2019 National HIV and Hepatitis Technical Assistance Meeting

December 3rd, 2019 to December 5th, 2019

NASTAD's 2019 National HIV and Hepatitis Technical Assistance Meeting provided technical assistance and educational opportunities for health department HIV and hepatitis staff as well as time for networking with one another and with invited colleagues from the federal government, industry and partner organizations. Download the entire meeting agenda here. Slides from the presentations can be downloaded below.

Plenary Presentations

Welcome and Opening Remarks: Ending the Epidemics – Federal Update

  • Description: In addition to welcoming remarks from NASTAD leadership and the NASTAD Board of Directors, the Department of Health and Human Services (HHS) presented the overall federal government vision the Ending the HIV Epidemic: A Plan for America (EtHE) and updates to the National Viral Hepatitis Action Plan. 
  • Speakers: Carol Jimenez (slides), Johanne Morne, and Natalie Cramer

Treatment Update

  • Description: This session included medical providers presenting updates on new treatments available for HIV and hepatitis.
  • Speakers: Dr. David Hardy (slides) and Dr. Kristen Marks (slides)
  • Facilitators: Boatemaa Ntiri-Reid and Tim Horn

Strengthening Community Engagement with Integrated Programs

  • Description: Community engagement, particularly with those underserved in the HIV and hepatitis response, is critical. This plenary focused on ways health departments can strengthen their community engagement in the development and implementation of policies and programs, particularly with a focus on EHE and hepatitis elimination planning. 
  • Speakers: Clifton Garmon (slides), Dominique Morgan (slides), and Mariah Wilberg (slides)
  • Facilitator: Marlene McNeese

Breakout Sessions

ADAP Track

ADAP: Modernizing Your ADAP: 2019 State Examples to Leverage Dental and HCV Service Options

  • Description: This session covered ways in which jurisdictions can work to modernize their ADAP and leverage new opportunities to provide more comprehensive services. First, a presentation on innovative ways to increase HCV direct-acting antiviral (DAA) uptake among ADAP clients who are living with HIV and HCV, such as inclusion on the ADAP formulary, a streamlined process for accessing DAA coverage, and informing providers about the availability of DAAs through ADAP. Second, the session included a presentation on an ADAP-designed dental plan and demonstrate how its implementation is ideal for ADAPs seeking to cover the oral health needs of PLWH and/or to outsource the administrative tasks of coverage determination and benefits coordination, which often lie outside the expertise of ADAP staff.
  • Speakers: Alicia Cooke (slides) and Jimmy Borders (slides)
  • Facilitator: Bianca Ward

ADAP: Preparing for Long-Acting Injectables: Considerations for ADAPs and RWHAP Part B Programs

  • Description: The first long-acting injectables for HIV treatment are expected to be approved by the end of 2019. This session provided a detailed overview of these products, including important formulary, cost, procurement, and coverage considerations for ADAPs and RWHAP Part B programs. Specific topics that were explored include: client demand (including results from a recent jurisdictional consumer needs assessment); supply and payment chain considerations; and RWHAP Part B program and ADAP best practices associated with physician-administered drugs (e.g., Trogarzo).
  • SpeakersMeredith Heckmann (slides) and Tim Horn (slides)
  • Facilitator: Milanes Morejon

ADAP: Program Income: ADAP Considerations and Collaborations with 340B Entities

  • Description: This session detailed considerations for generating program income, promising practices from ADAPs earning program income, and how to work across Ryan White HIV/AIDS Program (RWHAP) Parts and other 340B entities.
  • Speakers: Jonathan Livingston, Laine Snow, and Tim Horn (slides)

Care Track

Care: Addressing Intangible Barriers to Improve Client Health Outcomes

  • Description: This session provided health departments with tools and strategies to address the social and structural barriers patients face when engaging with the health service delivery infrastructure. The discussion surveyed issues related to stigma in service delivery, trauma informed care, community engagement, and health literacy/education.
  • Speakers: Kimberley Truss (slides), Rafael Gonzalez (slides), and Robbyn Kistler (slides)
  • Facilitator: Alexander Perez

Data and Surveillance Track

Data and Surveillance: Ensuring the Collection and Use of Sexual Orientation and Gender Identity Data

  • Description: Comprehensive data is critical for policy and programming yet is often lacking for underserved communities. How we collect, disseminate, and use that data for decision making may also be confusing to our stakeholders. This session showcased how different health departments and organizations use LGBTQ survey instruments to collect data, disseminate findings effectively, and develop effective programs. The session also provided tools for participants to think critically about the data they collect and how it used for decision making and will include updates to initiatives including the Medical Monitoring Project and the 2020 Behavioral Risk Factor Surveillance System (BRFSS).
  • Speakers: Andrew Zapfel (slides) and Thaddeus Pham
  • Facilitator: Mike Weir (slides)

Data and Surveillance: HIV Cluster Detection and Response: Community Engagement Lessons Learned

  • Description: This session highlighted challenges and opportunities in planning and implementation of HIV molecular surveillance activities within health departments. The discussion included a focus on community engagement and policy implications for cluster detection and response, its role in ending the HIV epidemic, and potential application of lessons learned to future cluster detection and response efforts in HCV.
  • Speakers: Biz McChesney (slides) and Emalie Huriaux
  • Facilitators: Dori Molozanov and Erin Bascom

Data and Surveillance: Leveraging Community-level Risk Information and Geo-mapping to Assess Vulnerability for HCV and HIV

  • Description: Health departments strive to better understand where HCV and HIV co-occur but face challenges when surveillance data does not exist or data systems do not align. Surveillance strategies including vulnerability assessments, and tools including geographic information systems (GIS), are valuable in mapping disparate health issues and the social determinants of health that contribute to poor health outcomes. This session explores how new and existing data can be leveraged for effective identification of and resource allocation for HCV and HIV.
  • Speakers: Chip Allen (slides), Katharine Howe (slides), and Lindsey Sizemore (slides)

Data and Surveillance: Tools and Innovations in Data to Care (D2C) Approaches

  • Description: This session highlighted innovative ways that health departments use surveillance data and/or other sources of health department data to enhance linkage and re-engagement in care for HIV. The session explored an HIV program process improvement project for D2C and a walkthrough of NASTAD’s online “Data to Care Hub” and how health departments can utilize these resources for enhancing their own D2C programs.
  • Speakers: Hannah Bowen, Melissa Richards, and Rachel Kusch (slides)
  • Facilitator: Erin Bascom

Data and Surveillance (Hepatitis Pathway): Zero to Sixty: Building Hepatitis Surveillance Infrastructure

  • Description: This session used a rapid-fire method to highlight a range of presentations related to using HCV surveillance and SSP data for action. Presentations covered the role of DIS in HCV surveillance and overdose prevention, using HCV surveillance data for program planning and implementation, and evaluating an SSP to address the needs of PWUD. Jurisdictions learned about key pieces in understanding how to implement surveillance infrastructure.
  • Speakers: Amelia Prebish, Danica Kuncio, Jessica Schwartz, Sophie Lewis, and Teresa Juridico (slides)
  • Facilitator: Isabel Lechuga

Prevention Track

Prevention (Hepatitis Pathway): Models for Navigation Services

  • Description: This session highlighted the development and implementation of models for peer and community patient navigation programs for people at high risk of hepatitis and/or HIV. These programs spoke to their navigation program models and services with a focus on improving hepatitis B and C care through competent care coordination services and addressing the importance of “meeting clients where they are.” Attendees learned about strategies, resources and tools to assist navigators to help patients overcome cultural and health systems barriers to get the prevention, care and treatment services they need. Attendees had the opportunity to provide feedback on a hepatitis patient navigation program model, toolkit and training dissemination plan that will be available to national health departments in 2020.
  • Speakers: Colleen Daley Ndoye and Thomas Bertrand (slides); Nirah Johnson and Umaima Khatun (slides)
  • Facilitator: Jasmine West

Prevention: Same-Day, Pharmacy-Based PrEP Delivery and Financing

  • Description: This session compared innovative models to provide same-day PrEP and leverage pharmacist expertise in PrEP care. The models discussed increase uptake, provide the infrastructure needed to support PrEP persistence, and reduce the cost of providing PrEP care. Speakers shared cutting-edge implementation models and discussed how their programs are financing these innovative strategies
  • Speakers: Edwin Corbin-Gutierrez (slides), Marisa Ramos, and Rupa Patel (slides)
  • Facilitator: Vrushabh Shah

Prevention: Status Neutral Approaches – Opportunities in Implementation

  • Description: This session provided an overview of status neutral services navigation, a multidirectional framework originally developed by the New York City Department of Health and Mental Hygiene, for providing services after an HIV test, successes and challenges around implementation, and how such a framework can help in EtHE planning. The session highlighted jurisdictions that have successfully implemented the status neutral approach, including through program oversight and partner contract processes.
  • Speakers: Avemaria Smith (slides) and Patrick Stonehouse (slides)
  • Facilitator:  Jennifer Flannagan

Tools and Resources

NASTAD

The following are tools, guides, and briefs provided by NASTAD:

O'Neil Institute 

The following are tools, guides, and briefs provided by the O'Neil Institute:

The ACE TA Center 

The ACE TA Center builds the capacity of the RWHAP community to navigate the changing health care landscape and help people with HIV to access and use their health coverage to improve health outcomes. Explore all the ACE TA Center resources at: targethiv.org/ace