ANNEX 2
FY 2014 PUBLIC HEALTH MASTER AGREEMENT ANNEX
Program Description and Reporting Requirements
PROGRAM NAME: HIV/AIDS Surveillance
PROGRAM CODE: 141
FUNDING SOURCE: Federal GA HIV AIDS Surveillance
PURPOSE: The purpose of this program is to support the expansion of HIV/AIDS Surveillance activity into the local district. This agreement facilitates the placement of a Full Time HIV Surveillance Staff within the Augusta, Savannah and Columbus Health Districts.
FUNDING REQUIREMENTS:
· Provide a secure office space to the employee.
· Provide work environment that ensures security and confidentiality of HIV/AIDS data based on Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its amendments, rules, procedures, and regulations, as well as CDC security and confidentiality guidelines for HIV data that will be provided.
· Establish regular communication with the employee to ensure an effective work related collaboration.
Restrictions:
· This agreement shall remain in full force and effect until terminated by the parties.
· Under normal or other conditions, this contract can be canceled by either party by giving to the other party a written thirty (30) day notice by certified mail of its intentions.
· No amendment, waiver or termination of this contract or any of the terms and provisions hereof, shall be binding upon either party unless confirmed in writing executed by both parties.
Deliverables:
Primary
¾ Provide logistics to the employee, including but not limited to computers, office supplies, office furniture, printer, file cabinets, and shredder.
¾ Provide the administrative processes for the position, including salary, leave approval, performance evaluation and other managerial functions.
¾ Provide supervision to the employee through the Regional HIV/AIDS Surveillance Coordinator.
¾ Pay up to $300.00 per month for the office space the employee will occupy during the execution of this agreement.
Secondary
Provide office space for HIV/AIDS Surveillance EPI 1 to perform the following duties:
¾ Conduct core surveillance activities for assigned geographic areas; as well as, to conduct surveillance activities as required in the HIV/AIDS Epidemiology Team office in Atlanta.
¾ Perform active and passive surveillance to ensure completeness and timeliness of HIV/AIDS case reporting.
¾ Use HIV/AIDS surveillance Enhanced HIV/AIDS Reporting System (eHARS) to identify providers with unreported HIV/AIDS cases and reach out to them to get cases reported.
¾ Reach out to different providers involved in HIV/AIDS prevention, treatment and care to collect patients’ risk history information.
¾ Track surveillance activity using necessary databases to generate new and follow-up cases for investigation to complete reporting.
¾ Contribute to special projects within HAEP and represent the team at internal and external meetings.
¾ Follow all HIV/AIDS reporting procedures as well as security and confidentiality guidelines for conducting HIV/AIDS surveillance.
¾ Foster community relationships; work cooperatively with others stakeholders, including Community-Based Organizations, laboratories and private/public health providers to achieve the HAEP goals.
¾ Display a high level of effort and commitment to performing work; operate effectively within the organizational structure; demonstrate trustworthiness and responsible behavior.
¾ Act as a resource for HIV/AIDS throughout area of responsibility by providing trainings and education to internal and external partners as needed.
PERFORMANCE MEASURES:
Objective: • Provide work environment that ensures security and confidentiality of HIV/AIDS data based on Health Insurance Portability and Accountability Act of 1996 (HIPAA) and its amendments, rules, procedures, and regulations, as well as CDC security and confidentiality guidelines for HIV data that will be provided.
Objective: • Provide a secure office space to the employee.
Objective:
ALLOCATION METHOD:
Funding allocation amount is based upon historical amount previously paid for this activity.
REFERENCES:
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996
https://www.cms.gov/Regulations-and-Guidance/HIPAA-Administrative-Simplification/HIPAAGenInfo/downloads/HIPAALaw.pdf
CDC security and confidentiality guidelines for HIV data
http://www.cdc.gov/nchhstp/programintegration/docs/PCSIDataSecurityGuidelines.pdf
REPORTING REQUIREMENTS:
HIV/AIDS Surveillance will conduct a sight visit to evaluate the work environment for the Epi 1 that will be conducting HIV/AIDS Surveillance activities within the respective district.
The will be no necessary reports that the health district should provide HIV/AIDS Surveillance because they’re goal is to provide only a work space for this employee.
PROGRAMATIC CONTACTS:
PROGRAMMATIC/STATISTICAL REPORTS ARE TO BE TRANSMITTED ELECTRONICALLY DIRECTLY TO: N/A
HIV/AIDS Section Chief:Georgia Department of Public Health
HIV/AIDS Epidemiology
Attention: Jane Kelly, MD
HIV/AIDS Epidemiology Section Chief
Georgia Department of Public Health
2 Peachtree Street, NW
Atlanta, Georgia 30303
Phone: 404-657-2601
/ HIV/AIDS Regional Liaison Supervisor:
Raimi Ewetola, MD, MPH
HIV Epidemiology Unit
Georgia Department of Public Health
Chatham CARE Center
107 B. Fahm Street
Savannah, Georgia 31401
912-651-0993 (Direct office Phone)
912-651-2365 (Fax)
404-561-3956 (Cell)
PROGRAMMATIC CONTACT:
Georgia Department of Public Health
HIV/AIDS Surveillance
Attention: Rodriques Lambert
HIV/AIDS Core Surveillance Coordinator
2 Peachtree Street, NW
12th Floor
Atlanta, GA 30303
Email:
Phone: 404-657-2515
/ Augusta Health District ORP:
For the District 6 East Central (Augusta)
Sylvia Williams, RN, BSN
HIV Coordinator
District Projects Office
1916 North Leg Road
Augusta, GA 30909
Phone: (706) 667-4342
Fax: (706) 667-4728
ANNEX 2
Columbus Health District ORP:Beverley A. Townsend, MD, MBA, FAAFP,
District Health Director.
Columbus Health District POC:
Loretta Willis, R.N., B.S.N.
Infectious Disease Coordinator
District Clinical Services
West Central Health District
2100 Comer Avenue
Columbus, GA 31904
Phone: (706)321-6420
Fax: (706)321-6428