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HomeMy WebLinkAbout1999-11-22 00-25 ORDERDate November 22, 1999 IteMSub]x . Responsible Department: Health@ Welfare commentary This is the renewal for the STD Gram. This grant runs from VINO to 12MAN). Funding for the year is $110,900. For your information a copy of the goals and objectives for the grant is allached. B� cn/ Dan mem Head Manager's Comments:')xw D�d. dW W Om O.ecnvd-Q T�4. City Mmugm Associated Information' 0" d,, r P.tpt6.s,n . Budget Approval: Finance Director Legal Approval: city Solicitor Introduced for. U lq,$j— X Passage Fire Reading Page of� Referral A ff"to Cwncaor Fax 9�ec 22. 1999 CITY OF BANGOR (TITLE.) Mrbff,...nuccoz_i:ma.. cne..c.ity. amoases_ca. A Ply -tar -.aAa-n�yc.. a..czaoc..... ....._faow. cumin-. vices... -.....S alLx_Tsenamixtea..¢taease..clinic By 94 Cay Co of W Ctty ofBm' . ORDER®, zmr the City Manager is authorized to apply for and accept from the State of Maine, Department of Hlmtatt Services, Bureau of Health a grant in the meant of $110,900 for continuation of STD/H1V services to be administered by the City of Bangor, Department of Health and Welfare for the period 1/l/00 to 12/31/00. In CRS COOtlQL 9ovenher 22. 1999 Passed ITY 1 00-25 ORDER Title, getloriaiug the City Hauagei to Apply for a" Rctept a Grant ftw the DepaRaevt of Demes Services - Sditislty iidugm1it'"'df:eeee L�linic ...................................... Assigned to ..F a........ Councilman STATE OF MAINE PROGRAM: Bangor STOMP Clinic DEPARTMENT OF HUMAN SERVICES BUREAU OF HEALTH Grant Dates: 1/1100-12/3l/00 Program Goals, Objectives, and Strategies: PERFORMANCE GOAL: The health and well- being of Maine people will be promoted through the prevention and control of sexually transmitted diseases (STD). Performance Indicator Title Increase attitudes that reduce the risk of STDs. Performance Indicator Increase by twenty percent over 99 baseline (50) the number ofadolescemts, age 1419, who demonstrate an increased awareness of personal risk for STDs and of rhe HIV and STD inter -relationship and the number of those expressing intent to implement at least one behavior change to reduce dales. Strategies 1. Provide can group -level interventions to high risk adolescents in their environments such as chemical dependency centers, shelter programs, comcrio od facilifies, etc. Target group members will be partners inthe design, implementation aM evaluation of the programs. 2. Free condoms and risk reduction information will be made available to the local adolescent shelter and to any yoWb requesting than 3. When possible, Wilive pw and post-test questionnaires assessing pertanal risks for HIV and STD and knowledge about the HIV and STD inter -relationship. Some environments (correctiorW facilities) do not allow writing implements to be made available to detainees. In these facilifies, we will work to find acceptable alternatives to written pre- and post-tests. Performance Measurement Pre- and post-test questionnaires will be compared and assessed for documentation of increased awareness of personal MV and STD risks and the HIV and SM inter- relationship. A staff completed post-rncorurcn room will document the number of adolescents receiving risk reduction information. PERFORMANCE GOAL: The health aM well-being of Maine people will be promoted through the prevention and control of sexually transmitted diseases. Performance Imitator Title Increase control of sexually transmitted diseases. Performance Indicator 1. Ensue adequate treatment for any clients testing positive for early syphilis, gonorrhea and/or chlamydia in the private sector. 2.100%of early syphilis, gonorrhea auVor chlamydia diagroused by the STD clinic staff will be treated. 3.100%of males testing positive for gonorrhea will be concomitantly tested and treated for chlamydia tr s 1. Receive reports of early syphilis, gonorrhea and chlamydia from private and public providers either directly or tluough HN/STD Control Program. 2. Contact reponing provider for locating information, testing, and treatment information and for permission to interview. 3. Assist with treathrart and management if requested. 4. Administer and stafftlnee weekly clinics during two evenings and one morning to accommodate clicarm'work schedules. 5. Every clinic will be staffed by a primary care provider. b. Support staff will include laboratory, clerical and DIS personnel. 9. No core clinical services will be refused based on inability to pay. 8. Clinic services will include STD relevant health history, relevant physical exam, STD and HIV education. Medication information and DIS services will also be provided if disease is diagnosed. Treatment will be consistent with CDC guidelines. 9. Maintain aced staff CLIA approved laboratory on site that is operating concurrently with the STD clinic with the capacity to provide stat labs for early disease diagnosis. 10. Free medication will be provided to clients for treatment of syphilis, gonorrhea, and chlamydia, regardless of clients' abili"pay. 11. Free medication will be provided to persons coN d to be exposed (contacts to) syphilis, gonorrhea and chlamydia, regardless of clients' ability to pay. 12. Operate a gonorrhea screening program for area medical providers. Performance Measurament Disease/treatmem logs will serve as tools for measurement. All reported cases of early syphilis, gonorrhea and chlamydia will be counted and compared with numbers of those trptd. Clinic stmistical data will compare the number of males tested for gonorrhea with the number of those who are tested for chlamydia. Information will he reported quarterly. Diseaseltreetmem logs will document co -treated individuals and the percentage of gonorrhea positive males who are co -treated far chlamydia will be reported. PERFORMANCE GOAL: The health and well-being of Maine people will be promoted through the prevention and control of sexually transmitted diseases. Performmce Indicator Tale 041-25 Increase control of sexually transmitted diseases. Performance Indicator .Increase the munber of adolescents tested for chlamydia by Inn, above the'" baseline. Straw 1. Continue current practice of encouraging testing to 100% of adolescent who present for initial visit at clinic and achieving a test rate of 50%. 2. Mail informational letter about Clinic services, with referral curds, m junior and senior high school health teachers and school nurses in the greater Bangor area. 3. Collaborate with at least one adolescant-serving agency to provide awareness training and recruitment of additional adolescent clients for chlamydia screening. 4. In conjunction with the DOH Chlamydia initiative with the Charleston Juvenile Youth Detention Center, we will provide partner services and any other requested follow-up or education for both the incarcerated adolescents and their partners. Performance Merrunguent Using 1999 data for chlamydia testing of adolescents at Clinic as baseline, compare 2000 dura of chlamydia [ening of adolescents at Clinic. A quarterly data inquiry will be conducted to determine whether or not an additional 10% PERFORMANCE COAL: Tine health and well-being of Maine people will be promoted through the prevention and control of sexually transmined diseases. Perfomorwe Indicator Title Increase control of sexually transmitted diseases. Performance Indicator Increase testing and trearment ofmmmed partners to reported STDs by 10% over 1999 baseline. Staff 1. Create[ reporting provider for open information and permission to interview within two working days of report. 2. Contact reported client within two working days of obtaining permission to interview. 3. Interview for sexual contacts over the period of time established by DIS guidelines. 4. Initiate contact notification attempts on all identified contacds requiring unification within twenty-four hours of receiving locating information. S. Follow reported early syphilis cases to assure adequate treatment. b. Named contacts to reportable STD will be located and heated. ]. In-state grnonhex contacts identified will be located, examined, and treated. 8. Persons presenting to the STD Clinic for initial visits will have RPR test for syphilis. Performance Measurement Using 1999 data for disease follow-up as baseline, compare 2000 data for disease follow UP. PERFORMANCE GOAL: The health of all Maine people will be improved by promoting behaviors, community building, knowledge andlor attitudes tbet reduce risks of infection. Performance Indicator Title Increase behaviors that reduce the risk of FIV traasrnission. Performance Indicator Fifty percent (50naa) of high-risk clients receiving HIV test results report taking one action step toward the safer goal behavior they iden ifid during the initial HIV prevention connecting session. Strom I. Supervisethe provision of anonymous HIV antibody counseling end testing, providing 550 tests during calendar year 2000. 2. During mtict prevention counseling session: assist client in identifying personal risk behavior and circumstances assist client in identifying safer goal behaviors " assist client in developing a multi -step action plan " make referrals and provide support as appropriate " document comseling session on counselor intake tom. I During the follow-up prevention counseling session: " review client's action plan; determine adherence to action plan and revise as appropriate assist client in identifying additional needs, re -testing or referrals • document counseling session on client information form Performance Measurement Counselor intake forms will sane as the measurement mol for the above performance indicator. Information documented regarding the prevention counseling session will include client risk behaviors and ciramstances, safer goal behaviors, action plan and referrals. Information documented attire follow- up session will include the action step complain. PERFORMANCE GOAL: The health of all Maine people will be improved by promoting behaviors, community building knowledge and/or attitudes that reduce risk of HN intention. Performance Indicator Title W -2s Increase attitudes that reduce the risk of MV infection. PMOrmance Indicator 65% of women contacted through outreach programs targeted to woman who are incarcerated and/or woman m substance abuse recovery programs will demonstrate intent to reduce risky behaviors. Strareeie 1. Provide 12 outreach presentations for incarcerated women and/or women in substance abuse recovery programs. 2. Presentations to include information about STDs are HIV and modes of transmission, opportunity for dialog to identify factors that contribute to risk taking and strategies to reduce risk-taking behaviors, offers of 1:t individual risk reduction counseling. 3. Coupons for flee STDMIV screenings will be provided to women sterling presentations. 4. Provide individual level contacting to interested woman contained through substance abuse recovery programs and outreach efforts. 5. Individual level will include: intake interview with assessment of EBV risk behavior, selfdesigned prevention plan, and review of prevention plan on subsr{uem contact. 6. Individuals will be identified and recruited for risk reduction counseling through outreach presentations delivered at agencies serving women m risk (substance abuse recovery agancies, homeless and domestic violence shelters, correctional facilities, em) T. On request, make appointments available in their environments for testing of incarcerated women and women in substance abuse recovery programs. Performance ance Measurement Pre,andpost-test forms will document the number of woman receiving risk reduction information and the number of those expressing intent to implement at lean one behavior change to reduce risks. Rationale The Bangor STD/MV Clinic is the BOH program responsible for seting the five northem counties for disease follow-up for reportable STDs as well as the anonymous HIV counseling and testing site for Penobscot, Maturatiois and Washington counties. The Clinic serves many woman who are described as being M risk fm HIV as defined by the 1999 Comprehensive HIV Prevention Plan. This includes but is not limited to woman with ahistary of STD or who are currently infected with a STD. Additionally,37%of men served by the Clinic are under the age of 25; this is an age group m which 31 %of Maine women with AIDS are assumed to have acquired infection. Gmup4evel interventions provide education are support in group settings to promote and reinforce safer behaviors and to provide interpersonal skills running in negotiating and sustaining appropriate behavior change in persons at increased risk or already infected. Itesearch demonstrates this type of outreach to be effective and well received. This group intervention will meet many of the identified needs for women at risk by increasing the availability aM accessibility of condoms, lube and safer sex products; promoting accurate knowledge of HIV transmission information; facilitating the development of skills to ensure covert condom use and other safer sex practices; and assisting with the development of negotiation and communication skills. It will also help to increase personal risk awareness and expand accessibility to HIV counseling and bating, including anonymous services. Involvemeat of Members of the Prioritized Population We will solicit an advisory committee to include members of the women at risk population. These members will be solicited through the substance abuse recovery programs with whom we work. This group's input will guide the content and delivery of our programs. Sessions will be evaluated by the participants. PERFORMANCE COAL: HIV infected persons in Maine will have reduced morbidity and mortality through increased access to early medical intervention - Performance Indicator Title Increase access to early medical intervention. Performance Indicator 75%ofcousumers testing positive for HIV Antibody at this site will access case management services within one monN of receiving positive test result. Straw 1. SuNrcise the provision of anonymous HIV antibody counseling and testing, providing 550 tests timing calendar year 2000. 2. Awing initial prevention counseling session: ' discuss the importance of early medical intervention to all clients ' clients will beinformed of available medical and rase management services at this agency and in the community. 3. Iberian the follow-up prevention counseling session: • discuss dre importance of early medical intervention with all clients testing positive • discuss and provide written material describing available medical and case management services • provide assistance with scheduling an appointment with a case manager for clients who decline services at the time of receiving result • document contracting session on counselor intake form. Performance Measurement Counselor intake forms will serve as the measurement tool for the above performance indicator. The number of newly denfified HIV positive clients who meet with a case mamuger and schedule a follow-up contort will be tabulated and reported. PEI2POI2MAHCEGOAL: HMV infected persons will have reduced morbidity and mortality through increased access to early medical intervention. Performance Indicator Title Increase access to early medical intervention. Peo ancelndicater 100%ofHIV infected persons presenting at the HIV Well care Clinic will receive early medial intervention within three weeks. Stmt 1. Provide initial immuee system testing and immu bention updates for persons who are HIV infected. 2. Offer Hepatitis A vaccine, Hepatitis B vaccine and mmual flu vaccine for all Well Cone Clinic clients and newly HIV diagnosed clients of Bangor MiT[[V test site. 3. Management HIV infection to attain optimal health mainte�mnce. 4. Act as a resource fer other providers morning patients with HIV infection. Perfomume Measurement Well Cme Clinic activity log will record how long people waited for the initial appointment and services.