Ryan White Part C Reauthorization: Impact On UW Health HIV Care Program

1. Ryan White Part C Reauthorization: Impact On UW Health HIV Care Program

2. Number of persons reported with HIV infection and presumed alive at year’s end, Wisconsin, 1990-2007 Number of persons reported with HIV infection by year of report, Wisconsin, 1990-2007 Wisconsin AIDS/HIV Surveillance DataDecember 31, 2007 • 407 new cases of HIV infection were reported in 2007. • 9,929 cases have been reported since 1983. • 6,684 cases are classified as AIDS, 3,245 as non-AIDS. • 3,635 persons reported with HIV infection are known to have died. • 6,294 persons with HIV infection were presumed to be alive at the end of 2007. Between 1998 and 2007: Average = 383 cases per year 95% Confidence interval=336-430 cases per year

3. Cases 0-2 3-5 6-10 11-50 50 New Cases of HIV Infection Reported Wisconsin data, cases reported through December 31, 2007. Wisconsin AIDS/HIV Program

4. UW Health HIV Care ProgramCatchment Area * *

5. UW HIV Clinic Demographics Compared to WI State Population and WI HIV Demographics UW HIV-18% Women 55% of Women are Minorities

6. UW Health HIV Care Program Risk Groups

7. Satellite Clinic 80 Patients Staff Nurse Social Worker NA ADAP Prison Case Manager Other Funding Multiple Specialties Funds several staff Contracts UWMF Beloit Community Health Center WI HIV/AIDS Bureau (RW Part B) University of Wisconsin Hospitals and Clinics UW Health HIV Care Program 17 Individuals Staff Clinic 2 HIV Infected 2 Multi-lingual CAB QA/QI Committee Testing and Counseling Prevention Wisconsin Prison System Aids Network 10 State Prisons 130 Patients Come to UW Clinic

8. Ryan White HIV/AIDS Treatment Modernization Act of 2006 Continuity of Care Increase Access to Services and Retention Enhanced Independence Medical Case Management Goals Increased Knowledge about HIV Integration of Services

9. UW HIV Care Coordination Model 4 Physicians 2 ID Immunologist Internist PA Provider 2 Social Workers 1 is Prison Case Manager Translation Research Services Coordinator Physicians/PA Social Worker Case Managers Nurse/NAs Brochure www.medicine.wisc.edu/hivuw CLIENT Pharmacists Treat/Adhere Pain Specialist (MD) Coordinator Mental Health Nutritionist Providers 2 Nurses 2 NAs NA Schedules Referrals Dentists Psychiatrist Psychologist In Clinic Administrator Data Analyst Appointment Coordinator

10. UW Health HIV Care Program Total, New and RW Part C Patients (2008 is Thru August) --

11. UW Health HIV Care Program Visits (2008 is Thru August)

12. CD4 Counts (New Patients) and HIV RNA Levels 2005-2007 <50 Viral Load 1998-2000

13. Prison Case Management • One of our social workers deals primarily with individuals infected with HIV and incarcerated • All incarcerated individuals with HIV from the State prisons attend our clinic in the UWHC and have access to all the services in our clinic and the hospital • The Prison Case Manager coordinates prisoner HIV discharge planning---sets up appointments in the community, assures have meds to time of appointment, etc • Data for time period January-July 2008--- 31 inmates released • 2 refused release planning • 1 took info only • 20 attended scheduled apt in community • 5 no-shows • 3 either did not have apt yet or release delayed

14. Challenges with RW—Part C • We continue to grow but our space does not • As the patient load grows our staff doesn’t—the nurse position especially challenging • Staff attrition • Transportation and weather at times a problem in our community • Dental—hospital dentist is retiring • State ADAP may go to a waiting list 2011 • The economy