2017 Prevention and Care Technical Assistance Meeting: Advancing Health Equity

July 19th, 2017 to July 21st, 2017

NASTAD's 2017 Prevention and Care Technical Assistance Meeting hosted directors of governmental public health HIV and hepatitis programs, national partners, and public health officials to share their expertise and ultimately prevent infections, strengthen care and reduce disparities. The meeting allowed for in-person collaboration between NASTAD members and program personnel planning and implementing HIV prevention and care programs. The three-day meeting included oral and panel presentations, as well as plenary sessions and roundtables. Slides from the presentations can be downloaded below.


Plenary Presentations

Chair's Challenge - Advancing Health Equity: This plenary showcases practical strategies for furthering NASTAD’s mission-driven focus to advance health equity at all levels of prevention and care.

Moderator: Angela C. Johnson (NASTAD)
Speaker: Shanell McGoy (Tennessee) (slides)

Clinical Update - Advancing HIV and Hepatitis: This plenary provides an overview of the current and future HIV and HCV landscapes including: anticipated long-acting HIV agents, PrEP, direct-acting hepatitis C medications, and HIV vaccine and cure research. 

Moderator: Murray Penner (NASTAD)
Speakers:  Richard Jefferys (Treatment Action Group) (slides) and Tim Horn (Treatment Action Group) (slides)

Updates from Federal Partners: In this session, panelists from CDC and HRSA provides information about agency priorities and initiatives.

Moderator: Natalie Cramer (NASTAD) and Ann Lefert (NASTAD)
Speakers: Michael Goldrosen (Health Resources and Services Administration, HIV/AIDS Bureau) (slides), Renata Ellington (Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, Office of the Director), and Angela Hernandez (Centers for Disease Control and Prevention, Division of HIV/AIDS Prevention, HIV Incidence and Case Surveillance Branch) (slides)

Uniting to End the Epidemics – Operationalizing Health Equity: This session focuses on the role of health equity in ending the epidemics of HIV and viral hepatitis, with attention to Black and Latino MSM, trans populations, and other disproportionately affected populations.

Moderator: Mahelet Kebede (NASTAD)
Speakers: Shelley Lucas (Texas) (slides), Carmarion Anderson (Black Transwomen, Inc.), James Stewart (Mississippi), and Kathy Garner (AIDS Services Coalition)

Establishing Programmatic Synergy for Prevention and Surveillance Integration: This plenary explores innovative thinking and best practices for the integration of prevention and surveillance, across state and locally-funded jurisdictions. Specifically, the session focuses on how health department HIV, viral hepatitis and STD divisions can seamlessly work across Data to Care, Partner Services, and Disease Intervention Specialists (DIS) programs to establish modernized integrated approaches.

Moderator: Natalie Cramer (NASTAD)
Speakers: Jessica Frasure-Williams (National Coalition of STD Directors) (slides) and Kimberly Truss (Tennessee) (slides)

Preparing for a Changing Coverage Landscape: Plan Perspectives: This session includes insights from both Medicaid managed care plans and commercial insurance plans on the current health care landscape and anticipated consumer access challenges, particularly for vulnerable populations. Speakers highlight the impact of federal policy changes regarding Medicaid and the individual market on plans and beneficiaries.

Moderator: Amy Killelea (NASTAD)
Speakers: Jenny Babcock (Association for Community Affiliated Plans) (slides) and Greg Gierer (America’s Health Insurance Plans) (slides


Breakout Sessions

Tailoring Ryan White HIV/AIDS Program (RWHAP) Part B/ADAP Data Systems, Outreach, and Services to Best Meet the Needs of Key Populations: Ryan White HIV/AIDS Program (RWHAP) Part B programs and ADAPs are well-poised to work in concert to address the unique challenges and needs of client sub-populations, including those who are justice-involved, living with hepatitis C (HCV), and/or in need of medication assisted treatment (MAT) as part of substance use treatment.  This session highlights successful strategies Part B programs and ADAPs have employed to target and deliver services to these populations, leveraging partnerships, data, and funding to do so. (slides

 

Addressing Health Equity in Data to Care ProgramsHealth departments are increasingly adopting strategies that use surveillance data to re-engage PLWH into care and improve outcomes across the care continuum. When planning and implementing a Data to Care (D2C) program, health departments should ensure they are taking health equity into consideration. This session discusses strategies that health departments and their partners can use to address health equity through their D2C programs, including meaningfully engaging community members, prioritizing Black, Latinx, MSM, and other priority populations, and assessing barriers to care related to social determinants of health.

Speakers: Erin Bascom (NASTAD) Amanda Bowes (NASTAD) (slides), Antoine Brantley (Louisiana) (slides)

PrEP Candidate NavigationThis session explores innovative models of PrEP insurance navigation, focusing on funding mechanisms and structure. The examples presented showcase health departments’ strategies for PrEP navigation services, particularly for MSM, the use of Disease Intervention Specialists (DIS) for linkage, and examine how these programs are being funded and staffed for sustainability. (slides)

Immigrant Populations and Participation in HIV Prevention and Care Programs: This session explores the impact of the political environment on immigrant populations, particularly Latino MSM and their engagement in public health services.  It allows participants to dialogue on partnerships and interventions to ensure continuity of services. (slides)

Innovative Ways to Fund Harm Reduction: Although harm reduction is a critical public health approach, it has not been supported and funded commensurate with its utility in HIV and HCV prevention. This session explores innovative ways to fund harm reduction by looking at efforts to bundle comprehensive harm reductions services so they are billable and leveraging health systems and payers to expand access to Naloxone.

Speakers: Allan Clear (New York State) (slides) and Laine Snow (New Mexico) (slides)

Opportunities to Engage Clinical Providers: Health departments have new opportunities to engage health care providers through academic detailing for HIV, hepatitis, and STD screening, PrEP, and vital treatment services. This session examines innovative data-driven strategies at the state and local level to identify service gaps and optimize provider engagement and other assurance efforts.

Speakers: Alyson Decker (San Francisco) (slides) and Janet Nuss (Illinois) (slides)

Modernizing RWHAP Part B/ADAP Enrollment/Recertification Processes and Infrastructure: This session highlights strategies to ensure efficient and client-centered RWHAP Part B program and ADAP enrollment and recertification processes, with an emphasis on data systems integration and enhancement.  These strategies include: leveraging data sharing between RWHAP Part B programs, ADAPs, and other entities (e.g., Medicaid) to facilitate eligibility determination); use of self-attestation and targeted communications to clients and staff; utilizing centralized eligibility across RWHAP Parts within a jurisdiction, including RWHAP Part A; measuring and improving rates of recertification as part of broader quality management activities; and transitioning to online/electronic application systems.

Speakers: Jimmy Borders (Arizona) (slides), Erin LaRose (Vermont) (slides), and Izza Cagle (Alabama) (slides)

Pharmacy-based HIV/HCV Prevention Delivery: Pharmacies are one of the most important and accessible entry points of the healthcare system, which is critical for expanding access to services for individuals most at risk for HIV and HCV. This session provides examples of different models of pharmacy-based HIV and HCV prevention including a one-step PrEP clinic and expanded access to HBV vaccination and HCV screening. 

Speakers: Michael Klepser (Ferris State University), (slides) Thaddeus Pham (Hawaii), (slides) and Cody Shafer (Iowa) (slides)

Gender Justice: During this breakout, participants expand the conversation to include transgender men, transgender women, cis-women, and gender nonconforming people in program development and implementation. The conversation focuses on how to design programs that serve the whole person and address trauma they may have experienced. 

Speakers: Jean-Michele Brevelle (Maryland) (slides) and Natasha Guynes (HER Resiliency Center)

Sexual Orientation and Gender Identity (SOGI) Data Collection: This session highlights the importance of robust SOGI data collection. Participants will hear from a jurisdiction that will detail how systems can be utilized for effective SOGI data collection and its implications on public health planning, and equitably representing Black and Latino MSM. Also, this session provides the latest information related to federal SOGI data collection activities.

SpeakersKellan Baker (Center for American Progress) (slides) and Michael Weir (NASTAD) (slides)

Public Health/Public Safety Partnerships: This session explores ways in which public health and public safety staff can partner to infuse criminal justice systems with public health interventions.

SpeakersSusan Carr (Virginia) and Daniel Atzman (Baltimore LEAD) (slides)

System-level Strategies to Address New HIV Infections Among Latino MSM: This session provides an opportunity for health department staff to the HIV and hepatitis epidemics in Latinx communities. The session focuses on system-level responses to address Latino MSM health equity outcomes, with particular attention to immigration and health insurance access, molecular surveillance initiatives, and geomapping resistant HIV strains to implement test and treat programs.  

Speakers: Jenny McFarlane (Texas), (slides) Eduardo Alvarado (Illinois), (slides) Jeffrey Maras (Illinois), and Janet Nuss (Illinois) (slides)

The Bridging of HIV Criminalization and Syringe Access: This session discusses criminalization as it relates to both HIV and syringe access as a barrier to reaching health equity. States discuss their ability to navigate challenging legal landscapes while promoting syringe access, implications of and efforts to reach HIV decriminalization, and the necessity of creating initiatives that recognize HIV criminalization, the opioid epidemic, and syringe access as intricately linked.

SpeakersLindsay Pierce (New Hampshire) (slides)  and Tyler Fisher (Utah) (slides)

Innovative Data Use for PrEP Programming: The implementation of new PrEP programs presents an opportunity to utilize new sources of data to inform and track HIV prevention efforts led by health departments including use of DIS. This session will highlight programs that are using data in innovative ways for PrEP programming, including for PrEP uptake estimations and/or program evaluation. This session will also discuss strategies to leverage ADAP systems and infrastructure to implement PrEP Drug Assistance Programs.

Speakers: Richard Aleshire (Washington), (Lori Delaney (Washington), (slides) and Todd Grove (Colorado) (slides)