1. Romni Neiman Jessica Frasure-Williams Wanda Jackson

3. Rev. 11/2015 Note: N=2,251; N does not include HIV status unknown or refused to state: 563 cases in 2014. * Includes primary, secondary, and early latent syphilis. † Los Angeles cases have been excluded as the data does not differentiate HIV results as being new or previous. New HIV Positive  Linkage to HIV care  HIV partner services  Counseling HIV Negative  HIV testing  Education & counseling  Linkage to PEP  Linkage to PrEP Previous HIV +  Re-engagement in care  Prevention counseling  HIV partner services New HIV+ 4%

8.  Goal: Develop a certification model that reflects the full spectrum of DIS knowledge, skills, and abilities across communicable diseases.  Certification expected to ◦ standardize and validate the knowledge, skills, and abilities of DIS ◦ drive standardization and improvement of training ◦ increase quality and consistency of service delivery ◦ increase recognition of skills and abilities of DIS

9.  Formally recognize the contribution of this classification  Professional growth and development  Political momentum regarding Ebola and other emerging issues  Potential reimbursement for service delivery

11. The mentor offers the following  Training on identified core competencies  Tracking tools and documentation of progress  Mentorship and coaching for 3 months  Observation of mentee to determine readiness.

13. 1. Identify patients for linkage 2. Assign to PS/Linkage DIS 3. DIS Conduct Linkage Activities 4. Confirm and Document Linkage 5. Feedback to Surveillance

14.  DIS embedded in testing clinics  Referral from private provider  Surveillance generates NIC list

15.  Patient is assigned to a PS/Linkage DIS  Prioritizing based on local criteria  Confirm through provider contact or other means that patient is NIC  Assess any specific needs from available information

16.  Necessary materials and resources organized  Patient contacted  Assure patient of confidentiality and benefit of linkage services  Make warm handoff to further linkage assistance

17.  Name, Role, Purpose of Call  Discuss Confidentiality  Polite Check-In around new diagnosis  Discuss Benefits of Linkage to Medical Care  Minimize transmission to others  Live healthy life  Reduce chance of advancing to AIDS through medical treatment  Increase T-Cell Count  Decrease viral load  Manage other infections  Ongoing immune system monitoring  Provide/monitor treatment to avoid drug resistance  Test and/or treat partners to reduce chance of HIV acquisition

18.  Discuss programs to support access to care  Ryan White Case Management Services  No-Cost services locally  ADAP  ACA  Medicare  Other services (e.g. drug rehab)  Inquire about patients readiness to link to medical care and/or discuss barriers to link to care  Secure initial medical appointment  Close (Thank patient, address final concerns, extend phone number with your name

19.  Confirm patient has attended first medical appointment  Document linkage as required by program  Disposition case using local Codes

20.  Information learned during linkage activities  Mechanisms for closing loop  Maintaining security of information

23.  Assist patients with starting HIV care within 1 month after diagnosis  Inform persons of benefits of starting HIV care/ART early  Assess facilitators/barriers to linkage  Help persons enroll in health insurance or medical assistance programs  Collaborate with other providers that promote prompt linkage services  Track outcomes of linkage services and provide follow-up assistance

24.  Record searches should be conducted within 24 hours and immediately documented  Initiation of follow-up of HIV positive persons for linkage to care services should begin within 24 hours  Newly tested HIV positive persons should be interviewed within 7 days  PLWHA should be referred to care within 30 days  Field visits should begin within 24 hours if unable to contact by phone, text, or e-mail

25.  All partners of newly diagnosed HIV positive persons should be located, tested and possibly treated within 7 days  Case closure should occur within 30 days or until first medical appointment has been made and verified, whichever comes first  Case closures should be submitted to supervisor for review within 24 hours  Once a case is complete, information should be updated in electronic HIV surveillance system within 1 week  Surveillance coordinator should follow up on all congenital labs and prenatal HIV reports within 48 hours

26.  Training and continuing education  Regular observation and feedback  Regular case conferences  Review of records

28. 4 discrete “Tracks” based on Partner Services job function 8 Disease Concepts web modules 5-7 Partner Services introduction and skills modules, depending on Partner Services function 3-day or 5-day instructor-led course after completion of web modules for Partner Services providers 8 Disease Concepts web modules 5-7 Partner Services introduction and skills modules, depending on Partner Services function 3-day or 5-day instructor-led course after completion of web modules for Partner Services providers Those who refer patients to Partner Services Those who provide various phases of Partner Services Those who refer patients to Partner Services Those who provide various phases of Partner Services Web-based training with no instructor-led component Structure: Blended curriculum: Intended audience: Online only:

29. For medical providers and other referring providers who refer patients to a Partner Services Program. Includes: 1 online module (CME, CNE, CHES credit), other modules are optional For medical providers and other referring providers who refer patients to a Partner Services Program. Includes: 1 online module (CME, CNE, CHES credit), other modules are optional Track A For those who conduct elicitation and referral primarily for HIV, with limited or no notification. Includes: 13 online modules and a 3-day instructor-led course For those who conduct elicitation and referral primarily for HIV, with limited or no notification. Includes: 13 online modules and a 3-day instructor-led course Track B For those who conduct elicitation and/or notification and referral for Gonorrhea, Chlamydia, HIV, and Syphilis (excludes Syphilis case management and VCA). Includes: 13 online modules and a 3-day instructor-led course For those who conduct elicitation and/or notification and referral for Gonorrhea, Chlamydia, HIV, and Syphilis (excludes Syphilis case management and VCA). Includes: 13 online modules and a 3-day instructor-led course Track C For those who conduct full spectrum of Partner Services- interviewing; elicitation; notification and referral; Syphilis case management; and, Visual Case Analysis (VCA). Includes: 14 online modules, VCA E3 webinar series, Lot System module (optional), and a 5-day instructor-led course For those who conduct full spectrum of Partner Services- interviewing; elicitation; notification and referral; Syphilis case management; and, Visual Case Analysis (VCA). Includes: 14 online modules, VCA E3 webinar series, Lot System module (optional), and a 5-day instructor-led course Track D

34.  What do you need to strengthen HIV/STD integration?  How can you build DIS capacity?  What support do you need form CDPH?  What concern do you have regarding STD/HIV integration and engagement of DIS to fulfill HIV LTC role?