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HIV Testing for CDC PS 12-1201 Prevention Grant. Welcome. Presentation w/participants on mute (*6) Questions may be submitted via chat throughout presentation Please submit questions to “everyone” using the chat drop down box Discussion & Q/A
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HIV Testing for CDC PS 12-1201 Prevention Grant
Welcome • Presentation w/participants on mute (*6) • Questions may be submitted via chat throughout presentation • Please submit questions to “everyone” using the chat drop down box • Discussion & Q/A • We will read questions submitted via chat and respond after the presentation • You may unmute your phone to ask questions during the discussion at the end • Recorded Webinar will be posted on OA’s website • Questions will be added to FAQ • If you encounter any technical difficulties, please contact Pete Ramirez at (916) 445-5702 or email Pete.Ramirez@cdph.ca.gov Fidel Encarnacion at (916) 893-9933 or email Fidel.Encarnacion@cdph.ca.gov
Goals of HIV Testing Webinar • Present OA Testing Goals for CDC 12-1201 • Define HIV Testing Terms • Share OA’s objectives and strategies forCDC 12-1201 HIV Testing • Answer Questions about the formulationof OA’s Testing Plan
HIV Testing in Healthcare / Clinical Settings CDC PS12-1201 - Category A OA’s Goal: Assist healthcare/clinical settings achieve integrated, sustainable HIV testing so that all patients have the opportunity to know their HIV status.
CDC HIV Testing Definitions HIV Screening – providing HIV testing to patients regardless of their behavioral risk or presence of signs and symptoms of HIV infection. Opt-out Testing – notifying a patient that an HIV test will be performed unless the patient declines testing. Recommended HIV Testing Definitions and Examples - http://www.cdc.gov/hiv/topics/funding/PS121201/pdf/Attachment-II.pdf
Testing in HCS (2) • Routine HIV Testing – HIV testing that is a usual and customary medical care practice based on an established protocol or policy. • Healthcare Setting / Clinical (HCS) – a setting in which both medical diagnostic and treatment services are provided. • Non-Healthcare Setting / Non-Clinical – a setting that does not provide both medical diagnostic and treatment services, i.e., OA-funded HIV testing sites.
OA Strategy for HIV Testing in Healthcare Settings CDC PS12-1201 - Category A • Assist LHJs to create inventory of current HIV testing in HCSs. • Assist LHJs in encouraging HCSs to implement routine, opt-out HIV testing. • Provide TA to LHJs and HCSs related to: • testing methodology • clinic work flow • reimbursement • data collection and submission • OA to develop best practices for HIV testing in HCSs. Please note: OA-provided HIV testing kits cannot be used for routine, opt-out testing in HCSs.
Consent for HIV Testing • Written consent is not required for HIV testing ordered by a healthcare provider in HCSs. • Provide specific information orally or in writing. http://www.cdph.ca.gov/pubsforms/forms/CtrldForms/cdph8700.pdf • Written consent is required for HIV testing that is performed (specimen collection, processing and/or results provision) by OA-certified HIV Test Counselors.
Reimbursement • AB 1894 – all private health insurance third-party payers must reimburse for HIV testing regardless of primary diagnosis. • Medi-Cal should reimburse for ICD-9-CM diagnosis codes V73.89 (Special screening for other specified viral diseases) or V69.8 (Other problems related to lifestyle). • Family PACT (Planning, Access, Care, Treatment) will reimburse for routine HIV screening. • Medicare will reimburse for individual risk factors and if the patient requests an HIV test.
Hiv Testing in NoN-Healthcare Settings as defined by the cdc • “A setting where neither medical diagnostic nor treatment services are provided but health screenings are provided.” • Examples of testing in a non-healthcare (non-clinical) setting are: • OA Funded HIV Testing Sites • Field Testing • Syringe Exchange Program
Program Shift • Alignment with National HIV/AIDS Strategy • OA maximizing its available resources to focus on testing efforts that yield an increase in numbers of newly-identified people with HIV infection who know their infection status
Testing objective • OA will increase the numbers of high risk (targeted) clients tested by 10 percent by year end 2012. • LHJs will target their testing efforts to • African American • Latino • MSM • Transgender Individuals • IDUs • And Partners of All Listed Groups
Testing objective • OA will increase the numbers of newly- identified HIV positive clients who access medical care and receive Partner Services. • LHJs will continue to be required to provide • Linkage to Care • Verified Medical Visit • Partner Services
Testing approach • Over the next 18 months, OA will work closely with funded LHJs to implement strategies to increase HIV testing which targets specified targeted (high risk) populations in non-healthcare settings. • OA has reviewed data of testing efforts made by funded LHJs to targeted populations. • OA will assist LHJs focus their testing activities to targeted populations and reduce testing in sites with low positivity rates.
Testing approach • Jurisdictions and agencies should consider which strategy or combination of strategies work best given the epidemiological characteristics of HIV infection in their area. • With OA assistance, LHJs will be asked to define ways to reach targeted populations focusing on C&T, surveillance, and 2010 census data.
OA Testing Support • Rapid HIV test kits and controls • HIV testing forms and lab slips • HIV Counselor training • Data management by LEO • Indicator reports • Technical Assistance • Program monitoring
Updates in Testing program • HIV counselor curriculum is being updated. • HCV testing and training for counselors. New legislation (AB 1382) effective January 1, 2012. • Preliminary positives can be referred to HIV care for confirmatory testing. http://www.cdph.ca.gov/programs/aids/Documents/HIVTestingConfTestiGuidance.pdf
Leo update • Local Evaluation Online • All testing data will go into LEO • CDC’s new reporting requirement – long-term changes • New LEO Testing Indicators Report (#14) • Key report to monitor your program • Positive test results, referrals to care, verified medical visit, and Partner Services • Gender, race/ethnicity, age groups • Risk level, (high or low), risk groups • Are you new to LEO? – help is on the way. An Operations Advisor will be assigned to assist you.
Leo customized reports • Program planning and evaluation, needs assessment, community planning, grants/proposals • Customized Testing Indicators Report (#14) (e.g., agencies, locations, location type, residence ZIP code, testing strategy, target populations) • Request for HIV Prevention Program Reports Form • Please allow at least two to four weeks for completion
Leo data and information sources • Prevention data files • Excel, SPSS, SAS • LEO Data File Request Form • Please allow at least five business days for completion. • Surveillance data • HIV/AIDS surveillance reports & data requests • Request for HIV/AIDS Summary Data (Please allow 60 days for completion.) • Know your target populations and community • OA website – OA’s EPI profile • US Census website – factfinder2.census.gov • 2010 US Census - population and demographic profiles • American Community Survey - socioeconomic status • Local EPI profile and community plan
Next Planning Steps • LHJs will work on development of testing plans using worksheets and format as described by OA (to be provided) • Using your Epi data and HIV Community Plans, prioritize Tier I activities in your new prevention program • Assess current Tier I activities that can continue and contribute to your prevention program • Identify gaps in activities or target populations that will need additional resources or new activities developed • Submit Plans to OA on worksheets and format provided by OA
Calendar of Upcoming webinars The following webinars will be held from 3-4pm on the dates listed below: • October 27 – PWP Activities • November 3 – Policy Initiatives • November 10 - Syringe Service Programs & California AIDS Clearinghouse • November 17 - Tier II Activities (Social Marketing, HE/RR for High Risk Negatives, Hepatitis C Testing, PrEP) • December 8 – Putting it all Together
Questions or comments? If you have any questions or feedback at any time before or after the webinars please send them to: OAFeedback@cdph.ca.gov