The HOPE Center

1. The HOPE Center The Past, Present & Future of A Center of Excellence

2. The Past MBCHD Hemlock Street

3. 1985 • 1 Patient • Dr. Harold Katner, M.D. is hired by MUSM • No local health care for HIV • People With AIDS (PWA) group was formed • Raised $ to help pay rent & utility bills • Provided transportation to Grady Hospital • Central City AIDS Network formed • First support group started

4. 1986 • MCCG tells Dr. Katner he can not tell where he works because the hospital doesn’t want to be “Grady South” • Dr. Katner opens private office • Starts delivering care locally

5. 1987 • Ambulatory Health Center agrees that Internal Medicine clinic can treat HIV and admit patients to hospital • No separate facilities • No privacy at registration and check-in • Better than Grady; but not a good solution • Patients had a co-pay to see doctor & lab

6. 1988 A meeting is called to discuss needs with: • MBCHD Administrator Cecil Baldwin • District Health Director Brooks Taylor, M.D. • District AIDS Coordinator Angela Strickland • Dr. Harold Katner, M. D. • Dr. David Parrish, M.D. • Director of CCAN Cathy Dillard • President of PWA Johnny Fambro

7. The night is always darkest before the dawn

8. 1989 • Partners used volunteers to start clinic: • MBCHD • District Health Office • MUSM • CCAN & PWA (organizations merged) • Medical Center of Central Georgia (MCCG) • No money is used to operate clinic • 24 clients attended first clinic day • Clinic was Friday morning in back of building

9. 1991 • Applied for Ryan White Title II funding • Initially request was denied because we already had a clinic operating & money was for new services • We eventually receive Title II support to expand services and staff • We have outgrown our facility

10. 1994 • Health Department building sold to MCCG • Health Department moves to new facility • Large private waiting room • Confidential check-in • Private clinical area • Private treatment rooms • Walter F. George School of Law, Georgia Legal Services and AIDSLaw Project in Atlanta start a project here with interns and advisor.

11. 1994 • CCAN begins offering housing assistance through Housing Opportunities for People With AIDS grant • Case management services added to clinic • Consortium is formed

12. 1999 • CCAN hires a consultant/grant writer to develop Ryan White Title III grant • District Health office could never find project money and we needed the primary healthcare, Early Intervention Services • Grant was awarded following year after 1/3 reduction in requested funds

13. 2001 • Title III contract awarded • Program Manager Patricia Yancey is hired • District office assumes administrative oversight with Program Director answering directly to Dr. Swartwout • Consortium begins developing a plan to relocate the clinic from the health department to a freestanding confidential setting

14. Again, Darkness is Broken

15. March, 2002 • Clinic is relocated to stand alone facility • Consumer survey implemented to name the clinic; The HOPE Center was chosen. • MBCHD assists in furnishing equipment we had not already purchased • CCAN assists in moving • Clinic days are expanded from 2 half days to 5 full days

16. 2002-cont’d • Free standing building gives more expectation of consumer privacy • Allowed expansion of specialty care • Staff dedicated to our consumers only • Able to capture & retain third party billing • More office space for CBO’s

18. Medical Center of Central Georgia

19. North Central Health District 5-2

20. Bibb County Board of Health

21. Mercer University School of Medicine

22. The HOPE Center On-Site Care

23. Specialty Care

24. CBOs and Faith Based Services

25. Community Partners Medical Center J. Michael Simmons, Jr., DO, FAAO W. T. Anderson Center Lenscrafters, Inc. Oconee Regional Hosp. Loaves & Fishes Houston County Hosp. Perry Hospital SEATAC Macon Coalition to End Homelessness Neighborhood Health Centers Georgia Legal Services River Edge Behavioral Health Oglethorpe Dental Center Phoenix Center Red Cross Oconee Center Salvation Army Hospice Care Providers Faith Based Organizations MOMAS Mentors Project Middle Georgia Sisterhood, Inc. Central City AIDS Network, inc.

26. Consumer Involvement • Started at MBCHD • Consumer Created • Consumer Built • Consumer Driven • Lead and serve on Consortium • Quarterly Consumer Satisfaction Survey • Active Grievance Policy • Serve on CQI Committee • Special Projects • Participate in needs assessment & focus groups

27. Clinic Flow • Check In with Program Assistant • Vital Signs taken and recorded • Nursing assessment • See an Intern and a Physician • Social Service assessment & follow-up • Assessment and follow-up by registered dietician • Nursing exit interview; Adherence & Compliance education offered • Lab tests (if indicated) • Meet with Program Assistant to work out financial requirements (sliding-fee-scale)

28. Reduce Duplication of Effort • Share forms and documents • Host tours to share info to other clinics • Policy & Procedures Manual copied often • Provide TA to State and other districts • Receive TA to State and other districts • State adopted HOPE Center’s medication adherence and compliance policy • Data support to track services for each consumer

29. Consortium • State recognizes North Central Ryan White Consortium as a model for the State • Meets Monthly • Active consumer involvement • Active community involvement • Support of Administration • Provide TA to other consortia • Experienced and stable leadership

30. A word about our grant • Grant document since the initial document has been written by a “grant team” • Team consists of President of Consortium; Consumer; Program Manager; Nurse Manager, District AIDS Coordinator; Office Manager and CBO representative • Use needs and gaps assessment; consumer satisfaction survey data; CADR data; CDC, DHR and local data; as well as existing and emerging trends to develop an effective application. • Application has steadily improved over the term of the grant because of stable membership and experience of the team

31. Center of Excellence • Dr, Harold Katner is Professor of Internal Medicine at MUSM and State of Georgia HIV Medical Advisor • Dr. Jeffrey Stephens Professor of Internal Medicine at MUSM and Director of Infection Control at MCCG • Dr. Katner producing an educational DVD for distribution • Multiple Pilot projects (ADAP, CAREWare, etc.) • Recognized by State of Georgia and HRSA • Asked by HRSA to present at August TA Conference • Asked by Dr. Swartwout to present at GPHA Conference in September

32. Make up of Consumers - Regional Data • 140 Million women in the USA • 29% of those women live in the South • 76% of the new infections in South are Women • 25% of the approximately 1 million HIV+ in America are women

33. Make-up of Consumers - Local • Largest % females in Georgia – 38% • More heterosexual transmissions than state average – 52% • Disproportionate number of consumers of color – 82% • 88% of females women of color • Average age of clients older – 38% >44 • Average age of new infections – 37 • Average CD4 at intake – 276 • Average viral load at intake – 87,845

34. Clinic Growth

35. The Future:So bright we gotta wear shades

36. $2 Million SPINS Plan • Mayor of Macon C. Jack Ellis and third district Congressman Jim Marshall are working on a plan to bring an additional $2,000,000 to the area for AIDS services through a Special Projects of National Significance grant. • Gave the Mayor our “wish list” • Waiting on reply and working on other angles to accomplish list

37. Wish List • 20 Unit apartment complex for homeless people living with HIV using profit to fund two staff positions • Build a new HOPE Center to local needs and specs adding an education center for training and small conferences • Contract a grant writer to develop additional resources for Substance abuse services • More $ to expand vision and dental services • Stable State level staff and TA • More clinical staff

38. Wish List – Cont. • Recruit, employ and retain a qualified, stable staff • Recruit, employ and retain a full or part time primary care physician • Hire two additional Social Workers • Have the State of Georgia recognize The HOPE Center as a specialty clinic to remove salary restraints imposed on public health employees