# Presentation: 524511

## Carl Vogel Center

- Ronnie M. Mealy, Executive Director
- President’s Advisory Committee on HIV/AIDS
- October 16, 2006

## History of Carl Vogel Center

- In 1990, Don Vogel founded Carl Vogel Center (CVC) in honor of his son, Carl, who succumbed to AIDS in January 1989.
- CVC, originally founded as a Buyer’s Club for people living with HIV/AIDS, has developed into a one-stop provider center for people living with the disease.

## Mission of Carl Vogel Center

- CVC is a nonprofit organization that provides multidisciplinary and integrated healthcare that responds to existing and emerging community needs of people living with HIV/AIDS.
- CVC educates and empowers persons living with HIV/AIDS to become full partners and informed advocates in the management of their care.

## Programs and Services	

- Outpatient Primary Medical Care (EIS)
- Counseling, Testing, and Referral Services
- Case Management Services
- Mental Health Services
- Treatment Education and Adherence Program
- Nutritional Counseling
- Peer/Paraprofessional Support Groups
- Rehabilitation Services/Complementary Therapy Program
- Treatment Resource Library and Computer Lab

## Demographic Breakdown of CVC Clients

| Gender | Number | Percentage |
| --- | --- | --- |
| Male | 713 | 74% |
| Female | 245 | 25.5% |
| Transgender | 2 | .5% |
| Total | 960 | 100% |

## Demographic Breakdown of CVC Clients (Cont.)

| Ethnicity | Number | Percentage |
| --- | --- | --- |
| Non-Hispanic | 776 | 81% |
| Hispanic | 59 | 6% |
| Unknown | 125 | 13% |
| Total | 960 | 100% |
| Race | Number | Percentage |
| African-American | 672 | 70% |
| Caucasian | 172 | 18% |
| Other | 66 | 7% |
| Unknown | 50 | 5% |
| Total | 960 | 100% |

## So What’s Unique About CVC?

**Rehabilitation Services/Complementary Therapy Program**** **
- Swedish massage and acupuncture
- Improves physical, cognitive and emotional well-being
-         (XIII International AIDS Conference, July 2000, Durban, South Africa)
- Promotes education regarding the benefits of integrated health care
- 	(“The Benefits of Massage Therapy for People Living with HIV/AIDS” (American Massage Association – 30,000 members))
**Treatment Education and Adherence Program**
- Shares program experiences with colleagues
-        (“The Benefits of Treatment Education and Adherence Counseling Services in a Multidisciplinary Health Care Environment,” XVI Int’l AIDS Conference, Aug. 2006, Toronto, Canada
- 	Ryan White CARE Act Annual Clinical Update, Aug. 2006, D.C.)
- CVC was one of seven model programs featured in the “Guide to CBO Programs” funded by HRSA and presented by AIDS Action Council

## Benefits of Acupuncture and Massage Therapy

- Improves mental health (anxiety and depression)
- May decrease medication-related symptoms; therefore, increasing adherence to antiretroviral drug regimens
- Provides venue for health promotion and self-care
- May decrease pain and fatigue
- Creates the opportunity for partnerships (conventional and CAM) that are essential to integrated health care
- Improves overall quality of life

## Goals for GY 06-07 (March 1, 2006 – Feb. 28, 2006)

|  | Goals | SMART Objectives |
| --- | --- | --- |
| 1) | To provide acupuncture and massage therapy to people with HIV and AIDS. | To increase the number of unduplicated clients by 25% (from 275 to 343) during the 12-months.  |
| 2) | To decrease the severity of neuropathic pain as characterized by numbness in the toes and fingers in persons with HIV disease (approximately 35% of persons with HIV disease suffer from this symptom). | To decrease pain in 120 clients by 30% (over baseline score) during the 12-month grant period. |
| 3) | To decrease mental stress and anxiety in people with HIV and AIDS. | To improve the mental health in 75 unduplicated clients by 35% (over baseline score) during the 12-month grant period. |
| 4) | To increase the ability of people with HIV and AIDS to be active and engaged. | To improve the energy level and reduce fatigue in 144 unduplicated clients by 40% (over baseline score) during the 12-month grant period. |
| 5) | To improve the overall well-being and quality of life of people with HIV and AIDS. | To improve the quality of life in 271 unduplicated clients by 50% during the grant 12-month period. |

## Challenges We Face

- Insufficient resources to meet increasing demands
- Ryan White CARE Act funding has been level for the past 6 years
- The District’s new HIV testing initiative is likely to create a significant demand for CVC services
- There is a great need for funding to build capacity, and maintain a steady clinical workforce
- Continual growth of the epidemic in disadvantaged populations
- Keeping clients with complex needs in care
- Improving coordination/linkages with prevention and care services

## Addressing Challenges

- Diversify funding sources and use of creative approaches to resource development
- Transition to a medical case management model
- Improve collaborative partnerships with other service providers
- Enhance multidisciplinary and integrated approaches to cover clients’ complex needs
- Continue participation in community planning to develop a seamless service-delivery system

**Notes:**
For example, CVC is currently discussing with a Title III hospital provider the use of the same treatment adherence questionnaire, to create a larger sample size for HIV clinics to evaluate, analyze, and repot our adherence outcome data.  The goal is to have this data available for critique at the annual 2008 Retrovirus Conference and the XVII International Conference on AIDS

CVC is collaborating with the DC Primary Care Association to develop recommendations to ensure that we have adequate resources to implement the District’s city-wide testing initiative