HRSA SPNS Border Health Initiative
All Projects Conference Call
Participants: Barbara Aranda-Naranjo, Robyn Schulhof, Ledia
Martinez, David Barney, Betty Duran, Tim Brittingham, Maria Zuniga, Rosana
Scolari, Steve Trujillo, Ken Burton, Tony Estrada, John Wiebe, Marisa Olivares,
Bob Smith, Sandi Duggan, Bob Smith, Yolanda Cantu, Tony Chavez, Veronica
Harding, Kari Maier, Michael Tarter
Project
Reports:
VAC
conducted "Proyecto Juntos" Quarterly Partnership Meeting
First
Quarter of Year Two - 18 attendees
- Agenda was as follows:
Action
Items/Highlights
·
Site visits
with five partners were completed on Thursday September 20. We spent about
three to four hours with each site reviewing program and evaluation issues. We
will be meeting locally to discuss summarizing what we learned. Alisa is
looking into the HRSA chronology documentation for ideas on documenting process
issues. Overall, the site visits allowed us to address programmatic and
evaluation issues specific to the partner’s target population as well as issues
that have come up across sites. The visits provided an excellent opportunity to
acknowledge how well our partners have carried out their evaluation data
collection functions and also reinforce the value of documentation on data
collection instruments. During the meeting, we assessed client and
institutional barriers to offering HIV services, and attempted to capture any
changes in HIV services offered since SPNS started. Site visit has resulted in the recommendation to change client
reassessment from 90 days to 4-months.
Will follow up with David and Betty regarding the feasibility of this
change.
·
Critical
Incident (as of 9/11/01): We also learned of a new border issue related to
persons who cross for their health care. Extended border waiting times (4 hours
or more) resulting from the terrorist attacks have impacted the ability to come
for services for those clients who live in Tijuana. Barbara suggested some discussion with physicians as to overall
impact on clinical care for Mexican clients encountering difficulty in crossing
the border to obtain care at San Ysidro and provide this information to HRSA
project officer in writing. Barbara
asked if this was impacting their Title III program, Rosana said has definitely
impacted the clinical care provided under Title III. Also want to know on impact on staff crossing the border.
·
Data
Collection Update/current outreach and multi site module numbers
As of the end of August
01:
Total number of enrolled
individuals: 224
Enrolled during baseline:
159 (April – June 2001)
Enrolled during
Intervention Phase: 65
Total Number of
Positives: 94
Total outreach contacts
to date: 1294
·
Focus group
coding issues are currently being reviewed by Dr. Organista
Rosana added that among the recommendations she has received is that
it's important to reward the people participating in the program and changing
the reassessment time from 90 days to four months.
Barbara asked has there been any discussion from San Ysidro clinicians
about the health issues on the border. Mari said apart from decline in numbers
there is not much reaction to it.
Rosana added that they just went from 1 to 3 days where they conduct
testing and seeing patients, and due to the New York incident, there have been significant cancellations for medical appointments. Mari said national security issues are affecting people ability to cross the border in order
to keep medical appointments. Barbara
suggested that they document what is going on and its impact on the border due
to the critical incident and it would allow the drop in number of patients
to be taken into consideration when
budget applications are considered. Rosana mentioned that it took her 31/2
hours to get back to San Diego from Tijuana. It has taken another staff member
six hours to cross the border to work at the center in San Diego.
Centro de Salud Familiar:
Wiebe - Data collection has
slowed as most of the regular clients have already been assessed.
However, baseline data are still needed on approximately 140 clients, and we
have been having a problem with clients not showing up for scheduled
appointments. In response, we have developed a plan to concentrate
clinic-based data collection on one day per week (Monday), and
have interviewers make home
visits scheduled by care managers (nurses) on other days of the week. In
addition, nurses will help with clinic-based data collection on other days of
the week as needed. During the next week, interviewers will train for
home visits and concentrate on getting data entry caught up (problems with our
internet connection from the clinic have
slowed progress on data
entry).
Tony – difficult time
finding a fourth nurse. The nurse they were interested in decline
the offer by saying that her husband was uncomfortable with her working with
AIDS patients. Working on pharmacy implementation. Problems with bridge security, it affects
client ability to keep appointments – may take up to five hours to cross bridge. Add an extra ˝ day to clinic hours. Checking to determine if registered nurse
practitioners. may prescribe prescriptions under Texas law, a concern due to
limited hours of physicians. Barbara suggested Tony contact Stephanie Tabone at
the Texas Nursing Association for clarification on nurses ability to issue
prescriptions.
Camino de
Vida:
Updates/Changes: Yvonne Roacho, Data Manager, will be collecting
data on the existing clients.
Local Evaluation:
Introduction of Michelle Valverde, new local evaluator. Michelle received adjunct status through
NMSU Sociology & Anthropology Department.
The department will assist with IRB application. Will review work plan this week for
submission to Robyn. Michelle provided
a detailed description of her educational background and research experience.
Outreach and In-House
Activities: On-going.
Promotores using group contact sheets but not submitted to date.
Technical Assistance
Needs: October 1 & 2 MIS training, Multi-site team (David & Tim)
David to meet with Michelle Valverde (New Evaluator).
Data Collection: HIV
tests to date = 90 with 75% return for test results. HIV positive client case load is five (5). Plan to collect 80 modules by end of October
on HIV positive clients.
Arizona
Border HIV/AIDS:
Trainings: Outreach
training Mariposa Health Center/Platicamos Salud have yet to reschedule the
outreach outing with Enrique Gomez to locations where individuals who may be at
high risk for HIV congregate in Nogales, AZ-Nogales, Sonora.
AZ AIDS ETC trainings for
dentists in Nogales and Sierra Vista for October 18th are
scheduled. The trainings are to be
provided by faculty members from the UCLA ETC.
Dr. Carmichael is scheduled
to conduct the CME training for physicians and health care professionals on
“Ambulatory Care of the HIV Patient”, County-Wide Grand Rounds on September 25th
in Bisbee, AZ.
Out Reach Activities: Yuma County
– Yuma County Health Department and Sunset Clinics conducted their outreach
activities during the weekend the 14th and 15th in
Somerton. Their activities were scaled
down due to the events of September 11th. They did test 14 individuals at the Somerton clinic from their
limited outreach efforts.
The medical assistant from
Sunset Clinics identified to provide primary care to HIV/ AIDS patients in Yuma
County has contacted the AZ AIDS ETC to schedule a date to train at the SIA
clinic. Dr. Carmichael will contact the
ID physician and to introduce himself and inform him of the ABHAC Project.
Steve spoke with Albert Moreno
of the Border Health Foundation regarding their (Puentes de Amistad) outreach
activities. Mr. Moreno assured that
outreach activities will resume.
Santa Cruz County – Mariposa
Health Center continues their outreach to health fairs, SEABHC SA groups, teen
court, detention centers adolescent/adults, and truck stops.
Cochise County – The Cochise
County Health Department is working with the Chiricahua Community Health Center
to train their promotoras. Cochise
County Health Department has begun outreach activities to their sites in
Douglas, Sierra Vista, Benson, and Wilcox.
Dr. Carmichael is discussing the logistics with Ken to implement
scheduled clinics at CCHC, MCHC and SCHC.
ADHS Funds: The project
has identified two individuals to attend the CDC TOT for counseling and
testing. Cochise County will identify
an individual soon and set up the arrangement to attend the training scheduled
for December 4-7, 2001 in Portland, OR.
Plans for the additional use of the funds are due to the ADHS office by
October 15th.
Dissemination Activities:
Project Enrollment:
No new enrollments to report.
Local Evaluation: The project
is developing a form to document medical referrals made by SIA staff on behalf
of ABHAC Project patients. Using
Physician Assessment form for data collection.
Evaluation
Center Issues:
1. Barriers Module: English
version is on-line. Spanish version is
ready for final review. NM and El Paso
will submit their comments to Betty for implementation in Module.
2. Re-visit next Grantee Meeting – DC or San Diego? Barbara advised that a new directive
limiting government staff travel. They
are wanting to consider teleconferencing for grantees meeting. Betty advised that cost would be excessive
and a cost the Centro de Evaluacion could handle within the present
budget. Barbara will meet with Kathy
Marconi today and advise the Centro as to HRSA recommendations on grantee
meetings. Mari suggested if meeting is
held in San Diego, we could hold teleconferencing with HRSA staff. Meeting dates selected are January 7-9,
2001.
Dissemination
Issues:
1. Group dissemination efforts – San Ysidro has four or five topics
which they are considering for local dissemination efforts. Herman asked Kurt to check with Multi-cultural Social Work is a journal
for consideration. Kurt suggested some
journals on community health could be considered. Wiebe asked is we are looking at a paper based on data or descriptive
report. Barbara said both if sufficient
information is available. Tony Estrada
stated he has reservations about using data from all sites due to the fact that
each site is so different. David said
this issue requires several hours discussion and should be scheduled for
another time.
2. APHA - projects still
plan to attend. Scheduled for October
24, 2001 @ 2:30 – 4:00 p.m.
HRSA Issues: Rosana had a question on roll-over funding – how long
will it take to receive final approval.
Ledia said deadline is September 30 for submission of FSR. Projects are to submit request for
carry-over either with the FSR or immediately thereafter. Projects should have a discussion with their
project officer on how local projects propose to use carry-over funds.
Other Issues: None
Next Conference call set for
October 15, 2001.