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Floridas Partnership for Care (P4C) Project Outcomes Mara Michniewicz, MPH Prevention Program Manager Florida Department of Health Bureau of Communicable Diseases HIV/AIDS Section, Prevention Program Florida Comprehensive Planning Network


  1. Florida’s Partnership for Care (P4C) Project Outcomes Mara Michniewicz, MPH Prevention Program Manager Florida Department of Health Bureau of Communicable Diseases HIV/AIDS Section, Prevention Program Florida Comprehensive Planning Network Meeting Tampa, FL November 8, 2018 Division of Disease Control and Health Protection 1

  2. P4C Project Overview • Centers for Disease Control and Prevention (CDC) and Health Resources and Services Administration (HRSA) led project over four years (July 2014–June 2018) • Increase collaboration between health departments and community health centers to: – Expand provision of HIV testing, prevention, care, and treatment – Build sustainable partnerships between health centers and health departments – Improve health outcomes among persons living with HIV, especially racial/ethnic minorities Division of Disease Control and Health Protection 2

  3. P4C Overview, continued • Florida’s P4C health center partners: – I.M. Sulzbacher Center (Jacksonville) – Health Care Center for the Homeless (Orlando) – Genesis Community Health Center (Palm Beach) – Broward Community and Family Health (Ft. Lauderdale) – Care Resource (Miami-Dade) – Community Health of South Florida (Miami-Dade) Division of Disease Control and Health Protection 3

  4. Florida P4C Partners • State Health Department – Prevention Program Manager – Project Coordinator Florida Community Department – Clinic Coordinator Health of Health, Centers – Monitoring and Evaluation Central Office Consultant • County Health Departments Six Health Centers P4C Core Team P4C Care Teams – HIV/AIDS Program Coordinators – P4C Managers P4C DIS and HIV Prevention Staff – P4C Disease Intervention Specialists (DIS) • Community Health Centers County Health – P4C Lead Departments – Care Team Lead Division of Disease Control and Health Protection 4

  5. P4C Project Data • Project data period: July 2015–December 2017 • Patients newly diagnosed at health centers: 318 • ‘Not in Care’ patients in P4C service areas: 2,267 • ‘Not in Care’ patients linked or re-engaged: 878 11/15/2018 Division of Disease Control and Health Protection 5

  6. Newly Diagnosed Patients at P4C Health Centers and those Interviewed for Partner Services, July 2015–December 2017 140 130 128 120 120 113 100 # of Patients 80 60 58 60 40 20 0 July 2015–June 2016 July 2016–June 2017 July 2017–Dec. 2017 # Newly Diagnosed Patients at Health Centers # Interviewed for PS Division of Disease Control and Health Protection 6

  7. P4C Client Demographics P4C Clients by Sex P4C Clients by Race/Ethnicity (N=318) (N=318) 2% 1% 6% 21% 40% 43% 77% 10% Male Female Transgender Black White Hispanic Multiracial/Other Unknown Division of Disease Control and Health Protection 7

  8. P4C Client Demographics, continued P4C Clients by Age Group (N=318) 140 117 120 Number of Clients 102 100 80 55 60 40 34 20 10 0 20-29 yrs 30-39 yrs 40-49 yrs 50+ yrs ≤19 yrs 11/15/2018 Division of Disease Control and Health Protection 8

  9. Newly Diagnosed Health Center Patients Interviewed for Partner Services and HIV Testing Positivity Rates among Named Partners, July 2015–December 2017 120% 96.6% 100% 92.3% 88.2% 80% 60% 40.0% 40% 23.6% 17.9% 20% 0% July 2015–June 2016 July 2016–June 2017 July 2017–Dec. 2017 Percentage of Newly Diagnosed Health Center Patients Interviewed for Partner Services HIV Testing Positivity Rates for Partners of Newly Diagnosed Health Center Patients Division of Disease Control and Health Protection 9

  10. Outcomes • HIV primary care • Routine HIV screening • Secure bi-directional data transfers and P4C Dashboard • Case conferencing for continuity of care (COC) • Health center-specific DIS • PrEP referrals, counseling, and provision Division of Disease Control and Health Protection 10

  11. Successes and Best Practices • Data sharing Memorandum of Agreement (MOA) template • Health center protocols, policies, and procedures for HIV services • P4C Dashboard: client search, out-of-care lists, task management • Case conferencing for COC services Division of Disease Control and Health Protection 11

  12. HRSA’s Health Center Toolkit, July 2018 • Provide clear roadmap for service integration • Identify best practices for HIV management in primary care • Provide tools for building health centers’ capacity • Provide a comprehensive set of educational and instructional materials https://bphc.hrsa.gov/qualityimprovement/pdf/p4c-toolkit-2018.pdf#zoom=125 11/15/2018 12 Division of Disease Control and Health Protection

  13. Sustainability • Replicate P4C model in other areas • Explore ways to fund P4C activities • Future implications for Dashboard (e.g., Data to Care) • Disseminate health center best practices for implementation of HIV primary care, routine HIV screening, and PrEP services • Develop strategies for retention and viral load suppression in health care settings Division of Disease Control and Health Protection 13

  14. Contact Information Mara Michniewicz, MPH Prevention Program Manager Mara.Michniewicz@flhealth.gov 850-901-6971 HIV/AIDS Section, Prevention Program Bureau of Communicable Diseases Florida Department of Health Division of Disease Control and Health Protection 14

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