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DHWDC News Archives
News Updates from the
Division of Health, Wellness and Disease Control (DHWDC) of the Michigan
Department of Community Health (formerly DHAS)
THE STRATEGIC PLAN FOR THE (former) DIVISION OF HIV/AIDS-STD
http://www.michigan.gov/mdch/0,1607,7-132-2940_2955_2982-72257--,00.html
See Archived News
Fall 2006
STD Section - New Vaccine
As reported in the Spring-Summer Issue, the FDA approved the vaccine,
Gardasil ® that protects against four strains of Human Papillomavirus (HPV). Two
of these strains cause 70% of diagnosed cervical cancer and two cause 90% of
genital warts in the United States. A second vaccine, developed by
GlaxoSmithKline, is not yet approved.
The implications from the Advisory Committee on Immunization Practices (ACIP)
recommendations released in June include several issues which will affect the
public health response and implementation. This vaccine targets young females to
prevent a sexually transmitted infection. This will result in attention to
issues such as parental consent, as well as appropriate venues and providers for
administration of vaccine. Contact: Kris Judd (JuddK@michigan.gov)
Detroit STD Surveillance and Intervention (DSTDSI) Program
The Detroit STD Surveillance and Intervention (DSTDSI) Program goal
currently is to decrease primary and secondary syphilis by 50% for year end,
2006. June figures indicated a 16% decrease so far. Notable is a reduction in
self-identified men who have sex with men (MSM) cases this year (11 last year
compared to 7 this year).
Community Contracts
The DSTDSI Program contracts with four (4) community based organizations
to provide STD education, outreach, and screening. These agencies target MSM,
substance abuse clients, adolescents age 15-19, high morbidity areas, and
persons in custody settings. Reported activities 1/06 - 6/06 revealedSTD
prevention services were provided to 1,489, with three cases identified for
field investigation and treatment from only one agency.
Electronic Reporting
Electronic reporting of positive STD reports (gonorrhea, chlamydia, and
syphilis) by laboratories is close to fruition with the Detroit Medical Center (DMC)
Laboratory, the largest reporter of STDs in the City of Detroit. The DSTDSI
Program hopes to start piloting this process in September and begin reporting of
STDs electronically on a permanent basis within 30 days after that.
The greatest advantage of electronic reporting for public health is the
timeliness of receiving reports. In addition, reports will now be more accurate
and complete, and will include patient demographics, as well as provider
information.
Partner Counseling and Referral Services (PCRS)
As reported in the Spring-Summer Issue, twenty-nine local public health (LPH)
jurisdictions have been designated as low HIV/STD morbidity health areas.
Through contractual agreement, the Central Michigan District Health Department (CMDHD)
assumed the responsibility to provide HIV positive test notification, PCRS and
syphilis investigation andcase management support to these areas.
An assessment of CMDHD’s efforts to date indicates that they are hard at work
helping to prevent the further spread of syphilis and HIV. A total of 109 HIV+
cases were referred to the CMDHD staff, and 93 (85%) received PCRS. A total of
74 at-risk partners were identified and referred for investigation throughout
various health jurisdictions.
The Department appreciates the efforts extended by all 29 low-morbidity
jursdictions, MDCH support staff, and especially the work by the CMDHD staff in
this health initiative.
Continuous Quality Improvement Management Unit
Quality Assurance
The Quality Assurance/Technical Assistance staff for funded local health
departments has completed visits in the last six weeks to Allegan, Berrien, and
Muskegon county health departments.
The visit to Muskegon County Health Department discovered that its program is
truly in a unique slot among its peers: it has an ambitious outreach program
where staff collaborate with other social and health services and provide HIV
counseling, testing and referral (CTR) in drug treatment, juvenile detention,
men’s rescue mission, transitional living, and youth services programs.
Ann Richards spearheads this effort and provides CTR. The agency has higher than
average return rates overall, as well as for positives (100% for the first six
months of 2006), and high risk clients ested (approximately 80%).
Continuum of Care Unit (COC)
PWA Needs Assesment
This summer over a hundred people living with HIV/AIDS (PWAs) discussed
their current care service needs at the seven open forums held around the state.
In addition, a PWA Survey gathered more detailed information. All data collected
will be used in the Care RFP, scheduled to be released in spring 2007.
Title IV Program
The Title IV Program, part of COC since May, has recently undertaken a campaign
to educate pregnant women on the importance of HIV testing in pregnancy and
providers on the Public Health Code. Both provider and consumer focused
brochures are being disseminated statewide. In addition, “Improving the Odds”
has been sent to physicians throughout the state.
Drug Assistance Program (DAP)
As of July 20, 2006 the DAP has 1,906 clients on the program. The
Michigan DAP renewal time period ended on March 31.
This year there were a few new factors that complicated the process of renewing
for DAP eligible clients, including the confusing Medicare prescription drug
coverage. Also the state’s open enrollment in June for the Adult Benefits Waiver
Program allowed over 30 people to be taken off of the DAP due to enrollment into
the ABW.
The DAP Formulary Committee has quarterly conference calls to discuss formulary
changes. In June 2006 the Formulary Committee called a special meeting to
discuss resource maximization.
As a result of that meeting the DAP has gone to a mandatory generics formulary.
DAP is currently developing prior authorizations for three drugs, including use
of a specialty pharmacy, and will be implementing quantity maximum refills and
step therapy for certain classes of drugs. DAP eligibility criteria will not
change at this time.
Michigan Dental Program (MDP)
As of July 20, 2006 the MDP has 1,418 clients on the program. Due to
increased enrollment, limited fiscal resources, and the availability of adult
dental services through Medicaid, the MDP closed enrollment effective May 1,
2006. Medicaid eligible MDP clients have until September 30, 2006 to complete
their treatment plan. For more details on changes to the program contact Kelly
Clevenger ( ClevengerK@michigan.gov
).
Education, Training and Resource Development Unit (ETRDU)
Module Training Revisions
ETRDU is in the process of rolling out the revisions that have been made
to the module trainings. The Unit is now in the observation stage to make
adjustments where necessary.
Adherence Training
The adherence curriculum is nearing completion. This project is the first of
three parts focusing on the ways that different professionals working with PWA’s
can help to promote medication adherence with their patients/clients. The first
part focuses on case managers. Subsequent curricula will focus on clinicians and
PWA’s. There will be a meeting presentation with key stakeholders in September
to get feedback and support for the curriculum. A pilot is planned for October.
STD Trainings
The STD Training Needs assessment conducted by the training unit has
been completed. Two topics, STD Management and Viral STD’s and Syphilis, will be
offered multiple times in various parts of the state. See the
Training Calendar.
Spanish-Language Module Trainings
The first advisory meeting for the development of Spanish-language
module trainings took place in May. This initial meeting yielded useful
information and staff look forward to working with community members to making
this a reality. Contact: Kimberly Snell at (313)
456-3394 or (SnellK@mich-igan.gov ).
Quality Assurance Training C & T
In June, staff representing ETRDU, CPU and Quality Assurance
participated in a training facilitated by Ellen Ives on conducting direct
observation and chart review for quality assurance of counseling and testing.
Tools and protocol associated with the project will be piloted this summer in
community-based organizations. The plan is to implement direct observation and
chart review in all funded agencies, including local health departments over the
next year. Contact: Amy Peterson at (313) 456-4425 or
petersonam@michigan.gov .
Community Partnerships Prevention Unit (CPU)
National HIV Test Day
This year marked the 25 year anniversary of HIV/AIDS. In Michigan,15
community-based organizations (CBOs) and 16 LHD participated. Provisional data
indicates that approximately 1,120 clients tested with 980 (88%) returning for
post-test counseling. A complete National Test Day 2006 report will be available
mid September. Contact: Sue Crandall
crandallsue@michigan.gov .
Rapid Testing
In partnership with the Bureau of Laboratories, the CPU completed an
investigation of false positive results associated with oral fluid testing using
OraQuick Advance rapid HIV tests. Based on the findings of the investigation,
they have recommended to agencies providing rapid HIV testing that they use
whole blood obtained via finger stick or venipuncture, rather than oral fluid,
if at all possible for rapid HIV testing. MDCH will continue to monitor false
positive results and make adjustments to this recommendation as appropriate.
Contact: Liisa Randall at (517) 241-5924.
DHWDC News Archives Summer 06
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