ADAP Crisis to Gulf Disaster: Environmental Indications & Implications

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2. Overview • The State of HIV Primary Care • Complementary & Alternative Medicine • Impact of the Political, Social, & Environmental • Health Care Reform, Public Health Infrastructure • Where people access care • Gulf Oil Spill • Introduction to HealthHIV

3. The State of HIV Primary Care • Why we conducted the survey? • Fewer HIV specialists • Perceived complexity of HIV care & treatment • Potential for more HIV diagnoses • 2009 Inaugural Survey • 1165 provider respondents from across the country • 148 HIV specialists 421 HIV primary care providers

4. State of HIV Primary Care 38% of respondents indicate their HIV caseload has “increased” or “dramatically increased”

5. State of HIV Primary Care Capacity to see newly diagnosed HIV positive patients by HIV PCPs

6. State of HIV Primary Care

7. State of HIV Primary Care Barriers to providing HIV primary care (for HIV PCPs) • Funding (19%) • Transportation (12%) • Lack of clinical staff time to take on new roles (10%) • Perceived complexity of HIV treatment (8%) • Lack of support staff time to take on new roles (7%)

8. State of HIV Primary Care Community barriers for PLWHA per HIV PCPs • Substance Abuse (14%) • Mental Illness (14%) • Lack of transportation (11%) • Homelessness (11%) • Immigration/citizenship concerns (7%)

9. Complementary & Alternative Medicine • 2009 Survey results forthcoming • Asked providers about recommending CAM • Asked PLWHA about using CAM • Are PLWHA using CAM as an alternative or complement? • Where do providers and PLWHA go for CAM information? • What types of CAM are being used and why?

10. “Social” Environment Community health centers clients are expected to increase dramatically CHCs are receiving increases in funding and attention

11. Political Environment Access to care • Health care reform • Public health workforce/infrastructure • Ryan White

12. PulsePoints: Oil Spill Survey

13. Provider Comments

14. Provider Survey “The oil spill impact may be slower to evidence itself and more long term in nature. We anticipate a number of clients who have been healthy and working may lose employment benefits and health insurance immediately and overtime and seek already strained public resources.”

15. Provider Survey • “We are increasing our mental health services and including support addressing the effects encountered as a result of the oil disaster.” • To do a “disaster plan” not a “hurricane plan.” • “A number of clients will likely fall out of care unless they are directly linked to new providers if necessary to relocate.”

16. PLWHA Comments

17. PLWHA Survey • “I used to work in the Gulf as a superintendent of a remote catering firm and their business has been hurt. Lots of friends affected by this spill” • “I am afraid the long term effects of the oil spill will negatively impact the already damaged economy of the region and that overall health will decline sharply” • “Depression medication failing”

18. PulsePoints: Oil Spill Survey “I fear the rest of the country will grow weary of this ‘newsworthy’ event and after awhile Anderson Cooper will go home.”

19. Texas Louisiana Rep. Charles Boustany (R-7) Rep. Charlie Melacon (D-3) Rep. Joseph “Anh” Cao (R-2) Rep. Steve Scalise (R-1) Rep. Bill Cassidy (R-6) Sen. Mary Landrieu (D) Sen. David Vitter (R) Rep. Solomon Ortiz (D-27) Rep. Ron Paul (R-14) Rep. Ted Poe (R-2) Rep. Pete Olson (R-22) Rep. Al Green (D-9) Rep. Gene Green (D-29) Rep. Sheila Jackson-Lee (D-18) Rep. John Culberson (R-7) Sen. John Cornyn (R) Sen. Kay Bailey Hutchison (R)

20. Mississippi Alabama Rep. Jo Bonner (R-1) Sen. Jeff Sessions (R) Sen. Richard Shelby (R) Rep. Gene Taylor (D-4) Sen. Thad Cochran (R) Sen. Roger Wicker (R)

21. Florida Rep. Jeff Miller (R-1) Rep. Allen Boyd (D-2) Rep Ginny Brown-Waite (R-5) Rep. Gus Bilirakis (R-9) Rep. Bill Young (R-10) Rep. Kathy Castor (D-11) Rep. Vern Buchanan (R-13) Rep. Connie Mack (R-14) Rep Mario Diaz-Balart (R-25) Rep. Ileana Ros-Lehtinen (R-18)  Sen. George LeMieux (R) Sen. Bill Nelson (D)

22. Highlights Access Matter

23. Highlights Formularies Matter

24. Highlights Economies Matter

25. Highlights Environments Matter

26. Mission & Vision MissionTo advance effective prevention, care, and support for people at risk for or living with HIV by providing education, technical assistance, and health services research to organizations, communities and professionals. VisionTo be recognized by the HIV community, the federal government, and others as the premiere national education, technical assistance, and health services research organization.

27. About HealthHIV • 19 experienced staff (incl. clinical, global, cultural competency, health literacy) and a TA faculty of 80+ with experience reaching medically underserved and minority communities • Core capabilities • Education, • Technical Assistance and Capacity Building, • Health Services Research/Evaluation, and • Advocacy • Numerous partnerships with national and local organizations (non-profit, clinical, and technological)

28. Health Services Research/Evaluation 28 Conduct health services research in the HIV setting to identify trends, issues, and needs to: • Support and justify educational, CBA, and TA initiatives • Document outcomes • Determine new educational offerings • Assure and improve quality • Present findings to funders, community and HIV thought leaders, policy makers, and program administrators to effect positive change

29. Contact Information Connie M. Jorstad Research & Evaluation Manager Connie@HealthHIV.org Paul A. Angelone Research & Program Associate Paul@HealthHIV.org