeen Rickett Disease Intervention Specialist Elizabeth Page Brockwell Service Chief Orange Countys Data To Care Programs What Are We Here to Talk About Surveillance Based Partner Services ID: 551740
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Slide1
Colleen Brody, Program Supervisor IIPristeen Rickett, Disease Intervention Specialist Elizabeth “Page” Brockwell, Service Chief
Orange County’s Data To Care Programs Slide2
What Are We Here to Talk About?
Surveillance Based Partner ServicesSurveillance Based Data to CareSlide3
Disease Control & EpidemiologySlide4
The steps we took
…Met with SurveillanceConsulted with
County Counsel
Developed
and faxed a letter
to
community
medical providers
to inform them of our new enhanced Partner ServicesDevised a system with surveillance to clear previously reported cases before they are assigned to DIS
Started Surveillance Based Partner Services in June 2014Slide5
Numbers So Far
476 non-jail labs have been assigned67 were not offered PS50 accepted PS
301
declined PS
12
were unable to locate
46
are still
open Slide6
Partner Services Outcomes
HIV Dispositions
Number
1 -
Previously Tested
Positive
16
2 -
Previously Negative, New
Positive
2
3 -
Previously Negative, Still
Negative
34
4 -
Previously Negative, Not
Re-Tested
1
6 -
Not Previously Tested, New
Negative
4
8 -
Test
History Unknown, New
Positive
1
9 -
Test History Unknown, New
Negative
3
10 - Test
History Unknown, Not Tested
Now
1
G -
Insufficient Information to Begin
Investigation
5
H -
Unable to
locate
15
J -
Located/Refused
Examination
5
K -
Out of
Jurisdiction
3
M -
Notified of Exposure, Agrees to seek testing, Results
Unknown
15
Q -
Initial Contact Made but No Health Info
Shared
5
STILL OPEN
19
Total
129Slide7
Some Challenges
Developing a DIS programStaffing issuesDocumentation issuesDatabase issuesSlide8
Walk Through Of A Case17th
Street Testing, Treatment & CareCases are assigned to DIS on a rotational bases or as the clinic Officer of the DayDIS reviews the medical record DIS contacts the patient to return to clinic for results
DIS discloses the results when the patient returns to the clinic
An Interview is done
Partner Services and Linkage to Care is offeredSlide9
Walk
Through Of A Case (cont.)Outside Providers
DIS contacts the provider
DIS contacts the patient
An
interview
is done
Partner Services and Linkage to Care is offered Slide10
Case Successes
Acceptance of Partner ServicesAcceptance of Linkage To Care Planting the seedSlide11
Some Challenges
Obtaining information from providersConfirming if the results have been disclosedApproaching someone newly diagnosed, addressing stigma, shame and fear
Anonymous partners
Patient insured and fearful
Patient not ready Slide12
How Have We Addressed These Challenges?
Created a letter for providersEnlisted help from our Medical Director and Surveillance staff
Developed
an Access
Database
Hosted
various staff trainings
Presentations to local planning groups, testing sites, and CBOs
Creation of a Linkage to Care NetworkEvolution of the Outreach TeamSlide13
Started Surveillance Based Data to Care in August 2015
The steps we took…
Planning and Implementation Group
Updated existing outreach protocol
Developed a letter to inform medical providers of this service
Coordinated
with surveillance
to get an initial list of individuals who were out of care in Orange CountySlide14
The List
The list had 1141 people!
To
make list
more manageable, we used data
to
target the most
impacted
populations in Orange CountyPriority 1 – African AmericansPriority
2 – Hispanic
males
in Santa
Ana
Priority
3 – Hispanic
males
in
Anaheim
This brought the number down to 418Slide15
Walk Through Of A Case
Case is assigned to Outreach team Outreach staff collaborates on daily outreach assignments based on location, time, and previous relationship if applicable Outreach worker reviews referral and any previous information availableOutreach worker contacts last providers and/or DIS for client information
Outreach worker contacts clientSlide16
Walk
Through Of A Case (cont.)Once a client is located the following takes place:
Complete a Barriers Assessment
I
ncentives are offered when applicable
C
ommunity resources are provided as needed
M
otivational interviewing to ready client for care Appointment assistance provided Linkage to care referral offeredClose out of client done with outcome in ARIES DatabaseSlide17
Successes
Planting the
seeds
Increase in amount of information available
Increase in amount of
people
being
reachedSlide18
Challenges
Deciding on priorities
Staffing issues
Old information/no information
Learning new databases
Collaborating with community medical providers
New
collaborative role
with DIS
Evolution of outreach to targeted outreach
No previous relationship with outreach individuals in many
cases
Lack of diverse resources for careSlide19
Lessons LearnedC
ommunication and collaboration with Surveillance is imperativeFigure out what information you need to collectKnow where you will you put that information and how will it be trackedBuild relationships with your community partners so that they are aware of what is going on and can inform clients
Keep getting great trainings for staff
to
build their skillsSlide20
Thank You
Colleen BrodyProgram Supervisor II, Disease Investigation UnitEmail: cbrody@ochca.com Telephone: 714.834.7833Pristeen Rickett Disease Invention Specialist, Disease Investigation Unit
Email:
Prickett@ochca.com
Telephone:
714.834.8615
Elizabeth “Page” Brockwell
Service Chief, Case Management & Outreach Email: ebrockwell@ochca.com Telephone: 714.834.7883