ANNEX 2
FY 2014 PUBLIC HEALTH MASTER AGREEMENT ANNEX
Program Descriptions and Reporting Requirements
PROGRAM NAME: Enhanced Comprehensive HIV Prevention Plan (ECHPP)
PROGRAM CODE:
PURPOSE:
The purpose of this program is to implement comprehensive human immunodeficiency virus (HIV) prevention programs to reduce morbidity, mortality, and related health disparities. In accordance with the National HIV/AIDS Strategy (http://www.whitehouse.gov/sites/default/files/uploads/HNAS.pdf), this program will focus on addressing the HIV epidemic in Georgia in four overarching areas: 1) by reducing new infections, 2) increasing access to care, 3) improving health outcomes for people living with HIV, and 4) promoting health equity.
CDC has mandated that prevention funds must be directed to the following activities with demonstrated potential to reduce new infections:
· HIV testing – including routine opt-out testing in healthcare settings and targeted testing programs for high-risk populations
· Prevention with HIV-positive individuals – helping people living with HIV reduce their risk of transmitting HIV to others
· Condom distribution for people at high risk of acquiring HIV
· Structural initiatives – aligning structures, policies, and regulations to enable optimal HIV prevention, care, and treatment
The aforementioned will be achieved by supporting high incidence health districts’ in the provision of HIV testing, linking HIV positive persons to medical care and other essential services, increasing HIV awareness and education in targeted communities and increasing program monitoring and accountability. Standard performance measures for HIV prevention programs that are consistent with the focus of the National HIV/AIDS Strategy on improving performance and accountability will be used to evaluate the performance and effectiveness of program activities.
FUNDING REQUIREMENTS:
- In collaboration with Office of HIV/AIDS Staff, recipients are responsible for developing a comprehensive HIV prevention plan specifically tailored to the needs of the district as well as an outcome driven program implementation work plan outlining the specific tasks and activities to be accomplished, time-line for completion of each task, and key performance indicators to evaluate its success, including, but not limited to the number of HIV tests to be conducted, number individuals to be linked to prevention services and condom distribution goals for each month.
- Recipients are required to comply with the Office of HIV/AIDS List of Minimum Quality Standards for HIV Prevention and HIV Testing Programs (Form HIV-900), as applicable.
- Recipients must cooperate with the contract monitoring process set forth by the Office of HIV/AIDS to ensure the appropriate use of federal awards and in compliance with the specifications of the annex agreement.
- Recipients must comply with all standardized training requirements for HIV Prevention and HIV Testing Programs and provide documentation that all staff positions funded in whole or in part by these funds have received the required training. Recipients must ensure ongoing performance assessment and continuous training and development of all staff positions funded by this annex.
- All clients who receive an HIV test must also receive pre and post test counseling and linkage services.
- All clients who receive a preliminary positive test result will receive confirmatory testing.
- All clients who are identified as HIV infected must be linked to HIV care as well as partner services (PS), STD, Hepatitis, and TB screening, and other supportive services. Documentation of linkage must be provided for each confirmed HIV-positive client.
- A copy of the Georgia Adult HIV/AIDS Confidential Case Report Form must be completed and attached to the test form of all confirmed HIV-positive clients. The original copy must be mailed to: Georgia Division of Public Health, EPI Section, PO Box 2107, Atlanta, GA 30301. All case report forms for HIV/AIDS must be completed within seven (7) days of patient diagnosis. At a minimum, sections 2 through 6 and sections 8 through 9 of the Confidential Case Report Form must be completed. Submitting a copy of this form with the CDC Test form does not replace any district or local procedures for Confidential Case Reporting.
- All clients who are identified as HIV negative with high risk behaviors must be linked to prevention services.
- Recipients who receive an annual allocation of $100,000 or greater shall provide at least one full-time Health Educator to conduct HIV rapid testing services, CRCS and/or EBIs for HIV infected individuals, or one full-time Communicable Disease Specialist (CDS) for contact tracing and testing of contacts of newly diagnosed HIV infected individuals giving priority to those with acute infection.
Restrictions:
- Recipients may only expend funds for reasonable program purposes, including personnel, travel, supplies and services such as laboratory fees
- Funds may not be used to provide direct patient medical care
- Funds may not be used for research purposes. (As defined in the Code of federal regulations (title 45, Part 46) the term “research” means, “a systematic investigation, including research development, testing and evaluation, designed to develop or contribute to generalizable knowledge.”
- Administrative costs may not be charged to this program unless the Department’s Office of Financial Services has approved a cost allocation plan.
- A portion of CDC prevention funds may be used for client incentives (such as for participation awards to facilitate client recruitment and retention) in accordance with the Office of HIV/AIDS List of Minimum Quality Standards for HIV Prevention and HIV Testing Programs (Form HIV-900). Awards to be used should be outlined in a plan submitted with the first monthly programmatic and data reports. All participation awards purchased must be inventoried and reported on monthly programmatic report.
- Funds may be used to develop, purchase or distribute health education materials only with the approval of each item by the Office of HIV/AIDS Materials Review Committee
Deliverables:
- Provide targeted, confidential HIV rapid testing services for persons with recent high risk behavior.
- Provide comprehensive HIV prevention services for HIV infected individuals (prevention for positives) to include Comprehensive Risk Counseling and Services (CRCS) and/or an Effective Behavioral Intervention (EBI) from the CDC compendium of EBIs for HIV-infected individuals.
- Recipients shall implement HIV rapid testing services and HIV prevention interventions with fidelity to the core elements of HIV rapid testing and/or HIV prevention interventions as set forth in the CDC Provisional Procedural Guidance for Community Based Organizations.
- Only FDA-approved, Clinical laboratory Improvement Amendments (CLIA)-waived rapid HIV antibody screening tests may be utilized for this program. Such technologies are considered more convenient when compared with conventional venipuncture methods and other options that require clients to return for their results several days later. Waived tests must use unprocessed specimens (such as oral fluid or blood from a finger stick). Recipients must have on file current documentation of either a CLIA Certificate of Waiver or a CLIA certification.
Outcome Measures:
- Measurable outcomes of the program will be in alignment with one or more of the following performance goals for the National Center for HIV/AIDS, Viral Hepatitis, Sexually Transmitted Disease (STD), and Tuberculosis (TB) Prevention (NCHHSTP).
1) Decrease the annual HIV incidence rate in communities where HIV is most heavily concentrated.
2) Decrease the rate of HIV transmission by HIV-infected persons.
3) Decrease risky sexual and drug-using behaviors among persons at high-risk for acquiring HIV.
4) Increase the proportion of HIV-infected people in Georgia who know they are infected.
5) Increase the proportion of HIV-infected persons who are linked to prevention and care services.
PERFORMANCE MEASURES:
- At least 80% of the total number of clients served must be from the target population described in the programmatic work plan. The remaining 20% of clients may be recruited from other target populations.
- To ensure at least 95% of the total number of clients tested have recent High-Risk Behavior (HRB) for HIV infection, the health district will determine eligibility using the established behavioral risk screening criteria. Recent high risk behavior is defined as having either one (or both) of the following two activities with a person of unknown or serodiscordant HIV status at least once during the past 12 months:
o High-Risk Activity #1: Having unprotected (without a condom) anal or vaginal intercourse (UAVI).
and / or
o High-Risk Activity #2: Sharing needles or injection drug works.
- The recipient must strive to attain a positivity rate of 2.0% or higher. The positivity rate is defined as the number of newly-diagnosed, confirmed HIV-positive cases (numerator) divided by the number of HIV tests conducted (denominator). On a monthly basis, recipient must calculate its positivity rate for all HIV tests conducted with funding from this grant-in-aid program. Each month, as part of its narrative progress report, the recipient must report the numerator, denominator and positivity rate for the previous month. If the positivity rate is less than 1.0% for any two consecutive months, recipient must develop and implement a corrective action plan aimed at increasing this rate, and describe those plans in its monthly narrative report. A corrective action plan might include options such as:
1) re-training staff on clear HIV testing eligibility criteria so that HIV tests funded under this grant are offered only to clients who meet the DPH definition of recent high risk behavior and emphasizing deferral of clients who do not meet this definition or who are of low risk;
2) making outreach plans more strategically-targeted and incorporating venues, web sites, organizations and events that are known to be popular with persons who have recent HRB;
3) using the social networks strategy as described at www.effectiveinterventions.org and/or other strategies as deemed by the recipient to be appropriate based on local needs and circumstances
- At least 95% of those identified as HIV infected will receive confirmatory test results.
- At least 95% of those identified as HIV infected will be referred to partner services (PS).
- 100% of those identified as HIV infected who receive a test result will be linked to HIV treatment and care services.
- 100% of clients identified as HIV negative with recent high risk behavior will be referred to HIV prevention services.
REPORTING REQUIREMENTS:
- Recipients must comply with all programmatic and data reporting requirements designated by the Office of HIV/AIDS.
- The health district must submit an updated program implementation work plan 30 days after the notification of availability of funds for grant expenditures.
- Monthly programmatic reports and data reports, including HIV data reporting forms (HIV Test Forms) must be submitted no later than the 15th of each month.
- Each year, the December monthly narrative report (due January 15) shall be written from a year-end perspective with narrative discussion of accomplishments and challenges for the preceding twelve months.
- A grant-in-aid budget must be submitted 30 days after the notification of availability of funds for grant expenditures. The following line item categories should be included: personal services, regular operating, travel, equipment, facility costs, subcontracts, and telecommunications.
- Recipient shall not exceed the budget for this grant (either total budget or any individual line item).
- If needed, recipient may request one budget revision per calendar year for the purpose of reallocating grant funds between any two or more budget line item categories, subject to approval from the assigned contract monitor.
- At the end of each grant period, if there are any funds remaining unspent in the health district’s grant, there exists a possibility that grant allotment amount for the health district’s next subsequent grant period may be reduced by the amount of funds that were unspent.
- A memorandum of agreement (MOA) must be signed annually by each collaborative partner (sites to which clients are referred for STD testing, or HIV care, sites that refer clients for HIV testing, etc.) and a copy submitted to the Office of HIV/AIDS.
- A quarterly expenditure summary report must be submitted to the HIV Unit at the end of each quarter using Form HIV-565 (“Quarterly Expenditure Summary for GIA Programs”). Quarterly expenditure summary reports are due April 15, July 15, October 15 and January 15.
- Every six months, a health district staff member shall observe and document each HIV testing facilitator conducting at least one HIV rapid testing and prevention counseling session.
HIV Prevention Intervention Reports:Georgia Department of Public Health
Office of HIV/AIDS
Attention: Michael Seabolt
2 Peachtree Street, NW
12th Floor
Atlanta, GA 30303
Email:
Phone: 404-656-6426
Note: Contract monitors are assigned to oversee each health district grant-in-aid program. Reports should be sent directly to the assigned contractor monitor for your health district. / HIV Testing and Counseling Data and Reports
Georgia Department of Public Health
Office of HIV/AIDS
Attention: Brandi Williams
2 Peachtree Street, NW
11th Floor
Atlanta, GA 30303
Email:
Phone: 404-657-3123
The most recent revision of reporting forms can be downloaded at http://health.state.ga.us/programs/stdhiv/index.asp or by contacting Michael Seabolt at .
PROGRAMMATIC CONTACT:
Georgia Department of Community HealthDivision of Public Health
Infections Disease and Immunization
Office of HIV/AIDS
Attention: Brandi Williams
2 Peachtree Street, NW
12th Floor
Atlanta, GA 30303
Email:
Phone: 404-657-3123