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Linkage to Care:From Preliminary Positive to
Primary Care
Robin PearceNO/AIDS Task ForceNew Orleans, LA
Overview
Describe NO/AIDS linkage to care system Share tools:
Access databaseIntake forms and staff training tips
Discuss challenges and lessons learned
Background
NO/AIDS is a “one stop shop” for PLWHA in New Orleans Counseling & Testing program has
multiple testing locations and times Administered 3,200 tests in FY 2010-11
2.8% positivity rate
NO/AIDS Linkage to Care
Inputs: Two full time staff: CTR Coordinator &
CRCS Wellness Manager
Microsoft Access Database
Secure server to allow database sharing
Intake Paperwork
Trained HIV Counselors
Day 1
Client will be contacted by CRCS when the confirmatory is ready
Counselor records client’s contact info Counselor collects confirmatory sample
(Orasure, offsite lab)
Client tests PP at evening testing site
Day 2
Counselor mails confirmatory sample
Counselor provides paperwork to CTR Coordinator & CRCS Wellness Manager CTR Coordinator makes file for client
and keeps original paperwork CRCS enters client information on
Microsoft Access database
Day 7
Confirmatory result available online CRCS contacts client to make
appointment to receive confirmatory result
Day 14
Client receives confirmatory result in person from CRCS Client begins enrollment paperwork or
sets date for enrollment appointment CRCS sets date for PMC/EIS
appointment CRCS follows up with PMC or client to
find out if client attended appointment
Results
2010 data: 73 clients received a preliminary
positive result and post-test counseling 96% completed a confirmatory test 82% received confirmatory result Of those clients who received their
confirmatory result, 90% were connected to care (54 of 60)
Tools
Tracking Database CTR Coordinator and CRCS
collaboration Confirmatory Intake paperwork for HIV
Counselors & training
Tracking Database
Tracking Database Inputs
Client Number (HIV Test Form 1 number) Orasure Number Last 4 SSN First Name
Tracking Database Inputs
Client did confirmatory: Y/N Date of PP
Date of confirmatory Client received confirmatory Date received confirmatory Actual confirmatory result
Tracking Database Inputs
Paperwork completed: Y/N Date paperwork completed Scheduled PMC/EIS appt Attended PMC/EIS appt Date attended PMC first appt
Tracking Database Inputs
Lost to Follow up Notes
Documenting & Follow-up
Regular communication between CTR & CRCS (work out of same office) Review client files Update database Deadlines:
- Quarterly referral reporting to the state- 60 day lost to follow up
Confirmatory Intake
Confirmatory Intake
Confirmatory Intake
Confirmatory Intake
Challenges
Client in unstable living circumstances Client lacks regular access to
communication tools (phone, email) Healthcare can be a low priority (relative
to other needs) Denial, shock, anger, stress
Lessons Learned
Collecting correct contact information at PP visit is the most important step Communicate with outreach teams and
HIV counselors Train & re-train HIV counselors Create intuitive intake paperwork
Goals
National HIV/AIDS Strategy:
“Establish a seamless system to immediately link people to continuous and coordinated quality care when they are diagnosed with HIV.”
Goals
“[By 2015] Increase the proportion of newly diagnosed patients linked to clinical care within three months of their HIV diagnosis from 65 percent to 85 percent.”
National HIV/AIDS Strategy:
Contact information
Robin PearceCounseling & Testing [email protected]
Mark Drake, LCSWCRCS Wellness [email protected]
