Check Hep B Patient Navigation Program

Transcription

1 Check Hep B Patient Navigation Program Nirah Johnson, LCSW Director, Capacity Building & Program Implementation Viral Hepatitis Program New York City Department of Health

2 Hepatitis B in NYC Estimated 100,000 with Hep B in NYC Average Average annual annual rate per 100,000 rate people per 100,000 people Close to 7,500 people newly reported with a positive Hep B test in ,625 Hep B positive women gave birth in 2014 People Newly Reported with Chronic Hep B in NYC by Zip Code, NYC Health Dept Hep B and C Annual Report, 2014 Online Data Portal: Epiquery 83,494 total people reported , regardless of year of initial report

3 Hepatitis B-Positive Women in New York City Who Delivered a Live Birth, 2014 Number % Region of Birth NYC Health Dept Hep B and C Annual Report, 2014

4 NYC City Council Funding

5 Check Hep B Patient Navigation Linkage to care and clinical care coordination services for underserved people infected with hepatitis B

6 Bronx Lebanon Beth Israel

7 NYC Health Depart Role Contract management Program development, management and monitoring Develop protocol and program materials Provide initial and monthly training and technical assistance Facilitate referral and sharing of best practices among programs Report on program progress and outcomes

8 Patient Navigator Activities Outreach and enrollment Patient Navigation assessment and care plan Linkage to hepatitis B medical care Care coordination services - Accompaniment and reminders - Referrals to supportive services - Alcohol screening and counseling - Health promotion - Medical interpretation - Case conference - Treatment readiness/adherence - Medication/pharmacy coordination - Contact services - Discharge/transition planning

9 Patient Navigation Materials Protocol Patient Navigation Form Demographic Info Brief Assessment Referrals Clinical Care Tracking Discharge Care Coordination Log Database Health Promotion Guide Care Plan Form Treatment Planning Form

10 Patient Navigation Form

11 Patient Navigator Database

12 Health Promotion Guide Guides health promotion and completion of patient navigation assessment and care plan

13 Patient Navigation Care Plan Completed by navigator and patient together Tracks patient progress in meeting program and individual health goals Documents referrals

14 Tool to support treatment readiness and adherence Treatment Planning Form

15 Patient Navigator Characteristics Each funded site hired one patient navigator Educational attainment: Some college - bachelor s degree. Patient navigation experience: 1-3 years Experience working with Hep B: 1-3 years Languages spoken: 2-7 Supervised by: MPH, MD or BA program manager who had a range of experience with Hep B from 1 to 8 years. Training: NYC Health Department provided program start-up training and ongoing training and technical assistance at monthly meetings.

16 Participant Characteristics African Services Committee 74 patients, 83% male, avg age: 45 years Born in 12 African countries, 7 languages spoken 70% uninsured, 26% Medicaid 54% income <$800/month Korean Community Services 58 patients, 62% male, avg age: 51 years Born in South Korea, China or Taiwan 72% uninsured, 16% Medicaid 29% income <$800/month

17 Participant Characteristics Charles B. Wang Community Health Center 126 patients, 82% female, avg age: 34 years Born in China, Taiwan or Vietnam 61% Medicaid, 23% temporary Medicaid for pregnant women (will be uninsured after delivery) 12% income of <$800/month (many declined to answer) Brooklyn Chinese Family Medical Center 107 patients, 58% female, avg age: 40 years Born in China 77% Medicaid, 8% uninsured 42% income of <$800/month

18 Number of Patients Program Outcomes July 1, 2014 June 30, 2016 Five organizations Total Enrolled 1st Medical Appointment Completed Medical Evaluation Treatment Candidate Treatment Initiated (33%)

19 Number of Patients Program Outcomes July 1, 2015 June 30, 2016 Five organizations Total Enrolled 1st Medical Appointment Completed Medical Evaluation Treatment Candidate Treatment Initiated (36%)

20 Future Check Hep B Support additional sites in NYC Improve liver cancer screening Pilot Check Hep B in Hawaii Hep B Moms linkage to care project Work with perinatal hepatitis B program Telephone linkage to care support for mom and contacts

21 Our goal is to share our resources with our partners. Contact: Nirah Johnson,