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Data, Delivery, and Decisions as Levers for Enhancing Whole-Person Care for People Living with HIV: Lessons From the Ruth M.
Rothstein CORE Center Webinar conducted by:
National Academy for State Health Policy (NASHP) and HealthHIV
Thursday, January 26th, 2017 3:00pm - 4:00pm ET
HealthHIV Core Capabilities
• Diverse staff of professionals with HIV, HCV, and LGBT clinical, global, cultural competency, prevention, and other experience – particularly within LGBT and other underserved communities
• Numerous strategic partnerships with national and local organizations (non-profit, clinical, behavioral, political, and technological)
Capacity Building
Education & Training
Health Services Research & Evaluation
Advocacy
© 2016 HealthHIV
HealthHIV CBA Programs
Workforce Capacity Building
Municipal Leadership Capacity Building
Health Center Capacity Building
Health Department
Capacity Building
ASO/CBO Capacity Building
HIV Prevention Technical Assistance
Patient-Centered HIV Care
Model
Retention in Care Institute
• Facilitate community infrastructure development and systems coordination to ensure sustainability of HIV services
• Expand care team integration through partnership development to include non-clinical HIV prevention partners
• Demonstrate cost effectiveness and outcomes monitoring of programs to maximize strengths and efficiencies and impact health outcomes
• Promote workforce development, including training the next generation of leaders in HIV prevention
Approach of Three D HIV Prevention Program
Available for Download
Following the webinar today: • PPT Slide Deck • Webinar Recording • Q&A
www.HealthHIV.org/resources/webinars
Instant Polling & Chat Box
• Multiple Choice Polling
• Chat Box
7
Speaker Introduc/ons
8
• Marissa Tonelli, Senior Capacity Building Manager, HealthHIV
• Chiara Corso, Research Analyst, NASHP
• Carmen Sanchez, Women’s Correc/onal Health Services Administrator, the Ruth M. Rothstein CORE Center, Cook County Health & Hospitals System
• Rebecca Goldberg, Nurse Clinician, the Ruth M. Rothstein CORE Center, Cook County Health & Hospitals System
• Eduardo Alvarado, Chief, HIV/AIDS Sec/on, Illinois Department of Public Health
Introduc/on to NASHP: Who are we?
9
• 29 year old non-‐profit, non-‐par/san organiza/on • Mission: to provide a forum for state officials to work across branches and agencies of government to accelerate and implement workable policy solu/ons that address major health and healthcare issues
• Academy Members:
• Peer-‐selected group of state health policy leaders • Commitment to iden/fy needs and guide work
• Offices in Portland, Maine and Washington, DC
NASHP Case Study
10
• Why did we focus on the Ruth M. Rothstein CORE Center? • Largest provider of HIV care in the Midwest, serving over 11,000 HIV-‐posi/ve pa/ents
• Successful, culturally-‐competent “one-‐stop shopping” care model that unifies the delivery of primary and specialty care, social services, and popula/on-‐specific services
• Illinois par/cipa/on in HIV Health Improvement Affinity Group
• Data, Delivery and Decisions at the CORE Center
• Release of case study
THE RUTH M. ROTHSTEIN CORE CENTER
Carmen Sanchez, Women’s Correctional Health Services Administrator
Rebecca Goldberg, Nurse Clinician
THE RUTH M. ROTHSTEIN CORE CENTER 2020 W. HARRISON AVENUE CHICAGO, ILLINOIS 60612
THE RUTH M. ROTHSTEIN CORE CENTER
� Opened in 1998 as The CORE Center
� Founded by the Cook County Bureau of Health Services and Rush University to house the Cook County HIV Primary Care Center (1982) AND THE Cook County Women & Children’s HIV Program (1988)
� Operated by and a part of the Cook County Health & Hospitals System
� Renamed The Ruth M. Rothstein CORE Center in 2009
MISSION STATEMENT
The mission of the Ruth M. Rothstein CORE Center is to provide the highest quality care for persons affected by infectious diseases with respect, dignity, and compassion, without regard to the ability to pay, ensure a patient-centered and consumer-guided environment and to seek to better understand and to prevent these diseases through education and research.
RUTH M. ROTHSTEIN CORE CENTER
� One of the five largest HIV clinics in the United States
� Provided 17,724 primary care visits to 4,349 PLWA/HIV*
� Provided 13,630 Specialty Care visits*
� Provided 11,308 Sexually Transmitted Infection Clinic visits*
� Provided 50,000+ HIV tests through routine opt-out testing in Stroger Hospital and selected Fantus Outpatient Clinics
*FY 2016
DELIVERY SYSTEM: COMPREHENSIVE PRIMARY MEDICAL, SUBSPECIALTY, &
SUPPORTIVE SERVICES
� Medical Services include Adult & Women Primary Care, OB/Gyne, Pediatrics, Adolescent Medicine, Hematology/Oncology, Infectious Disease Consults, Neurology, Nephrology, Infusion Therapy, Dental/Oral Health, Hepatitis B & C, Psychiatry, Clinical Pharmacists, Nutrition Counseling
� Supportive Services include Medical and Supportive Case Management, Mental Health Counseling, Chemical Dependency Counseling
� Benefits Services include eligibility determination & assistance, Corrections Outreach & Linkage to Care, Legal Services (AIDS Legal Council of Chicago), Social Security counseling (Social Security Administration), Prevention & Education Services, access to Research
� Other Population-specific Clinics: Continuity of Care; HEAT with PrEP Clinic
Funding Streams
§ Total operating budget is approximately $20 M
§ CCHHS provides just over half of CORE’s operating budget
§ Most federal support is from the Ryan White program
DATA INFRASTRUCTURE AND SHARING
� Cerner (EMR) � CAREWare receives relevant information from
Cerner
� PROViDE /Illinois Department of Public Health
� WebCM-Illinois Department of Rehabilitation
PROGRAMMATIC DECISIONS
� Peer Educators and Peer Support
� Social services (e.g. Benefits Assistance, etc.)
� Specialty Services PreP
� Working with outside entities (Child Welfare, Social Security, Legal Assistance, Midwest AIDS and Education Center and AIDS Foundation of Chicago)
� Cost Effective initiatives (Trainings, mentoring with students etc.)
CLOSING THOUGHTS
� Lessons learned (offer to other health systems, other states)
� Multidisciplinary Approach to Medical Care
� Sharing Information both internally and externally
� Educational Approach both internally and externally (Nursing, Peers, Social Workers, Public Health Workers and Medical staff)
Ruth M. Rothstein CORE Center: A Model of Excellence
Eduardo Alvarado, MPH, MPAP Chief, HIV/AIDS Section
Illinois Department of Public Health January 26, 2017
Welcome
• Since 1987, IDPH HIV/AIDS Sec/on has been coordina/ng Illinois’ response to the Epidemic
• Annual Number of Clients Served in Illinois: – 200,000 clients served through Preven/ve Svcs – 8,500 clients receive RW, ADAP or CHIC Svcs
• Long Standing Partner of CCHHS and CORE
IDPH HIV/AIDS SecBon
Ryan White
ADAP
Enhanced Case Management
Clinical Educa/on & Training
Integrated HIV Planning Group
HIV Preven/on
HIV Counseling and Tes/ng
Surveillance & Epidemiology
Provide Enterprise System
eHARS Surveillance System
IDPH HIV/AIDS SecBon Funding
State of the State
• New Illinois General Assembly • Pending State FY17 Budget • Pending Union Contract • Changes to Policies and Procedures:
– Grants (GATA) – Procurement – Hiring/CMS Grading
CORE: A Model of Excellence
• Pioneer in Chicago’s HIV/AIDS Landscape • Evolu/on of Care Delivery Model
– HIV and Ambulatory Care – County Care (Pre-‐ACA) – ACA Enrollment & Naviga/on – Adolescent and Young Adult Medicine Clinic (AYAC)
• Same Gender Loving AYAC Clinic – PrEP Champion and Naviga/on – Expanded HCV Treatment – Peer Educator Program
CORE: A Model of Excellence • Con/nuum of Exemplary HIV/STI/TB Care
– Research and data-‐driven program development – Leaders in HCV Treatment – ACA/FQHC/MCH enrollment naviga/on – Mental Health & Substance Abuse Services
• Community Engagement – CAPUS (peer shadowing) – Community Health Worker Program – Integrated Planning Body (Chicago and IL State) – Community Advisory Board
Future OpportuniBes • Enhancing HIV Con/nuum of Care
– Surveillance Driven Care + Preven/on – Dispari/es in Access and Care – IDPH Partnered Opportuni/es (HIV/OWHFS, i.e.) – Intersec/ng LGBTQ and HIV/AIDS Care needs
• CMS-‐Medicaid Affinity Group • Ryan White & Medicaid Standards of Care
• Illinois Gehng to Zero & PrEP Expansion
• Opioid Epidemic
31
Discussion Please use the web chat to ask ques/ons!
32
Wrap-‐Up
33
Thank you for joining today!
Please complete the webinar evaluaBon at: hmps://www.surveymonkey.com/r/MXFPMZT
If you have quesBons about today’s webinar,
email Shayna Linov ([email protected]) or Chiara Corso ([email protected]).
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