Introduction - The AIDS Institute...delivered by CBOs and CHDs which contain information and messaging around HIV testing FDOH – HIV/AIDS Section (Prevention) Objective 1.2.: By

Proposed Revision Summary: Florida Integrated HIV Prevention and Care Plan Activity Table

Fall 2019

Introduction In managing and monitoring The Florida Integrated HIV Prevention and Care Plan, revisions are

recommended for the plan’s activity table. The recommendations include rewording, removing,

or combining activities were duplicate, unmeasurable, listed incorrect metrics/data indicators,

listed incorrect responsible parties, or were routine.

In reviewing the proposed revisions, please use the following legend to identify the changes

made throughout the corresponding activities table.

• Duplicate item: __________ Activity is found elsewhere in activity table

• Routine activity: __________ Activity is business as usual, part of routine operations

• Combined activities: __________ Items joined together to form a more comprehensive

activity

Summary of Revisions For ease in reviewing, a summary of activity revisions is listed below for each NHAS goal.

NHAS Goal 1

Duplicate

1.1.A.5 1.1.B.10 1.3.B.3 1.1.C.3 1.2.C.5 1.2.B.9 1.2.C.6

Routine

1.1.A.1 1.1.B.6 1.2.B.5 1.2.C.3 1.3.C.2 1.1.B.1 1.1.C.4 1.2.B.6 1.2.C.4 1.1.B.2 1.2.B.1 1.2.B.8 1.2.C.7

Combined

1.1.A.6 and 1.1.A.8 → 1.1.A.5 1.3.A.3-1.3.A.5 → 1.3.A.3 1.1.B.3 and 1.1.B.4 → 1.1.B.2 1.3.C.3-1.3.C.5 → 1.3.C.2 1.2.B.2 and 1.2.B.3

NHAS Goal 2

Duplicate

2.1.B.5 2.2.C.4 2.4.B.3 2.5.A.6 2.5.E.3 2.2.B.7 2.2.C.5 2.5.A.3 2.5.E.1 2.2.C.3 2.2.C.6 2.5.A.4 2.5.E.2

Proposed Revision Summary: Florida Integrated HIV Prevention and Care Plan Activity Table

Fall 2019

Routine

2.1.A.3 2.3.C.7 2.1.B.3 2.3.C.8 2.3.C.4

Combined

2.1.B.1 and 2.1.B.2 → 2.1.B.1 2.4.A.2-2.4.A.5

NHAS Goal 3

Duplicate

3.1.B.8 3.2.C.3 3.2.A.4 3.2.A.2 3.2.B.9 3.2.A.3

Routine

3.1.B.2 3.1.B.9 3.2.B.3 3.2.C.2 3.1.B.3 3.1.C.3 3.2.B.4 3.1.B.6 3.1.C.7 3.2.B.7

Combined

3.2.A.2 and 3.2.A.3 3.2.B.10 and 3.2.B.11

Rev 2.2 1

Appendix 8: Integrated Plan Activity Table

Status Activity Target Population Data Indicators Responsible Parties

NHAS Goal 1: Reducing new HIV infections

Objective 1.1: By December 31, 2021, increase the proportion of HIV-infected persons who know their serostatus from 87.2% to 90%

Strategy 1.1.A.: Expand routine HIV screening in health care settings (for example, hospitals, health centers, and emergency departments) as part of medical care

Activities 1.1.A. (1 – 8) 1.1.A.1 - Identify qualifying health care settings that do not offer routine HIV screenings and provide them information on the need and process of offering the service

Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Acute reports and logs, meeting/call agendas and notes FDOH – HIV/AIDS Section (Prevention,

Medical, Data Integration)

1.1.A.2 - Develop monitoring and evaluation plan, to include data collection, quality assurance measures and feedback loops


Final monitoring and evaluation plan FDOH – HIV/AIDS Section (Prevention, Medical, Data Integration)

1.1.A.3 - Develop toolkits and resources to assist healthcare providers with implementation of routine HIV screening


Final toolkits disseminated to CHD clinics and other healthcare providers FDOH – HIV/AIDS Section (Prevention);

AETC

1.1.A.4 - Provide training to DOH early intervention consultants (EICs) and ensure they have the skillset necessary to provide technical assistance to healthcare providers in their local areas


EIC face-to-face training materials (including sign-in sheets and agendas)

FDOH – HIV/AIDS Section (Prevention)

1.1.A.5 - Provide outcomes of the expanded testing initiative (ETI) to encourage other hospitals, health centers and emergency departments to begin routine HIV screening in their facilities


ETI outcomes summary dissemination log (emails)

FDOH – HIV/AIDS Section (Prevention); AIDS Education and Training Center (AETC)

1.1.A.6 - Educate healthcare providers and healthcare facilities on the “opt-out” HIV screening law, rule and model protocols through collaboration with the AIDS Education and Training Center (AETC)


AETC outreach reports (with evidence of opt-out training) FDOH – HIV/AIDS Section (Prevention,

Medical); AETC

1.1.A.7 - Provide education and training to DOH staff and community providers through consortia meetings, conference calls, town halls, etc.


Meeting/call agendas and notes


1.1.A.8 - Attend healthcare provider meetings (e.g., Florida Medical Association, Florida Hospital Association, other association meetings), grand rounds, etc. to provide education


Meeting agendas and notes FDOH – HIV/AIDS Section (Prevention, Medical); AETC

Strategy 1.1.B.: Effectively identify and test individuals in populations at highest risk

Activities 1.1.B. (1 – 6)

1.1.B.1 - Use statewide data to target areas and communities with highest incidence of HIV infection for HIV testing


HIV/AIDS surveillance data FDOH – HIV/AIDS Section (Prevention, Surveillance, Data Integration)

Commented [KBN1]: Combined 1.1.A.6 and 1.1.A.B to make 1.1.A.5 in revised table

Rev 2.2 2

1.1.B.2 - Encourage and support health department and non-health department providers to increase the number of persons diagnosed with HIV through strengthening current HIV testing efforts and creating new services that include homeless and incarcerated populations


EIC updates from local areas


1.1.B.3 -Maintain the provision of partner services (PS) to HIV-infected individuals and ensure social and sexual networks of HIV-infected persons are offered testing and counseling


PRISM reports showing # of HIV-positive individuals receiving PS and # of partners of HIV-positives offered testing

FDOH – HIV/AIDS Section (Prevention); STD and Viral Hepatitis Section

1.1.B.4-Maintain current system for tracking individuals with acute HIV infection and continue to provide follow-up to the respective areas to ensure individuals and partners are tested


Acute reports and logs; follow-up correspondence from local CHD and DIS; PRISM records

FDOH – HIV/AIDS Section (Prevention); State Laboratories; STD and Viral Hepatitis Section

1.1.B.5- Explore new testing technologies that may simplify testing and lead to increased access, or early diagnosis and diagnosis of acute HIV infection


Resource materials on the latest testing technologies and supporting literature


1.1.B.6 - Provide technical assistance and guidance to HIV testing providers on integrating HIV testing with other STDs, HCV and TB


EIC updates from local areas; HIV Testing Team correspondence to local area providers


1.1.B.7 – Open new testing facilities to include outlying counties Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

EIC updates from local areas; HIV Testing Team correspondence to local area providers


Strategy 1.1.C.: Reduce stigma in communities and among providers around HIV testing to increase test acceptance and build social norms in high-risk populations to increase health care seeking behavior

Activities 1.1.C. (1 – 4)

1.1.C.1 - Develop and expand social marketing/media campaigns and statewide education initiatives that focus on increasing HIV testing and decreasing stigma


Number of social materials and educational materials supporting HIV testing


1.1.C.2 - Ensure at least 90% of statewide social marketing/educational materials developed by the DOH contain an HIV testing message


Number of social marketing/educational materials containing an HIV testing message


1.1.C.3 - Provide education and training to providers on the latest testing technologies and ways to increase testing acceptance within their organizations


Number of trainings conducted by EICs and HIV Testing Team staff


1.1.C.4 - Ensure behavioral interventions for high-risk populations delivered by community-based organizations and health departments contain information and messaging around HIV testing


Number and types of interventions delivered by CBOs and CHDs which contain information and messaging around HIV testing


Objective 1.2.: By December 31, 2021, reduce the annual number of newly diagnosed HIV infections in Florida from 4,613 (2014) to 4,004

Strategy 1.2.A.: Ensure universal access to and availability of pre-exposure prophylaxis (PrEP) and increase awareness of non-occupational post-exposure prophylaxis (nPEP)

Activities 1.2.A. (1 – 7)

1.2.A.1 - Identify key factors for providers and health care settings not providing PrEP/nPEP in order to mediate the causes where possible and allow an expansion of providers

Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women

Inventory of PrEP/nPEP providers, acute reports, meeting/call agendas and notes

FDOH – HIV/AIDS Section (Prevention, Medical, Data Integration)

Commented [KBN2]: Combined 1.1.B.3 and 1.1.B.4.

Commented [KBN3]: Reworded to 1.1.B.2 in revised table

Commented [KBN4]: Changed wording of this objective to use case rate instead of numbers for ease with comparison to other states

Rev 2.2 3

Black, White, Hispanic IDU

1.2.A.2 - Develop a statewide inventory of providers who are able and willing to prescribe PrEP and nPEP


Inventory of PrEP/nPEP providers

FDOH – HIV/AIDS Section (Prevention, Medical)

1.2.A.3 - Develop toolkits, guidelines and other resources to assist health department and community-based organizations in implementing PrEP and nPEP clinics


Inventory of PrEP/nPEP resources FDOH – HIV/AIDS Section (Prevention, Medical)

1.2.A.4 - Provide education and training to healthcare providers, hospitals, emergency departments and sexual assault nurses on the delivery of nPEP


Number of trainings provided to healthcare providers and settings on the delivery of nPEP

FDOH – HIV/AIDS Section (Medical, Prevention); AETC

1.2.A.5 - Expand the use of PrEP navigators in counties/areas with active PrEP clinics


Inventory of PrEP/nPEP navigators in areas with active PrEP clinics FDOH – HIV/AIDS Section (Prevention,

Medical)

1.2.A.6 - Develop social marketing and educational materials that contain information on PrEP and nPEP (basic information, how to access, etc.)


Inventory of social marketing and educational materials FDOH – HIV/AIDS Section (Prevention,

Medical)

1.2.A.7 - Explore non-traditional ways to purchase PrEP medications Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Inventory of current purchasing methods for PrEP medications; inventory all available resources to obtain PrEP

FDOH – HIV/IADS Section (Medical, Prevention)

Strategy 1.2.B.: Ensure access to and availability of HIV prevention efforts for at-risk communities

Activities 1.2.B. (1-10)

1.2.B.1 - Expand condom distribution to target HIV-infected persons and persons at highest risk of acquiring HIV infection


Condom distribution reports (DOH and funded providers) # of condoms distributed in high risk target areas - quarterly


1.2.B.2 - Expand the Faith Responds to AIDS (FRTA) initiative to additional churches and faith-based organizations statewide


Inventory of FRTA partnerships; # of FRTA organizations - quarterly FDOH – HIV/AIDS Section (Prevention);

Statewide Minority AIDS Coordinator

1.2.B.3 - Maintain the Business Responds to AIDS/Leadership Responds to AIDS (BRTA/LRTA) initiatives through collaboration with local Minority AIDS Coordinators (MACs)


Inventory of BRTA partnerships # of BRTA businesses - quarterly FDOH – HIV/AIDS Section (Prevention);

Statewide Minority AIDS Coordinator

1.2.B.4 - Maintain partnership with the Department of Education to ensure, where possible, HIV/STD information is provided in school setting


Meeting minutes/summaries; inventory of schools providing HIV/STD education This should probably be removed because this happens at the local level. School districts have autonomy.

FDOH – HIV/AIDS Section (Prevention); Department of Education

1.2.B.5 - Maintain the Peer Education Program with the Department of Corrections to train inmates as peer educators for HIV/STDs in the correctional setting


Current MOA with Department of Corrections

FDOH – HIV/AIDS Section (Prevention); Department of Corrections

1.2.B.6 - Maintain the Targeted Outreach for Pregnant Women (TOPWA) provider network to educate pregnant women in high-risk communities about HIV/STDs

Black, White, Hispanic MSM Black Hetero Men and Women

List of TOPWA providers in network FDOH – HIV/AIDS Section (Prevention)

Commented [KBN5]: Moved to Goal 3

Rev 2.2 4

Hispanic Hetero Men and Women Black, White, Hispanic IDU

# of providers in network. They try to maintain 7 providers each year.

1.2.B.7 - Increase individual, group and community-level evidence-based interventions through partnerships with health departments, health care providers and community-based organizations to include on-site HIV screenings


Inventory of providers implementing individual, group and community-level evidence-based interventions Recent prevention RFA helped accomplish this. 44 agencies funded 2019-2022.


1.2.B.8 - Incorporate Treatment as Prevention (TasP) messaging and education in social marketing and educational materials developed by the DOH


Inventory of current resources/materials for TasP

FDOH – HIV/AIDS Section (Prevention, Patient Care, Medical)

1.2.B.9 - Increase education and training for health departments and community-based organizations around drug user health


Inventory of materials/resources related to drug user health

FDOH – HIV/AIDS Section (Prevention) This should be a local focus not dropped down from the state

1.2.B.10 - Expand the use of drop-in centers for gay, bisexual and other men who have sex with men (MSM)


Inventory of current drop-in centers We fund providers, but this should be a local strategy for implementation. # of drop-in centers in priority areas


Strategy 1.2.C.: Increase HIV awareness among members of the general public, community leaders, and policy makers

Activities 1.2.C. (1-10)

1.2.C.1 - Educate public officials on addressing policies that act as barriers to HIV prevention information and activities


Distribution logs, emails, communications with public officials FCPN needs to identify specific policies they want addressed. This is too general


1.2.C.2 - Ensure engagement of key stakeholders, advocates and other community members through the statewide HIV planning process (includes FCPN)


Minutes, agendas and attendee lists from statewide planning meetings

FDOH – HIV/AIDS Section (Prevention, Patient Care); FCPN/PCPPG

1.2.C.3 - Sustain HIV prevention outreach efforts (both traditional and Internet-based) for the general public and high-risk communities


Inventory of current outreach efforts performed around the state


1.2.C.4 - Maintain and update the Florida HIV/AIDS Hotline to include information on new prevention strategies, testing locations and treatment providers


Inventory of Hotline resources, information FDOH – HIV/AIDS Section (Prevention,

Medical, Patient Care)

1.2.C.5 - Expand education and training for health departments, community-based organizations and community leaders on the use of social determinants of health in HIV prevention


Webinars, logs and emails documenting education/training


1.2.C.6 - Expand on existing and develop new social marketing and media campaigns to raise awareness and reduce stigma of HIV


Inventory of current social marketing and media initiatives # of campaigns?


1.2.C.7 - Expand the use of social network strategy (SNS) to engage hard-to-reach social and sexual networks in HIV prevention and awareness


Current inventory of sites using SNS # of sites implementing SNS


Commented [KBN6]: Duplicate of 1.1.C.1

Rev 2.2 5

1.2.C.8 - Ensure community engagement related to HIV prevention through town halls, focus groups and community forums


Meeting reports, list and locations of community meetings # of consultation sessions with priority populations

FDOH – HIV/AIDS Section (Prevention) should be done at local level as well

1.2.C.9- Expand mobilization efforts for communities at highest risk of acquiring HIV through collaborations with health departments (Minority AIDS Coordinators) and community-based organizations.


Inventory of current statewide mobilization initiatives # of S.O.S. chapters

FDOH – HIV/AIDS Section (Prevention); Statewide Minority AIDS Coordinator

Objective 1.3.: By December 31, 2021, reduce the annual number of HIV-infected babies born in Florida from 6 (2014) to less than 4

Strategy 1.3.A.: Ensure health care providers are complying with the opt-out HIV and STI screening law for pregnant women

Activities 1.3.A. (1 – 5) 1.3.A.1 - Disseminate information regarding Florida’s opt-out HIV/STD testing law for pregnant women through medical associations, conferences, newsletters and grand rounds

Black Hetero Men and Women Hispanic Hetero Men and Women

Perinatal prevention program reports FDOH – HIV/AIDS Section (Prevention, Medical); STD and Viral Hepatitis Section; USF Perinatal Prevention Program

1.3.A.2 - Expand awareness among health departments and community-based providers on Florida’s opt-out HIV/STD testing law for pregnant women


Perinatal prevention program reports FDOH – HIV/AIDS Section (Prevention, Medical); STD and Viral Hepatitis Section; USF Perinatal Prevention Program

1.3.A.3 - Educate and provide training opportunities for OB/GYN providers through the Department’s contract with USF Perinatal Prevention Program


Perinatal prevention program reports # of providers educated # of training opportunities (up until 8/2018 because USF canceled contract at that time).

FDOH – HIV/AIDS Section (Prevention, Medical); USF Perinatal Prevention Program

1.3.A.4 - Provide technical assistance and training for perinatal providers through a contract with the University of South Florida’s (USF) Center for HIV Education and Research, Perinatal HIV Prevention Program


Training/TA logs and reports # of providers educated # of training opportunities (up until 8/2018 because USF canceled contract at that time).


1.3.A.5 - Continue to provide education and training for medical providers which provide services to HIV-infected and other high-risk pregnant women through a contract with USF


Perinatal prevention program reports # of providers educated # of training opportunities (up until 8/2018 because USF canceled contract at that time).


1.3.A.6 - Monitor cases of HIV-exposed infants to assess provider compliance with the opt-out HIV testing law


Exposed infant data, case reports; PRISM data # of provider unaware of opt-out HIV testing law (want to decrease this number)

FDOH – HIV/AIDS Section (Prevention, Surveillance, Medical); USF Perinatal Prevention Program; STD and Viral Hepatitis Section

Strategy 1.3.B.: Increase awareness among women of childbearing age about HIV testing and perinatal prevention strategies

Activities 1.3.B. (1 – 5)

1.3.B.1 - Continue to fund Targeted Outreach for Pregnant Women (TOPWA) service providers to provide HIV testing, education, outreach and linkages for HIV-infected pregnant women and those at very high risk of acquiring HIV and STDs to decrease perinatal HIV infections


Current inventory of funded TOPWA providers


1.3.B.2 - Expand social marketing and media efforts around HIV/STD testing and perinatal prevention strategies to reduce stigma and increase awareness


Inventory of current social marketing and media efforts for perinatal prevention and HIV/STD testing

FDOH – HIV/AIDS Section (Prevention, Medical); STD and Viral Hepatitis Section; USF Perinatal Prevention Program

Commented [KBN7]: Combined 1.3.A.3, 1.3.A.4, and 1.3.A.5 into revised table 1.3.A.3

Rev 2.2 6

1.3.B.3 - Expand information on Department websites regarding Florida’s opt-out HIV/STD testing law for pregnant women and perinatal prevention resources


Inventory of current information, materials and resources on Department websites

FDOH – HIV/AIDS Section (Prevention, Medical); STD and Viral Hepatitis Section

1.3.B.4 - Expand partnerships with other DOH programs (Women Infants and Children [WIC], Healthy Start, family planning clinics, etc.) to increase awareness of HIV/STD testing and other prevention services for pregnant women and identify opportunities for community mobilization


Meeting minutes with other programs to discuss potential partnerships This is being done but I’m not sure how to measure it

FDOH – HIV/AIDS Section (Prevention, Medical); STD and Viral Hepatitis Section

Strategy 1.3.C.: Ensure access to the Baby RxPress program for all women in need

Activities 1.3.C. (1 – 5)

1.3.C.1 - Evaluate usage and cost benefit of Baby RxPress program Black Hetero Men and Women Hispanic Hetero Men and Women

Baby RxPress program data # of Baby RxPress sites # of women served


1.3.C.2 - Ensure funds are available to continue expansion of the Baby RxPress program


Prevention and general revenue budget reports


1.3.C.3 – Identify accessibility and availability of the Baby RxPress program Black Hetero Men and Women Hispanic Hetero Men and Women

Baby RxPress locations and usage reports; communication with perinatal nurses and coordinators statewide # of Baby RxPress sites # of women served


1.3.C.4 - Expand the number of Walgreens locations participating in the Department’s Baby RxPress program


Current Baby RxPress locations and usage reports


1.3.C.5 - Increase visibility of the Baby RxPress program through partnerships with AETC and USF’s perinatal HIV prevention program


Marketing materials, online resources FDOH – HIV/AIDS Section (Prevention, Medical); AETC; USF Perinatal Prevention Program

NHAS Goal 2: Increasing access to care and improving health outcomes for PLWH

Objective 2.1.: By December 31, 2021, reduce the number of HIV-related resident deaths from 878 (2014) to 762.

Strategy 2.1.A.: Analyze allocation of funding (Ryan White and General Revenue) in each area to assess if funding is reflective of the proportion of the epidemic in the area and adequate to meet the demand for core services

Activities 2.1.A. (1 - 3)

2.1.A.1 - Perform an analysis to include a workgroup/”think tank” to examine cost per patient in each area and if funding meets service demand


Work group meeting minutes Hired a vendor to review and propose allocation methodology changes. It needs to be shared with FCPN.

FDOH – HIV/AIDS Section (Medical, Patient Care)

2.1.A.2 - Develop a plan to reallocate funding if necessary, based on results from funding analysis


Funding plan FDOH – HIV/AIDS Section (Patient Care, Medical)

2.1.A.3 - Seek additional resources as needed Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Meeting minutes; email records FDOH – HIV/AIDS Section (Patient Care, Medical)

Strategy 2.1.B.: Reduce barriers for linkage to and retention in care:

Activities 2.1.B. (1 - 6)

2.1.B.1 - Assess risk and protective factors to keeping PLWHA retained in/engaged in care


Semi-annual RW needs assessment survey

FDOH – HIV/AIDS Section (Patient Care, Prevention, Medical)

Commented [KBN8]: Combined 1.3.C.3 to 1.3.C.5 to revised plan 1.3.C.2

Commented [KBN9]: Changed the objective to reflect the rate instead of number.

Commented [KBN10]: Combined 2.1.B.1 and 2.1.B.2 to revised table 2.1.B.1

Rev 2.2 7


2.1.B.2 - Examine ways to streamline processes at the state and local level that pose barriers to linkage to and retention in care to include


Semi-annual RW needs assessment survey FDOH – HIV/AIDS Section (Prevention,

Patient Care, Medical)

2.1.B.3 - Promote the HIV/AIDS hotline as an informational resource for HIV-infected persons seeking entry/re-entry into medical care


Hotline report; Social marketing materials and distribution log; meeting minutes; related artifacts (sample messages/images)

FDOH – HIV/AIDS Section (Prevention, Patient Care)

2.1.B.4 - Provide training and resources to private medical providers on how to link newly diagnosed HIV-infected persons into the RW program


AETC outreach reports (with evidence of linkage training); email records from Part B office. # of trainings # of providers educated Increase in linkage/referrals from those providers?

FDOH – HIV/AIDS Section (Patient Care, Medical, Prevention); AETC

2.1.B.5 - Expand social media and marketing efforts to address stigma associated with healthcare, explain benefits of beginning medical care immediately after diagnosis, and support community mobilization


Social marketing materials and distribution log; meeting minutes; related artifacts


2.1.B.6 - Expand healthcare access points by working with community health centers, federally qualified health centers (FQHCs) and prisons to identify new HIV medical care providers and access points


List of community health centers and federally qualified health centers (FQHCs) providing HIV care

FDOH – HIV/AIDS Section (Medical, Patient Care); AETC; FL Association of Community Health Centers

Strategy 2.1.C.: Increase the number of PLWH on ART

Activities 2.1.C. (1 - 4)

2.1.C.1 - Educate HIV providers on the importance of immediate treatment after diagnosis


AETC outreach reports (with evidence of immediate treatment after diagnosis training); email records from Part B office. # of trainings # of providers educated Increase in linkage/referrals from those providers?

FDOH – HIV/AIDS Section (Patient Care, Prevention, Medical); AETC

2.1.C.2 - Provide education and resources to PLWHA on the benefits of ART and medication adherence on positive health outcomes


Social marketing materials and distribution log; CAREWare reports (if expanded to include point of care medication adherence services)


2.1.C.3 - Expand Implementation of Test and Treat programs Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Written Test and Treat guidance; logs or other records of guidance dissemination # of T&T sites statewide - quarterly

FDOH – HIV/AIDS Section (Medical, Prevention, Patient Care); AETC

2.1.C.4 - Increase the availability of nutritional counseling to educate HIV-infected clients on the importance of proper diet and nutrition


CAREWare reports # of Lead Agencies conducting counseling # of clients counseled

FDOH – HIV/AIDS Section (Patient Care, Medical)

Strategy 2.1.D.: Increase the number of medications that treat HIV-related and co-morbid conditions on the statewide formulary and ADAP formulary

Activities 2.1.D. (1 - 3)

2.1.D.1 - Work with surveillance to determine top five co-morbidities associated with HIV-related deaths and the medical team to determine appropriate treatments


Email records from surveillance; Data-at-a-Glance and other reports

FDOH – HIV/AIDS Section (Surveillance, Data Integration, Medical)

Commented [KBN11]: Combined with 2.1.C.1

Commented [KBN12]: Duplicate 1.1.C.1

Rev 2.2 8


2.1.D.2 - Work with the HIV/AIDS Section Workgroup on ADAP, the budget unit and central pharmacy to expand the formulary


Meeting minutes from the HIV/AIDS Section Workgroup on ADAP

FDOH – HIV/AIDS Section (Patient Care, Medical); Central Pharmacy; ADAP Workgroup

2.1.D.3 - Educate HIV providers regarding the expanded formulary Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

AETC outreach reports (with evidence of opt-out training); email records from Part B office.

FDOH – HIV/AIDS Section (Patient Care, Medical); AETC

Strategy 2.1.E.: Strengthen the Department’s Clinical Quality Management (CQM) initiative

Activities 2.1.E. (1 - 4)

2.1.E.1 - Support ongoing efforts of local HIV clinical trial networks Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Email records to local investigators; HIV Research Consortium meeting minutes (via AIDS Institute).

FDOH – HIV/AIDS Section, The AIDS Institute

2.1.E.2 - Ensure each RW service category has updated and appropriate standards of care


Florida RW Part B Administrative Guidelines Updated guidelines by June 2019 Annual review complete by February each year

FDOH – HIV/AIDS Section (Patient Care)

2.1.E.3 - Establish systems to track medication adherence among RW clients Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Written guidance to current and possible providers of medication adherence (nurse case managers, health educators, etc.)

FDOH – HIV/AIDS Section (Patient Care, Medical, Surveillance, Prevention, Data Integration)

2.1.E.4 - Develop strategies for measuring community viral load Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Email records from surveillance, prevention, and/or patient care units; minutes from strategy development meetings; written communication alerting stakeholders of new strategies

FDOH – HIV/AIDS Section (Patient Care, Surveillance, Medical, Prevention, Data Integration)

Objective 2.2.: By December 31, 2021, increase the proportion of PLWHs linked to care (ever in care) from 90 percent (2014) to 96 percent.

Strategy 2.2.A.: Create approaches to locate and link PLWHs not in care

Strategies 2.2.A. (1 - 7)

2.2.A.1 - Maintain the current Antiretroviral Treatment and Access to Services (ARTAS) providers and explore opportunities to expand the use of the strengths-based case management intervention


List of ARTAS providers; DOH FOA procurement documents, written guidance to agencies not currently providing ARTAS.

FDOH – HIV/AIDS Section

2.2.A.2 - Maintain education and training to HIV counselors and testers regarding their role in encouraging linkage to care at post-test counseling sessions


Written guidance from CTL unit to EICs (material used in 500/501 class and 501 update) # of trainings - quarterly # of staff attending - quarterly Revised guidance – annual review and update


2.2.A.3 – Increase number of DOH disease intervention specialists (DIS) and provide training and education on their role in facilitating linkage to care upon notification of HIV-positive test results


Training materials (in-person meetings and webinar records)

FDOH – HIV/AIDS Section, STD and Viral Hepatitis Section

2.2.A.4 - Strengthen collaboration between DIS and linkage specialists at the local level and across county lines


Written guidance to DIS and linkage specialists


Commented [KBN13]: Increasing DIS is out of our control because those positions are linked to the STD Section. We can provide training and education related to linkage activities. Planning 6-10 trainings in 2019.

Rev 2.2 9

2.2.A.5 - Expand the provision of partner services to HIV-infected individuals Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

PRISM report on PS to existing 900 cases


2.2.A.6 - Expand the use of Data-to-Care to identify, link and re-engage HIV-infected persons to medical care


Data-to-Care quarterly reports # of individuals re-engaged in care as a result of D2C efforts

FDOH – HIV/AIDS Section (Surveillance, Patient Care, Prevention)

2.2.A.7 - Expand the use of peer navigation programs and develop model protocols for dissemination to health departments and community-based organizations


List of peer program providers; DOH FOA procurement documents, written guidance to agencies not currently providing peer programs.

FDOH – HIV/AIDS Section (Patient Care (Part B), Prevention)

Strategy 2.2.B.: Ensure all newly diagnosed persons have immediate access to care and ART


2.2.B.1 - Monitor and evaluate phase one Test and Treat sites to understand best practices and challenges experienced with program implementation


Meeting minutes; email records, monitoring and evaluation plan, monitoring and evaluation reports.

FDOH – HIV/AIDS Section (Medical, Prevention, Patient Care), AETC

2.2.B.2 - Work with the STD Section to develop evaluation mechanisms within the PRISM database


Meeting minutes; email records, PRISM reports (see P4C Project for example)

FDOH – HIV/AIDS Section (Medical, Prevention, Patient Care), STD and Viral Hepatitis Section, AETC

2.2.B.3 - Identify opportunities to streamline processes and reduce barriers to Test and Treat


Meeting minutes; email records. FDOH – HIV/AIDS Section (Medical, Prevention, Patient Care), AETC

2.2.B.4 - Explore options through the Department to purchase starter packs of HIV medications to facilitate expedited treatment and finalize Test and Treat protocol


Email records, meeting minutes/summaries from medical director.

FDOH – HIV/AIDS Section (Medical, Patient Care), Central Pharmacy

2.2.B.5 - Provide education and training to all health departments, community health centers, hospitals and other community-based partners on the Test and Treat initiative


Training materials and participant records (sign in sheets, etc.)

FDOH – HIV/AIDS Section (Medical, Patient Care, Prevention), AETC, Florida Comprehensive Planning Network (FCPN) members

2.2.B.6 - Promote the Test and Treat initiative through medical associations, grand rounds, professional conferences and other such opportunities


Written Test and Treat guidance; logs or other records of guidance dissemination


2.2.B.7 - Develop monitoring and evaluation plan, to include data collection, quality assurance measures and feedback loops


Monitoring and evaluation plan FDOH – HIV/AIDS Section (Medical, Prevention, Patient Care, Surveillance)

Strategy 2.2.C.: Reduce barriers to linkage (for example, stigma, structural issues, processes)

Strategies 2.2.C. (1 - 8)

2.2.C.1 - Explore ways to streamline processes at the state and local level that pose barriers to linkage


Meeting minutes; email records; list of strategies developed.

FDOH – HIV/AIDS Section (Prevention, Patient Care), STD and Viral Hepatitis Section

2.2.C.2 - Streamline and automate the RW eligibility process and better integrate RW systems throughout the state


RW eligibility process guidance FDOH – HIV/AIDS Section (Patient Care)

Commented [KBN14]: What is expected to be evaluated? PRISM is now STARS

Commented [KBN15]: Duplicate of 1.1.A

Rev 2.2 10


2.2.C.3 - Promote the Florida HIV/AIDS Hotline as an informational resource for HIV-infected persons seeking entry/re-entry into medical care


Florida HIV/AIDS Hotline report FDOH – HIV/AIDS Section (Prevention)

2.2.C.4 - Expand social media and marketing campaigns to address stigma associated with HIV medical care and explain the importance of beginning medical care soon after diagnosis


List/catalog of social media and marketing campaigns


2.2.C.5 - Identify opportunities to train private medical providers on how to link newly diagnosed HIV-infected individuals into the Ryan White program with cultural sensitivity incorporation


Logs of trainings private medical providers

FDOH – HIV/AIDS Section (Patient Care, Medical, Prevention)

2.2.C.6 - Expand the use of peer navigators/peer programs to facilitate the linkage-to-care process


List of peer navigators/peer programs FDOH – HIV/AIDS Section (Prevention, Patient Care)

2.2.C.7 - Expand access to care by working with community health centers and federally qualified health centers (FQHCs) to identify new HIV medical care providers


List of community health centers and federally qualified health centers (FQHCs) providing HIV care

FDOH – HIV/AIDS Section (Prevention, Patient Care, Medical), AETC

2.2.C.8 - Increase the number of PLWHA in Florida’s Ryan White Programs (A-D) who obtain and maintain health insurance


Annual ADAP transition project report # of ADAP clients transitioned each year


Objective 2.3.: By December 31, 2021, increase the proportion of HIV-infected persons retained in care from 64 percent (2014) to 90 percent.

Strategy 2.3.A.: Ensure that care systems include access to support and behavioral health services


2.3.A.1 - Strengthen partnerships between HIV care providers and substance abuse treatment centers and mental health providers


List of partnerships; MOAs and/or referral protocols


2.3.A.2 - Expand the use of holistic health approaches that address physical, mental and psychosocial aspects of PLWH


List of approaches implemented (including type and location)


2.3.A.3 - Expand risk reduction activities and develop initiatives to address drug user health


List of initiatives FDOH – HIV/AIDS Section (Patient Care, Prevention, Medical)

2.3.A.4 – Ensure HIV care providers have access to support and behavioral health services on-site or have MOAs with local providers to facilitate linkage to these services


Local MOAs and/or referral protocols FDOH – HIV/AIDS Section (Patient Care)

Strategy 2.3.B.: Create mechanisms to identify and respond to individuals at risk of dropping out of care


2.3.B.1 – Increase number of Ryan White case managers to reduce workload and provide training and education on their role in retaining HIV-infected clients in care


Guidance to case managers # of case managers trained and educated # of training and education sessions


Commented [KBN16]: Duplicate of 2.2.A.7

Commented [KBN17]: Strengthen to do…? The HIV/AIDS Section is working on this with a focus on pregnant women.

Commented [KBN18]: This may be a local effort

Commented [KBN19]: May be addressed through statewide efforts around opioid epidemic which is DCF with SAMHSA grant.

Commented [KBN20]: CBOs and ASOs need to do this. We may be able to include language in our contracts with those entities.

Commented [KBN21]: This part shouldn’t be part of this activity. Training and education among case managers is in progress.

Rev 2.2 11

2.3.B.2 - Expand the use of the ARTAS intervention to Ryan White case managers, where applicable


List of trained ARTAS facilitators, with indication of role (case manager) # ARTAS facilitators through MAI contracts


2.3.B.3 - Expand the use of Data-to-Care to identify and re-link clients who have fallen out of care


List of Data-to-Care participants FDOH – HIV/AIDS Section (Prevention, Surveillance, Data Integration)

Strategy 2.3.C.: Reduce the barriers to retention in care (for example, stigma, structural issues, transportation, etc.)


2.3.C.1 - Identify opportunities for improvement within the Ryan White eligibility process


Meeting minutes, RW eligibility process guidance


2.3.C.2 - Identify barriers to care on the part of providers through community engagement


Semi-annual Part B needs assessment survey report


2.3.C.3 – Assess service and expenditure patterns and assure availability of key information for consumers, providers and policy makers.


Catalog of technical assistance available by AETC

FDOH – HIV/AIDS Section (Patient Care, Prevention, Medical); AETC

2.3.C.4 - Increase HIV awareness among members of the general public, community leaders, and policy makers


Marketing materials and distribution log

FDOH – HIV/AIDS Section (Patient Care, Prevention)

2.3.C.5 - Market the availability of case management services provided in the local area to the hospitals and private providers


Marketing materials and distribution log


2.3.C.6 - Expand social media and marketing efforts to integrate messaging around the importance of retention in care on health outcomes


List of social media and marketing efforts by message type


2.3.C.7 - Ensure retention in care is a key component of the CQM initiative Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

CQM initiative materials FDOH – HIV/AIDS Section (Patient Care, Medical, Prevention)

2.3.C.8 - Strengthen relationships between testing sites and access points to care Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

List of MOAs and/or referral protocols FDOH – HIV/AIDS Section (Prevention, Patient Care)

2.3.C.9 - Increase the number of trained clinicians providing Ryan White HIV care Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

List of trained clinicians providing Ryan White HIV care (from Medical Director and/or AETC)

FDOH – HIV/AIDS Section (Medical, Patient Care)

2.3.C.10 - Collaborate with other state agencies and DOH programs to promote integration of client services wherever possible


Email or meeting minutes documenting collaboration.


Strategy 2.3.D.: Increase the number of PLWHs that are in stable housing, within the RW Part (A, B, C, D, ADAP) programs

Commented [KBN22]: What is considered “key information”?

Commented [KBN23]: This should be a local effort.

Rev 2.2 12


2.3.D.1 - Evaluate HOPWA criteria and establish a baseline percentage of mortgage assistance


HOPWA criteria and baseline FDOH – HIV/AIDS Section (Patient Care)

2.3.D.2 - Increase the number of PLWH served by the State’s HOPWA Program (not City HOPWA) who are in a stable housing arrangement


State HOPWA Program report FDOH – HIV/AIDS Section (Patient Care)

Strategy 2.3.E.: Strategize on the development of a family-focus model for HIV care to increase retention (improves partner involvement and provides access to care for other children in the household)


2.3.E.1 - Research best practices implemented by other states Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

List of best practices FDOH – HIV/AIDS Section (Patient Care)

2.3.E.2 - Educate providers of medical care and case management on these objectives


Email and other correspondence FDOH – HIV/AIDS Section (Patient Care, Medical)

2.3.E.3 - Strengthen partnerships with Parts A-D to increase the services provided through Part D and community based organizations


List MOAs and/or referral protocols (esp. Part D and CBOs)


2.3.E.4 - Promote Part D family centered care model with other programs to assist with patient assistance


Email and other correspondence FDOH – HIV/AIDS Section (Patient Care, Medical)

Objective 2.4.: By December 31, 2021, increase the proportion of HIV-infected persons with a suppressed viral load (<200 copies/mL) from 58 percent (2014) to 80 percent.

Strategy 2.4.A.: Increase the number of diagnosed PLWHs on ART

Strategies 2.4.A. (1 - 5)

2.4.A.1 - Identify gaps and constraints that impede PLWH from achieving viral suppression


Semi-annual Part B needs assessment survey report


2.4.A.2 - Develop and implement adherence interventions Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

List of interventions FDOH – HIV/AIDS Section (Prevention, Patient Care)

2.4.A.3 - Collaborate with industry partners to provide tools that assist with adherence


Email and other correspondence; MOAs/MOUs


2.4.A.4 - Implement adherence interventions for Ryan White clients who are not virally suppressed


Report from CAREWare custom tab for adherence interventions


Commented [KBN24]: Need to discuss if this strategy should be included in the Part B integrated plan. Whose role is this?

Commented [KBN25]: Combined 2.4.A.2, 2.4.A.3, 2.4.A.4, and 2.4.A.5

Rev 2.2 13

2.4.A.5 - Enhance systems and strategies to locate and re-engage clients lost to follow-up


Linkage team reports FDOH – HIV/AIDS Section (Prevention, Surveillance, Data Integration, Patient Care); STD and Viral Hepatitis Section

Strategy 2.4.B.: Increase understanding of viral suppression as a key health indicator


2.4.B.1 - Conduct focus groups to determine the best ways to improve access to and utilization of treatment


Focus group reports FDOH – HIV/AIDS Section (Patient Care, Prevention, Medical)

2.4.B.2 - Develop strategies to address the stigma that prevents individuals infected with HIV from adhering to treatment


Social marketing materials and distribution log; meeting minutes; related artifacts.


2.4.B.3 - Promote knowledge of the research detailing the benefits or value of PLWHA starting ART early


Test and Treat meeting minutes and reports.

FDOH – HIV/AIDS Section (Medical, Prevention, Patient Care)

2.4.B.4 - Expand the use of social marketing to educate clients on the importance of viral suppression and its effect on health outcomes


Social marketing materials and distribution log


Strategy 2.4.C.: Develop and implement effective adherence strategies


2.4.C.1 - Interview persons who remain suppressed to understand effective strategies and approaches


Interview logs FDOH – HIV/AIDS Section (Patient Care, Prevention, Medical)

2.4.C.2 - Research the literature for models that have proven success Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Overview of literature review; meeting minutes


2.4.C.3 - Seek provider input on effective strategies through quality management activities


Email to providers FDOH – HIV/AIDS Section (Patient Care, Medical)

2.4.C.4 - Develop and implement strategies based on community and stakeholder input


Program implementation notes; meeting minutes.


2.4.C.5 - Enhance the use of peers Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Peer program reports FDOH – HIV/AIDS Section (Prevention, Patient Care)

Objective 2.5.: By December 31, 2021, increase the proportion of ADAP clients with a suppressed viral load (<200 copies/mL) from 89 percent (2014) to 94 percent

Strategy 2.5.A.: Develop and implement effective adherence strategies for ADAP clients


2.5.A.1 - Interview clients who remain suppressed to understand effective strategies and approaches


Interview logs FDOH – HIV/AIDS Section (Patient Care)

Commented [KBN26]: This can be combined with Strategy 2.4.A

Rev 2.2 14


2.5.A.2 - Determine the role of ADAP staff and pharmacists in obtaining better outcomes for ADAP clients than other populations


ADAP workgroup meeting minutes FDOH – HIV/AIDS Section (Patient Care, Medical)

2.5.A.3 - Research the literature for models that have proven success Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

DUPLICATIVE OF 2.4.C.2? FDOH – HIV/AIDS Section (Patient Care)

2.5.A.4 – Increase CAG membership and include CAG and provider input on effective strategies


Email records; interview logs DUPLICATE 2.4.C.3


2.5.A.5 - Develop and implement strategies based on client, CAG and provider input Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Implementation records DIPLICATE 2.4.C.4


2.5.A.6 - Enhance the use of peers Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Peer program reports DUPLICATE 2.4.C.5


Strategy 2.5.B.: Enhance support for treatment adherence


2.5.B.1 - Establish a protocol for adherence intervention referral services Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Adherence protocol FDOH – HIV/AIDS Section (Prevention, Patient Care, Medical)

2.5.B.2 - Monitor client pick up activity for antiretroviral regimens Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

ADAP Database (Provide) reports FDOH – HIV/AIDS Section (Patient Care, Data Integration)

Strategy 2.5.C.: Establish a protocol for ART regimen review


2.5.C.1 - Identify clients who are picking up regularly for at least six months but are

not achieving viral suppression for antiretroviral therapy appropriateness review


ADAP Database (Provide) reports crosschecked with Part B CAREWare

FDOH – HIV/AIDS Section (Patient Care, Data Integration)

2.5.C.2 - Develop/incorporate an electronic ADAP system component to hard-halt

the provision of ADAP medication services when clients are attempting to pick-up

inappropriate ART regimens


ADAP Database (Provide) reports FDOH – HIV/AIDS Section (Patient Care, Data Integration)

Strategy 2.5.D.: Enhance program operations to facilitate ease of access to medication treatment


2.5.D.1 - Evaluate existing infrastructure for service delivery effectiveness to

identify opportunities for community mobilization


Patient Care evaluation report FDOH – HIV/AIDS Section (Patient Care)

2.5.D.2 - Develop standards for prompt and equitable services statewide Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women

Standards document FDOH – HIV/AIDS Section (Patient Care, Medical)

Rev 2.2 15


2.5.D.3 - Increase local communication with external pharmaceutical providers

statewide


Email and other correspondence; MOAs/MOUs


2.5.D.4 - Educate and create awareness of the ADAP service delivery system among

all persons who serve ADAP clients in the continuum of care


ADAP marketing materials and distribution log


2.5.D.5 - Add new antiretroviral classes to the ADAP formulary within 90 days of

publication in the PHS guidelines


ADAP formulary FDOH – HIV/AIDS Section (Patient Care, Medical); Central Pharmacy

Strategy 2.5.E.: Build partnerships with state and local entities to identify and re-engage clients who have been lost to care


2.5.E.1 - Develop a protocol to identify and inform service providers when clients stop medication pick up and fall out of care


Protocol FDOH – HIV/AIDS Section (Patient Care, Medical)

2.5.E.2 - Use Data-to-Care to locate clients lost to care


Data-to-Care reports FDOH – HIV/AIDS Section (Surveillance, Patient Care, Prevention, Data Integration)

2.5.E.3 - Increase the use of peers Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

Peer program reports


Strategy 2.5.F.: Increase the number of ADAP clients who are covered by insurance plans

Activities 2.5.F. (1 - 3)

2.5.F.1 - Expand the range of insurance options supported by ADAP Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

ADAP program guidance FDOH – HIV/AIDS Section (Patient Care)

2.5.F.2 - Minimize eligibility requirements for insurance coverage supported by ADAP


ADAP program guidance FDOH – HIV/AIDS Section (Patient Care)

2.5.F.3 - Ensure client readiness for insurance coverage Black, White, Hispanic MSM Black Hetero Men and Women Hispanic Hetero Men and Women Black, White, Hispanic IDU

ADAP marketing materials and distribution log; ADAP Database (Provide) reports


NHAS Goal 3: Reducing HIV related disparities and health inequities

Objective 3.1.: By December 31, 2021, reduce the annual number of newly diagnosed HIV infections in Florida’s black population from 2,024 (2014) to 1,757.

Strategy 3.1.A.: Ensure universal access to and availability of PrEP and increase awareness of nPEP


3.1.A.1 - Expand the use of culturally competent PrEP navigators in counties/areas with active PrEP clinics

Black Hetero, Black MSM, Black IDU Inventory of PrEP navigators in areas with PrEP clinics


Commented [KBN27]: This is covered under Data-2-Care activities above. Not sure it needs to be separated out.

Commented [KBN28]: Change to match our internal strategic plan (we moved to rate instead of case count): reduce the rate per 100,000 population of HIV transmissions diagnosed annually in Florida’s Black population, from 66.9 per 100,000 population (2015) to 65.0 per 100,000 population (2021)

Rev 2.2 16

# of PrEP locations/providers All CHDs are active PrEP providers

3.1.A.2 - Develop social marketing and educational materials that contain information on PrEP and nPEP (basic information, how to access, etc.) specific to Florida’s black population

Black Hetero, Black MSM, Black IDU Inventory of resources # of PrEP materials developed and distributed - quarterly


3.1.A.3 - Provide education and training to healthcare providers, hospitals, emergency departments and sexual assault nurses on the delivery of nPEP specific to Florida’s black population

Black Hetero, Black MSM, Black IDU Number of trainings provided FDOH – HIV/AIDS Section (Prevention, Medical)

Strategy 3.1.B.: Ensure access to and availability of culturally-appropriate prevention activities


3.1.B.1 - Maintain representation and feedback from agencies or individuals from at-risk and special populations (e.g., persons living with HIV/AIDS, incarcerated and persons recently released from jail or prison, injection drug users, men who have sex with men, transgender individuals and youth) and key HIV/AIDS stakeholders on the Florida Comprehensive Planning Network (FCPN) to inform stigma-reducing and service activities

Black Hetero, Black MSM, Black IDU List of FCPN members, alternates FDOH – HIV/AIDS Section (Prevention, Patient Care)

3.1.B.2 - Sustain the use of epidemiologic data to focus prevention activities Black Hetero, Black MSM, Black IDU Inventory of prevention activities compared with local area data


3.1.B.3 - Sustain condom distribution and outreach activities conducted by health departments and community-based organizations

Black Hetero, Black MSM, Black IDU Condom distribution reports


3.1.B.4 - Increase community mobilization and engagement activities (e.g., SOS, Man-Up, etc.) through DOH Minority AIDS Coordinators, other key partners and use of community resources

Black Hetero, Black MSM, Black IDU Inventory of mobilization initiatives/activities # of SOS chapters in the state (ask Ron)


3.1.B.5 - Sustain culturally appropriate social media and marketing activities to Florida’s black populations to increase awareness of available prevention activities and reduce stigma

Black Hetero, Black MSM, Black IDU Inventory of social marketing and media activities


3.1.B.6 – Ensure availability of HIV/AIDS surveillance data; prevention and care information; and educational resources for consumers, providers, policy makers and other key stakeholders.

Black Hetero, Black MSM, Black IDU Email records, meeting minutes, website information

FDOH – HIV/AIDS Section (Surveillance, Prevention, Patient Care)

3.1.B.7 - Ensure the availability of cultural competency training on at-risk and special populations to front-line HIV prevention and care staff

Black Hetero, Black MSM, Black IDU Number of trainings provided FDOH – HIV/AIDS Section (Prevention)

3.1.B.8 - Increase knowledge and sense of urgency to act through culturally tailored social media and marketing campaigns

Black Hetero, Black MSM, Black IDU New social media and marketing activities


3.1.B.9 - Promote capacity building assistance (CBA) to increase minority providers Black Hetero, Black MSM, Black IDU Number of CBA trainings provided FDOH – HIV/AIDS Section (Prevention)

3.1.B.10 - Expand the Business and Faith Responds to AIDS (BRTA, FRTA) initiatives in communities with the highest HIV disease burden

Black Hetero, Black MSM, Black IDU Inventory of FRTA activities and partners # of partners onboarded each quarter


3.1.B.11 - Expand HIV prevention services to Florida’s black population through contracted community-based organizations

Black Hetero, Black MSM, Black IDU Number of service providers We have 44 providers with the new Prevention contract/RFA


Strategy 3.1.C.: Reduce barriers to service access and address social determinants that increase risk

Strategies 3.1.C. (1 - 8)

3.1.C.1 – Expand and strengthen community partnerships of traditional and non-traditional stakeholders to support prevention and care services and identify areas to increase for Florida’s black population

Black Hetero, Black MSM, Black IDU Inventory of community partnerships FDOH – HIV/AIDS Section (Prevention, Patient Care)

Commented [KBN29]: Not sure how this links to the strategy

Rev 2.2 17

3.1.C.2 - Conduct community engagement activities, town halls, stakeholder and community forums, etc. to identify barriers to service access and improve recruitment process for local planning councils

Black Hetero, Black MSM, Black IDU Number of engagement activities conducted


3.1.C.3 - Sustain data collection and reporting systems that allow for detailed analysis of risk factors and social determinants that increase HIV infection among Florida’s black population

Black Hetero, Black MSM, Black IDU Current data collection systems FDOH – HIV/AIDS Section (Surveillance, Data Integration, Prevention, Patient Care)

3.1.C.4 - Examine state, local and Departmental policies and resources to identify operational and funding opportunities for reducing barriers to prevention and care services access

Black Hetero, Black MSM, Black IDU Current policies that pose barriers FDOH – HIV/AIDS Section (Prevention, Patient Care)

3.1.C.5 - Promote awareness of the HIV care continuum and level of engagement needed to lower viral load among key stakeholders, consumers, advocates, policy makers and health professionals to ensure the coordination and collaboration required to reduce HIV

Black Hetero, Black MSM, Black IDU Emails, meetings minutes, website information


3.1.C.6 - Provide education and training for HIV prevention and care providers around social determinants, stigma and discrimination

Black Hetero, Black MSM, Black IDU Number of trainings provided FDOH – HIV/AIDS Section (Prevention)

3.1.C.7 - Expand the use of structural interventions, such as condom distribution, in communities with the highest HIV disease burden

Black Hetero, Black MSM, Black IDU Condom distribution reports FDOH – HIV/AIDS Section (Prevention)

3.1.C.8 - Expand the use of holistic health models and integrated health services Black Hetero, Black MSM, Black IDU Inventory of current holistic health providers


Objective 3.2. By December 31, 2021, reduce the annual number of newly diagnosed HIV infections in Florida’s men who have sex with men (MSM) population from 2,761 (2014) to 2,397.

Strategy 3.2.A.: Ensure universal access and availability of PrEP and increase awareness of nPEP


3.2.A.1 - Explore non-traditional ways to fund and purchase PrEP medications MSM

Inventory of methods for purchasing PrEP medications

FDOH – HIV/AIDS Section (Medical, Prevention)

3.2.A.2 - Develop toolkits, guidelines and other resources to assist health department and community-based organizations in implementing PrEP and nPEP clinics [redundant]

MSM Inventory of resources FDOH – HIV/AIDS Section (Prevention,

Medical)

3.2.A.3 - Develop social marketing and educational materials that contain information on PrEP and nPEP (basic information, how to access, etc.) specifically for gay, bisexual and other MSM

MSM Inventory of resources FDOH – HIV/AIDS Section (Prevention,

Medical)

3.2.A.4 - Provide education and training to healthcare providers, hospitals, emergency departments and sexual assault nurses on the delivery of nPEP

MSM Number of trainings provided FDOH – HIV/AIDS Section (Medical,

Prevention)

3.2.A.5 - Expand the use of culturally competent PrEP navigators in counties/areas with active PrEP clinics

MSM Inventory of PrEP navigators in areas with PrEP clinics



MSM Inventory of PrEP/nPEP providers FDOH – HIV/AIDS Section (Prevention,

Medical)

Strategy 3.2.B.: Ensure access to and availability of culturally-appropriate prevention and care activities


3.2.B.1 - Maintain representation and feedback from agencies or individuals from at-risk and special populations (e.g., persons living with HIV/AIDS, incarcerated and persons recently released from jail or prison, injection drug users, men who have sex with men, transgender individuals and youth) and key HIV/AIDS stakeholders on the Florida Comprehensive Planning Network (FCPN) to inform stigma-reducing and service activities

MSM

List of FCPN members, alternates FDOH – HIV/AIDS Section (Prevention, Patient Care)

3.2.B.2- Sustain culturally appropriate social media and marketing activities for MSM to increase awareness of available prevention activities and reduce stigma

MSM Inventory of social marketing and media activities


3.2.B.3 - Sustain the use of epidemiologic data to focus prevention activities MSM

Inventory of prevention activities compared with local area data

FDOH – HIV/AIDS Section (Prevention, Surveillance)

Rev 2.2 18

3.2.B.4 - Sustain condom distribution and outreach activities conducted by health departments and community-based organizations

MSM Condom distribution reports


3.2.B.5 - Conduct community engagement activities, town halls, community forums, etc. to identify barriers to service access and opportunities for community mobilization

MSM Number of engagement activities FDOH – HIV/AIDS Section (Prevention,

Patient Care)

3.2.B.6 - Promote capacity building assistance to increase LGBT-specific providers MSM Number of CBA trainings provided FDOH – HIV/AIDS Section (Prevention)

3.2.B.7 - Ensure availability of HIV/AIDS surveillance data; prevention and care information; and educational resources for consumers, providers, policy makers and other key stakeholders.

MSM Email records, meeting minutes, website information

FDOH – HIV/AIDS Section (Surveillance, Prevention, Patient Care)

3.2.B.8 - Ensure the availability of cultural competency training on at-risk and special populations to front-line HIV prevention and care staff

MSM Number of trainings provided FDOH – HIV/AIDS Section (Prevention,

Patient Care)

3.2.B.9 - Increase knowledge and sense of urgency to act through culturally tailored social media and marketing campaigns

MSM New social media and marketing activities


3.2.B.10 - Increase cultural diversity training for HIV service providers in the Ryan White program

MSM Number of trainings FDOH – HIV/AIDS Section (Prevention)

3.2.B.11 - Require cultural competency trainings for all HIV/AIDS, Ryan White providers in the state of Florida

MSM Number of trainings FDOH – HIV/AIDS Section (Prevention,

Patient Care)

3.2.B.12 - Expand HIV prevention services to Florida’s gay, bisexual and other MSM through contracted community-based organizations

MSM Number of service providers FDOH – HIV/AIDS Section (Prevention)

Strategy 3.2.C.: Reduce barriers to service access and address social determinants that increase risk


3.2.C.1 - Examine current state, local and Departmental policies to identify opportunities for reducing barriers to prevention and care services access

MSM Inventory of policies FDOH – HIV/AIDS Section (Prevention,

Patient Care)

3.2.C.2 - Sustain data collection and reporting systems that allow for detailed analysis of risk factors and social determinants that increase HIV infection among gay, bisexual, other MSM and transgender individuals

MSM Current data collection systems FDOH – HIV/AIDS Section (Surveillance,

Data Integration, Prevention, Patient Care)

3.2.C.3 - Conduct community engagement activities, town halls, community forums, etc. to identify barriers to service access

MSM Number of engagement activities conducted


3.2.C.4 - Provide education and training for HIV prevention and care providers around social determinants, stigma and discrimination

MSM Number of trainings FDOH – HIV/AIDS Section (Prevention)

3.2.C.5 - Strengthen community partnerships of traditional and non-traditional stakeholders to support prevention and care services for Florida’s gay, bisexual, other MSM and transgender populations

MSM Number of partnerships FDOH – HIV/AIDS Section (Prevention)

3.2.C.6 - Promote awareness of the HIV care continuum and level of engagement needed to lower viral load among key stakeholders, consumers, advocates, policy makers and health professionals to ensure the coordination and collaboration required to reduce HIV

MSM

Emails, meetings minutes, website information

FDOH – HIV/AIDS Section (Surveillance, Prevention, Patient Care, Medical)

3.2.C.7 - Expand the use of holistic health models and integrated health services for gay, bisexual, other MSM and transgender individuals

MSM Inventory of service providers FDOH – HIV/AIDS Section (Prevention)

3.2.C.8 - Expand the use of drop-in centers and safe spaces for gay, bisexual, other MSM and transgender individuals, especially for youth and youth of color

MSM Inventory of drop-in centers FDOH – HIV/AIDS Section (Prevention)

Objective 3.3.: By December 31, 2021, reduce the rate of new HIV infections in Miami-Dade and Broward counties from 45.8 (2014) to 39.7 and 38.6 (2014) to 33.5, respectively so these counties will no longer be in the top three U.S. MSA/divisions with the highest rate of new HIV infections diagnosed.

Strategy 3.3.A.: Ensure all newly diagnosed persons have immediate access to care and ART


3.3.A.MD.1 - FDOH-MDC will optimize patient health by ensuring newly diagnosed HIV positive persons identified through the “Test and Treat” model will have received antiretroviral therapy within seven (7) days following diagnosis

Hispanic, Black and White MSM Black Hetero Men and Women Hispanic Hetero Men and Women

FDOH – Miami- Dade County

Commented [KBN30]: Combined and reworded to 3.2.B.4 in revised table

Commented [KBN31]: Not sure what this speaks to.

Commented [KBN32]: We need to ask if Miami-Dade and Broward have these activities in their local plans. If not, I suggest remove them from integrated plan and just track local plans.

Rev 2.2 19

3.3.A.MD.2 - FDOH-MDC and publicly funded testing sites will provide linkage within 30 days to HIV care, treatment, and prevention services for those persons testing HIV positive or currently living with HIV/AIDS



3.3.A.MD.3 - FDOH-MDC 80% of “Data to Care” clients with positive diagnosis but without CD4/VL data will be contacted to determine eligibility for linkage to care in Miami-Dade County



3.3.A.MD.4 - FDOH-MDC will collaborate with Ryan White Part A and B to streamline the enrollment process, improving timely access to ARV medications.



3.3.A.MD.5 - FDOH-MDC will collaborate with partners to expand the “Test and Treat” model to other locations in the County, increasing availability for newly diagnosed HIV positive persons to access same-day HIV clinical services



3.3.A.B.1 - Design a Ryan White/Prevention Collaborative model that ensures a seamless continuum for PLWH to transition from testing and counseling sites to linkage, treatment and retention in Medical Care

Broward County Priority populations; PLWH

Design a model that ensures a seamless continuum

FDOH – Broward County

3.3.A.B.2 - Implement “Test and Treat” immediately following a positive HIV test result to reduce transmission and improve morbidity and mortality in all stages of infection

PLWH Number of clients that received ART following the “Test and Treat” model


3.3.A.B.3 - Design and/or modify data reporting systems to track PLWH along the HIV Care Continuum from time of diagnosis

PLWH Data reporting systems designed FDOH – Broward County

3.3.A.B.4 - Develop targeted strategies and interventions for individuals who may not seek care or who may fall out of care

PLWH Number of developed interventions for vulnerable populations who may not seek care or who may fall out of care.


3.3.A.B.5 - Establish pilot project for integrated electronic medical record sharing across providers

Ryan White Providers Pilot project established FDOH – Broward County

3.3.A.B.6 - Strengthen coordination across data systems and the use of data to inform decision making among grantees and local organizations

HIV prevention, care and treatment providers; ancillary providers

Data systems strengthened; Data systems used to inform decision making


Strategy 3.3.B.: Ensure universal access and availability of PrEP and increase awareness of nPEP


3.3.B.MD.1 - FDOH-MDC will partner with identified agencies to create a local directory of providers prescribing PrEP and nPEP.



3.3.B.MD.2 - FDOH-MDC will partner with medical providers to expand services and availability of PrEP/nPEP within the County



3.3.B.MD.3 - FDOH-MDC will provide adherence and behavioral interventions to clients seen at the PrEP Clinic



3.3.B.MD.4 - FDOH-MDC will organize PrEP presentations in the community improving awareness and acceptability of PrEP and nPEP



3.3.B.MD.5 - FDOH-MDC will implement a PrEP clinic in the local health department infrastructure

Hispanic, Black and White MSM Black Hetero Men and Women


Rev 2.2 20

Hispanic Hetero Men and Women

3.3.B.B.1 - Conduct a demonstration project involving the direct provision of PrEP/nPEP through STD clinics or with community clinical partners with specific emphasis on minority communities

Broward County Priority Populations; STD Clinics; Community clinic partners

Demonstration project conducted


3.3.B.B.2 - Develop and implement PrEP community ambassadors program and marketing materials to disseminate information and available PrEP resources to individuals who are at-risk of new HIV infections

Broward County Priority Populations

PrEP community ambassadors program implemented; Number of marketing materials distributed.


3.3.B.B.3 - Conduct public health detailing and companion workshops to support implementation of PrEP throughout Broward County

Medical and non-medical providers Number of public health detailing and workshops conducted


3.3.B.B.4 - Include PrEP/nPEP as a core competency in provider-focused HIV prevention education and training with special emphasis on clinical settings and emergency departments

Medical providers

Number of provider-focused HIV prevention education and trainings that include PrEP/nPEP as a core competency


3.3.B.B.5 - Develop a Broward PrEP/nPEP Referral Network and provide technical assistance to sites wishing to participate

Medical providers Broward PrEP/nPEP Referral Network developed; Number of sites that received technical assistance


3.3.B.B.6 - Monitor the uptake of PrEP/nPEP in Broward County through the use of surveys, provider report forms, databases, etc. to further guide program implementation

Broward County Priority Populations

Monitoring and Evaluation plans conducted


Strategy 3.3.C.: Expand routine HIV screening in health care settings as part of medical care and targeted HIV testing in non-health care settings


3.3.C.MD.1 - FDOH-MDC will explore partnerships with hospitals to conduct routine HIV testing.



3.3.C.MD.2 - FDOH-MDC will support the education of medical providers on routine opt-out testing



3.3.C.MD.3 - FDOH-MDC will support community mobilization initiatives to create environments that support HIV prevention and treatment by actively involving community members in efforts to raise awareness and motivate individuals to end HIV stigma



3.3.C.MD.4 - FDOH-MDC will promote and coordinate Take Control events in identified high prevalence areas



3.3.C.MD.5 - FDOH-MDC will coordinate outreach and testing events targeting priority populations (Hisp. MSM, B Hetero M and W, Black MSM, White MSM, and H Hetero M and W)



3.3.C.B.1 - Provide education and promote adherence to operate under the guidance of the new Florida HIV Testing Law (Statute 381.004)

Medical Providers Number of educational sessions provided


3.3.C.B.2 - Establish a collaborative agreement to model routine testing in accordance with the new Florida HIV Testing Law (Statute 381.004)

Medical Providers Collaborative agreements established


3.3.C.B.3 - Use geo mapping to identify areas that are underserved by HIV/STI/HCV testing staff in order to

Broward County Priority Populations Number of testing activities conducted in underserved areas identified


Rev 2.2 21

coordinate testing activities by using geo-mapping and other methodologies

3.3.C.B.4 - Develop and implement concierge in-home HIV testing

Broward County Priority Populations Number of in-home HIV testing conducted


3.3.C.B.5 - Conduct geo mapping and ethnographic methodologies to identify underserved areas Underserved Areas

Number of identified underserved areas through the use of geo mapping and ethnographic methodologies


Objective 3.4: By December 31, 2021, reduce the annual number of newly diagnosed HIV infections in Florida’s Hispanic population from 1,281 (2014) to 1,112.

Strategy 3.4.A: Ensure universal access to and availability of PrEP and increase awareness of nPEP


3.4.A.1 - Develop Spanish-language social marketing and educational materials that contain information on PrEP and nPEP and are representative of Florida’s Hispanic population

Hispanic MSM, Hispanic Hetero Men and Women





3.4.A.3 - Expand the use of culturally-competent PrEP navigators in counties and areas with active PrEP clinics


FDOH – HIV/AIDS Section (Medical, Prevention)

3.4.A.4 - Develop toolkits, guidelines, and other resources to assist CHDs and CBOs in implementing PrEP and nPEP clinics



3.4.A.5 - Provide education and training to health providers, hospitals, emergency departments and sexual assault nurses on the delivery of nPEP


FDOH – HIV/AIDS Section (Medical, Prevention); AETC

3.4.A.6. - Identify and collaborate with national and regional providers that have experience and can share best practices in working with Hispanic populations on the delivery of PrEP and nPEP



Strategy 3.4.B: Ensure access to and availability of culturally-appropriate prevention activities


3.4.B.1 - Develop a survey that assesses whether prevention and care activities are culturally appropriate for the Hispanic population



3.4.B.2 - Create a clearing house to increase media and marketing for the Hispanic community and ensure social marketing and educational material are linguistically and culturally appropriate to reduce stigma and increase awareness



3.4.B.3 - Coordinate with the Department’s Statewide Latino AIDS Coordinator to lead and implement community mobilization efforts targeting the Hispanic community



3.4.B.4 - Strengthen community partnerships of traditional and non-traditional stakeholders to support prevention and care services for Florida’s Hispanic population



3.4.B.5 - Maintain community mobilization and engagement activities through Department MACs and other key partners



Rev 2.2 22

3.4.B.6 - Expand the BRTA and FRTA initiatives in communities with the highest HIV disease burden


FDOH – HIV/AIDS Section (Prevention); Statewide Minority AIDS Coordinator

3.4.B.7 - Expand HIV prevention services to Florida’s Hispanic population (with an emphasis on Hispanic gay, bisexual, and other MSM) through contracted community providers



3.4.B.8 - Maintain representation and feedback from agencies or individuals from at-risk and special populations (for example, PLWH, incarcerated and persons recently released from jail or prison, IDUs, gay, bisexual, and other MSM, transgender individuals, and youth) and key HIV/AIDS stakeholders on the Florida Comprehensive Planning Network (FCPN) to inform stigma-reducing and service activities



3.4.B.9 - Identify and collaborate with national and regional providers that have experience and can share best practices in working with Hispanic populations on the delivery of culturally-competent prevention services



Strategy 3.4.C: Reduce barriers to service access and address social determinants that increase risk


3.4.C.1 - Provide training to HIV specific providers and health departments on the risk of intimate partner violence and substance abuse among the Hispanic population



3.4.C.2 - Disseminate information that immigration status does not affect seeking HIV testing and care to the community and partners



3.4.C.3 - Conduct community engagement activities, town halls, community forums, etc., to identify barriers to service access and improve recruitment process for local planning councils



3.4.C.4 - Expand the use of holistic health models and integrated health services



3.4.C.5 - Examine current state, local, and Departmental policies and practices to identify opportunities for reducing barriers to prevention and care services access and improving process to better monitor and manage integrated plan objectives and activities



3.4.C.6 - Maintain data collection and reporting systems that allow for detailed analysis of risk factors and social determinants that increase HIV infection among Florida’s Hispanic population


FDOH – HIV/AIDS Section (Surveillance, Data Integration, Prevention, Patient Care)

3.4.C.7 - Strengthen community partnerships of traditional and non-traditional stakeholders to support prevention and care services for Florida’s Hispanic population



3.4.C.8 - Identify and collaborate with national and regional providers that have experience and can share best practices in working with Hispanic populations



Documents

Introduction - The AIDS Institute...delivered by CBOs and CHDs which contain information and messaging around HIV testing FDOH – HIV/AIDS Section (Prevention) Objective 1.2.: By