Integrated HIV Prevention and Care Plan · 2020. 11. 11. · California’s Integrated HIV...
Transcript of Integrated HIV Prevention and Care Plan · 2020. 11. 11. · California’s Integrated HIV...
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E X E M P L A RY I N T E G R AT E D H I V P R EV E N T I O N A N D C A R E P L A N S E C T I O N S
targetHIV.org/IHAP
Integrated HIV Prevention and Care PlanLaying a Foundation for Getting to Zero: California’s Integrated HIV Surveillance, Prevention, and Care Plan
REGION WestPLAN TYPE Integrated state/city/county prevention and care plan
JURISDICTIONSState of California, Santa Clara County TGA, San Bernardino County TGA, Sacramento County TGA
HIV PREVALENCE High
California’s Integrated HIV Prevention and Care Plan, which includes three of the State’s TGAs (Santa Clara County TGA, San Bernardino County TGA, Sacramento County TGA), outlines specific objectives that align with all four NHAS goals and include key strategies to accomplish objectives. The objectives are associated with specific quantitative measures and will be measured against baseline data. The section includes sub-objectives for the three different TGAs that have targets and baseline data.
Additional exemplary plan sections are available online: www.targetHIV.org/exemplary-integrated-plans
SELECTION CRITERIA: INTEGRATED HIV PREVENTION AND CARE PLANExemplary Integrated HIV Prevention and Care Plan sections met the following criteria (based on the Integrated HIV Prevention and Care Plan Guidance):
5 Comprised of SMART objectives, strategies to correspond to each objective, activities, targeted population, timeframe, resources needed, who is responsible for each task, covers time period 2017-2021
5 Specific metrics to monitor activities 5 Objectives and activities aimed at addressing gaps along the HIV Care Continuum. 5 Objectives that align with the National HIV/AIDS Strategy (NHAS) 5 Description of how the Integrated Plan was developed
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Laying a Foundation for Getting to Zero:
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This Integrated Plan is divided intoseven parts:
Part 1
Part 2
Part 3
Section II:
Part 4
Part 5
Part 6
Part 7
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Laying a Foundation for Getting to Zero:
Actions At-A-Glance
PART ONE
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Laying a Foundation for Getting to Zero:
GOAL 1: REDUCING NEW HIV INFECTIONS IN CALIFORNIA
Objective 1:
Strategy B: Strategy C: Strategy M: Strategy N:
Objective 2:
Strategy A: Strategy C: Strategy E: Strategy L:
Strategy N: Strategy O:
Objective 3:
Strategy A: Strategy F: Strategy G: Strategy K:
Strategy L:
Strategy O:
Objective 4:
Strategy B: Strategy C: Strategy F:
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Laying a Foundation for Getting to Zero:
Objective 5:
Strategy G: Strategy H:
Strategy I: Strategy N: Strategy O:
Objective 6:
Strategy D: Strategy G: Strategy K:
Strategy N: Strategy O:
Objective 7:
Strategy D: Strategy E: Strategy F: Strategy G: Strategy O:
Objective 8:
Strategy D: Strategy E: Strategy F: Strategy G: Strategy I: Strategy K:
Strategy O:
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Laying a Foundation for Getting to Zero:
Objective 5:
See strategies under previous Objective 5
Objective 6:
See strategies under previous Objective 6
Objective 7:
See strategies under previous Objective 7
Objective 8:
See strategies under previous Objective 8
Objective 9:
Strategy D: Strategy G: Strategy I: Strategy J:
Objective 10:
Strategy I: Strategy J: Strategy M: Strategy N:
INCREASING ACCESS TO CARE AND IMPROVING HEALTH OUTCOMES FOR PLWH IN CALIFORNIAGOAL 2:
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Laying a Foundation for Getting to Zero:
Objective 11:
Strategy F: Strategy I: Strategy M: Strategy N:
Objective 12:
Strategy D: Strategy E: Strategy F: Strategy G: Strategy H:
Strategy I: Strategy O:
Objective 2:
See strategies under previous Objective 2
Objective 3:
See strategies under previous Objective 3
Objective 4:
See strategies under previous Objective 4
Objective 10:
See strategies under previous Objective 10
REDUCING HIV-RELATED DISPARITIES AND HEALTH INEQUITIES IN CALIFORNIAGOAL 3:
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Laying a Foundation for Getting to Zero:
Objective 11:
See strategies under previous Objective 11
Objective 5:
See strategies under previous Objective 5
Objective 10:
See strategies under previous Objective 10
Objective 11:
See strategies under previous Objective 11
ACHIEVING A MORE COORDINATED STATEWIDE RESPONSETO THE HIV EPIDEMICGOAL 4:
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Laying a Foundation for Getting to Zero:
Objectives
PART TWO
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Laying a Foundation for Getting to Zero:
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Laying a Foundation for Getting to Zero:
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Laying a Foundation for Getting to Zero:
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Laying a Foundation for Getting to Zero:
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Laying a Foundation for Getting to Zero:
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Laying a Foundation for Getting to Zero:
Strategies
PART THREE
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Laying a Foundation for Getting to Zero: S
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Laying a Foundation for Getting to Zero:
Activities
PART FOUR
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Laying a Foundation for Getting to Zero:
STRATEGY A: Improve PrEP Utilization
Expand PrEP and PEP Access Throughout the StateActivity A1:
Targeted Populations:
Responsible Parties:
Center
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Educate Medical Providers About PrEP and PEPActivity A2:
Targeted Populations:
Responsible Parties:
Health plans in California
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
®
Targeted Populations:
Responsible Parties:
Increase Availability of PrEP for Key Populations at Free or Low CostActivity A3:
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Laying a Foundation for Getting to Zero:
Promote PrEP and Educate about PrEP in Key Populations withLow UptakeActivity A4:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
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Laying a Foundation for Getting to Zero:
Improve Services that Support Linkage and Retention in PrEPActivity A5:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Metrics:
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Laying a Foundation for Getting to Zero:
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who know their serostatus.
CDC
®
®
Expand Routine Opt-out HIV Testing in Health Care SettingsActivity B1:
STRATEGY B: Increase and Improve HIV Testing
Targeted Populations:
Metrics:
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Laying a Foundation for Getting to Zero:
Increase Use of Laboratory-based Fourth Generation Algorithms for HIV Testing to Identify Acute InfectionsActivity B2:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Targeted Populations (continued):
Responsible Parties:
Health plans in California
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Laying a Foundation for Getting to Zero:
Expand HIV Testing Targeted to Key PopulationsActivity B3:
Targeted Populations:
Targeted Populations:
Responsible Parties:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
clinics
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Laying a Foundation for Getting to Zero:
continue to become more important as we continue
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who know their serostatus, as well as the proportion who are engaged in care.
STRATEGY C: Expand Partner Services
Responsible Parties:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations (continued):
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Laying a Foundation for Getting to Zero:
Increase Utilization of Surveillance-based Partner Services ActivitiesActivity C1:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Activity C2:
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Laying a Foundation for Getting to Zero:
Improve Linkage of Partners to Care (if HIV Positive), or PrEP and Other HIV Prevention Interventions (if HIV Negative)Activity C3:
Targeted Populations:
Responsible Parties:
Responsible Parties:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
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Laying a Foundation for Getting to Zero:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Develop and Implement a Statewide HIV Outbreak Response PlanActivity C4:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Responsible Parties:
Targeted Populations:
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Laying a Foundation for Getting to Zero:
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who are engaged in care, as well as the proportion who are virally suppressed.
STRATEGY D: Improve Linkage to Care
Implement Systems for Rapid Linkage to CareActivity D1:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Metrics:
Enhance ‘Data to Care’ Activities to More Rapidly Identify People Who Have Fallen Out of Care and Actively Re-engage Them in CareActivity D2:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
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Laying a Foundation for Getting to Zero:
Targeted Populations:
Responsible Parties:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Expand Use of Patient/Client Navigation ProgramsActivity D3:
Metrics:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Identify Barriers to Linkage to Care and Develop Strategies to Address ThemActivity D4:
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Laying a Foundation for Getting to Zero:
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who are retained in care, as well as the proportion who are virally suppressed.
STRATEGY E: Improve Retention in Care
Expand Provider Education to Improve Capacity to Retain ClientsActivity E1:
Targeted Populations:
Responsible Parties:
of care
Existing Resources Committed Toward Implementing the Activity:
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Laying a Foundation for Getting to Zero:
Implement Pharmacy Tickler ProgramsActivity E2:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Pharmacists
Metrics:
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Laying a Foundation for Getting to Zero:
Increase the Number of Californians Living with HIV Who Are Enrolled in Health Insurance Coverage (Also See Activities Under Strategy J)Activity E3:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Mental health facilities
Strengthen Relationships with Organizations that Provide Housing Support for Clients in Unstable or Disadvantageous Living SituationsActivity E5:
Improve Integration of Basic Substance Abuse/Mental Health Interventions with HIV Care SettingsActivity E4:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who are retained in care, as well as the proportion who are virally suppressed.
Improve Cultural Competency of Medical and Service ProvidersActivity F1:
STRATEGY F: Improve Overall Quality of HIV-Related Care
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Laying a Foundation for Getting to Zero:
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.
.
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
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Laying a Foundation for Getting to Zero:
Expand the Use of Treatment Adherence InterventionsActivity F2:
®
health plans in California to measure performance in this area.
Explore Establishing Standards of Care for Services Provided through Ryan White HIV/AIDS Program Funding, and Take Other Actions to Ensure that High-Quality Care can be Measured and is Tracked
Activity F3:
Targeted Populations:
Responsible Parties:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
-
Laying a Foundation for Getting to Zero:
Targeted Populations:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
Metrics:
® measure
Targeted Populations:
Responsible Parties:
Encourage Housing Evaluation as a Routine Part of Medical Assessment Activity F4:
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Laying a Foundation for Getting to Zero:
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who are engaged in care, as well as the proportion who are virally suppressed.
High-need AreasActivity G1:
STRATEGY G: Improve Availability of HIV Care
Targeted Populations:
Responsible Parties:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
-
Laying a Foundation for Getting to Zero:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Improve Use of Pharmacists as ProvidersActivity G2:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Pharmacists
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Laying a Foundation for Getting to Zero:
Work with Clinics in Under-resourced Areas to Apply for Medical Federal Shortage DesignationActivity G3:
Metrics:
prescription
Metrics:
Responsible Parties:
Targeted Populations:
Existing Resources Committed Toward Implementing the Activity:
-
Laying a Foundation for Getting to Zero:
, the
STRATEGY H: Improve Integration of HIV Services with STD, TB, Dental,and Other Health Services
Improve Integration of Behavioral Health and HIV/STD/Viral Hepatitis Programs Activity H1:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
Targeted Populations:
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Laying a Foundation for Getting to Zero:
Increase Concurrent HIV/STD TestingActivity H2:
Targeted Populations:
Responsible Parties:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Coordinate and Integrate Data Systems to Identify and Track STD and TB Diagnoses Among PLWHActivity H3:
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Laying a Foundation for Getting to Zero:
Targeted Populations:
Responsible Parties:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Incentivize Comprehensive Health Care Programs for PLWH (Including Dental, Vision, Mental Health, Substance Use, Acupuncture, and Chiropractic Along with Medical Care)
Activity H4:
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Laying a Foundation for Getting to Zero:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Targeted Populations:
Responsible Parties:
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who are engaged in care and retained in care, as well as the proportion who are virally suppressed.
STRATEGY I: Improve Case Management for PLWH with High Need
Increase Case Management Services for PLWH with Demonstrated Need from Diagnosis through Viral SuppressionActivity I1:
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Laying a Foundation for Getting to Zero:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Metrics:
facilities.
Work with Transitional Case Management Programs for PLWH Leaving Correctional FacilitiesActivity I2:
Targeted Populations:
Health care staff within correctional facilities
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
Continue to Collaborate with DHCS to Administer MCWP Activity I3:
Targeted Populations:
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Laying a Foundation for Getting to Zero:
Identify Homeless ADAP Clients for Referral to Housing ProvidersActivity I4:
Responsible Parties:
Targeted Populations:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
This strategy will address gaps along the HIV Care Continuum in California by increasing the proportion of PLWH who are engaged in care and retained in care, as well as the proportion who are virally suppressed.
STRATEGY J: on PrEP
Targeted Populations:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Require HIV Care Program Providers to Coordindate Timely Enrollment in Health Coverage and ADAP, if ApplicableActivity J1:
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Laying a Foundation for Getting to Zero:
Responsible Parties:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Locate Culturally/Linguistically-appropriate ADAP Enrollment Sites in Affected Communities of ColorActivity J2:
Metrics:
people of color
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Develop a System to Assist PLWH Paying Initial Health Insurance Premiums for Individuals Enrolled in ADAPActivity J4:
Provide Incentives to ADAP Enrollment Sites for Enrolling Eligible Individuals into ADAP/OA-HIPP within a Week of DiagnosisActivity J3:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
STRATEGY K: Increase and Improve HIV Prevention and Support Services for People Who Use Drugs
Integrate Syringe Exchange into Existing HIV ProgramsActivity K1:
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Laying a Foundation for Getting to Zero:
Metrics:
Targeted Populations:
Responsible Parties:
Existing Resources Committed Toward Implementing the Activity:
Fund New Syringe Exchange ProgramsActivity K2:
Targeted Populations:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Existing Resources Committed Toward Implementing the Activity:
Metrics:
Implement Harm Reduction-based Models of HIV Prevention and Care Services that Integrate Other Health Services Critical to People Who Use Drugs
Activity K3:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Encourage Naloxone Programs throughout the StateActivity K4:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Pharmacies
Metrics:
-
Laying a Foundation for Getting to Zero:
Encourage Access to Syringes through Nonprescription Sale of Syringes in Pharmacies
Activity K5:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
Targeted Populations:
report.
Encourage Access to Medication-assisted Treatment (Methadone and Buprenorphine/Suboxone) for People with Opioid Addiction
Activity K6:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
STRATEGY L: Increase General HIV Education and Awareness and Reduce Stigma Around HIV, Sexual Orientation, and Gender Identity
Work to Ensure that All California Pupils in Grades 7-12 Receive Comprehensive, Medically Accurate Sexual Health and HIV Prevention Education
Activity L1:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
Targeted Populations:
Work with Service Providers to Develop Clear and Consistent Messaging around HIV Statewide
Activity L2:
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Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
General public
Continue Widespread Condom Promotion and DistributionActivity L3:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Metrics:
Work to Ensure that HIV Infection is Decriminalized throughout CaliforniaActivity L4:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
STRATEGY M: Improve Usability of Collected Data
Improve Tracking of HIV Prevention and Care Outcomes in Patients
and Other Large Health Insurance Plans and ProvidersActivity M1:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Integrate HIV-related Interventions into the Major EHRs in Usein California
Activity M2:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Interventions Across State and Local Levels, Including Measures Related to Experiences of Stigma and Interventions to Address Stigma
Activity M3:
Targeted Populations:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Improve Completeness and Consistency of Data Collection for: a) Gender Identity; b) Sexual Orientation; c) Housing, d) Substance Use; and c) Mental Health Status
Activity M4:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
-
Laying a Foundation for Getting to Zero:
Metrics (continued):
not fallen out of care.
Explore the Development of a System to Accurately Measure PLWH Moving Between Care Systems
Activity M5:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
as out of care
Targeted Populations:
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Laying a Foundation for Getting to Zero:
further.
STRATEGY N: Enhance Collaborations and Community Involvement
Improve Utilization of Community Engagement Strategies at Both State and Local Levels, Especially Involving PLWHActivity N1:
Targeted Populations:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
Targeted Populations:
Enhance Direct Collaborations Between HIV/STD/Viral Hepatitis Prevention and Surveillance Programs at the State and Local LevelsActivity N2:
Targeted Populations:
Coordinate HIV Prevention and Care Activities for the Criminal Justice Population throughout CaliforniaActivity N3:
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Laying a Foundation for Getting to Zero:
Work More Closely with Other Payers, Including Medi-Cal and Activity N4:
Responsible Parties:
Targeted Populations:
Targeted Populations (continued):
Responsible Parties:
CDCR
Metrics:
Existing Resources Committed Toward Implementing the Activity:
-
Laying a Foundation for Getting to Zero:
Responsible Parties (continued):
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Improve Partnerships Between Local Health Departments and Primary Care ProvidersActivity N5:
Metrics:
Responsible Parties:
Targeted Populations:
Existing Resources Committed Toward Implementing the Activity:
-
Laying a Foundation for Getting to Zero:
STRATEGY O: Further Leverage Existing Resources to Better Meet the Needs of People at Risk for and Living with HIV in California
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Ensure the Most Appropriate Distribution of Funds in Order to Best Meet the Needs of People at Risk for and Living with HIV in CaliforniaActivity O1:
-
Laying a Foundation for Getting to Zero:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Targeted Populations:
Responsible Parties:
Evaluate Statewide Need for MCWP Services Among Eligible PLWHActivity O2:
Transition at Least Some HIV Care Program Contracts from a Consortia Model (in which State Funding goes to a Local Health Jurisdiction to then Subcontract Out Services) to a Direct Services Model (in which State Funding goes Directly to Agencies Providing Services)
Activity O3:
-
Laying a Foundation for Getting to Zero:
Targeted Populations:
Metrics:
Existing Resources Committed Toward Implementing the Activity:
Responsible Parties:
-
Laying a Foundation for Getting to Zero:
Anticipated Challenges and Barriers
PART FIVE
-
Laying a Foundation for Getting to Zero:
Funding
implement this plan.
Staff Time
possible.
Differing Guidance from Federal Funders
Administrative Barriers