Evidence of Success - Pennsylvania/MidAtlantic AETC Service Area: Delaware, District of Columbia, Maryland, Ohio, Pennsylvania, Virginia, West Virginia

Philadelphia Local Performance Site

Illustration: Cluster Training

One priority area for the AETCs is to provide accelerated programming to enhance clinic site ability to provide quality HIV care. In addition, assistance to newly funded Title III programs is encouraged.

In 2000, the Philadelphia LPS organized a meeting for Northeastern Pennsylvania in order to plan "cluster" training for the region. The planning committee identified Scranton-Temple Health Center as a recent provider of HIV care and a nurse coordinator from the site joined the planning committee. The committee developed a program plan involving multiple interactive programs for physicians and nurses. An identified need for Scranton-Temple Health Center was to receive individual site needs assessment and program planning.

After the needs assessment was conducted, the next objective was to improve the quality of clinical care and to develop the Scranton-Temple Health Center into a lead HIV medical provider in the region. The action plan strategy was to provide capacity building for the clinic as well as to promote the clinic's leadership and expertise in HIV disease to the community. The training plan included multiple on-site consultations, joint skills building programs for the region to promote referral relationships and feature clinical leaders from the Scranton-Temple clinic, clinical training programs at the Philadelphia clinical teaching site, and on-site assistance in preparing a Title III planning grant and a Title III Early Intervention Services/Primary Care grant.

The clinic successfully competed for a Title III grant in 2003. It now serves as the primary clinical referral site for HIV care in the region. The Scranton-Temple Health Center has provided HIV primary care for more than 500 HIV-infected people.

The Philadelphia LPS continues to work collaboratively with the clinic which will serve as a new site for clinical training. In addition, a continuous quality improvement process is being established and an on-site adherence product is being piloted in 2004.

Outcomes

Immediate/Short-term:

	Identified training needs.
	Increased skills and knowledge of clinical staff.

Mid-term/Long-term:

	Increased the number of patients served to 500 after successful bid for Ryan White funding.
	Developed continuous quality improvement process.
	Developed on-site adherence product.

Virginia Local Performance Site

Illustration: Minority Clinical Training

The Virginia LPS based at Virginia Commonwealth University sent a minority physician provider from Richmond to attend HIV clinical training at Howard University and Johns Hopkins Hospital in 2001 through the Minority Clinical Training Initiative sponsored by HRSA. The physician provided primary care as a family practice physician and also provided care in the city and county health department STD clinics. After participating in clinical training, she decided to offer medical care to HIV-infected clients at one of the RWCA Titles II and III clinical sites where she sees 10-15 HIV-infected clients every Thursday afternoon. Presently, she is a consultant for the Virginia LPS on STD/HIV issues.

Outcomes

Immediate/Short-term:

	Increased HIV knowledge and skills of one physician.

Mid-term/Long-term:

	Expanded sites in which the physician provides clinical services.

Illustration: Virginia Department of Corrections

The Virginia Community Planning Group looked at populations at risk for HIV infection and recognized a need to educate parole officers and discharge planning staff who are instrumental in the post-release transition of HIV-infected and high-risk offenders back to the community. The Virginia LPS, the Virginia Department of Health, and the Department of Corrections have collaborated in the development of pre- and post-release training programs to meet these needs. The programs support continuity of care and services for HIV-infected inmates released into the community.

Training programs conducted for the Department of Corrections have established pre- and post-release programs for HIV-infected parolees, who are now assessed prior to release. Follow-up appointments for medical care are made and the parolee is released with a 30-day supply of medications. The parole office follows up with the parolee on the medical appointment. Fifteen training programs have been conducted for probation and parole officers in the Virginia Department of Corrections (DOC) and five "Seamless Transition" programs were conducted throughout the state. In June 2001, the program expanded into Northern and Eastern Virginia and the state Department of Corrections has adapted the program for local jails and corrections facilities.

Outcomes

Immediate/Short-term:

	Established pre- and post-release programs for HIV-infected parolees.

Mid-term/Long-term:

	Expanded training to other parts of Virginia.
	Adapted training for local jails and corrections facilities.
	Increased discharge planning and linkage to care.