By Ejay Jack, Community Health Program Supervisor, Hennepin County (MN) Public Health

NACCHO supported staff from four local health departments to attend NHPC to share their local perspectives.

In December 2015, the National HIV Prevention Conference was held in Atlanta and I had the pleasure to attend through NACCHO’s support. This opportunity allowed me to network with colleagues and experts from across the county in an effort to share research and innovative practices.

One of the topics we discussed was Data to Care (DTC), a new public health strategy that utilizes surveillance data to identify HIV-diagnosed individuals who are not receiving HIV care and to link them to care. DTC is considered a CDC high impact prevention activity that supports the HIV Care Continuum. My health department, Hennepin County Public Health in Minnesota, recently applied for funding to implement DTC, so I found these conversations relevant and helpful. Our public health clinic houses a seamless system of HIV prevention and care that includes community outreach and testing, testing and treatment in the clinic setting, partner services, and linkage to care services. With this new funding, we plan to expand our linkage to care services to include individuals who are not reached through typical outreach efforts or coming into the clinic on their own.

Using statewide surveillance data as a local public health department will allow us to perform targeted outreach to specific individuals who are thought to be out of HIV care. Anyone who has been an outreach worker or a disease intervention specialist (DIS) understands how difficult it is to identify and engage “high-risk” populations due to internal and external HIV stigma, housing instability, mental and chemical health issues, and various others reasons. Therefore, a more targeted approach that uses surveillance data will provide outreach workers and DIS with an advantage to identify and engage that individual back into HIV care.

The first day of the conference there were three sessions on DTC that discussed factors that public health programs should consider when implementing this strategy. For instance, in order to implement DTC effectively our program must tailor it to local needs. This will likely involve building a better relationship with the state health department, infectious disease clinics, and our Ryan White Part A community advisory board. One potential challenge is to validate consumers and infectious disease clinics’ concerns about unnecessarily and mistakenly contacting clients who are in HIV care. We plan to mitigate this challenge through the methodical analysis of surveillance data’s lab reporting in conjunction with contacting a consumer’s last clinical provider in an effort to confirm someone is out of HIV care through these two sources.

Strengthening relationships with the following partners is key:

• The state health department will ensure data sharing occurs across state and local health departments to help build efficient and effective services while providing feedback to help inform and improve the state surveillance data system.
• Infectious disease clinics will provide a two-way street for our care linkage navigator to refer individuals back into HIV care while also helping the clinic to identify and refer out-of-care individuals to our program.
• Consumers will ensure we are providing competent care and help us anticipate issues during the initial implementation phase.

The conference was an invaluable learning experience. It provided important opportunities to learn and connect with others implementing DTC, as well as to explore other new ideas and initiatives. For more resources on DTC and local health departments, please see the following:

• Using HIV Surveillance Data to Support the HIV Care Continuum. Effective Interventions. Centers for Disease Control and Prevention (CDC).
• Data to Care: Improving Treatment Outcomes & Addressing Disparities, Public Health- Seattle & King County (Archived Webinar)