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DHWDC News
News Updates from the Michigan Department of Community Health, Division of
Health, Wellness and Disease Control (DHWDC)
HIV National Test Day Mini-Grant Opportunity
For the second year in a row, HAPIS/DHWDC will provide “mini-grants” to
agencies that propose innovative testing events targeted to persons at risk for
Human
Immunodeficiency Virus (HIV). The purpose of this funding opportunity is to
encourage adoption of innovative strategies employed in conjunction with NTD
events, designed to raise awareness about the impact of HIV/AIDS, the importance
of knowing one’s HIV status and to encourage people at high risk for learning
their HIV status through voluntary testing. Special emphasis is placed on
reaching African Americans and hard-to-reach populations (e.g., transgender
persons).
Available Funds - HAPIS/DHWDC expects to award up to $8,000 through this
mini-grant process. The award maximum will be $500 per event. Mini-grant funds
can be spent only for National HIV Testing Day related activities and events.
These events must take place on or around National HIV Testing Day. Applicants
may apply for two mini-grants, providing that each application relates to a
separate event.
HAPIS/DHWDC will provide in-kind supplies including HIV testing supplies and
condoms for agencies who submit a plan of action, regardless of whether they
apply for the mini-grant funds. See the
letter and
application form.
Return this application no later than Monday March 31, 2008.
Winter 2008 DHWDC News
from Michigan HIV & STD News Winter 2008
Continuum of Care Unit (COC)
By instituting a variety of cost saving measures, the Michigan Drug Assistance
Program (DAP) saved $1.2 million in 2007.
In 2006, the DAP faced an $800,000 budget shortfall for the first time in
program history. Creation of a waiting list for persons needing HIV medications
was a possibility. In an effort to continue serving the maximum amount of DAP
eligible individuals in the State, drug formulary management measures were
implemented in late 2006. These included a mandatory generic program, and a step
therapy program for certain classes of drugs, which ensures that less expensive
and therapeutic equivalent medications are used before more expensive therapy.
The DAP continued to manage the formulary closely in 2007 with the assistance of
the Pharmacy Benefits Management company, Rx America, and instituted a specialty
medication program with Diplomat Specialty Pharmacy for some high cost
medications.
The DAP is funded with federal resources, from the Ryan White HIV Treatment
Modernization Act of 2006, which are required to be used as a payment of last
resort. Patients receiving assistance from DAP are not eligible for any other
prescription coverage. As patients do become eligible for other insurance
coverage, they are moved off the program.
The Adult Benefit Waiver (ABW), one such type of insurance, provides medical
coverage to persons who may not meet the eligibility threshold of Medicaid. ABW
is open only to new applicants periodically as funds allow. An opening on
December 1, 2007 and a collaborative effort between HAPIS staff and CBO case
managers allowed the move of fifty of the 2,300 current DAP clients, which will
save the DAP $595,000 over one year. In addition, the ABW provides coverage for
office visits, diagnostic testing and hospitalization that the DAP is not able
to cover.
Michigan Dental Program (MDP)
MDP currently has 1,419 clients on the program receiving dental care. The fees
for preventive dental care and specialty care have been increased. This is the
first time the fees have been adjusted since the program began. It is hoped this
change will encourage more dental providers to join the program.
If you have any individuals in need of dental services please feel free to
contact the MDP office at 1-888-826-6565 for more information.
Community Partnership Prevention Unit
Social Networks Strategy Training
In October 2007, HAPIS sponsored a Centers for Disease Control and
Prevention (CDC) Training of Trainers on Social Networks Strategy (SNS).
Thirteen participants from five state health departments attended the training
facilitated by Cicatelli Associates. Four individuals from Michigan attended,
including three HAPIS staff members from the Community Partnerships Unit and the
Education, Training, and Resource Development Unit.
CDC has endorsed Social Networks Strategy as a community-based approach for
identifying persons with undiagnosed HIV infection. The strategy consists of
enlisting HIV-positive or high-risk HIV-negative persons who encourage people in
their network to be tested for HIV.
In a two-year CDC-funded demonstration project, agencies achieved an average of
6% seropositivity rate using SNS as a recruitment strategy for Counseling,
Testing and Referral (CTR). This prevalence rate is six times higher than the
average of most publicly-supported CTR programs. HAPIS expects to roll out
trainings on SNS in early spring (see Training Section).
MHAC A4C Legislative Training
The African American AIDS Advisory Committee (A4C) of MHAC had to cancel the 3rd
Legislative Training scheduled in December due to lack of registration. The
training will be rescheduled for 2008. (Check on the website’s In the News
page.)
The Michigan League for Human Services will facilitate the training. All A4C and
MHAC members are invited to attend. For more information, please contact Robin
Orsborn at 517-241-5936 or
orsbornr@michigan.gov .
Expanded HIV Testing For Minorities
The Michigan Department of Community Health (MDCH) was awarded $1,039,923 to
support expansion of HIV testing in health care settings to address
racial/ethnic disparities in access to HIV testing, particularly in African
American communities. Grants have been awarded to Advantage Health Centers of
Detroit, Henry Ford Health Systems Emergency Department, Oakland County Health
Division, and Wayne County Jail Health Services.
Funding for these efforts was made available through a grant from the U.S.
Centers for Disease Control and Prevention (CDC). Michigan was one of 23 states
selected by CDC to receive funding to increase HIV testing among populations
disproportionately affected by HIV, primarily African Americans. The main focus
of funding is on making HIV testing a routine part of health care services
provided in community health centers, hospital emergency departments, sexually
transmitted disease clinics and correctional health facilities.
STD Section
The Michigan Infertility Prevention Project (IPP)
Chlamydia and gonorrhea infect thousands, mainly those from 15-24 years of
age, in Michigan every year. If not discovered early, significant public and
private health care resources are expended to manage costly complications.
Fortunately, Michigan has a robust program to provide for early diagnosis and
treatment.
In July 2007, an analysis was done to calculate health care costs avoided as a
result of this screening program. In 2006, IPP screening saved well over $10
million due to cases of Pelvic Inflammatory Disease (PID) prevented.
In 2003, the STD Section saw an opportunity to better target finances for the
IPP screening program. At the time all specimens submitted to the Michigan
Regional Laboratory System (MRL) for chlamydia (CT) testing were tested
simultaneously for gonorrhea (GC). However, only 28 of Michigan’s 83 counties
had a prevalence rate of over 1% among GC specimens submitted to the MRL.
Considering the low positive predictive value of the GC test in low-prevalence
jurisdictions, and the potential cost savings associated with the CT-only test,
Michigan decided to adopt a CT-only testing algorithm. Under the algorithm,
counties with GC prevalence of < 1% in public sites were designated for CT-only
testing. A positive CT result automatically triggers GC testing of the same
specimen in these areas.
Today, two years after implementing the CT-only testing algorithm, data has been
analyzed to determine the impact of this decision on disease prevalence and IPP
costs in Michigan. In 2003, 83,140 combined CT/GC tests were performed in
Michigan’s publicly funded IPP sites. Of those 2,052, or 2.9% were positive for
GC. In 2006, following the implementation of the CT-only algorithm, the number
of specimens tested for GC decreased 5% to 78,818. However, among these tests,
4,094 cases (5.2% positivity) of GC were identified, an increase of 67% from
2003 (p<0.00001). During the same time period, the number of specimens tested
for CT increased 20% from 82,681 in 2003 to 98,698 in 2006. CT positivity
increased from 8.6 to 10.3% (p<0.00001).
Utilizing the CT-only test for specimens from low prevalence jurisdictions
increased the availability of testing and detected more positives while holding
program costs in check. For more information contact Michigan’s IPP Coordinator,
Amy Peterson, at 313-456-4425 or
petersonam@michigan.gov .
Health Disparities Section
Check Up! or Check Out! (CUCO)
This African American Male Health Initiative (CUCO), was established to
address a growing epidemic in the state of Michigan and nationally - the
disproportionate morbidity and premature death of African American men.
The over arching goal of CUCO is to increase the utilization of preventive
health care services by African American men. To date CUCO has had success in
both the clinical and community intervention strategies that were formulated to
combat racial and ethnic health disparities.
One notable success is that by encouraging African American males to engage in
preventive health care in Detroit, CUCO has lowered the cost of care for
providers by reducing unnecessary emergency room visits, as well prolonged
treatment costs for detection in latter stages of disease.
The goal for 2008 is to expand the CUCO initiative to both Kent and Muskegon
counties in West Michigan.
See
Fall News Archives |
