Online Program

Increasing Health Care Access: Fulfilling the Promise of Health Care Reform Through the iDU Care Collaborative

Monday, November 2, 2015

Thomas Stopka, PhD, MHS, Department of Public Health & Community Medicine, Tufts University School of Medicine, Boston, MA
Ashley Donahue, MPH, Tufts University School of Medicine, Boston, MA
Marga Hutcheson, MA, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Helen Queenan, BS, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA
Max Sandusky, BS, Prevention and Screening Services, AIDS Support Group of Cape Cod, Provincetown, MA
Lena Asmar, MSW, LICSW, AIDS Action Committee of Massachusetts, Boston, MA
Sarah Mackin, BS, Addicts Health Opportunity Prevention Education (AHOPE), Boston Public Health Commission, Boston
Timothy Purington, M.Ed., Tapestry Health, Inc., Springfield, MA
background: With passage of the Affordable Care Act, universal healthcare has become a reality for many underserved communities, including people who inject drugs (PWID) and people living with HIV. We implemented the iDU Care project, with health navigators in five Massachusetts syringe exchange programs (SEPs), to improve access to health insurance and healthcare services among PWID.

methods: We collected data on: client demographics, risk behaviors, disease status, health insurance enrollment, and healthcare referrals. We created GIS maps to highlight: HIV treatment cascade sites, public health resources, disease clusters, and regions of unmet need.

results: From July-December 2014, we completed 1,087 client visits, and client contacts increased by 48%, from 438 to 649 contacts. Two-thirds (67%) of client contacts were male, 71.7% white, 20.2 % Latino, and 4.7% African American. Among clients receiving services, 732 received referrals to healthcare and ancillary services. The most common referrals were: risk reduction counseling (702), behavioral risk assessments (698), HIV prevention counseling (515), overdose prevention (334), HIV testing services (241), sexually transmitted infection (STI) testing and treatment (171), and hepatitis C virus (HCV) testing (139). Forty-six clients were enrolled or re-enrolled in health insurance, or received assistance changing insurance and providers. High prevalence rates among client contacts were reported for HIV (3%), HCV (42%), and STIs (16%). Maps portrayed areas with adequate and inadequate access to health services, and spatial disease clusters (p<0.05).

conclusions: Through collaborative efforts with SEPs, we were able to train health navigators, and provide health insurance enrollment and referrals to PWID.

Learning Areas:

Provision of health care to the public
Public health or related public policy

Learning Objectives:
Discuss the iDU Care Collaborative model to enhance access to health insurance, healthcare, and enhanced referrals among people who inject drugs who are living with or at risk for HIV. Describe the collaborative work that Health Navigators across all authorized syringe exchange programs in Massachusetts are doing with PLWH, and people at risk for HIV, to assist in navigating health insurance and healthcare systems, and provide enhanced ancillary referrals. Discuss successes, challenges, and lessons learned across all iDU Care program sites through combined qualitative, quantitative, GIS, and spatial analyses.

Keyword(s): Affordable Care Act, Community Health Workers and Promoters

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have years of experiences conducting research in the realm of HIV. I have been the principal or co-principal investigator of multiple state, private, and federally funded grants focusing on the epidemiology and prevention of HIV and HCV among people who inject drugs. Among my scientific interests has been the development of strategies for preventing HIV, HCV, and STDs in out-of-treatment drug users, and enhancing access to healthcare services.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3364.0: HIV and Substance Use