The document describes NO/AIDS' linkage to care system for connecting HIV-positive clients to primary care in New Orleans. It discusses their counseling and testing program, which administered over 3,000 tests in 2010-2011. Their linkage process involves counseling clients after a preliminary positive test, collecting a confirmatory sample, and using a database and collaboration between staff to schedule confirmatory results, enrollment paperwork, and a primary care appointment within 14 days of the preliminary positive result. In 2010, 96% of clients received confirmatory testing and 82% received their results, with 90% of those clients connected to primary care. The document also reviews their tools, challenges, and goals of establishing seamless linkage to care.

1. Linkage to Care:
From Preliminary Positive to
Primary Care
Robin Pearce
NO/AIDS Task Force
New Orleans, LA

2. Overview
 Describe NO/AIDS linkage to care
system
 Share tools:
Access database
Intake forms and staff training tips
 Discuss challenges and lessons learned

3. Background
 NO/AIDS is a “one stop shop” for
PLWHA in New Orleans
 Counseling & Testing program has
multiple testing locations and times
 Administered 3,200 tests in FY 2010-11
 2.8% positivity rate

4. NO/AIDS Linkage to Care
 Inputs:
 Two full time staff: CTR Coordinator &
CRCS Wellness Manager
 Microsoft Access Database
 Secure server to allow database sharing
 Intake Paperwork
 Trained HIV Counselors

5. Day 1
 Client tests PP at evening testing site
 Counselor records client’s contact info
 Counselor collects confirmatory sample
(Orasure, offsite lab)
 Client will be contacted by CRCS when
the confirmatory is ready

6. Day 2
 Counselor mails confirmatory sample
 Counselor provides paperwork to CTR
Coordinator & CRCS Wellness Manager
 CTR Coordinator makes file for client
and keeps original paperwork
 CRCS enters client information on
Microsoft Access database

7. Day 7
 Confirmatory result available online
 CRCS contacts client to make
appointment to receive confirmatory
result

8. Day 14
 Client receives confirmatory result in
person from CRCS
 Client begins enrollment paperwork or
sets date for enrollment appointment
 CRCS sets date for PMC/EIS
appointment
 CRCS follows up with PMC or client to
find out if client attended appointment

9. Results
2010 data:
 73 clients received a preliminary
positive result and post-test counseling
 96% completed a confirmatory test
 82% received confirmatory result
 Of those clients who received their
confirmatory result, 90% were connected
to care (54 of 60)

10. Tools
 Tracking Database
 CTR Coordinator and CRCS
collaboration
 Confirmatory Intake paperwork for HIV
Counselors & training

11. Tracking Database

12. Tracking Database Inputs
 Client Number (HIV Test Form 1
number)
 Orasure Number
 Last 4 SSN
 First Name

13. Tracking Database Inputs
 Date of PP
 Client did confirmatory: Y/N
 Date of confirmatory
 Client received confirmatory
 Date received confirmatory
 Actual confirmatory result

14. Tracking Database Inputs
 Paperwork completed: Y/N
 Date paperwork completed
 Scheduled PMC/EIS appt
 Attended PMC/EIS appt
 Date attended PMC first appt

15. Tracking Database Inputs
 Lost to Follow up
 Notes

16. Documenting & Follow-up
 Regular communication between CTR &
CRCS (work out of same office)
 Review client files
 Update database
 Deadlines:
- Quarterly referral reporting to the state
- 60 day lost to follow up

17. Confirmatory Intake

18. Confirmatory Intake

19. Confirmatory Intake

20. Confirmatory Intake

21. Challenges
 Client in unstable living circumstances
 Client lacks regular access to
communication tools (phone, email)
 Healthcare can be a low priority (relative
to other needs)
 Denial, shock, anger, stress

22. Lessons Learned
 Collecting correct contact information at
PP visit is the most important step
 Communicate with outreach teams and
HIV counselors
 Train & re-train HIV counselors
 Create intuitive intake paperwork

23. Goals
National HIV/AIDS Strategy:
“Establish a seamless system to
immediately link people to continuous and
coordinated quality care when they are
diagnosed with HIV.”

24. Goals
National HIV/AIDS Strategy:
“[By 2015] Increase the proportion of newly
diagnosed patients linked to clinical care
within three months of their HIV diagnosis
from 65 percent to 85 percent.”

25. Contact information
Robin Pearce
Counseling & Testing Coordinator
robinp@noaidstf.org
Mark Drake, LCSW
CRCS Wellness Manager
markd@noaidstf.org