Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110514

Koren Odierna¹, Martha Dale, MPH², Jennifer Ring, BS³, Sarah Zalud¹, and Howard Forman, MD MBA⁴. (1) Yale University, 60 College Street, New Haven, CT 06511, 8604903886, koren.odierna@aya.yale.edu, (2) Executive Director, Leeway, 40 Albert Street, New Haven, CT 06511, (3) Department of Epidemiology and Public Health, Yale University, 60 College Street, New Haven, CT 06510, (4) Department of Diagnostic Radiology, Yale-New Haven Hospital, 20 York Street, New Haven, CT 06510

People living with HIV/AIDS suffer a disproportionate burden of co-morbidities, increasing the likelihood that their disease will progress. In severe cases, patients linger in sub-acute care facilities because of their inability to adhere to treatment while living in the community. Analyses of Medicaid claims data suggests that Aggressive Community Treatment (ACT) model case management programs can increase co-morbid AIDS patients' ability to adhere to treatment in the community, decrease their related health care expenditures and improve their overall quality of life in the least restrictive setting possible. Several states have sought Medicaid Home and Community-based (1915c) waiver funding for such programs. However, literature synthesizing vital information regarding the efficacy of various models of ACT programs enacted by different states for a specific HIV/AIDS population is lacking.

Leeway Inc., a 40-bed SNF located in New Haven, CT, is creating such a program to expand the continuum of services offered to co-morbid HIV/AIDS low income residents in the state. This will include an ACT-model intensive clinical case management program as well as new housing and supportive service models. The scope of our project includes an evidence-based product analysis of existing HIV/AIDS case management programs across the United States to help policy makers and funders in this and other states make informed decisions regarding the efficacy, structure, and funding streams available to start HIV/AIDS ACT model programs. Outcomes will be measured through literature review, program design, and business plan as well as identifying opportunities for funding for infrastructure and on-going program costs.

Learning Objectives: At the conclusion of the session, the participant will be able to

• How to conduct a product analysis integrating the necessary components of a business plan along with evaluative analyses.
• The gravity of the situation facing AIDS patients with co-morbid conditions and the necessity for integrated and comprehensive care methods.
• How to begin to apply for a 1915 c Medicaid waiver.
• How other states have handled this issue and the preferred methods for a sustainable community-based program.

Keywords: Access to Care, Evidence Based Practice

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.