Future Directions of HIV/STD Programs

Transcription

1 Future Directions of HIV/STD Programs Julie M. Scofield, Executive Director 2012 Annual NNPTC Meeting August 28, 2012 Denver, Colorado Presentation Overview NASTAD Overview NASTAD Policy, Program and Technical Assistance Priorities Future Directions Questions and Answers 1

2 NASTAD Overview NASTAD is an international non-profit association of U.S. state health department HIV/AIDS program directors who administer HIV/AIDS and viral hepatitis programs funded by U.S. state and federal governments. NASTAD was established in 1992 as the voice of the states. NASTAD is governed by a 20 member, elected Executive Committee charged with making policy and program decisions on behalf of the full membership. NASTAD has a Washington, DC headquarters with 38 staff and field offices/programs in Bahamas, Botswana, Ethiopia, Haiti, Trinidad, South Africa and Zambia with 65 staff. Mission and Vision Mission NASTAD strengthens state and territory-based leadership, expertise and advocacy and brings them to bear on reducing the incidence of HIV and viral hepatitis infections and on providing care and support to all who live with HIV/AIDS and viral hepatitis Vision NASTAD s vision is a world free of HIV/AIDS and viral hepatitis 2

3 State Health Department HIV/AIDS Programs Prevention HIV Testing Linkage to Care Retained in Care/ART Virally Suppressed Prevention for High- Risk negatives Prevention with Positives Syringe Service Programs Condom Distribution Partner Services HIV/AIDS Programs Prevention and Treatment of STDs Care Support Services Primary Care ADAP & Insurance Continuation Disease Surveillance Planning, Evaluation & Quality Assurance Policy Capacity Building & TA Public Information NASTAD Overview Domestic Policy, Program and Technical Assistance Health Care Access Health Equity HIV Prevention and Surveillance Policy and Legislative Affairs Viral Hepatitis Global Technical Assistance 3

4 NASTAD Technical Assistance NASTAD uses many mechanisms to communicate, inform, educate and collaborate with our state health department members and their staff. NASTAD s approach is organic, customized and member driven. Mechanisms for delivery include: Peer-to-peer technical assistance Surveys and program assessments Meetings Coalition activities Policy and advocacy activities Issue briefs and policy statements Trainings and webinars Work groups, committees and various listservs Affordable Care Act (ACA) implementation Advocating to protect ACA and for full implementation Medicaid and Exchanges Providing TA to state AIDS Drug Assistance Programs (ADAPs) to prepare for implementation Assessing the short and long term impacts on Ryan White systems Participating on PACHA work group on access to care and the future of Ryan White Working with ASTHO and CDC to prepare health departments for billing and reimbursement for preventative services - HIV and HCV screening 4

5 Access to care and treatment during ACA implementation Advocating continuation of Ryan White to ensure that all critical RW services continue while clients with new sources of coverage transition Advocating for RW and ADAP funding to keep the doors open Working with the Clinton Health Access Initiative (CHAI) and HarborPath to ease access to industry Patient Assistance Programs Providing TA to strengthen health department/community health center collaboration National HIV/AIDS Strategy Providing input and recommendations to HHS on Core Indicators and reducing reporting burden Issued policy statement, National HIV/AIDS Strategy Imperative: Fighting Stigma and Discrimination by Repealing HIV-specific Criminal Statutes (2011) Conducted an assessment of state HIV criminalization policies and procedures and issued guidelines for their review and modification along with a sample survey assessment for states to better assess these practices Conducted a webinar for members 5

6 Funding Advocating for President Obama s budget and proposed increases for HIV/AIDS and viral hepatitis programs Talking with OMB on impact of ACA on categorical funding Educating on the impact of sequestration and its 8 percent cut to all our programs Advocating for lifting the ban on federal funds for syringe exchange programs Providing peer-based TA on implementation of the new CDC health department HIV prevention FOA (PS ) Conducted five delegation (twinning) site visits that included 14 states between March May 2012 Working with groups of 2 to 3 states to plan agenda for meetings focused on key elements of the new coags Participating in CDC Post Award Assessment Site Visits (3 to date) Providing on-going follow-up with the visited jurisdictions to provide intensive support on implementing PS Convening a listserv and facilitating peer TA with the Category C grantees whose activities include using surveillance data to improve programming 6

7 Updating the National HIV Prevention Inventory (NHPI) Originally released in 2009, the NHPI will be a series of reports based on data from modular assessments. The first report on health department HIV testing is due to be released any day now - the second assessment on HIV funding will be released in the late Fall. Future modules include: Integration and Collaboration, Evidence-based Interventions and Stakeholder Engagement. Linking with CSTE s HIV surveillance coordinators work group Developed joint recommendations for the new HIV surveillance FOA Focused TA and policy to address health equity Issued NASTAD/NCSD Statement of Urgency on HIV/STDs among gay men/msm (2010) Convene Gay Men s Health Equity Work Group with focus on health department evidence based, combination approaches and sharing best practices Implementing MAC AIDS Funds NCSD/NASTAD initiative assessing stigma in public health practice among Black and Latino MSM Working with 8 states to identify and build the capacity of indigenous organizations serving Black gay men 7

8 Issued policy statement, Promoting Injecting Drug User Health (2011) Recently released Syringe Services Program (SSP) Development and Implementation Guidelines for State and Local Health Departments Conducting second cohort of Minority Leadership Program (MLP) MLP is a year-long program to build the leadership and management skills of junior and/or mid-level minority staff identified as emerging and future leaders of state and local health department HIV/AIDS and viral hepatitis programs Participants complete program modules in leadership and vision; history of HIV/AIDS; coalition building and advocacy; programmatic strategic planning; program management and change management; and communication styles and conflict resolution 8

9 Future Directions The HIV Treatment Cascade The new framework for seeing where we are and where we need to be. HIV prevention other than testing may be vulnerable in a test and treat environment. Individual states are replicating the cascade with statespecific data. The drop off from linked to retained in care is alarming. Implementation of ACA should be viewed an opportunity to improve the cascade. Health Care Reform and ADAPs 9

10 Elections 2012 Every public health decision rests on a political decision. William H. Foege, MD, MPH Questions? Julie M. Scofield Executive Director National Alliance of State & Territorial AIDS Directors (NASTAD) 444 North Capitol Street NW, Suite 339 Washington, DC Phone: jscofield@nastad.org 10