Check Hep B Patient Navigation Program Nirah Johnson, LCSW Director, Capacity Building & Program Implementation Viral Hepatitis Program New York City Department of Health
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 2014 1,625 Hep B positive women gave birth in 2014 People Newly Reported with Chronic Hep B in NYC by Zip Code, 2013-2014 NYC Health Dept Hep B and C Annual Report, 2014 Online Data Portal: Epiquery 83,494 total people reported 2011-2014, regardless of year of initial report
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
NYC City Council Funding
Check Hep B Patient Navigation Linkage to care and clinical care coordination services for underserved people infected with hepatitis B
Bronx Lebanon Beth Israel
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
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
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
Patient Navigation Form
Patient Navigator Database
Health Promotion Guide Guides health promotion and completion of patient navigation assessment and care plan
Patient Navigation Care Plan Completed by navigator and patient together Tracks patient progress in meeting program and individual health goals Documents referrals
Tool to support treatment readiness and adherence Treatment Planning Form
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.
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
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
Number of Patients Program Outcomes July 1, 2014 June 30, 2016 Five organizations 450 400 402 389 369 350 300 250 200 150 134 133 100 50 0 Total Enrolled 1st Medical Appointment Completed Medical Evaluation Treatment Candidate Treatment Initiated (33%)
Number of Patients Program Outcomes July 1, 2015 June 30, 2016 Five organizations 300 250 256 249 240 200 150 100 94 93 50 0 Total Enrolled 1st Medical Appointment Completed Medical Evaluation Treatment Candidate Treatment Initiated (36%)
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
Our goal is to share our resources with our partners. Contact: Nirah Johnson, njohnso2@health.nyc.gov