HRSA SPNS US/Mexico Border Health Initiative Grantee Meeting

The River Inn

924 25th Street NW – Washington, DC

August 2-3, 2001

 

 

Introductions:  Guests, Participants, HRSA Staff and Centro de Evaluación Staff (Participant list attached).

 

Welcome:  Dr. Katherine Marconi (HRSA) - Greeted all attendees.  Advised this is the 3rd decade of HIV disease and 2nd decade of Ryan White Care Act.  Stated access is critical – important to get persons infected into primary health care with quality management – connection between services and medical care/therapies.  Primary means of determining what works is evaluation, an important role for SPNS projects.

 

SPNS Up-date:  Barabara Aranda-Naranuo – Reviewed issues to be addressed during meeting.

 

●          Site visits – have been impacted due to federal travel restrictions.  HRSA staff may visit with projects for one visit throughout grant cycle.  The evaluation center will conduct site visits with HRSA staff participating in a conference call during the second day of the site visit.  HRSA staff want to be updated on evaluation and program implementation at project and multi-site levels. 

 

●          What is role of center and role of HRSA?  The evaluation center will oversee evaluation and provide technical assistance.  HRSA will oversee projects as well as evaluation.  Overlap between two agencies – when Evaluation Center conducts site visits it will be looking at all aspects of program implementation as well as TA and evaluation issues.  Encouraged open communication.

 

●          Evaluation Center will provide written project site reports

 

●          When in doubt who should receive copies of correspondence, always cc: HRSA project officer 

 

●          Technical Assistance – encouraged projects to utilize this service.  This could be relevant to projects with substantial staff changes.  David – overview of TA includes use of SPSS for data analysis; 101 HIV Case Management, data entry & management

 

●          Change in Agenda:  Friday morning at 8:30 am Janice Gordon will be here to provide information on budget carry-over

 

●          Items to be completed during grantees meeting:

            a.  Barriers Modules – English and Spanish versions

            b.  Publications Policy development – to be include program staff and evaluators as members of Publications Committee.

 

Barbara encouraged projects to keep their local HIV Planning Councils informed on what they are doing under SPNS and their collaboration with other community providers and multiple federal service funding (Title III and others).  Local projects need to look at long-term sustainability after end of five year cycle, includes looking and documenting lessons learned.  Methods of communicating findings is also important – other means of dissemination besides journal publications.

 

Acknowledged efforts of all projects with implementing the SPNS projects locally.  Also thanked Joseph Baldi for taking time to participate in meeting.

 

Bureau of Primary Health Care:  Joseph Baldi, Chief – HRSA Border health Unit.  Advised grantees that Eva Moya accepted position with US/Mexico Border Health Commission and has done a great job of collecting information about issues facing residents along the border.  Mr. Baldi provided a presentation on health issues along the US/Mexico Border (over head presentation)

1.  Child stepping over rubble in a canal located on the border

2.  Map of California – 11 million people within 48 counties – unique region to US & Mexico – most frequently crossed border in world. 

3.  El Paso is second busiest  - picture of traffic crossing border

●  Time Magazine covering issues along the border (handout).  Expected border population will double within next ten years.  Role of NAFTA discussed. 

4.  Living conditions in Colonias – substandard, often worse than what is found in 3rd world nations.

5.  Environmental health concerns – hepatitis A is 3-4 times greater on the border.

6.  Air Quality is raising environmental concerns.  Agricultural issues affect rates of asthma.

7.  Poverty Conditions – lack of insurance, unemployment rate is 2.5 – 3 times higher than US average – 3 of the 5 poorest cities of the 4 – 10 poorest in US located on the border

8.  Rates of Uninsured

9.  Border Health – lack to access, diabetes is 2-3 times higher

10. Ranking last in access to health care, second in death rates due to hepatitis, third in death related to diabetes, first in the number of cases of TB, first in school children living in poverty, and  last in per capita income

11.  Strategic Goals by HRSA:  increases access to primary health care, improve the status of maternal and child health, reduce racial and ethnic health disparities, and address environmental health concerns -  all through services and funding provided by HRSA

12. Increase Access:  New border health center access points/clinics; award school health, homeless, and public housing grants; NSHC providers & Border Loan Repayment Program; HCOP, HCOE, AHECs, Border HETCs; enhance PC workforce and diversity

13. Improve Maternal and Child health:  HRSA Border Healthy Start Initiative – have funded some along the US/Mexico border – existing programs in US have enrolled 21,000 children in Medicaid and other health insurance programs

14.Reduce Health Disparities:  HRSA Border HIV/AIDS SPNS Initiative – intended to address the rapid spread of HIV in the Border Region (Tucson, El Paso, most “Sister Cities”). Diabetes projects includes BPHS Diabetes Collaborative, BMS Por Una Comunidad Saludable Project and Diabetes leadership and promotora training

15.  Por Sue Corazon Project works with Cancer surveillance

16.  Environmental Health – HRSA-EPA Agreement includes pesticide training contract, border asthma surveillance, Colonias Water Safety Project, and Border “Yellow Pages” (EPA, OIRH)

 

Where do we go from here?  The Secretary has indicated he wants to commit additional resources to the border by establishing line item in budget.  Fund additional clinics along the border through grants.  Commended SPNS projects for the progress achieved with implementing their SPNS projects.  Also commended the University of Oklahoma with coordinating the multi-site effort.  The Bureau of Primary Health Care continues to support the projects in their efforts.

 

Discussion - Dr. Garcia: Are their any efforts with Mexico to address HIV surveillance?  Baldi advised that the Border Health Commission & Dr. Nautsen with National Center for Health Statistics have worked with agencies to develop Healthy La Gente 2010 which has been endorsed by the Mexican Government.  Four priorities:  immunizations, TB, violence, and a 5th encouraged by Bureau of Primary Health Care is diabetes.  HRSA in collaboration with CDC is looking at international efforts. Katherine Marconi stated that HRSA is looking at health care on the border with an effort to look at issues internationally.  AETC is working on training of medical providers.  Barbara stated she forwards information from projects to Joseph Baldi for their planning efforts.  CDC and USAID are the agencies which have congressional authorization to work on international health issues and are currently working with Africa on AIDS.  Mr. Baldi stated he is exploring possibilities of  working with CDC at examining TB and HIV along the border.

 

Barbara – do you have an scenarios that have emerged at your clinics that can be shared with Joe Baldi?  Charles Smith said one of the concerns (misconceptions) is that HIV patients will not be seen due to fear of air borne HIV.  Joe said Title III capacity grants will be available in the future to allow communities to plan for Title III services.  Rosana stated that their presentation on HIV/AIDS to Dr. Fox has aided in increasing local community health centers awareness on issues and needs in the area of HIV.  This has also resulted in a substantial increase in agency funding for HIV services.  Tony Chavez – this new initiative has resulted in the identification of 7 new cases in El Paso which can not be enrolled in the program due to state eligibility rules, therefore, he needs to know what can be done to access services and treatment for these individuals?  Baldi encouraged this information be communicated to SPNS project staff for follow-up.  This information will be used for planning future services to address these newly identified needs.  Advised there is a potential to provide financial support to address the needs of persons residing in El Paso and across the border.  Dr. Garcia – gay organization in Mexico has contacted him for assistance.  He advised that the agency in Mexico will not report to Mexican government information about client cases due to homophobia.  He wanted to know if VAC can provide the agency’s Mexican clients with medical care.  Under current conditions, unless they are able to enter the US and obtain medical care locally, VAC cannot provide medical care in Mexico. 

 

Review of Goals & Objectives for meeting:   Herman Curiel

1.  Meet HRSA Leadership

            Dr. Marconi

            Joseph Baldi

II.  Program Developments – Dr. Aranda-Naranjo

III.  Learn about AETC

IV.  Review and Adopt the Barriers Modules

V.  Grantees will review a proposed policy for Publications – Tony Estrada

VI  Projects will report on Year 01 Findings and Lessons Learned

VII.  Multi-site data overview – David Barney

VIII.  Learn of a potential resource for training of promotores – Farm Workers Justice Agency

IX.  Plan next Meeting

X.  Other items for agenda

 

National AETC Agenda:  Ledia Martinez – National AETC Agenda (Power Point Presentation posted on ou web page)  She advised that AETC is collaborating with SPNS to provide training to local medical providers and  collaborating partners.  AETC’s have been provided specific funding to provide training for local SPNS projects.  Mandate from Ryan White is to provide training in areas related to primary care, although AETCs may also provide training for case managers, nutritionists, nurses, and others working with HIV/AIDS patients.  Some AETCs will provide training in Spanish based on needs of community.  Barbara said she is working with the Bureau to determine what materials need to be translated into Spanish for public dissemination.  NIH and CDC have chosen Spanish translations for their agency web site information. 

 

HIV Medical Care:  Dr. Fernando Garcia, VAC Medical Director (Power Point Presentation)  Presentation is based on his experience with HIV/AIDS patients served by his clinic and is not to be generalized to the 2000 mile border.  Serve a population area with 1-million persons. 

 

Barbara recommended projects develop case studies on access/compliance with medical care to outlines issues that attribute to low viral loads or reduction in risk behaviors.  These case studies should address how issues of hopelessness are addressed.  Case studies can be an important contribution to dissemination products.  Bob Smith informed group that Dr. Garcia only treats HIV/AIDS patients.  Tony asked how Dr. Garcia deals with prioritizing care for patients with substance abuse problems.  Dr. Garcia advised he first determines whether or not the patient is ready for HIV therapy, then works on educating the client on affects of drug abuse with HIV treatment.  Dr. Garcia will schedule home visits by clinic nurses and if necessary, will accompany the nurse.  Compliance means taking medications and keeping appointments.  Bob Smith advised that VAC uses the Harm Reduction Model, although clients are encouraged to abstain from drug abuse.  Dr. Garcia is working on developing a clinical trial for Hepatitis C treatment.  Pablo Magaz advised Title III will pay for Hepatitis treatment. 

 

Dr. Gary Sinclair (Power Point Presentation):  How is what Dr. Garcia spoke about being translated to other sites (Barbara)?  He advised that coordination between nurses and experienced case management staff at VAC, as well as cross-training between Dr. Garcia and physicians at other CHCs, has put in place the approach described by Dr. Garcia.  Bob Smith advised that HIV case managers and nurses are what he believes, contributes to their success.  Barbara encouraged projects to really look closely at the staffing of the SPNS program to determine what were the credentials necessary to ensuring success of the project and client adherence.  Evidence based practice is critical to justifying continued support from the Bureau of Primary Care.  Local evaluators need to look specifically at what is being done locally that impact client outcomes.  Barbara said recommendations made based on experiences of local clinics will affect the collaboration effort between SPNS, AETC, and Bureau of Primary Health Care in the delivery of care along the border in the future.  Important for projects to document all efforts undertaken to ensure that physicians are able to provide HIV care without penalties for failing to meet CHC client quotas.  Also important to document how many patients are seen at individual CHCs to demonstrate need for HIV services and health care.  Rosana shared with group the experience at San Ysidro - advised that HIV care has been the result of the HIV/AIDS program staff advocating for the service.  This has been a struggle when the Executive Director does not perceive HIV care to be a priority health issue for the clinic.  Barbara informed the group that the future direction of health care will be based on recommendations received by HIV physicians, as well as executive directors of CHCs.  Pablo Magaz said it is important to also take into consideration other systems that can also be looked at for paying costs of HIV care such as Medicaid.  Tony said El Paso’s definition of “underserved” includes persons who do not have social security number and are not eligible for Medicaid.  Barbara – asked Dr. Sinclair if he has shared his approach with other AETCs outside of Texas?  Kari said their AETC is still mini-seminar focused.  Barbara suggested that another outcome of the meeting could be to outline how the system of care and training is occurring across projects as a result of physician training. 

 

Barriers Module:  Review and modification of English Version.  John Wiebe said he had question regarding client fears about the effects of medication.  Three projects supported idea of reducing items in module.  Dr. Garcia recommended that questions be posed in positive format versus negative.  Wiebe also suggested posing all as questions.  Ledia expressed concern that manner in which questions are posed can influence response.  David advised module assesses Barriers to Primary HIV Care.  Joao asked if this would be administered to HIV negative clients.  He was informed this would be administered to HIV positive clients.  Kari said their rural clients never come into the office for services, they will see a physician locally and the case manager will travel to see them in their home.  Yolanda said past experience has demonstrated that clients are often confused with the term “services,”  need to explain whether this applies to case management or health care, therefore suggests that form be very specific.  Rosana asked if intent was to assess what client overcame to get to services, as many clients are already accessing medical services.  The cases will be identified as pre and post SPNS when assessing for barriers.  Ken suggested that #29 may need to be more specific such as asking “difficult to get time off work” and “difficult to schedule appointments.” 

 

Group consensus:  Module is to address Barriers to Access HIV Medical Care.  Will be administered only to HIV positive clients.  Yolanda stated that we need to ask these questions of all clients by posing questions about prior to entering care, did client know that HIV medical care was available?  SY discussed concern that case management and medical care are both important to their program and they would want clients to assess their access to both services.  Group agreed to then leave barriers to services and not just primary care.  Mari suggested phrasing questions with “Before you came into care…”  Alisa said some questions asked about current services, wherein those when can then be posed in current tense.  Tony suggested we could pose a question “before entering care, did you encounter any of these barriers” (with a list to check off).  This could be followed with a check off for what continues to be a barrier.  Joao said for some questions we could consider a one shot pre and post response.  Barbara reminded grantees that purpose of the initiative is to get clients into primary care, therefore she encouraged projects to use Barriers to Primary Care.  She further stated that it is important to not muddy the issue by addressing services versus being specific to primary care.  David suggested that the form should be administered within the environment to which the module applies.  Rosana said she is uncertain if she could ask medical staff to administer this form.  Barbara said agencies will need to make the determination as to how this form is administered.  Rosana said their sub-sites do not have medical staff that could administer this form.  Barbara advised the HRSA project officers will work with SY on how to work out these issues.  She re-emphasized the need to narrowly focus the barriers module to primary care.  She acknowledged that there is no way of take away the burden of data collection as a requirement of the SPNS Initiative.  Wiebe stated we could develop a barriers to medical care module, then local projects could develop a barrier to social services.  Barbara asked each grantee to reach a consensus as to how they would like to proceed.

NM – agreed to use barriers to HIV medical care

ELP – medical care

SY – medical care

VAC – medical care

AZ – medical care

EC – medical care

 

Questions selected for Barriers Module:

1.  Did you know that HIV medical care existed around here?

2.  Did you know where to get HIV medical care?

3.  Did you have to wait too long to get a medical appointment? It was recommended that all questions have a Before service question and Current service question (pre & post question)

4.  Did you think the medical services would cost too much? 

5.  Did you know the requirements that you needed to qualify for HIV medical care?

6.  Were you afraid the medical staff would not like you?

7.  DELETE

8.  OK  but reword

9.  OK but reword

10.  Did you not seek treatment because you thought your health was in God’s hands?

11.  (STAT) You don’t want treatment because you believe you got what you deserved?

12.  DELETE

13.  Is it hard for you to travel to your medical provider?

14.  STAT

15.  Did the presence of the Border Patrol keep you from getting medical care?

16.  Keep 

Barbara will work to pay for translation of instrument by Dr. Ford and his students.  She will work with Wiebe to get this done. 

17.  Were you concerned others might think you were “gay or lesbian” if you received HIV  medical care?  Issue related to prostitution – stigma of services in an agency that serves a predominant male pop.

18.  DELETE

19.  Were you concerned that HIV/AIDS medications might make you feel bad?

20.  STAT

21.  DELETE

22.  STAT  - correct to state “available to you”

23   STAT

24.  STAT with changes

25.  STAT

26.  STAT

27.  STAT

28.  You don’t have anyone to care for your kids when you are seeking medical services.

29.  Does lack of access to a phone keep you from communicating with your medical provider?

30.  Were concerned that people might make judgments about your lifestyle?

SY – Women’s Question: These questions can be included in local modules.

Were you concerned that the medical staff might think you were promiscuous (substance abuser can be interjected here instead)?  Did you delay medical services because you believed they were gay oriented?  Barbara asked Rosana, Tony Estrada and Wiebe to review Barriers module and determine if the questions are adequate or recommend which questions should be deleted.  Tony expressed concern about the responsibility of needing to review what has already been worked on by the group.  Barbara stated the group is being asked to review and make a recommendation to the group as to whether the module should be left intact or reduced, then the group will make the final decision.  Tim will put all corrected questions into final draft, Sudhir will have the draft printed and provide copies to review committee by 8:00 pm this evening for their review.  Grantees agreed to convene at 7 am on Friday morning.  Meeting ended at 6:25 pm.

 

 

Friday - August 3, 2001 - Grantee resumed meeting at 7:00 am

 

Barbara opened meeting.  Thanked participants for reconvening at such an early time. 

 

Review of Barriers Module:  Tony Estrada said committee reviewed Barriers Module – Item 6 and 27 were similar, they recommended keeping #27.  Recommended deleteing item #8 because similar to 7 & 27.  Rewording #11 – Use: Is it hard to get to medical care due to lack of Transportation?  #5 delete “that you need.”  #15 Reworded.  #17 Reworded.  #21 added medical services.  #23 reworded.  Deleted #26  Reword # 24 and 25.  #28 changed to “getting medical care.”   #27 changed “think badly of you because your were HIV positive?”   Follow-up questions should state: “Is this a problem now?”  Recommended items be clustered based on subject matter.  Follow-up questions need to be assessed for all questions.  Tony would like to write the questions in a format that flows better, then send it to David who will send out the module to all grantees for final review.  Bob Smith and John Wiebe both offered to pilot the Barriers Module.  Barbara and Herman will coordinate the translation of the module.  Sites require a week to pilot instruments. 

 

Publications Policy:  Tony Estrada – Committee reviewed several publication policies and recommended a format that David finalized for the grantees review.  Page 2 deals with the purpose of the evaluation center:  Second bullet - committee membership: opened for discussion. Mari said the policy considers efficiency with a committee that represents everyone and not one that includes a large number of persons.  Bob stated membership of project director and evaluator with one vote for each grantee would work well.  Project directors will designate the project representative.  One representative each from Evaluation Center and HRSA.  Tony recommended Chair be elected for a one year term.  Mari said budgets have not allocated resources for Publications Committee to meet.  Barbara said other grantees have their committee meet during regular grantees meeting.  Joao asked if George Huba will stay on as a consultant? David advised it is contingent on budget negotiations.  Concern with second bullet - confidentiality should be an agency responsibility, grantees agreed to be delete this bullet.  Last bullet – Wiebe said it does not state HRSA’s role.  Mari questioned contribution for authorship, felt that intellectual contribution should be a requirement in addition to data contribution.  Wiebe suggested that it could be re-written to state that demonstration sites who make a data contribution as well as intellectual contribution will be listed as an author.  Contributions of data only will result in acknowledgement within the article.  Barbara stated that HRSA in the past has required all grantees to state that funding was received from HRSA.  Also HRSA staff are entitled to authorship and will work with grantees on publications.  HRSA staff typically work with grantees on seminal papers.  Tony said these papers should also include acknowledgement to grantees who contributed data.  Mari suggested a boiler plate.  Joao inquired about order of authorship.  Barbara said committee when reviewing requests from two authors for papers which are similar, should recommend collaboration between the authors.  Betty reminded group that the committee will be responsible for monitoring timeline for publication.  Tony said committee should not be involved in peer review.  Authors are provided 90 days for draft of article which should be sufficient.  Barbara will check with Jospeh Baldi about the Bureau of Primary Health Care’s interest in participating in authorship of papers.  Herman asked about Monograph in Year 03.  David said it has not been decided due to budget constraints.  Barbara suggested that George Huba could be a consultant with that effort.  Types of analysis and data: Barbara said Columbia has used a form to request data form a collaborating site which serves as a signed agreement to share data, she suggested our grantees also consider using such a form.  Type III – Wiebe questioned descriptive data which is multi-site.  David said the only time the policy applies is when there is a conflict between two projects and publications by Evaluation Center.  Local data changed to include data collected on modules A-G.  Joao questioned whether a project could refuse to have their data used in a seminal paper.  Barbara said typically this has never happened.  She emphasized that it is critical that HRSA be able to support publications for disseminating outcomes of the grants but prior to dissemination, grantees should keep HRSA informed about proposed publications because HRSA will receive calls asking questions about statements made in publications.  She said that HRSA pays for the data but does not take ownership.  Tony shared with the group that under UofA policies, the data obtained through a grant awarded to the University, the University holds ownership regardless of who is listed at principal investigator.  Wiebe asked what would happen is local project produces a paper incorporating multi-site and local data for project, would this conflict with a multi-site paper?  Barbara suggested that any proposed articles be laid out so that P&D committee is aware of potential conflicts on future publications.  Recommended that papers coming from multi-site instrument data that does not include local data be considered as only Type III papers.  Policy revised.  Robyn read a statement that HRSA should like included into policy.  Steve asked if requests for publications could be posted on web page.  David said yes and it could be password protected.  Tony asked who should receive the requests.  It was agreed all requests would be sent to David at Evaluation Center who will have the request posted on the web, provide copies to committee members, and schedule a conference call.  The ten day window begins on the day the committee reviews the request.  Joao asked what happens when an evaluator leaves a project, would they be recognized for their contributions prior to their leaving, also applies as to when the grant is completed.  Barbara advised other grantees have been able to address this issue as they progress with publications and revise the policy at a later date.  Tony said Graduate Student use is also a concern – Barbara will look at moratorium for use of data by persons outside of group as well as use by Graduate Students. 

 

Members elected:

                        Joao & Kari (New Mexico)

                        Rosana & Mari (San Ysidro)

                        Tony & John (El Paso)

                        Steve & Tony (Arizona)

                        Robyn (HRSA)

                        Bob & Yolanda (Valley AIDS)

                        David (Centro de Evaluación)

 

Tony nominated for Chair – unanimous vote

 

FSR and Budget Issues:  Jan Gordon, Deputy Grants Officer – HRSA.  She handed out letters to projects with instructions for carry-over fund requests.  FSR instructions can be located on HRSA web site.  FSR is due 90 days after budget period ends.  Due September 30, 2001.  Revisions can be made up to 15 months after end of the budget year (June 30th).  This is typically the result of an auditors recommendations.  Reviewed entry of FSR.  Grantees can request an extension if they anticipate they will be late in submitting the FSR.  Barbara asked grantees to designate in their revised budget what was carried over from Yr. 01 - Bureau of Primary Health Care funds so that it can be tracked.  This is not reflected in FSR as carry-over is identified as a whole and not broken down in categories. 

 

Project Reports:   Presentations in Power Point / all posted on www.ou.edu/border

                                                  

1.         Arizona Border HIV/AIDS Care (special issues listed as follows)

●          Steve advised Arizona offers unanimous testing which many of their outreach contacts elect.  Positive results received are provided to client, then a report is provided to State Health Department identifying the HIV positive individual.  Arizona also has partner notification policy. 

●          While profiling pre-SPNS cases found that a significant percentage of those clients entered into care in advanced stages of disease. 

●          An issue raised by clients is fear that project will transfer their care to a local CHC, in these cases, clients have been assured this will not happen. 

●          HIV-risk factors being collected through CDC bubble form

●          Satisfaction Survey to date demonstrate that clients are very satisfied with services received.  Tony said no variance among surveys received from clients.

●          Presently working on training Promotoras in Spanish for HIV testing certification enabling them to conduct HIV testing in field – expect this may increase the number of persons agreeing to HIV testing.

●          When clients question on HIV/AIDS status, many clients reported being HIV positive, when medical chart reviewed to verify the information, Steve found that majority had entered into care with CD-4 counts of 23 or so, thus many clients didn’t really know their HIV status.

 

2.         Camino de Vida Center for HIV Services (special issues listed as follows)

●          All promotores and HIV staff have been trained in HIV testing

●          Homelessness is high in New Mexico and are identified as a high risk population

●          Temporary shelters for migrants exist in Columbus and Hatch

●          Las Cruces is intersection for two major Interstates (I-10 and I-25)

●          Have encountered difficulty finding promotores who are either gay or speak Spanish

●          State Health Dept. only allows health centers to be confidential sites, other agencies are certified as unanimous site

 

3.  Centro de Salud Familiar La Fe (special issues listed as follows)

●          Kendall Carnie – Deputy Director

●          Local modules consist of 6 or 7 instruments – modules collected at various points of time

●          Data collection is scheduled in two phases in order to ease burden on clients

 

4.  San Ysidro Health Center (special issues listed as follows)

●          Project has needed to overcome mistrust of University Evaluators with all collaborating partners

●          Essential to provide HIV education training to promotores in order to ensure that they are comfortable in collecting risk factor information from outreach contacts

●          Agreements with collaborating partners are in form of contracts which identify specific roles and responsibilities of participating agencies.

●          45 persons in various sites collecting data – provide QA on on-going basis

●          Have six local instruments with local data variables

 

Valley AIDS Council (special issues listed as follows)

●          Local data collection instrument based on instrument used previously for South Texas HIV providers

●          Eagle Pass site serves a geographical area which exceed 15,000 sq. miles

 

 

PresentationWeb Page Development:  Sudhir Vallamkondu, Centro de Evaluació

 

Presentation Fact Sheet II – Hispanic HIV/AIDS Literature Resources:  Saleem Ahmad, Centro de Evaluación

 

Presentation by  Farmworkers Justice Fund:  Rosana Cardoso & Myrtelina Gonzalez

●          In existence for 20 years

●          Short video on local play developed by promotoras

●          Also have an adolescent promotoras program (14-17 year olds)

●          Provided handouts to all grantees

 

Multi-site Data:  David Barney

●          Provided power point presentation of frequencies on data collected to date

●          Dr. Sinclair made reference to research question of circumcision being a transmission cause for persons infected among Hispanic populations.  A study on African couples (N-50 couples) indicated that men who were circumcised were less likely to become infected with HIV in cases where they had been actively involved in sexual activity for fifty years.  Questioned whether circumcision would be a concern among Hispanic populations.  Group stated circumcision is not an issue among Hispanics.

 

Referral Source – clients going into case management should be asked how they were referred into case management

 

Quality Assurance: Timothy Brittingham, Information Technology Analyst – Centro de Evaluación

●          All correspondence to correct forms should be e-mailed to Tim who will copy e-mail, post correction in data base, note when & who posted correction in data base, and file e-mail with notations in log file.

●          Household Income – If client reports zero income for Household Income, that should be recorded.  Existing cases need to be corrected – project will submit corrections if necessary. 

●          Lifestyle – live or visit Mexico compared with Border crossings CHECK TO VERIFY

 

 

AETC Module: David Barney - Will post module on web for projects to review.

 

Next Meeting:  Betty Duran, Centro de Evaluación

Next meeting will be held in Norman, Oklahoma due to budget limitations.  Grantees would like early January, 2002 for 2.5 days.   To be held on Monday – Wednesday.  Grantees decided not to include skills development training for support staff at this time.  Selected dates for next meeting are:  January 7-9, 2002 or Jan 14-16, 2002.  

 

Meeting concluded at 3:30 p.m.