123NoMi

1. 123NoMi A 3-year project by Hep-C ALERT to increase and evaluate viral hepatitis screening, vaccination coverage and completion among underserved minority adults in North Miami-Dade County

2. Acronyms HCV Hepatitis C Virus HIV Human Immunodeficiency Virus STD Sexually Transmitted Disease (or Infection) OMH Office of Minority Health BOI Bureau of Immunization “09 Program” - Florida Hepatitis and Liver Failure Prevention and Control Program 09 CTL Counseling, Testing and Linkage (referral) Hep-C ALERT, Inc.

3. Hep-C ALERT Background • 1997 – chronic HCV focused • National: Hep-C Hotline; Education, HCV CTL, Cause Advocacy • Local: Support Groups, Outreach, Education. Local HCV CTL in 1999 • 2002 – added HIV CTL and hepatitis vaccination (vaccine in collaboration with Miami-Dade County Health Dept.) • 2006 – added Rapid HIV & STD CTL Hep-C ALERT, Inc.

4. Area Description Hep-C ALERT, Inc.

5. Annual Growth On-Site CTL Hep-C ALERT, Inc.

6. Baseline Data • Hep-C ALERT Hepatitis Risk Assessments reveal that 81% of minority adults self-reported not ever receiving hepatitis vaccination • Upon viral hepatitis testing, approximately 50% were not immune • Even with these compelling results, vaccine coverage and completion rates remained low Hep-C ALERT, Inc.

7. Barrier Identified • Resources were needed to bridge the client’s gap between risk appraisal and action • Novel approaches to increasing adult vaccine coverage and completion for our community was necessary Hep-C ALERT, Inc.

8. Closing The Gap Grant • Rationale • Community interest demonstrated through “Vaccine Interest Survey” • Prior experience with managing vaccination services off-site (ARHIP) • Already serving primarily at-risk young adult / adult minority population at the Hep-C ALERT office Hep-C ALERT, Inc.

9. Office: Race/Ethnicity Hep-C ALERT, Inc.

10. Office: Age Groups Hep-C ALERT, Inc.

11. 123NoMi Objectives • Reduce barriers to viral hepatitis screening and vaccination • Identify susceptible at-risk persons and provide vaccination • Achieve target vaccine coverage and completion rates • Monitor, evaluate and disseminate 123NoMi project results Hep-C ALERT, Inc.

12. #1 - Reduce Barriers • Diversify project staff (Spanish/Creole speaking) • Offer 100% walk-in services, non-traditional hours (including Sat) • Implement vaccine reminder system • Utilize incentives for new client recruitment and vaccine completion Hep-C ALERT, Inc.

13. #2 - Screen • Test (one time) all adult clients to determine their serostatus using the State Lab chronic hepatitis panel • Counsel and refer acute/chronic HBV and HCV to medical care • Recall at-risk/susceptible adults to initiate vaccination Hep-C ALERT, Inc.

14. #3 - Vaccinate • A and B vaccine administered per 09 program Memorandum of Agreement • Coverage • Year 1 thru 3 @ 60% • Completion • Year 1 =/> 20% • Year 2 =/> 30% • Year 3 =/> 40% Hep-C ALERT, Inc.

15. #4 - Evaluate • Coverage and completion rates • Client satisfaction with • Cultural responsiveness • Screening and vaccination services • Tools • VACTRAC 4.0 (SmithKlineBeecham) • IMM07 (OMH/BOI software) • HIMS (proprietary software) • QuestionPro.com (subscription survey creation/analysis site) Hep-C ALERT, Inc.

16. Hep-C ALERT, Inc.

17. Struggles • Reaching consensus on • 09 program vaccine distribution to non-governmental organization (NGO) • Type of nurse (RN or LPN) needed for vaccine administration at NGO • Agency liability insurance coverage • Contract vs. Finance & Accounting • Totally unanticipated issue w/finance • In process of resolution Hep-C ALERT, Inc.

18. Strengths • Standing Orders • Project staff were incumbent or hired and trained before the contract start date • Existing infrastructure for data gathering and analysis • Pool of previously-screened clients to recruit from at project launch • Great Board and Medical Directors Hep-C ALERT, Inc.

19. New Era Of Collaboration • Cooperation between the 09 program, and community-based (and private) organizations has resulted in several new projects in non-traditional settings • Success has wide implications for promoting other adult vaccinations Hep-C ALERT, Inc.

20. Summary To Date • 123NoMi data show substantial increase in susceptible persons initiating hepatitis vaccination • 0% baseline vs. 37% present • Need improvement in getting clients in for first dose to achieve 60% coverage • Client satisfaction is higher than expected in all domains during roll-out period and loyalty rating for vaccine service ranks all time high for agency Hep-C ALERT, Inc.

21. Acknowledgements • Office of Minority Health • Phil and Cheryl for opening 09 program vaccine access to NGOs • Rick Barrett, Bureau of Immunization Contract Manager for 123NoMi • Anita Martinez, RN, MDCHD for sharing vaccine inventory • Bob Griffin for years of unconditional support at the local level • Hep-C ALERT’s excellent staff Hep-C ALERT, Inc.

22. Contact Information Andi Thomas Executive Director, Hep-C ALERT andi@hep-c-alert.org www.hep-c-alert.org Offc: 305-893-7992 x101 Cell: 954-931-8463 Hep-C ALERT, Inc.