Linkage to Care:From Preliminary Positive to

Primary Care

Robin PearceNO/AIDS Task ForceNew Orleans, LA

Overview

Describe NO/AIDS linkage to care system Share tools:

Access databaseIntake forms and staff training tips

Discuss challenges and lessons learned

Background

NO/AIDS is a “one stop shop” for PLWHA in New Orleans Counseling & Testing program has

multiple testing locations and times Administered 3,200 tests in FY 2010-11

2.8% positivity rate

NO/AIDS Linkage to Care

Inputs: Two full time staff: CTR Coordinator &

CRCS Wellness Manager

Microsoft Access Database

Secure server to allow database sharing

Intake Paperwork

Trained HIV Counselors

Day 1

Client will be contacted by CRCS when the confirmatory is ready

Counselor records client’s contact info Counselor collects confirmatory sample

(Orasure, offsite lab)

Client tests PP at evening testing site

Day 2

Counselor mails confirmatory sample

Counselor provides paperwork to CTR Coordinator & CRCS Wellness Manager CTR Coordinator makes file for client

and keeps original paperwork CRCS enters client information on

Microsoft Access database

Day 7

Confirmatory result available online CRCS contacts client to make

appointment to receive confirmatory result

Day 14

Client receives confirmatory result in person from CRCS Client begins enrollment paperwork or

sets date for enrollment appointment CRCS sets date for PMC/EIS

appointment CRCS follows up with PMC or client to

find out if client attended appointment

Results

2010 data: 73 clients received a preliminary

positive result and post-test counseling 96% completed a confirmatory test 82% received confirmatory result Of those clients who received their

confirmatory result, 90% were connected to care (54 of 60)

Tools

Tracking Database CTR Coordinator and CRCS

collaboration Confirmatory Intake paperwork for HIV

Counselors & training

Tracking Database

Tracking Database Inputs

Client Number (HIV Test Form 1 number) Orasure Number Last 4 SSN First Name

Tracking Database Inputs

Client did confirmatory: Y/N Date of PP

Date of confirmatory Client received confirmatory Date received confirmatory Actual confirmatory result

Tracking Database Inputs

Paperwork completed: Y/N Date paperwork completed Scheduled PMC/EIS appt Attended PMC/EIS appt Date attended PMC first appt

Tracking Database Inputs

Lost to Follow up Notes

Documenting & Follow-up

Regular communication between CTR & CRCS (work out of same office) Review client files Update database Deadlines:

- Quarterly referral reporting to the state- 60 day lost to follow up

Confirmatory Intake

Confirmatory Intake

Confirmatory Intake

Confirmatory Intake

Challenges

Client in unstable living circumstances Client lacks regular access to

communication tools (phone, email) Healthcare can be a low priority (relative

to other needs) Denial, shock, anger, stress

Lessons Learned

Collecting correct contact information at PP visit is the most important step Communicate with outreach teams and

HIV counselors Train & re-train HIV counselors Create intuitive intake paperwork

Goals

National HIV/AIDS Strategy:

“Establish a seamless system to immediately link people to continuous and coordinated quality care when they are diagnosed with HIV.”

Goals

“[By 2015] Increase the proportion of newly diagnosed patients linked to clinical care within three months of their HIV diagnosis from 65 percent to 85 percent.”

National HIV/AIDS Strategy:

Contact information

Robin PearceCounseling & Testing Coordinatorrobinp@noaidstf.org

Mark Drake, LCSWCRCS Wellness Managermarkd@noaidstf.org