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Goal 1: Prevention Through Health Care

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Objective Strategy Progress
1A. Maximize opportunities to adopt, integrate, and leverage NCHHSTP prevention priorities into other HHS Op Divs and other federal agencies.

I. Identify opportunities to expand, leverage, and integrate NCHHSTP priority prevention programs and policies with other CDC centers, institutes, and offices, and HHS Op Divs.

FY 2011-2012 Accomplishments

  • Presented CDC’s routine HIV screening recommendations and available technical assistance materials/outlets to community health centers funded by the Health Resources and Services Administration (HRSA).
  • Released a funding opportunity announcement to improve early identification of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in clinical and community settings and to enhance linkage to care, treatment, and preventive services for infected persons.
  • Facilitated the identification of critical STD and TB service providers for inclusion in the CMS Center for Consumer Information and Insurance Oversight‘s (CCIIO’s) “essential community provider” database.
  • Initiated discussions with the Agency of Healthcare Research and Quality (AHRQ) on the importance of reviewing TB screening and treatment guidelines.

FY 2013 Plans

  • Implement an educational webinar to increase awareness of community health centers and their role in delivering recommended preventive services to NCHHSTP priority populations.
  • Collaborate with HRSA in working with Community Health Applied Research Networks to assess health care delivery issues among CHCs.
  • Implement a project in collaboration with the National Association of Community Health Centers (NACHC) and the National Coalition of STD Directors (NCSD) to facilitate collaborative relationships between local and state health departments and community health centers identifying best practices and disseminating findings to partners.
  • Estimate the prevalence of HIV/AIDS among persons enrolled in Medicaid.

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Goal is progress.

II. Collaborate with external health partners and stakeholders to develop joint guidelines and recommendations for implementing NCHHSTP prevention priorities.

Indicator: Number of joint HHS guidelines and recommendations developed (annually)

FY 2011-2012 Accomplishments

  • Developed the CDC/ HRSA “Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States" to support the provision of appropriate care to persons living with HIV/AIDS.
  • Published “Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945-1965.”
  • Published in the MMWR “Recommendations for Use of an Isoniazid-Rifapentine Regimen with Direct Observation to Treat Latent Mycobacterium tuberculosis Infection.”
  • Published guidance on the “Implementation of Routine HIV Testing in Health Care Settings: issues for Community Health Centers.”
  • Worked with HRSA to increase compliance with recommendations regarding routine STD testing among persons living with HIV/AIDS.

FY 2013 Plans

  • Partner with HRSA to disseminate “Recommendations for HIV Prevention with Adults and Adolescents with HIV in the United States.”
  • Collaborate with HRSA to develop guidelines that outline the roles and functions of community health centers and health departments in advancing program objectives, highlighting areas where roles differ and overlap and identifying gaps in service delivery.
  • Contribute to primary care and public health integration strategic roadmap being developed by CDC’s Scientific Education and Professional Development Program Office.
  • Take advantage of opportunities identified in the strategic roadmap for primary care and public health integration being developed by the Institute of Medicine (IOM) and the Association of State and Territorial Health Officials (ASTHO).
  • Collaborate with the National Chlamydia Coalition and the National Center of Quality Assurance (NCQA) to identify practical strategies to increase Chlamydia screening among managed care and other private providers.
  • Identify approaches to help NCHHSTP health department partners take advantage of capacities supported by the Medicaid Adult Quality Measure Grants.

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Goal is in progress.
1B. Maximize opportunities to advance NCHHSTP strategic priorities in a transformed health system.

I. Ensure that NCHHSTP programs are aligned with, and able to leverage, opportunities for improving prevention and wellness, health disparities, and healthcare quality arising from health reform in the United States.

FY 2011-2012 Accomplishments

  • Held the Prevention Through Health Care Consultation to discuss how changes in the health system can or may affect delivery of NCHHSTP clinical and preventive services, describe the implications of the changes on health departments, identify activities or strategies to respond to these changes, and prioritize “next step” activities.
  • Published the “Prevention of HIV/AIDS, Viral Hepatitis, STDs, and TB Through Health Care: Supporting Health Departments – Next Steps” to outline next step approaches for addressing some of the most critical drivers of change that will impact NCHHSTP programs.
  • Developed the “Prevention of HIV/AIDS, Viral Hepatitis, STDs, and TB Through Health Care” website to compile information and resources that are relevant to NCHHSTP program partners with regard to the transforming health system.
  • Developed language for future NCHHSTP FOAs to support Prevention Through Health Care activities.
  • Contributed to the “Reproductive and Sexual Health” chapter in the National Prevention Strategy to highlight the clinical and community preventive services that are critical to prevent HIV/AIDS, viral hepatitis, and other STIs.
  • Organized a Center-wide effort, in collaboration with NACCHO and other program-specific partners, to compile information and guidance to support health departments with billing processes.
  • Developed a “TB Medical Coding for Dummies” handout to notify TB clinics of the appropriate codes to use to bill for TB services.
  • Organized an HIV/AIDS Billing Workgroup to assess program needs with regard to billing, gather information on HIV/AIDS billing practices, and determine how best to build billing capacity for HIV testing.
  • Supported the NCSD in conducting a survey and analysis of 3rd party billing among STD health programs that identified barriers to billing public and private insurance carriers and receiving reimbursement for services rendered.
  • Disseminated templates for TB programs to compare the program-specific services included in their state’s essential health benefit benchmark plans.

FY 2013 Plans

  • Publish the “Prevention of HIV/AIDS, Viral Hepatitis, STDs, and TB Through Health Care” website to increase awareness and take advantage of opportunities to advance NCHHSTP program objectives in the transforming health system.
  • Publish “Making the Future work for STD and HIV Prevention – Taking advantage of changes in health care delivery” to increase awareness of the issues that are broadly relevant for NCHHSTP programs.
  • Work with ASTHO to increase awareness of the implications health reform has on the delivery of STD preventive services.
  • Collaborate with the National Association of City and County Health Officials (NACCHO) to identify tools to help health department STD programs assess and assure availability of STD services in the community.
  • Collaborate with the Health Partners Institute for Education and Research to develop models to project “safety net STD service needs,” based on estimates of individuals left uninsured despite implementation of health care reform.
  • Identify the tools and services health departments need to meet core STD prevention objectives.
  • Compile general billing resources and contacts identified by National Center for Immunization and Respiratory Diseases’ Billable Project grantees.
  • Disseminate general billing information and program-specific guidance on third party billing practices to receive reimbursement for services rendered.
  • Provide support and guidance for roundtable discussions with Insurance Commissioners and payers, to be conducted by the American Health Insurance Plans (AHIP), to identify best practices in addressing compromises to patient confidentiality as a result of compliance with Explanation of Benefits.
  • Publish the “Making the Future work for STD and HIV Prevention – Taking Advantage of Changes in Health Care DSelivery” paper to highlight the issues that are broadly relevant for NCHHSTP programs.

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Goal is in progress.

II. Increase support for, and the dissemination of, comparative effectiveness research in HIV, viral hepatitis, STDs, and TB prevention.

Indicator: Number of comparative effectiveness research projects funded (annually)

FY 2011-2012 Accomplishments

  • Initiated collaboration with the American Academy of Pediatrics (AAP), American College of Physicians, and American Medical Association (AMA) to identify and address operational approaches that could increase provision of high intensity behavioral counseling to prevent STIs.

FY 2013 Plans

  • Work with other CDC centers to develop and disseminate resources to incorporate “intensive behavioral counseling” for STD prevention into the primary care setting, as recommended by the USPSTF.
  • Consult with stakeholders on approaches to identifying and maintaining high-priority safety net services that address communicable diseases.
  • Collaborate with partners to provide guidance to health departments on the utilization of electronic health records and opportunities for client billing.
  • Develop metrics to track adequacy of safety net services.
  • Disseminate findings on the success of clinical decision support systems in advancing program objectives.

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Goal is in progress.
1C. Monitor performance and quality of prevention services and interventions.

I. Improve overall NCHHSTP program performance by promoting the utilization of performance management systems and quality improvement techniques and sharing best practices.

FY 2011-2012 Accomplishments

  • Contributed to the development of four new HIV/AIDS quality measures that address critical steps along the HIV prevention and care continuum.
  • Submitted a population health measure on late HIV testing to the NQF that was later endorsed.
  • Initiated processes to revise and standardize STD performance measures to ensure continuity across data collection.
  • Worked with the AMA’s Physician Consortium for Performance Improvement to include prenatal screening for HIV as part of its new bundled measure for prenatal care.
  • Participated in the CDC’s Quality Workgroup to inform programs of new quality improvement opportunities and disseminate available CDC resources to program staff.

FY 2013 Plans

  • Disseminate guidance on how quality measures are developed, endorsed, selected, and used for population health purposes.
  • Develop new meaningful quality measures.
  • Collaborate with HRSA to ensure the 4 new HIV/AIDS quality measures endorsed by National Quality Forum (NQF) are included in the interim rule for Meaningful Use Stage 3.

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Goal is in progress.

II. Utilize and advance opportunities afforded by emerging data integration technologies and techniques.

FY 2011-2012 Accomplishments

  • Planned the 2012 NCHHSTP Surveillance Consultation to discuss emerging opportunities in health information technology and to identify approaches that allow NCHHSTP programs take advantage of opportunities to use surveillance data to improve quality of care.
  • Collaborated with OSELS to take advantage of opportunities in implementing clinical decision support systems to improve service delivery.

FY 2013 Plans

  • Facilitate utilization of Regional Extension Centers resources to support adoption of electronic health record systems and participation in the Meaningful Use program for qualified STD and TB clinics.
  • Identify opportunities for health department and community based organization partners to support accountable care organizations (ACOs) in improving the health care system, improving the health of patients, and lowering costs.

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Goal is in progress.
1D. Promote innovative, systems- and health-based approaches to the prevention and control of HIV, viral hepatitis, STDs, and TB.

I. Collaborate within and across HHS to advance a syndemic orientation and approach to prevention of HIV, viral hepatitis, STDs, and TB in the United States.

FY 2011-2012 Accomplishments

  • Disseminated updates regarding Meaningful Use and participated in the Meaningful Use Advisory Group to address NCHHSTP-specific issues.

FY 2013 Plans

  • Increase awareness of the potential for Medicaid health homes to improve the standard of care provided to Medicaid enrollees with HIV/AIDS and viral hepatitis.
  • Provide technical assistance and other means of support to maximize the public health benefits of Medicaid Health Home programs in states that include HIV/AIDS and viral hepatitis as qualifying chronic diseases.
  • Support NCHHSTP grantees in developing the capacity needed to help priority populations enroll in insurance plans or policies for which they are eligible.

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Goal is in progress.

II. Work with internal and external partners and stakeholders to promote sexual health in the United States and identify other relevant frameworks for implementation.

FY 2011-2012 Accomplishments

  • Supported the National Chlamydia Coalition in exploring opportunities to improve Chlamydia screening via collaboration with private health insurance managed care systems.
  • Created a Sexual Health Workgroup of the CDC/ HRSA Advisory Committee on HIV/STD Prevention and Treatment.
  • Published a meeting report on the consultation addressing “A Public Health Approach to Advancing Sexual Health in the U.S.”
  • Completed a coordinated communication project to identify appropriate frameworks, metaphors, and messages to promote a sexual health approach across a range of stakeholders.
  • Provided technical assistance to NCSD to conduct a survey to gain insight on sexual health activities taking place at the state-level across the U.S. and its territories.
  • Presented plenary sessions and symposia on sexual health at national and international scientific meetings.
  • Held a NCHHSTP Youth HIV/STI Prevention and Sexual Health External Review.
  • Funded a national coalition of organizational partners to enhance STD/HIV prevention though the promotion of holistic approaches to sexual health and wellness.

FY 2013 Plans

  • Identify the critical factors that determine success of the Medical Home concept in managing NCHHSTP conditions.
  • Release a Public Health Reports Supplement on Sexual Health.
  • Publish a CDC White Paper on “A Public Health Approach to Advancing Sexual Health in the U.S.”
  • Identify a concise set of indicators that allows tracking of key domains of sexual health to provide an initial characterization of the current state of sexual health in the U.S.
  • Support NCSD to organize a conference for state health department representatives and partners to develop statewide sexual health plans to enhance core public health programs.
  • Work with CDC’s National Network of Prevention Training Centers and HRSA’s AIDS Education Training Centers to develop and strengthen sexual health messaging and training for clinical providers.
  • Develop a curriculum to give parents and/or caregivers the resources needed to effectively discuss healthy sexuality with their children in collaboration with The Center of Excellence for Sexual Health.

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Goal is in progress.


FY 2010-2011 Goal 1: Prevention Through Health Care
 
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