WI State Report

RVIPP, Indianapolis, IN June 9-10, 2010

Wisconsin State ReportRVIPP Meeting Indianapolis: June 9-10, 2010

Timeliness to Treatment Update

State Report Update

Status of Re-testing for Chlamydia

Timeliness to Treatment Update

Status on Wisconsin Action Items Reported Morbidity Positives vs. RVIPP

Positives To be addressed by December 2010

Treatment Rates vs. Data Collection Issues To be addressed through Tx Audits in PPW, FP

and STD clinics WI Planned Parenthood Chart Audit

To be completed July 2010 Family Planning & STD Clinic Chart Audits

To be completed by December 2010

Timeliness to Treatment

WI Planned Parenthood STD Tx Audit STD Treatment Audit Tool to be

completed by the end of June 2010 Will field test tool in one PPW clinic in

early June 25 charts to be reviewed: (20 females, 5

males) Positive CT and/or GC test results for males

and females

Timeliness to Treatment

Conduct Chart Audit July 2010 in all PPW Sites Statewide (27 clinics) using STD Tx Audit Tool WSLH will generate a line list of positive female

and male patients for CT and GC for each clinic site from SLH laboratory positives

Select date range for positive patients to allow 120 days for quality assurance check on practice of re-test

High volume clinics: randomly select maximum of 25 positives from 4th quarter 2009

Medium volume clinics: randomly select maximum of 25 positives from 4th quarter 2009

Low volume clinics: select positives from 2009 up to a maximum of 25 positives

Timeliness to Treatment

Evaluation of Chart Audit for STD Tx Rate

PPW sites will complete the audit tool electronically from chart review

HCET will compile electronic forms into an STD TX audit database

Results available for STD Grant application August 2010

Wisconsin State Report Update

April GYT 2010 Update School Based Clinics in Milwaukee

Update Male FP Medicaid Waiver EPT Update Rural Screening Project Status of Re-screening in Wisconsin

April GYT 2010 Update

Universal testing on 4 days in April 2010 offered at 27 PPW clinics for CT (& GC in Milwaukee clinics only)

In 2009, we were able to offer “free” CT-GC testing for entire month; used data in lieu of planned “Universal Screening” study. Identified approximately 1200 “extra”

tests based on average month.

GYT 2010 PPW Data

Criteria for noting “GYT” on lab slip not consistently defined

Similar proportion met SSC (74 vs. 81%) Higher number reached via GYT? Possibly higher risk patients? Numbers are small…

Met Selective Screening Criteria

Did NOT meet SSC

# Pos # Tested % Pos # Pos # Tested % Pos

“GYT” on LRF

74 505 14.7% 18 177 10.2%

“GYT” not on LRF

206 1863 11.1% 25 424 5.9%

Milwaukee School Based Clinics Update 2010

Testing in 15 SBC began Jan 2009 Low volume of testing/positivity at first Volume and positivity picking up Higher-risk kids more comfortable with health

center presence? Staff efforts?

# Tested #/% Pos CT #/%Pos GC

1-2 Q ‘09 107 10/ 9.3% 0/0%

3-4 Q ‘09 169 24/14.2% 6/3.5%

1-2Q ’10* 185 38/20.5% 10/5.4%

Male FP Waiver Update

Male FP Waiver Effective May 1, 2010 Covers office visit, STD tests,

treatment, condoms for 15-44 year olds, up to 200% poverty, with 30 days to complete enrollment application following presumptive eligibility enrollment

EPT Update

EPT signed into Wisconsin Law May 11, 2010 Becomes effective May 26, 2010 EPT allowed for one dose therapy for CT, GC, Trichomoniasis

No name prescription allowed if partner name not obtainable, in which case, ‘EPT’ required to be written on prescription

An information sheet for patient/partner developed by the Wisconsin DPH must be delivered by the provider with EPT, as required by the new law ready for distribution June 1

WEB site and official DPH letter of announcement to providers launched June 1

Guidance for providers under development, ready for distribution June 15th

Training for implementation for Family Planning Providers scheduled for July and September WFPRHA meetings

Plans for evaluation under development

Rural Screening Project

4 sites in Northern Wisconsin participated in Universal screening for the months of April and May Objective: to estimate CT prevalence in

rural clinic populations Determine if there are risk criteria

outside of the evidence based SSC currently in use in WI FP which add greater sensitivity to the risk assessment for CT and GC infection in men and women attending these clinics

Rural Screening Project

Preliminary Findings Nuances of interviewing patients

important Consider the consistency and how

questions are asked and perceived by the patient

Numbers are small, but prevalence appears to be under 3% threshold

Final analysis pending Will present at Winter RVIPP meeting

Status of Re-Screening

Plan to evaluate rates of re-screening in FP as a quality assurance measure in FP clinics

Plan to include ‘Re-screened?’ field in STD Tx Audit Tool in PPW in July 2010

PPW will add a required field for ‘Re-screened?’ to Electronic Medical Record when ready in July 2011

Re-screening will be discussed during annual WFPRHA meeting in September 2010 as part of Quality Assurance discussion

Specific guidance on writing in re-screened information on the LRF until a permanent field is in place on the LRF will be provided during a November SLH and STD Update Teleconference

Recommendations in guidance to re-screen will include males (any input from RVIPP group during June 2010 meeting?) and females

When have SSC changes from prevalence evaluations finalized, will add these changes and ‘Re-screened?’ field to laboratory request form at SLH