The HOPE Center The Past, Present & Future of A Center of

1
The HOPE Center

• The Past, Present Future
• of
• A Center of Excellence

2
The Past

• MBCHD
• Hemlock Street

3
1985

• 1 Patient
• Dr. Harold Katner, M.D. is hired by MUSM
• No local health care for HIV
• People With AIDS (PWA) group was formed
• Raised to help pay rent utility bills
• Provided transportation to Grady Hospital
• Central City AIDS Network formed
• First support group started

4
1986

• MCCG tells Dr. Katner he can not tell where he
  works because the hospital doesnt want to be
  Grady South
• Dr. Katner opens private office
• Starts delivering care locally

5
1987

• Ambulatory Health Center agrees that Internal
  Medicine clinic can treat HIV and admit patients
  to hospital
• No separate facilities
• No privacy at registration and check-in
• Better than Grady but not a good solution
• Patients had a co-pay to see doctor lab

6
1988

• A meeting is called to discuss needs with
• MBCHD Administrator Cecil Baldwin
• District Health Director Brooks Taylor, M.D.
• District AIDS Coordinator Angela Strickland
• Dr. Harold Katner, M. D.
• Dr. David Parrish, M.D.
• Director of CCAN Cathy Dillard
• President of PWA Johnny Fambro

7
The night is always darkest before the dawn
8
1989

• Partners used volunteers to start clinic
• MBCHD
• District Health Office
• MUSM
• CCAN PWA (organizations merged)
• Medical Center of Central Georgia (MCCG)
• No money is used to operate clinic
• 24 clients attended first clinic day
• Clinic was Friday morning in back of building

9
1991

• Applied for Ryan White Title II funding
• Initially request was denied because we already
  had a clinic operating money was for new
  services
• We eventually receive Title II support to expand
  services and staff
• We have outgrown our facility

10
1994

• Health Department building sold to MCCG
• Health Department moves to new facility
• Large private waiting room
• Confidential check-in
• Private clinical area
• Private treatment rooms
• Walter F. George School of Law, Georgia Legal
  Services and AIDSLaw Project in Atlanta start a
  project here with interns and advisor.

11
1994

• CCAN begins offering housing assistance through
  Housing Opportunities for People With AIDS grant
• Case management services added to clinic
• Consortium is formed

12
1999

• CCAN hires a consultant/grant writer to develop
  Ryan White Title III grant
• District Health office could never find project
  money and we needed the primary healthcare, Early
  Intervention Services
• Grant was awarded following year after 1/3
  reduction in requested funds

13
2001

• Title III contract awarded
• Program Manager Patricia Yancey is hired
• District office assumes administrative oversight
  with Program Director answering directly to Dr.
  Swartwout
• Consortium begins developing a plan to relocate
  the clinic from the health department to a
  freestanding confidential setting

14
Again, Darkness is Broken
15
March, 2002

• Clinic is relocated to stand alone facility
• Consumer survey implemented to name the clinic
  The HOPE Center was chosen.
• MBCHD assists in furnishing equipment we had not
  already purchased
• CCAN assists in moving
• Clinic days are expanded from 2 half days to 5
  full days

16
2002-contd

• Free standing building gives more expectation of
  consumer privacy
• Allowed expansion of specialty care
• Staff dedicated to our consumers only
• Able to capture retain third party billing
• More office space for CBOs

17
(No Transcript)
18
Medical Center of Central Georgia
19
North Central Health District 5-2
20
Bibb County Board of Health
21
Mercer University School of Medicine
22
The HOPE Center On-Site Care
23
Specialty Care
24
CBOs and Faith Based Services
25
Community Partners
Medical Center J. Michael Simmons, Jr., DO,
FAAO W. T. Anderson Center Lenscrafters,
Inc. Oconee Regional Hosp. Loaves
Fishes Houston County Hosp. Perry Hospital
SEATAC Macon Coalition to End
Homelessness Neighborhood Health Centers Georgia
Legal Services River Edge Behavioral
Health Oglethorpe Dental Center Phoenix
Center Red Cross Oconee Center Salvation
Army Hospice Care Providers Faith Based
Organizations MOMAS Mentors Project Middle
Georgia Sisterhood, Inc. Central City AIDS
Network, inc.
26
Consumer Involvement

• Started at MBCHD
• Consumer Created
• Consumer Built
• Consumer Driven
• Lead and serve on Consortium
• Quarterly Consumer Satisfaction Survey
• Active Grievance Policy
• Serve on CQI Committee
• Special Projects
• Participate in needs assessment focus groups

27
Clinic Flow

• Check In with Program Assistant
• Vital Signs taken and recorded
• Nursing assessment
• See an Intern and a Physician
• Social Service assessment follow-up
• Assessment and follow-up by registered dietician
• Nursing exit interview Adherence Compliance
  education offered
• Lab tests (if indicated)
• Meet with Program Assistant to work out financial
  requirements (sliding-fee-scale)

28
Reduce Duplication of Effort

• Share forms and documents
• Host tours to share info to other clinics
• Policy Procedures Manual copied often
• Provide TA to State and other districts
• Receive TA to State and other districts
• State adopted HOPE Centers medication adherence
  and compliance policy
• Data support to track services for each consumer

29
Consortium

• State recognizes North Central Ryan White
  Consortium as a model for the State
• Meets Monthly
• Active consumer involvement
• Active community involvement
• Support of Administration
• Provide TA to other consortia
• Experienced and stable leadership

30
A word about our grant

• Grant document since the initial document has
  been written by a grant team
• Team consists of President of Consortium
  Consumer Program Manager Nurse Manager,
  District AIDS Coordinator Office Manager and CBO
  representative
• Use needs and gaps assessment consumer
  satisfaction survey data CADR data CDC, DHR and
  local data as well as existing and emerging
  trends to develop an effective application.
• Application has steadily improved over the term
  of the grant because of stable membership and
  experience of the team

31
Center of Excellence

• Dr, Harold Katner is Professor of Internal
  Medicine at MUSM and State of Georgia HIV Medical
  Advisor
• Dr. Jeffrey Stephens Professor of Internal
  Medicine at MUSM and Director of Infection
  Control at MCCG
• Dr. Katner producing an educational DVD for
  distribution
• Multiple Pilot projects (ADAP, CAREWare, etc.)
• Recognized by State of Georgia and HRSA
• Asked by HRSA to present at August TA Conference
• Asked by Dr. Swartwout to present at GPHA
  Conference in September

32
Make up of Consumers - Regional Data

• 140 Million women in the USA
• 29 of those women live in the South
• 76 of the new infections in South are Women
• 25 of the approximately 1 million HIV in
  America are women

33
Make-up of Consumers - Local

• Largest females in Georgia 38
• More heterosexual transmissions than state
  average 52
• Disproportionate number of consumers of color
  82
• 88 of females women of color
• Average age of clients older 38 gt44
• Average age of new infections 37
• Average CD4 at intake 276
• Average viral load at intake 87,845

34
Clinic Growth
35
The FutureSo bright we gotta wear shades
36
2 Million SPINS Plan

• Mayor of Macon C. Jack Ellis and third district
  Congressman Jim Marshall are working on a plan to
  bring an additional 2,000,000 to the area for
  AIDS services through a Special Projects of
  National Significance grant.
• Gave the Mayor our wish list
• Waiting on reply and working on other angles to
  accomplish list

37
Wish List

• 20 Unit apartment complex for homeless people
  living with HIV using profit to fund two staff
  positions
• Build a new HOPE Center to local needs and specs
  adding an education center for training and small
  conferences
• Contract a grant writer to develop additional
  resources for Substance abuse services
• More to expand vision and dental services
• Stable State level staff and TA
• More clinical staff

38
Wish List Cont.

• Recruit, employ and retain a qualified, stable
  staff
• Recruit, employ and retain a full or part time
  primary care physician
• Hire two additional Social Workers
• Have the State of Georgia recognize The HOPE
  Center as a specialty clinic to remove salary
  restraints imposed on public health employees