HRSA SPNS All
Project Conference Call
Conference Call 11-19-01 @ 10:30 am
Participants: Robyn Schulhof, Ledia Martinez, Adon Cajina, Richard Moore, Marisa Olivarez, Yolanda Cantu, Sandi Duggan, Kari
Maier, Michelle Valverde, Yvone, John Wiebe, Rosana Scolari, Alisa Olshefsky, Ken Burton, Steve Trujillo,
Tony Estrada, Mike Tarter, David Barney, Betty Duran, Tim Brittingham, Saleem
Ahamad, Herman Curiel
Project Reports:
q Updates/Changes:
o
Site visit on 11/9 and
11/10
o
CDC Update on HIV
Counseling, Testing, and Referral: November 15th
o
Met with Dr. Crespin,
Medical Director of LCDF
o
Hired new Case Manager
and Promotora
q Local Evaluation:
o
Site visit on 11/9 and
11/10 (review of data, logic model, data collection training MSW Student,
Adherence Nurse, and Prevention Case Manager). Ivan will have 3 more people
assisting her in data collection.
§
Updated: Logic model,
Evaluation and Data Measurement Plan, Data Collection Plan
§
To be updated: Work
Plan, Evaluation Work Plan
o IRB application still under development-may be asking local evaluators for assistance.
o
In-House Data
Collection:
§
Current status
§
Training: Yvonne is
setting up a follow-up meeting to answer any questions and set up a plan of
action for data collection: Yvonne has
four interviews this week and possibly three more. Her data collection team will be collecting data as soon as
possible.
o
Outreach data collected
§
Current status
q Technical Assistance Needs: N/A
|
OUTREACH |
|
GROUP |
IN HOUSE |
|
|
Number of tests: |
|
OUTREACH |
Number of interviews and data collected on HIV+ Clients: 23 |
|
|
FY1 TOTAL: |
90 |
Total number of Contacts: 38 |
||
|
|
|
Number in both sessions: 10 |
||
|
FY2 TOTAL: |
50 |
Number of Appointments: 0 |
||
|
|
|
Number Tested: 6 |
||
|
Total to Date: |
140 |
|
||
San Ysidro Health
Center: Alisa
Olshefsky
·
Progress
on the development of the local social marketing campaign for various target
populations.
·
The Centro de
Evaluación conducted a two-day site visit with our project (11/12 & 11/13).
We presented an update on evaluation and project activities and requested
feedback on some of the measurement issues we are looking at locally, and
particular feedback on our proposed changes for the logic model. The Management
Information Systems training on day two included reviewing local data in the
context of how we might consider analyzing it.
·
Alisa and
Rosana provided a presentation on our local SPNS initiative during the local
HIV Border Health Conference in Tijuana (Friday November 16, 2001)—this
presentation was the same given at the APHA conference. The turnout at the
conference was excellent.
·
Data
Collection Update/current outreach and multi site module numbers
As
of the end of November 13, 2001:
Module A 302
Module B 300
Module D 392
Module E 91
Module G 43
Local Module 4 (testing
& lifestyle module) = 93
·
Total HIV + persons identified through SPNS since
July 1, 2001 (initiation of intervention phase) =
34
·
3 our of 34 were identified in outreach.
NOTE:
Three of 34 person who tested positive were those identified at risk at
outreach, referred, and came in for testing
·
Total HIV + persons identified during baseline
4/1/01 – 6/30/01 = 53
Arizona Border HIV/AIDS Care: Steve Trujillo
Trainings: The AZ AIDS ETC conducted an in service
training at Sunset Clinic on November 14th basic HIV 101. Training was rescheduled for January.
Training will be provided once a month.
Health provider assessments
have been turned over to Anthony and Barbara Estrada.
Out Reach Activities: Yuma County – The Yuma County Health
Department (YCHD) and Campesinos Sin Frontera continue to collaborate on
outreach activities. Puentes de Amistad
is in the process of advertising and hiring a program coordinator. YCHD will continue to invite and include
Puentes de Amistad in their outreach activities. Steve requested from Albert Moreno of the Border Health
Foundation a timeline for the process to hire a coordinator and to recruit and
train volunteer promotoras. The next
community outreach activity scheduled is Dia del Campesino Health and
Information Fair on December 1, 2001 (World AIDS Day).
Santa Cruz County –
Platicamos Salud is working with the community on the activities for World AIDS
Day. Platicamos Salud received two
cases of condoms from the Southern Arizona HIV Prevention Planning Group
(SAHPPG) the CDC community planning group.
Sonia Guerrero is working to schedule a meeting with Maria de la Luz at
Centro de Información para la Salud (CISAL) a prevention agency in Sonora, MX
to assist in outreach to the truck drivers.
It is expected that with the recent security at the border crossing that
trucks may have to wait hours to cross.
Cochise County – The Cochise
County Health Department continues their outreach from their outlying
counseling and testing sites.
ADHS Funds: The project is awaiting the contract from
the state for the Congressional Black Caucus funds to include in subcontract
amendments.
Dissemination Activities: None to date
Project Enrollment: The project enrolled two additional patients
in Cochise County. One patient from
Cochise County was disenrolled as he moved out of the catchment area.
Local Evaluation: Steve is addressing the issue of inferred
problems identified by the recent OU site visit. Met with the therapist to review list of patients enrolled into
the project and to assess issues of mental health and substance use/abuse.
Bob Smith and Marisa met with Dr. Nuchovich regarding HIV medical services provided at the Brownsville
CHC. The doctor is not interested in
money but is more concern with issue of being penalized for seeing HIV
patients. Seeing HIV patients affects
his ability to meet client patient caseloads as established by the CHC. Also spoke about personnel issues the doctor
is having with a nurse and asked that the nurse be replaced.
Nurses training will be provided by Michelle Rowe
on December 6, 2001. Plan to provide
nurse training on a quarterly basis.
Brownsville CHC has agreed to accept medications
from VAC pharmacy for distribution to patients. Previously would not accept patients medications from VAC due to
agency policies. This new arrangement
will facilitate delivery of HIV medications to patients being seen in
Brownville. Only condition is that
Brownsville must dispense medications to patients within 30 days of receipt.
LOCAL EVALUATION SYSTEM LEVEL
INTERVENTION ACTIVITIES
·
Routine
evaluation contact (e-mail and/or telephone call) with Project physicians and
nurse care coordinators to systematically assess needs and satisfaction with
the Juntos Project process reveal the following themes:
1.
Continued
expressed need for HIV nurse care provider training
2.
Protecting
physician time to provide local HIV primary care
3.
Systemic
barriers with regard to ‘long distance’ (approximately 35 miles) case
management services for clients across partner sites
4.
Development
and agreement on Project procedures
·
Critical Incident - Positive
An HIV positive male, residing in Brownsville was referred
by VAC to partner agency Brownsville Community Health Center. Patient has private insurance. He presented
very ill and Dr. Nuchovich admitted him to the Valley Regional Medical Center
in Brownsville, stating he had ‘a very serious condition,’ but
too early to determine the origin.
During this time, Dr. Nuchovich consulted with Dr.
Sinclair, using the fax consult form (SEE
ATTACHED). A series of e-mail consults
discussed Infectious Disease rule outs, general rule outs, mapped a plan for
series of tests to be conducted, etc…
Following a
clinical plan of action developed between the Project physician and the HIV
specialist consultant, via e-mail and fax correspondence, the Project physician
forwarded lab results, the medications and his prescribed course of clinical
treatment. Dr. Sinclair agreed with Dr. Nuchovich’s clinical treatment plan.
Since the patient’s admission, Dr. Nuchovich has seen the patient every
morning prior to his regular duties at the clinic. He will remain there for two weeks where Dr. Nuchovich will continue
to see the patient every AM and weekends, then he will be seen at BCHC where
Dr. Nuchovich will manage his HIV disease.
This patient is receiving local continuity of care, by the same
physician, throughout the various stages of his HIV disease. This case provides evidence of training
impact.
PROJECT DATA COLLECTION ACTIVITIES
·
Project
data collection activities continue at a steady pace. As of October 26, 2001, there are 64 records in the Local
Database, comprised of 9 from United Medical Centers in Eagle Pass, Texas and
55 from Brownsville, Harlingen and Pharr, Texas combined.
·
To
date, a total of 173 forms have been entered in the multi site database:
50 Demographic A Project
Implementation Date: 030101
49 Lifestyle B Project
Implementation Date: 030101
48 Risk Factor D Project
Implementation Date: 070101
*0 Barriers to Care F Project Implementation Date: 110101
12 Quality of Life
E Project Implementation Date: 070101
06 Client
Satisfaction G Project Implementation Date: 070101
*16 reported
November 5th conference call was an error associated with National
Evaluation Data
OTHER EVALUATION ACTIVITIES
·
Development
of a data template for reporting to Project partners and for conference
presentations is in progress. Template
will be used to systematically report data by Project and by individual sites
and will also include narrative around emerging patterns.
·
Question
related to what (if any) data will be collected on pregnant women as part of
the multi-site data collection. David
advised we would add this as an agenda item for the grantees meeting in
January.
Yolanda: Raised
issue of collecting information on pregnant
women as part of the multi-site data collection. David advised we would add this as an agenda item for the
grantees meeting in January.
Centro de Evaluation:
Adobe – (Tim) Asked grantees
to not download Adobe 5 onto their computers.
Tim needs to upgrade the modules to Adobe 5 before local sites can
upgrade their adobe software and submit data.
Currently, TELEform only recognizes Adobe 4.0.
AETC (Betty) – discussion
with HRSA staff – concluded that it would be beneficial to ask projects to
provide a brief assessment of AETC training and evaluation activities
locally. Then Centro would compile the
information to be shared with all projects for review on a group conference
call in which we would discuss our future activities with AETC. Betty will contact everyone via e-mail and
schedule the conference call as well.
Tim will post the AETC module on the web page. Betty advised that the grantees had agreed to use the Arizona
AETC module during the grantees meeting in August. Yolanda advised that she did not recall reaching an agreement to
using Arizona AETC during last Grantee Meeting. David advised this was one of the last issues raised during the
meeting. The module will be reviewed by
everyone during our discussion on AETC evaluation activities.
Pacific AETC will be invited
to present at Grantee Meeting in January regarding the border assessment to be
conducted in the next year.
Grantees Meeting (Betty) –
deadline for hotel reservations is December 6, 2001. Asked if anyone had any changes or recommendations for the
agenda. General feedback was that Agenda
looked OK. Betty will finalize and post
on web page.
Yolanda reminded Betty to
add the issue of pregnant women to the January agenda.
Betty: Centro de Evaluacion
will be hosting an open house on World AIDS Day so everybody is invited.
David asked grantees to
please re-visit V 126 on the Demographics module. This variable asks projects to provide a best guess assessment of
potential client issues. The present
figures received from sites indicate that only 21 percent of clients have
alcohol related treatment issue needs, this is substantially lower that national
trends. Low reporting of client needs
also suggests that the population being served is healthier than is the
reality. Additionally, low figures in
this variable would also suggest that case managers do not have many client
issues that need to be addressed. Yolanda said that case managers often do not
know the client well at intake, therefore report small numbers. Over time they become more familiar with the
client and are in a better position to identify potential problems. She asked if there was anyway we could ask
this information a second time at a later date in service delivery. David said we could review this issues at
the grantees meeting.
HRSA Issues:
Adon Cajina has been
transferred to the SPNS program to assist Barbara Aranda-Naranjo with the
supervision of SPNS grants. Presently
he anticipates that he will be working closely with the Evaluation Center.
Ledia advised projects that
Dr. Chivers and Dr. O’Neal have decided to send a letter to all CHC’s
encouraging them to collaborate with the AETC on training issues and asking
them to better manage physician time.
Ledia advised that physician time is a local mandate on patient caseload
quotas, thus some effort need to be focused on how to correct this issue with
local CHCs.
Rosana said that clinical
care funding includes HIV testing. She
asked if their grantee subcontracts with clinics could also include resources
to provide incentives for client participation. Ledia will check and advise Rosana.
Other:
Barney: Next conference call
is on December 10, 2001 @ 10:30 am.