# Presentation: 236090

## Ryan White Part C Reauthorization:

**Impact On UW Health HIV Care Program**

## 
407 new cases of HIV infection were reported in 2007.

9,929 cases have been reported since 1983.

6,684 cases are classified as AIDS, 3,245 as non-AIDS.

3,635 persons reported with HIV infection are known to have died.

6,294 persons with HIV infection were presumed to be alive at the end of 2007.

**407 new cases of HIV infection were reported in 2007.**
**9,929 cases have been reported since 1983.**
**6,684 cases are classified as AIDS, 3,245 as non-AIDS.**
**3,635 persons reported with HIV infection are known to have died.**
**6,294 persons with HIV infection were presumed to be alive at the end of 2007.**

**Wisconsin AIDS/HIV Surveillance Data***** ******December 31, 2007***

**Number of persons reported with HIV infection by year of report, Wisconsin, 1990-2007**

- Between 1998  and 2007:
- Average = 383 cases per year
- 95% Confidence interval=336-430 cases per year

**Number of persons reported with HIV infection and presumed alive at year’s end, Wisconsin, 1990-2007**

## New Cases of HIV Infection Reported 

***Wisconsin AIDS/HIV Program***

***Wisconsin data, cases reported through December 31, 2007.***

## *

**UW Health HIV Care Program****Catchment Area**

*****

*****

## UW HIV Clinic Demographics Compared to 

**UW HIV-18% Women**
**              ****55% of Women**
**              ****are Minorities**

- UW HIV Clinic Demographics Compared to
- WI State Population and WI HIV Demographics

## UW Health HIV Care Program Risk Groups

**UW Health HIV Care Program Risk Groups**

## UW Health HIV 

**Beloit **
**Community**
**Health**
**Center**

**Wisconsin**
**Prison**
**System**

**Aids **
**Network**

**WI**
**HIV/AIDS**
**Bureau**
**(RW Part B)**

- UW Health HIV
- Care Program

- University of Wisconsin
- Hospitals and Clinics

**Satellite Clinic**
**80 Patients**
**Staff Nurse Social**
**Worker NA**

**10 State Prisons**
**130 Patients**
**Come to UW Clinic**

**Testing and **
**Counseling**
**Prevention**

**ADAP**
**Prison Case**
**Manager**
**Other Funding**

**17 Individuals **
**Staff Clinic**
**2 HIV Infected**
**2 Multi-lingual**
**CAB**
**QA/QI Committee**

**Multiple Specialties**
**Funds several staff**
**Contracts UWMF**

## Medical Case Management

**Medical Case Management**

**Integration of Services**

**Increase Access to Services and Retention**

**Continuity of Care**

**Enhanced Independence**

**Increased Knowledge about HIV**

**Ryan White HIV/AIDS Treatment Modernization Act of 2006**

**Goals**

## CLIENT

**CLIENT**

**Physicians/PA**

**Nurse/NAs**

**Social Worker Case Managers**

**Dentists**

**Treat/Adhere**

**Pharmacists**

**Mental Health**

**Nutritionist**

**Data Analyst**

**Translation**

**Research**

**Appointment**

**UW HIV Care Coordination Model**

**Coordinator**

**Providers**

**Coordinator**

**Coordinator**

**Services**

**4 Physicians**
**2 ID **
**Immunologist**
**Internist**
**PA Provider**

**2 Nurses**
**2 NAs**
**NA Schedules**
**Referrals**

**Psychiatrist**
**Psychologist**
**In Clinic**

**2 Social **
**Workers**
**1 is Prison **
**Case**
**Manager**

**Administrator**

**Pain Specialist**
**        ****(MD)**

**Brochure**
**www.medicine.wisc.edu/hivuw**

## UW Health HIV Care Program Total, New and RW 

**UW Health HIV Care Program Total, New and RW **
**Part C Patients (2008 is Thru August)**

**--**

## UW Health HIV Care Program Visits 

**UW Health HIV Care Program Visits **
**(2008 is Thru August)**

## CD4 Counts (New Patients) and HIV RNA Levels 

**CD4 Counts (New Patients) and HIV RNA Levels **

**1998-2000**

**2005-2007**

**<50 Viral Load**

## Prison Case Management

**One of our social workers deals primarily with individuals infected with HIV and incarcerated**
**All incarcerated individuals with HIV from the State prisons attend our clinic in the UWHC and have access to all the services in our clinic and the hospital**
**The Prison Case Manager coordinates prisoner HIV discharge planning---sets up appointments in the community, assures have meds to time of appointment, etc**
**Data for time period January-July 2008--- 31 inmates released**
**2 refused release planning**
**1 took info only**
**20 attended scheduled apt in community**
**5 no-shows**
**3 either did not have apt yet or release delayed**
** **

## Challenges with RW—Part C

**We continue to grow but our space does not**
**As the patient load grows our staff doesn’t—the nurse position especially challenging**
**Staff attrition**
**Transportation and weather at times a problem in our community**
**Dental—hospital dentist is retiring**
**State ADAP may go to a waiting list 2011**
** **
**The economy**