Ryan White Part C Reauthorization: Impact On UW Health HIV Care Program

407 new cases of HIV infection were reported in ,929 cases have been reported since ,684 cases are classified as AIDS, 3,245 as non-AIDS. 3,635 persons reported with HIV infection are known to have died. 6,294 persons with HIV infection were presumed to be alive at the end of Wisconsin AIDS/HIV Surveillance Data December 31, 2007 Number of persons reported with HIV infection by year of report, Wisconsin, Between 1998 and 2007: Average = 383 cases per year 95% Confidence interval= cases per year Number of persons reported with HIV infection and presumed alive at year’s end, Wisconsin,

New Cases of HIV Infection Reported Cases Wisconsin AIDS/HIV ProgramWisconsin data, cases reported through December 31, 2007.

UW Health HIV Care Program Catchment Area * *

UW HIV-18% Women 55% of Women are Minorities UW HIV Clinic Demographics Compared to WI State Population and WI HIV Demographics

UW Health HIV Care Program Risk Groups

Beloit Community Health Center Wisconsin Prison System Aids Network WI HIV/AIDS Bureau (RW Part B) UW Health HIV Care Program University of Wisconsin Hospitals and Clinics Satellite Clinic 80 Patients Staff Nurse Social Worker NA 10 State Prisons 130 Patients Come to UW Clinic Testing and Counseling Prevention ADAP Prison Case Manager Other Funding 17 Individuals Staff Clinic 2 HIV Infected 2 Multi-lingual CAB QA/QI Committee Multiple Specialties Funds several staff Contracts UWMF

Medical Case Management Integration of Services Increase Access to Services and Retention Continuity of Care Enhanced Independence Increased Knowledge about HIV Ryan White HIV/AIDS Treatment Modernization Act of 2006 Goals

CLIENT Physicians/PA Nurse/NAs Social Worker Case Managers Dentists Treat/Adhere Pharmacists Mental Health Nutritionist Data Analyst TranslationResearch Appointment UW HIV Care Coordination Model Coordinator Providers Coordinator Services 4 Physicians 2 ID Immunologist Internist PA Provider 2 Nurses 2 NAs NA Schedules Referrals Psychiatrist Psychologist In Clinic 2 Social Workers 1 is Prison Case Manager Administrator Pain Specialist (MD) Brochure

UW Health HIV Care Program Total, New and RW Part C Patients (2008 is Thru August) --

UW Health HIV Care Program Visits (2008 is Thru August)

CD4 Counts (New Patients) and HIV RNA Levels <50 Viral Load

Prison Case Management One of our social workers deals primarily with individuals infected with HIV and incarcerated All incarcerated individuals with HIV from the State prisons attend our clinic in the UWHC and have access to all the services in our clinic and the hospital The Prison Case Manager coordinates prisoner HIV discharge planning---sets up appointments in the community, assures have meds to time of appointment, etc Data for time period January-July inmates released –2 refused release planning –1 took info only –20 attended scheduled apt in community –5 no-shows –3 either did not have apt yet or release delayed

Challenges with RW—Part C We continue to grow but our space does not As the patient load grows our staff doesn’t—the nurse position especially challenging Staff attrition Transportation and weather at times a problem in our community Dental—hospital dentist is retiring State ADAP may go to a waiting list 2011 The economy