MINNESOTA STATE REPORT

RVIPP Regional Meeting

Chicago

By Candy Hadsall

March 8-10, 2011

STDs in Minnesota in 2010 New stats will be announced

April 6 via webinar. Preliminary: CT up again, GC

continuing to go down

MIPP TESTING LOCATIONS 2010-2013

Planned Parenthood Minnesota, North Dakota, South Dakota (16 sites in Greater MN) Title X

St. Paul-Ramsey County Department of Public Health (FP and STD clinics – combining into 1 clinic) Title X

Hennepin County STD clinic Health Start: School-based clinics in 10

high schools, funding 5 based on positivity rates

Change to MIPP contractor Teen Age Medical Services (TAMS)

Was part of Children’s Hospital – now part of an FQHC (Cedar Riverside People’s Ctr)

Still in transition, awaiting final approval by MDH Financial Mgmt

MIPP data collection not in place so will not be reimbursed for screening until it is – when?

Expect program components and target audience to remain the same

Includes street outreach to African American males

Update on MDH Activities Progress on GC Plan

Change DIS protocols to contact partners of CT and GC + and have DIS do field-delivered therapy = slow progress due to resistance

Update on EPT provider survey Purpose: to identify support for and extent of use of

EPT, barriers Use for data: improve EPT Guidance, training for

providers, Cap bldg Results: 59 out of 248 responded (24.1%), 68% drs.;

majority supportive; 58% use it, 30% will start or resume; 79% give Rx, 43% meds

Clinic Capacity Building Developed “Responding to the CT

Epidemic: Tools for Enhancing Screening and Treatment in MN Clinics” (12 topics)

Adapted clinic assessment and provider training assessment

Discussed document at 5 IPP site visits & one non-IPP clinic, did assessments

Working with system of 3 private provider clinics in county outside metro

Will be expanding efforts in 2011

Topics in “Responding to Chlamydia” document Stats, description, consequences Sexual history – 5 Ps Screening, treatment recommendations Testing options Rescreening What about GC? EPT Minor Consent Reporting requirements Minnesota Chlamydia Partnership

EPT Pilot Project EPT pilot project (April 2010- Dec 2011)

13 clinics: 7 urban, 2 suburban, 4 in Greater MN (Planned Parenthood)

Protocols: Could distribute meds or Rx – all are doing

meds Clinics fill out logs of participants Original pt must have confirmed + tests Allow providers to treat initial pts w/meds

provided even if they are unable to deliver meds to partners

Allow tx of MSM when partners of both genders Student conducts phone interviews with

everyone listed on logs - match with report forms

Update on EPT Pilot Project

Interview questions: Did pts give meds/Rx to partners? All partners?

Why/why not? More likely to take med if med was provided vs.

Rx? How many partners took meds? Have sex after given treatment?

Student conducting phone interviews with original patients. Results as of January:

375 accepted (79%) 101 refused (21%) 313 interviewed (66%) 26 refused (5%) 137 unable to reach (29%)

Results of interviews (cont)

Spoke to all partners: 269 (87%) Spoke to some partners: 11 (4%) Did not speak to partners: 19 (6%) Certain that all partners completed tx:

207 (85%) Certain that some partners completed tx:

14 (6%) Certain that no partners completed tx: 8

(3%) Uncertain if partners completed tx: 15

(6%)

Provider Report Card MPH student collected data

Number of days between dx and reporting, dx and tx Focused on highest reporters and IPP sites Used surveillance data 2007-09

Major findings: Problems w/reporting time, not treatment Some clinics 60-90 days late despite multiple ltrs

from MDH Surveillance working with most delinquent clinics

Plan to use data in capacity building w/clinics STD clinic – went from bundling reports and

submitting every 30 days to submitting daily after discussions with staff and changes in protocol. Had been unaware.

National Chlamydia Coalition Grant & MN CT Partnership Held Summit on CT: August 3, 2010 140 people attended in St. Paul; 130 people at

9 video conferencing locations in Grtr MN 19% PH & 8% private providers, 19% youth, 3%

health plan, 24% non-profit, 8% education, 1% each: religious, tribal, research orgs & 1% fed

Speakers provided epidemiological backgrd, motivation to get involved, personal stories, information on using social media

Brainstorming in afternoon - World Café process generated ideas for what needs to be done

Feedback from Summit #1: Healthy sexuality information needed

Consistent, positive messages everywhere Messages that cover lifespan, deal with

sexuality issues as adolescent AND as adult Mandatory Comprehensive Sexuality

Education in all types of schools; health ed in colleges

#2: Testing for CT, GC should be routine #3: Need funding for testing, treatment,

prevention, EPT, partner notification

Activities following Summit 5 workgroups formed, 4-16 participants each

from across state Educating teens, parents, teachers Educating providers Building awareness in community Affordable testing and treatment Access to testing and treatment

Workgroups met multiple times Sept – Jan submitted ideas/recommendations for actions in

each area “MN CT Strategy” now being written, will

incorporate recommendations

Activities after Summit (cont)

Received additional funding to coordinate outreach materials: Cincinnati, MOAPPP, Medica Logo, dedicated website, design & print

summary of plan Strategy to be announced April 12 via

webinar, will be posted to website MCP members to take Strategy to

communities across state in 2011

MDH Other STD Activities Syphilis Elimination Efforts: Media campaign launched June 2010, new

phase launches July 2011 Info on Facebook – search www.stopsyphmn.com Twitter feeds weekly – sx, prevention msgs

Two provider trainings were offered on the management of syphilis and HIV co-infection (Tony Mills, Will Wong)

4th Annual Hepatitis Symposium Aug All funding raised outside MDH (Amer Liver Fdn)

Ideas for IPP Supplemental Rescreening pilot project: enc clinics to stress

rescreening, design posters, offer incentives to youth to come back for screening in one group, compare to group without incentives, use results

Provide educational materials and training to Child and Teen Checkup coordinators to encourage private drs (esp. peds) to screen

Outreach, testing targeted to specific neighborhoods using geo-coding, focus on disparities in AA pop

2 provider trngs to increase screening, PN and EPT

Support dissemination of Strategy Assess CT screening in IHS hospital near

reservation

Candy Hadsall, RN, MASTD Clinical ConsultantMinnesota Department of Health651-201-4015Candy.Hadsall@state.mn.us