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in+care CampaignWebinar

November 19, 2012

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Ground Rules for Webinar Participation

• Actively participate and write your questions into the chat area during the presentation(s)

• Do not put us on hold• Mute your line if you are not speaking

(press *6, to unmute your line press #6)• Slides and other resources are available

on our website at incareCampaign.org• All webinars are being recorded

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Agenda

• Welcome & Introductions, 5min• Retaining Aging HIV+ Patients

in+care, 30min• Data Review and Discussion of

Retention Strategies Collected Through the Campaign, 15min

• Q & A Session, 5min• Updates & Reminders, 5min

HIV and Aging

Presented by

Emily Tsuchida, RN, MSN, PHN, FNP-CCenter for AIDS Research,

Education & Services (CARES)Sacramento, CA

Comprehensive Clinical Care

Medical Dental

Psychiatry Nutrition

Mental Health counseling Substance Abuse

Case Management Health Education

Pharmacy Laboratory Services

Clinical Trials/Research STD/HIV Testing

Risk Reduction Counseling Prevention

2600 HIV+ patients

Over 74% are below 200%of poverty level

Approximately half have substance abuse and mental health issues.

African Americans are impactedat an alarming rate.

Young people are our fastestgrowing group.

Who We Serve at CARES:

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Audience Responses

What proportion of your caseload

is aged 45 years or more?

25% of fewer

Between 26% and 50%

Between 51% and 75%

Greater than 75%

I have no idea / I do not have an HIV patient

caseload

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Audience ResponsesPROVIDERS

In the chat room, tell us what you

have done at your sites to prepare

for an aging population if you serve

HIV patients. CONSUMERS / ALLIES

In the chat room, tell us what

special concerns you see as HIV+

people grow older and have more

complex health needs.

An Aging Population at CARES

Point# 1:

Important to get all ages tested for HIV.

Point #2

Treatment for all as being over 45 is an indication for treatment.

Point #3

You must have expertise inpoly-pharmacy.

Point #4

Develop connections with home care and skilled nursingfacilities.

Point #5

Elderly alone… HIV+ people feeling alone…The combination of the two.

Point #6

Need expert in geriatric patientsto assist with the care of theseaging patients.

Point #7

Nutritional needs for elderly aredifferent.

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Audience ResponsesPROVIDERS

In the chat room, tell us what you

have found most useful as training

for Geriatric concerns and

Nutritional counseling. CONSUMERS / ALLIES

In the chat room, tell us what

special concerns you can identify

in terms of aging and nutrition as

they relate to People with HIV?

Point #8

Issues around dementia andnormal loss of cognitivefunctioning.

Point #9

Assistance with insurancecoverage to maintain HAARTcoverage: ACA provisions andMedicare/Medicaid.

Point #10

Retaining people in care isimportant for all ages but moreurgent for those with diseasesassociated with aging.

In summary:

Woman infected at HS reunion.

86 year old woman from India.

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Thinking about Emily’s 10 points and

the resources participants list in the

chat room, which resources have you

found to be the most useful?

Let us know your experiences LIVE!

Speaking from Experience:Brief Peer Learning Exercise

Are there are any resources in the literature you recommend?

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Improvement Strategies Exercise

Michael Hager, MPH MANQC Manager

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in+care Campaign National Data Snapshot

December – October Data as of 11/16/2012

Dec Average

(Patients)

Dec Sites

Feb Average

(Patients)

Feb Sites

Apr Average

(Patients)

Apr Sites

Jun Average

(Patients)

Jun Sites

Aug Average

(Patients)

Aug Sites

Oct Average

(Patients)

Oct Sites

Measure 1: Gap Measure

16.19%(124,462) 207 16.15%

(130,231) 201 14.71%(129,910) 206 15.03%

(116,888) 185 14.19%(110,810) 171 15.79%

(108,669) 159

Measure 2: Visit Frequency Measure

63.44%(84,213) 155 65.74%

(87,068) 152 62.20%(103,351) 175 64.20%

(92,495) 166 64.32%(91,561) 159 62.32%

(89,541) 148

Measure 3: New Patient Measure

55.87%(7,789) 194 58.25%

(8,802) 190 58.54%(8,421) 195 59.67%

(7,220) 179 59.64%(7,074) 169 58.95%

(6,931) 156

Measure 4: Viral Suppression Measure

69.69%(135,806) 199 69.46%

(147,223) 192 70.41%(156,089) 198 71.87%

(139,967) 183 71.80%(129,933) 167 71.49%

(127,207) 155

Coming Soon – new analyses at AGM!

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Improvement Strategies Discussion

Take Home Points – Interventions!•HIV Testing

• Routine testing of all ages

•Treatment• Treat all PLWH > 45 years of age with ARVs

•Training• Understand specific MH issues, social-psychology and

cognitive impairment• Experience with treatment with multiple meds for multiple

conditions• Experience in geriatric concerns, treatments and referrals• Experience in nutrition and nutritional counseling

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Improvement Strategies Discussion

Take Home Points – Interventions!•Connect

• Leverage Health Information Exchanges (HIE) / Regional Health Information Organizations (RHIO) in your region

• Link your service to skilled nursing facilities / Visiting Nurse Association (medical care) and Patient Navigation Systems (other supports)

• Patients with appropriate payer resources and systems to support PLWH engagement (increasingly important with Affordable Care Act implementation)

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Submit Improvement Updates!

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Announcements

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• Next Meet-the-Author Webinar: L.Gardner – Low-Effort, Clinic-Wide Intervention December 12, 2012 at 1pm ET

• Next Partners in+care Webinar: Optimal Wellness for PLWHDecember 13, 2012 at 2pm ET

• Next Campaign Webinar: Sustainability of Retention Projects in Unsure Funding Environments January 9, 2013 at 2pm ET

• Campaign Webinar: Mental Health and RetentionDate Pending – to be announced!

Upcoming Events

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• Campaign Office Hours: Mondays & Wednesdays 4-5pm ET• Monday, November 19 - Open Space, no set topic• Wednesday, November 21 - National Holiday, no office hours• Monday, November 26 - Open Space, no set topic• Wednesday, November 24 - All Grantee's Meeting, no office hours• Monday, December 3 - Open Space, no set topic• Wednesday, December 5 - Sustaining Retention Projects Over Time

• Data Collection Submission Deadline: December 3, 2012

• Improvement Update Submission Deadline:December 17, 2012

Upcoming Deadlines and Office Hours

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Wednesday, November 28, 2012

12pm ET

Thurgood Marshall Ballroom South

in+care at AGM

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MedScape Retention in HIV Care Series

• Technical Working Group working on articles for a new Medscape Today News Series.

• We recommend that you subscribe to HIV/AIDS MedPlus to be informed of new and exciting articles in this series!

• Published Pieces:• Monitoring Rates of Retention in HIV Care Across the State• How Health Departments Promote Retention in HIV Care• Improving Retention in HIV Care: Which Interventions Work?• Engaging in HIV Care: What We Learned from AIDS 2012• How Should We Measure Retention in HIV Care? • Retention In HIV Care: The Scope of the Problem

http://www.medscape.com/index/section_10285_0

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Partners in+care

• Partners in+care Private Facebook Group is live! • Share tips, stories and strategies• Join a community of PLWH and those who love them• Email michael@nationalqualitycenter.org for more

details

• Partners in+care website is live!• http://www.incarecampaign.net/index.cfm/77453 • Join our mailing list (a list-serv version of the FB

Group)

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Time for Questions and Answers

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Campaign Headquarters:National Quality Center (NQC)90 Church Street, 13th floorNew York, NY 10007Phone 212-417-4730incare@NationalQualityCenter.org

incareCampaign.orgyoutube.com/incareCampaign