David B. Peyton, MPHNovember 16, 2017

National Coalition of STD Directors2017 Annual Meeting

Since 1995, the Mississippi State Department of Health (MSDH) has managed an integrated STD/HIV program.

The STD/HIV Office is responsible for the prevention and control of sexually transmitted diseases (STDs)/Human Immunodeficiency Virus/Acquired Immunodeficiency Disease Syndrome (HIV/AIDS) in Mississippi and manages all federally funded public health programs available for STDs, HIV/AIDS, and Hepatitis C Virus (HCV).

The Office provides programmatic support, guidance, and performance evaluation to state and regional-level STD/HIV staff.

The Office manages several grants and contracts with a total value of $22 million.

• The STD/HIV Office is part of the Office of Communicable Diseases which also includes the Office of Immunization, Office of Tuberculosis (TB), and Epidemiology.

• The STD/HIV Office consist of:– Care and Services Bureau– HIV Surveillance and Epidemiology– HIV and Hepatitis C Prevention– STD/HIV Field Services (Partner Services)– Operational Management– Five Points STD Clinic

Manages funds received under the provision of Title II of the Ryan White Comprehensive AIDS Emergency (C.A.R.E) Act.

These federal dollars are often the only funds available to people living with HIV disease for life-sustaining therapies in Mississippi.

Provides ongoing, systematic collection, analysis, evaluation, and dissemination of data on STDs and HIV disease.

Administers the HIV Surveillance and Medical Monitoring Project (MMP) Cooperative Agreements.

Manages all data entry operators with close coordination with the STD/HIV Field Services Branch.

Implements and evaluates prevention interventions designed to reach high priority target populations.

This branch administers the HIV Prevention and Hepatitis C Cooperative Agreements.

Augments regional-level field epidemiology efforts designed to locate and investigate STD and HIV, and to provide partner services including partner elicitation, notification, and referral, and HIV linkage/re-engagement to care.

Administers the STD AAPPS and STD Evaluation Cooperative Agreements.

Assists the branches with the administration, coordination and implementation of federal grants.

Responsible for the fiscal management of the categorical grants for the Office.

Process purchase requests and purchase orders for procurement of critical STD/HIV supplies, invoices and payment requests, and employee payroll (both full time and contract).

Process Human Resources (HR) documents for new hires and termination of employee. Also, staff process employee leave forms, compensatory time request, travel training request and reimbursement.

Located in the Jackson Medical Mall is Mississippi’s only clinic dedicated to providing exclusive STD/HIV testing and treatment.

This clinic provides comprehensive STD/HIV testing, diagnosis, and treatment services, and referral for additional services and care as required.

Due to a massive cut in state funding for public health beginning 2016, the health department initiated a reduction in staff.

As a result, the Mississippi State Department of Health transitioned from 9 public health districts to 3 regions effective July 1, 2017.

Fortunately, DIS were not affected due to the fact they perform core public health functions that are not performed by any other group.

Elimination of some small clinics Reduced days of operations for some clinics◦ A reduction in staff has caused some clinic staff to

work two or more clinics with alternating days of service.

Limited access for walk-in patients and have to obtain appointments.

Issues with providing service to priority STDs syphilis and HIV cases and/or contacts.

As a result of the reorganization, all DIS were placed under Central Office management.

Three Regional Manager position were created to manage the daily PRISM STD/HIV cases management and provide QA for data flow to and from the field.

Program Initiatives Supported by CDC HIV/AIDS Prevention $5,033,209 STDs $1,559,280 Viral Hepatitis $111,389

HRSA Funding (HIV Care) $22,000,000

DIS activities have increasingly become the core of the overall STD/HIV Programing.

DIS related activities which support prevention objectives are found and all program grants except for Hepatitis C.

The DIS have not always been supported by all grants in which they provide related activities.

During 2016, 50% of DIS were supported 40% by STD AAPPS and 60% by HIV Prevention. The other 50% were supported entirely by state funding.

Possibility to cost share all DIS 30% with Ryan White funding since they all participate in linkage to care. The 30% cost share will allow for a 10% increase in salaries for all DIS positions.

Ryan White purchase of camera ready laptops for all DIS for LTC PRISM entry and participation in related video conferencing.

Purchase approximately 50% of cell phones and services for all DIS. Currently only DIS Supervisors and Team 5 DIS had access to agency cell phones.

Possible use of Ryan White and HIV Prevention funding for HIV related PRISM enhancements to include:◦ import of CD4 and viral loads◦ addition of eHARS variables◦ building the capacity to capture HIV testing

information that can be used to import into EvaluationWeb

◦ building the capacity to collaborate with CBOs to enter information from STD/HIV partner services encounters

◦ CareWare integration with PRISM

Use of the Medicaid Family Planning Waiver to fund 4 sexual health visits per year to include labs and medication. The Waiver will also pay for PrEP.