Statewide Community Planning Group

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=82 BGCOLOR="#33FF00" TEXT="#080000" bgproperties="fixed" background="05bfd523.jpg"> <div> <FONT SIZE="5" COLOR="#000000" FACE="Arial" ><B>Cape Fear Regional Bureau For Community Action, Inc.</B></FONT><B>     |     </B><A HREF="index.htm" TARGET="_top" TITLE="Cape Fear Regional Bureau For Community "><U><B>home</B></U></A></div> <div> <A HREF="index.htm" TARGET="_top" TITLE="Cape Fear Regional Bureau For Community "><U><B><IMG SRC="04e0e0e0.png" border=0 width="14" height="14" ALT="up" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>  </B><IMG BORDER="0" SRC="1x1.gif" HEIGHT="14" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" WIDTH="14"><B>    </B><A HREF="id58.htm" TARGET="_top" TITLE="National Epidemology"><U><B><IMG SRC="04d0e0e0.png" border=0 width="14" height="14" ALT="previous" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A><B>  </B><A HREF="id60.htm" TARGET="_top" TITLE="News and Events"><U><B><IMG SRC="04f0e0e0.png" border=0 width="14" height="14" ALT="next" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></U></A></div> <div> <A HREF="http://www.capefearregionalbureauforcommunityactioninc.org/mf.htm" TARGET="_top" TITLE="http://www.capefearregionalbureauforcomm"><U><B>Click Here For Site Map</B></U></A></div> </td> </tr><tr> <td valign="top" width=210 BGCOLOR="#FFCC66" TEXT="#080000" bgproperties="fixed" background="23fd2993.jpg"> <div> <B>Statewide Community Planning Group members are invited to submit reports and information of concern to the SCPG process.  By posting these concerns on the web the Cape Fear Regional Bureau For Community Action, Inc. takes no position as to content, unless otherwise noted.</B></div> <bR> <bR> <bR> <bR> </td> <td valign="top" height=398 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I><B>Statewide Community Planning Group</B></I></div> <div>  <A NAME="scpg"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A></div> <div> The purpose of Community Planning is to develop an ongoing <A HREF="id56_paratnershipping.htm" TARGET="_top" TITLE="Public Private Partnershipping"><U>community/government partnership</U></A> and establish effective plans for <A HREF="id44_hiv_antibody_testing.htm" TARGET="_top" TITLE="HIV Antibody Testing"><U>HIV</U></A> & <A HREF="id68_std.htm" TARGET="_top" TITLE="What Are STD (Sexually Transmitted Disea"><U>STD</U></A> prevention efforts.  The Statewide Community Planning Group (SCPG) is the system mandated by the Centers for Disease Control and Prevention of the United States Department of Health and Human Services (“CDC”) whereby the HIV/STD Prevention and Care Branch of the North Carolina Department of Health and Human Services (“Branch”) shares decision making power regarding HIV prevention activities with representatives of affected and infected groups from across the state.</div> <bR> <div> The overall mission of SCPG is to develop and negotiate comprehensive HIV prevention plans on behalf of the citizens of North Carolina.  The Comprehensive HIV prevention plans will include:</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">An <A HREF="id57_state_epidemology.htm" TARGET="_top" TITLE="State Epidemiology"><U>HIV/AIDS epidemiological profile</U></A> indicating the current epidemic in the state, including a description of the impact of HIV/AIDS in defined populations.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">An HIV/AIDS epidemiological profile indicating the projected epidemic in the state, including a description of the impact of HIV/AIDS in defined populations.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">An assessment of the met and unmet HIV prevention needs of defined populations.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Prioritization of target populations in order to address high priority unmet needs.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Prioritization of target intervention strategies in order to address high priority unmet needs.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">An analysis of the effectiveness of intervention strategies.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Assessing HIV prevention with respect to CTRPN, STD, TB, Substance Abuse, Mental Health and other HIV related services.</div> <bR> <div> <IMG BORDER="0" SRC="Symb075c00b700f000000000.png" HEIGHT="16" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">An evaluation of the effectiveness of the Community Planning process.</div> <bR> <div> This mission will be accomplished in collaboration with the Branch, CBOs and members of the community that have demonstrated a willingness to explore a broad range of perspectives, build consensus and mobilize resources in the prevention efforts of the HIV disease.  </div> <bR> <bR> <bR> <div> <B><U>REPORT RECEIVED FROM MR. KEVIN P. NUTTALL, REGION ONE</U></B></div> <div> <B>Received December 13, 2002</B></div> <bR> <div> <B>Riched20 5.40.11.2210;Phyllis et al:</B></div> <bR> <div> <B>On the drive home yesterday, as with each opportunity in which I visit Raleigh, there was ample time (5 hours) to consider the business of the day.  Yesterday's meeting was progressive, (perhaps too) action packed... and forward moving.  However, I don't believe that the issue of "Shared Responsibility" has been appropriately/fully addressed. Therefore, I would like to reiterate my request for the CDC NC Project Officer(s) to explain to the membership of the NC SCPG, any official interpretation of the Guidance pertaining to the HIV/STD prevention budget, or perhaps, the entire section regarding "Shared Responsibility."  Another option might be to invite Acting State Health Director Leah Devlin or Secretary Carmen Hooker-Odom to perform this task.</B></div> <bR> <div> <B>In addition to this request for Technical Assistance, and to enhance the 'time line' of future activities that was distributed yesterday, it would perhaps be appropriate to inform the SCPG membership of when the FY 2004 DRAFT budget for the prevention Cooperative Agreement with the CDC will be produced and distributed for the communities' perusal. Moreover, it would be proactive to deliver some assurance to the SCPG, that next years' budget will be reviewed - and potentially subject to change - in a "participatory" process, and with AMPLE time for public comment/input.  This would enhance the SCPGs perception that "accountability" is more than a BUZZword to the Prevention Section of the Branch.</B></div> <bR> <div> <B>As an aside, it is always of concern to me when any individual attempts to personalize the issues - by using words like "seems" in a personal context - as it tends to divert attention from the actual issues. Perhaps Ms. Foust circumvented one of those "Ground Rules" we are supposedly bound too?  Whatever the case, as I have said before on many an occasion, an attorney once told me that: "If the courts were to incarcerate individuals based upon the belief system of others, rather than actual fact, we would all be in jail!"  So, regardless of how Ms. Foust perceives my attempts to create an air of openness and "community" participation in all SCPG processes, it should be known that my intentions are honorable, and my respect for her/you remains high.  And my personal conduct yesterday, or on any occasion, should act as an indication of this fact.</B></div> <bR> <div> <B>Moving forward, I was congratulated and appreciated for finally cracking the egg on the issue of budget accountability to the "community" yesterday, although this may not have been evident within the SCPG meeting room.  As is often the case, I receive kudos' in the hall or on the way to the parking lot.  I was also reminded that it is now no longer important what may have happened in the past - for several years running - so long as we see sweeping change in the future.  I can only hope that the staff of the AIDS Care and Prevention Branch will agree.</B></div> <bR> <div> <B>On that note... the timeline please?!  And as I indicated/implied above, a little TA from the CDC would go a long way to demonstrate the willingness of the Branch to "share" the ENTIRE prevention planning process with the community.  In making this declaration, I and others are well aware that the 'final' decision for budget allocations of the $4.7+ million lies with Ms. Evelyn Foust and/or her superiors.  I am also certain that the "community" will act in a responsible manner when the Branch asks for concurrence on next years entire Continuation Application to the CDC.</B></div> <bR> <div> <B>Separately, yesterday's meeting was held in a room that was entirely too small for the number of people present.  Would it be possible to plan for a meeting space that holds a minimum of 45 people in the future, all of which should be afforded "a seat at the table"?  Also, please plan to have recording equipment available that suits the need (not just a portable unit), which can be turned off in the event that someone would like to speak "off the record," such as Ms. Foust personally supports with vigor.  And as I had requested once before, if the Branch is planning to make any declarations regarding the work of the SCPG, it would be extremely helpful to deliver those statements in writing... "on" the record per se.</B></div> <bR> <div> <B>In closing, it would interest me to learn if the Cooperative Agreement/Continuation Application was constructed based upon particular "Guidance" from the CDC.  As with funds that are solicited from the federal government for care (from HRSA), are the funds the CDC distributes through Cooperative Agreement's for HIV/STD prevention subject to solicitation in a particular format, as would be dictated in Guidance issued by the CDC?  If so, I would be interested in receiving a copy of that Guidance, which I was unable to find on the web.  A hard copy would be appreciated, but if a web-based copy of that Guidance exists, a hyper link would suffice to complete this request for information.  At your earliest convenience, a table that illustrates the allocations of prevention funds distributed to providers (ASOs and CBOs) across NC, for the FY 2003, would also be helpful.</B></div> <bR> <bR> <div> <B>respectfully submitted,</B></div> <bR> <div> <B>Kevin P. Nuttall - "NK0525611"</B></div> <div> <B>State & Federal Affairs Director</B></div> <div> <B>North Carolina AIDS Policy Center</B></div> <div> <B>81 Baird Street, Suite 105</B></div> <div> <B>Asheville, NC 28801-2093</B></div> <div> <B>p: 828.251.2229 / f: 828.285.0080 <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:retroart@buncombe.main.nc.us" TARGET="_top" TITLE="mailto:retroart@buncombe.main.nc.us"><U><B>mail to:retroart@buncombe.main.nc.us</B></U></A></FONT><B>></B></div> <bR> <bR> <bR> <bR> <bR> <div> <B>Received December 11, 2002</B></div> <bR> <div> <B>Phyllis A. Gray - Project Manager </B></div> <div> <B>HIV/STD Prevention and Care Branch </B></div> <div> <B>NC DHHS, Division of Public Health </B></div> <div> <B>1902 Mail Service Center </B></div> <div> <B>225 North McDowell Street </B></div> <div> <B>Cooper Memorial Health Bldg. Room 5035 </B></div> <div> <B>Raleigh, NC 27699-1902 </B></div> <div> <B>Cellular: (919) 218-1258 </B></div> <div> <B>Fax: (919) 715--4760 </B></div> <div> <B>Work: (919) 715-0347 </B></div> <div> <B><phyllis.gray@ncmail.net> </B></div> <div> <B>Re: Accountability of Cooperative Agreement #U62/CCU416703 with the CDC </B></div> <div> <B>Dear Ms. Gray: </B></div> <div> <B>According to "HIV Prevention Community Planning: An Orientation Guide," which can be found at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><B>http://www.hivaidsta.org/ta_materials/ta_tools.htm</B></FONT><B>>, ACCOUNTABILITY is a "framework that has been created to determine how a group and its members will be responsive and responsible to itself and the community as it carries out its mission." CDC is committed to the concept of HIV prevention community planning as outlined in this guidance. In summary, CDC expects that: * Community planning groups will review the entire application for their jurisdiction, including the budget, prior to writing letters of concurrence / nonconcurrence. It is critical that CPG members read and understand the Orientation Guide. It is sometimes referred to as the "bible" of community planning. </B></div> <bR> <div> <B>In accordance with the CDCs "Guidance" for Community Planning Groups, Steps in the HIV Prevention Community Planning Process, once a CPG has been convened, the steps of HIV prevention community planning include updating the Plan. Once a comprehensive plan has been developed, the community planning group should periodically review it to determine whether or not it is necessary to: * Revise priorities, budget allocations, or community planning group composition to reflect any changes in the epidemiologic profile. </B></div> <bR> <div> <B>HIV prevention community planning group members should carefully review the comprehensive HIV prevention plan and the health department's entire application to CDC for federal funds (including the proposed budget). Because the community planning process requires prioritization of HIV prevention needs and because prioritization directly corresponds to resource allocation, it is critical that the community planning group review the proposed allocation of resources in the health department's application (and, especially, to review expenditure levels in light of the epidemiologic profile). </B></div> <bR> <div> <B>Community planning groups are not asked to review and comment on internal health department issues, such as salaries of individual health department staff, but instead to indicate: * The extent to which the health department and the HIV prevention community planning group(s) have successfully collaborated in developing, reviewing, or revising the comprehensive HIV prevention plan; * The extent to which the activities, programs, and services, for which the health department is requesting CDC funds, are responsive to the priorities in the comprehensive plan; * The process used for obtaining concurrence, including * A description of the process used for review of the application by the community. </B></div> <bR> <div> <B>_ _ _ _ Regarding Letters of Concurrence/ Nonconcurrence _ _ _ _ </B></div> <bR> <div> <B>As part of its application to the CDC for federal HIV prevention funds, every health department must include a letter of concurrence or nonconcurrence from each CPG convened in the jurisdiction. At a minimum: the letter(s) should be signed by the Co-Chairs of each CPG on behalf of the CPG. CPG members should carefully review the comprehensive HIV prevention plan and the health department's entire application to CDC for federal funds (including the proposed budget). </B></div> <bR> <div> <B>It is critical that the CPG review the proposed allocation of resources in the health department's application -- especially, a comparison between expenditure levels and the epi profile, because: * The community planning process requires prioritization of HIV prevention needs, and * Prioritization directly corresponds to resource allocation. </B></div> <bR> <div> <B>Letters should indicate the: Degree to which the health department and CPG(s) has successfully collaborated ("how well or not") in developing, reviewing, or revising the comprehensive HIV prevention community plan; Degree to which the health department has responded to the priorities in the comprehensive HIV prevention plan in its application to the CDC for federal HIV prevention funds. Process used for concurrence, including: * A description of the process used by the CPG to review the application, * The amount of time the CPG had to review the application, * Who from the CPG reviewed the application * The time frame allotted for the review, * Who from the community planning group reviewed it (co-chairs, members, subcommittee chairs), and * The quality of the concurrence (e.g., without reservation, with minor concerns, with important concerns). </B></div> <bR> <div> <B>Letter(s) of concurrence may include reservations or a statement of concern/issues. The health department should address these reservations or concerns in an addendum to the HIV prevention application. </B></div> <bR> <div> <B>Letter(s) of nonconcurrence indicate that an HIV prevention community planning group disagrees with the program priorities identified in the health department's application. The letter should cite specific reasons for nonconcurrence. In instances of nonconcurrence and when a health department does not concur with the recommendations of the HIV prevention community planning group(s) and believes that public health would be better served by funding HIV prevention activities/services that are substantially different, the health department must submit a letter of explanation in its application. CDC will assess and evaluate these explanations on a case-by-case basis and determine what action may be appropriate. </B></div> <bR> <div> <B>A letter of nonconcurrence does not necessarily mean that the jurisdiction will lose any portion of its CDC funding. </B></div> <bR> <div> <B>CDC will assess and evaluate nonconcurrence letters and/or health department letters of explanation on a case-by-case basis and determine what action may be appropriate. Actions can range from * obtaining more input/information regarding the situation; * meeting with the health department and co-chairs; * negotiating with the health department regarding the issues raised; * recommending local mediation; * approving the health department's application as is; * requesting that a detailed plan of corrective action be developed to address the areas of concern and to be executed within a specified timeframe; * conducting an on-site comprehensive program assessment to identify and propose action steps to resolve areas of concern; members, committees, committee chairs, co-chairs, etc.), * developing a detailed technical assistance plan for the project area to help systematically address the situation; and * placing conditions or restrictions on the award of funds pending a future submission by the applicant. </B></div> <bR> <div> <B>Regarding Concurrence with Reservations... Letter(s) of concurrence may include a statement of concern/issues or reservations. If such a letter is submitted, the health department should address the reservations or concerns in an attachment to the HIV prevention application. </B></div> <bR> <div> <B>Regarding Nonconcurrence... Letter(s) of nonconcurrence indicate that the CPG(s) disagrees with the program priorities identified in the health department's application. The letter should cite specific reasons for nonconcurrence. If a health department does not concur with the recommendations of the CPG(s), and believes that public health would be better served by funding HIV prevention activities/services that are substantially different, the health department must submit a letter of explanation in its application. </B></div> <bR> <div> <B>In closing, is the NC DHHS Cooperative Agreement #U62/CCU416703 with the CDC, which was signed by NC DHHS Secretary Carmen Hooker-Odom, considered valid if the "community" was not privy to the budget data on pages numbered 1-58? If not, whom at the NC AIDS Care and Prevention Unit is ultimately responsible for this error?</B><FONT SIZE="3" COLOR="#000000" FACE="Times New Roman" ><B> </B></FONT></div> <bR> <div> <B>Please make multiple copies of this letter for distribution to the NC DHHS SCPG on December 12, 2002, and also, be prepared to explain to the body of the SCPG, what their respective "fiduciary responsibility" is in regard to the issues contained herein. </B></div> <div> <B>respectfully submitted, </B></div> <div> <B>Kevin P. Nuttall - "NK0525611" </B></div> <div> <B>State & Federal Affairs Director </B></div> <div> <B>North Carolina AIDS Policy Center </B></div> <div> <B>81 Baird Street, Suite 105 </B></div> <div> <B>Asheville, NC 28801-2093 </B></div> <div> <B>p: 828.251.2229 / f: 828.285.0080 </B></div> <div> <B><</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><B>mail to:retroart@buncombe.main.nc.us</B></FONT><B>> </B></div> <bR> <bR> <div> <B>* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *</B></div> <div> <B>Received December 10, 2002</B></div> <bR> <div> <B>Riched20 5.40.11.2210;Thank you for your careful review of the summary. Your points are well taken I will attach them to the summary as an appendix. See you tomorrow!</B></div> <bR> <div> <B>page</B></div> <bR> <div> <B>retroart@buncombe.main.nc.us wrote:</B></div> <bR> <div> <B>> Phyllis Gray wrote:  * Alternative Reconfigure of Regions: It was </B></div> <div> <B>> recommended that rather than reorganizing regional clusters to </B></div> <div> <B>> coincide with consortia regions that the SCPG should strongly consider </B></div> <div> <B>> (1) aligning clusters with HIV epidemic hot spots and or  (2) HIV </B></div> <div> <B>> service providers, including Ryan White Title II, III, and IV</B></div> <div> <B>></B></div> <div> <B>> ***</B></div> <div> <B>></B></div> <div> <B>> Phyllis:</B></div> <div> <B>></B></div> <div> <B>> I would like to reiterate that it is my continuing belief that: </B></div> <div> <B>> Regional CPGs should be reconfigured to  a) more closely match the </B></div> <div> <B>> epi-profile; and  b) in consideration of the resource allocations </B></div> <div> <B>> across the state; and  c) with additional consideration to epi-profile </B></div> <div> <B>> "hot spots" --- which may result in recommendations that regional CPGs </B></div> <div> <B>> be equivalent to consortium configuration in some geographic areas of </B></div> <div> <B>> the state.  In striving to achieve this goal, a study of the </B></div> <div> <B>> epi-profile AND existing resources would be a first step (which I </B></div> <div> <B>> offered to perform), and consensus from the various regions affected </B></div> <div> <B>> by any proposed change in configuration would also need to be achieved </B></div> <div> <B>> (to assure a greater level of outcomes).</B></div> <div> <B>></B></div> <div> <B>> Having given much of this language many years of consideration, I can </B></div> <div> <B>> only hope I will be "quoted" _verbatim_. kpn</B></div> <div> <B>></B></div> <div> <B>> --- page break ---</B></div> <div> <B>></B></div> <div> <B>> Phyllis Gray wrote: 3. Cluster Membership Issues: Priority Issues For </B></div> <div> <B>> Immediate Resolution:  <snip> (3) Burn out for HIV service consumers;</B></div> <div> <B>> (4) Lack of participation as reflected by problems with recruitment </B></div> <div> <B>> and retention --- Discussion: <snip> While general maintenance of </B></div> <div> <B>> cluster membership is a problem, the involvement of consumers is more </B></div> <div> <B>> problematic.</B></div> <div> <B>></B></div> <div> <B>> ***</B></div> <div> <B>></B></div> <div> <B>> Phyllis:</B></div> <div> <B>></B></div> <div> <B>> I would appreciate appropriate attention to the issue of lack of </B></div> <div> <B>> communication by ASOs to be reflected with respect to consumer </B></div> <div> <B>> participation in prevention planning.  As I have mentioned for many </B></div> <div> <B>> years, the ASOs generally DO NOT advise consumers of the SCPG or the </B></div> <div> <B>> RCPGs.  A suggestion that _all_ funded ASOs should be REQUIRED (by the</B></div> <div> <B>> Branch) to post notices and hand out flyers to consumers is NOT </B></div> <div> <B>> reflected in your summary.  Until such a time as ASOs are required to </B></div> <div> <B>> be proactive on this issue, I believe it is wholly improper to lay </B></div> <div> <B>> blame on consumers via assertions regarding "burn out."  A top down </B></div> <div> <B>> approach to burn out would lay the responsibility for lack of consumer </B></div> <div> <B>> participation where it belongs -- in the laps of the ASOs which FAIL </B></div> <div> <B>> to promote this activity.  Clearly, with consumers outweighing </B></div> <div> <B>> providers by a ratio of 50:1 (at a minimum), the issue seems to be </B></div> <div> <B>> lack of communication by ASOs with respect to consumer participation, </B></div> <div> <B>> which could easily be attributed to lack of Branch leadership!  </B></div> <div> <B>> Blaming consumers for this concern is counterproductive. kpn</B></div> <div> <B>></B></div> <div> <B>> --- page break ---</B></div> <div> <B>></B></div> <div> <B>> Phyllis Gray wrote:  Action Steps: Define "consumers,"</B></div> <div> <B>></B></div> <div> <B>> ***</B></div> <div> <B>></B></div> <div> <B>> Phyllis:</B></div> <div> <B>></B></div> <div> <B>> The request was to "define consumers consistently across programs and </B></div> <div> <B>> funding streams, under care, treatment and prevention."  This is an </B></div> <div> <B>> IMPORTANT distinction, for which a definition recommendation has long </B></div> <div> <B>> been in place... just ask Steve Sherman!  To define consumers across </B></div> <div> <B>> funding streams and programs would  a) be one way the Branch could </B></div> <div> <B>> demonstrate a collaboration within the Branch and with the Branch's </B></div> <div> <B>> community partners; and  b) establish consistency in recruitment with </B></div> <div> <B>> respect to ACUAC, NCAAC and the SCPG; and  c) establish an improved </B></div> <div> <B>> relationship with NCs two consumer organizations (NC AIDS Policy </B></div> <div> <B>> Center and NC Council for Positive Living).</B></div> <div> <B>></B></div> <div> <B>> Prior to consistently defining "consumer" across programs and funding </B></div> <div> <B>> streams, the SCPG could proactively put the wheels in motion by </B></div> <div> <B>> adopting a ByLaw to assist in achieving appropriate consumer </B></div> <div> <B>> participation.  This ByLaw could read:</B></div> <div> <B>></B></div> <div> <B>> To the maximum extent possible, the membership of the SCPG shall </B></div> <div> <B>> represent the demographics of the communities affected by the local </B></div> <div> <B>> HIV epidemic, and to the maximum extent possible, not less than a </B></div> <div> <B>> minimum of 33% of the Officers shall be comprised of self-identified </B></div> <div> <B>> people living with HIV who are consumers of services under 42 USCA </B></div> <div> <B>> 300ff-11 (Section 2611), otherwise known as: Ryan White CARE Act Title </B></div> <div> <B>> II and/or, Medicaid, Medicare or the NC Purchase of Care Program  -- </B></div> <div> <B>> who do not serve on the executive or governing board and are not staff </B></div> <div> <B>> or consultants of  -- (i) a Ryan White Care Act funded agency; (ii) a </B></div> <div> <B>> Counseling - Testing - Referral - Partner - Notification funded </B></div> <div> <B>> agency; or (iii) an agency which administers a state or federal grant </B></div> <div> <B>> contracted through the NC DHHS, HRSA or the CDC.  For purposes of the </B></div> <div> <B>> preceding definition, an individual shall also be considered to be a </B></div> <div> <B>> "consumer" if the individual is a parent or sibling of, an </B></div> <div> <B>> affectionate partner of, or a sole caregiver for, any _mortal_ person </B></div> <div> <B>> *living* with HIV, who is the recipient of such services defined </B></div> <div> <B>> herein, and does not serve on the executive or governing board and are </B></div> <div> <B>> not staff or consultants of the entities defined herein.  Furthermore, </B></div> <div> <B>> the SCPG shall NOT be chaired solely by any individual who is not </B></div> <div> <B>> defined as a consumer of services under the provisions of this ByLaw.</B></div> <div> <B>></B></div> <div> <B>> I welcome the SCPG to entertain and reiterate this recommendation when </B></div> <div> <B>> the ByLaw Committee convenes.  And, I can only hope that the above </B></div> <div> <B>> recommendation demonstrates my future commitment to that committees' </B></div> <div> <B>> important work! kpn</B></div> <div> <B>></B></div> <div> <B>> --- page break ---</B></div> <div> <B>></B></div> <div> <B>> Perhaps you could attach this response to your summary to assure that </B></div> <div> <B>> my positions are not misquoted, misconstrued, diminished or otherwise </B></div> <div> <B>> (mis)interpreted.</B></div> <div> <B>></B></div> <div> <B>> respectfully submitted,</B></div> <div> <B>></B></div> <div> <B>> Kevin P. Nuttall - "NK0525611"</B></div> <div> <B>> State & Federal Affairs Director</B></div> <div> <B>> North Carolina AIDS Policy Center</B></div> <div> <B>> 81 Baird Street, Suite 105</B></div> <div> <B>> Asheville, NC 28801-2093</B></div> <div> <B>> p: 828.251.2229 / f: 828.285.0080 </B></div> <div> <B>> <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:retroart@buncombe.main.nc.us" TARGET="_top" TITLE="mailto:retroart@buncombe.main.nc.us"><U><B>mail to:retroart@buncombe.main.nc.us</B></U></A></FONT><B>></B></div> <bR> <div> <B>* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * </B></div> <div> <B>Received December 10, 2002</B></div> <bR> <div> <B>Riched20 5.40.11.2210;Phyllis Gray wrote:  * Alternative Reconfigure of Regions: It was recommended that rather than reorganizing regional clusters to coincide with consortia regions that the SCPG should strongly consider (1) aligning clusters with HIV epidemic hot spots and or  (2) HIV service providers, including Ryan White Title II, III, and IV</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>Phyllis:</B></div> <bR> <div> <B>I would like to reiterate that it is my continuing belief that: Regional CPGs should be reconfigured to  a) more closely match the epi-profile; and  b) in consideration of the resource allocations across the state; and  c) with additional consideration to epi-profile "hot spots" --- which may result in recommendations that regional CPGs be equivalent to consortium configuration in some geographic areas of the state.  In striving to achieve this goal, a study of the epi-profile AND existing resources would be a first step (which I offered to perform), and consensus from the various regions affected by any proposed change in configuration would also need to be achieved (to assure a greater level of outcomes).</B></div> <bR> <div> <B>Having given much of this language many years of consideration, I can only hope I will be "quoted" _verbatim_. kpn</B></div> <bR> <div> <B>--- page break ---</B></div> <bR> <div> <B>Phyllis Gray wrote: 3. Cluster Membership Issues: Priority Issues For Immediate Resolution:  <snip> (3) Burn out for HIV service consumers;</B></div> <div> <B>(4) Lack of participation as reflected by problems with recruitment and retention --- Discussion: <snip> While general maintenance of cluster membership is a problem, the involvement of consumers is more problematic.</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>Phyllis:</B></div> <bR> <div> <B>I would appreciate appropriate attention to the issue of lack of communication by ASOs to be reflected with respect to consumer participation in prevention planning.  As I have mentioned for many years, the ASOs generally DO NOT advise consumers of the SCPG or the RCPGs.  A suggestion that _all_ funded ASOs should be REQUIRED (by the</B></div> <div> <B>Branch) to post notices and hand out flyers to consumers is NOT reflected in your summary.  Until such a time as ASOs are required to be proactive on this issue, I believe it is wholly improper to lay blame on consumers via assertions regarding "burn out."  A top down approach to burn out would lay the responsibility for lack of consumer participation where it belongs -- in the laps of the ASOs which FAIL to promote this activity.  Clearly, with consumers outweighing providers by a ratio of 50:1 (at a minimum), the issue seems to be lack of communication by ASOs with respect to consumer participation, which could easily be attributed to lack of Branch leadership!  Blaming consumers for this concern is counterproductive. kpn</B></div> <bR> <div> <B>--- page break ---</B></div> <bR> <div> <B>Phyllis Gray wrote:  Action Steps: Define "consumers,"</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>Phyllis:</B></div> <bR> <div> <B>The request was to "define consumers consistently across programs and funding streams, under care, treatment and prevention."  This is an IMPORTANT distinction, for which a definition recommendation has long been in place... just ask Steve Sherman!  To define consumers across funding streams and programs would  a) be one way the Branch could demonstrate a collaboration within the Branch and with the Branch's community partners; and  b) establish consistency in recruitment with respect to ACUAC, NCAAC and the SCPG; and  c) establish an improved relationship with NCs two consumer organizations (NC AIDS Policy Center and NC Council for Positive Living).</B></div> <bR> <div> <B>Prior to consistently defining "consumer" across programs and funding streams, the SCPG could proactively put the wheels in motion by adopting a ByLaw to assist in achieving appropriate consumer participation.  This ByLaw could read:</B></div> <bR> <div> <B>To the maximum extent possible, the membership of the SCPG shall represent the demographics of the communities affected by the local HIV epidemic, and to the maximum extent possible, not less than a minimum of 33% of the Officers shall be comprised of self-identified people living with HIV who are consumers of services under 42 USCA 300ff-11 (Section 2611), otherwise known as: Ryan White CARE Act Title II and/or, Medicaid, Medicare or the NC Purchase of Care Program  -- who do not serve on the executive or governing board and are not staff or consultants of  -- (i) a Ryan White Care Act funded agency; (ii) a Counseling - Testing - Referral - Partner - Notification funded agency; or (iii) an agency which administers a state or federal grant contracted through the NC DHHS, HRSA or the CDC.  For purposes of the preceding definition, an individual shall also be considered to be a "consumer" if the individual is a parent or sibling of, an affectionate partner of, or a sole caregiver for, any _mortal_ person *living* with HIV, who is the recipient of such services defined herein, and does not serve on the executive or governing board and are not staff or consultants of the entities defined herein.  Furthermore, the SCPG shall NOT be chaired solely by any individual who is not defined as a consumer of services under the provisions of this ByLaw.</B></div> <bR> <div> <B>I welcome the SCPG to entertain and reiterate this recommendation when the ByLaw Committee convenes.  And, I can only hope that the above recommendation demonstrates my future commitment to that committees' important work! kpn</B></div> <bR> <div> <B>--- page break ---</B></div> <bR> <div> <B>Perhaps you could attach this response to your summary to assure that my positions are not misquoted, misconstrued, diminished or otherwise (mis)interpreted.</B></div> <bR> <div> <B>respectfully submitted,</B></div> <bR> <div> <B>Kevin P. Nuttall - "NK0525611"</B></div> <div> <B>State & Federal Affairs Director</B></div> <div> <B>North Carolina AIDS Policy Center</B></div> <div> <B>81 Baird Street, Suite 105</B></div> <div> <B>Asheville, NC 28801-2093</B></div> <div> <B>p: 828.251.2229 / f: 828.285.0080 <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:retroart@buncombe.main.nc.us" TARGET="_top" TITLE="mailto:retroart@buncombe.main.nc.us"><U><B>mail to:retroart@buncombe.main.nc.us</B></U></A></FONT><B>></B></div> <bR> <bR> <bR> <div> <B>* * * * * *  *  * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * </B></div> <bR> <div> <B>Riched20 5.40.11.2210;Table of Contents (approx. 2 pages):</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>SCPG Survey Reply from Bengie Hair (approx. 2 pages)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>NASTAD News - December 2002 (12 pages):</B></div> <bR> <div> <B>LEGISLATIVE AND POLICY REPORTS</B></div> <div> <B>1 - FY2003 Appropriations Update</B></div> <div> <B>1 - Election Impact</B></div> <div> <B>2 - Party Pre-election Post-election Gain/Loss (converted table) 3 - HIV/AIDS Community Meetings with Administration Officials 3 - Homeland Security</B></div> <bR> <div> <B>CARE AND TREATMENT REPORTS</B></div> <div> <B>3 - NASTAD Executive Committee Meeting with HRSA/HAB</B></div> <div> <B>3 - HRSA Reorganization</B></div> <div> <B>4 - Title I and II "Opening Doors" Training</B></div> <div> <B>4 - Quality Improvement Panel</B></div> <bR> <div> <B>ACROSS CARE AND PREVENTION</B></div> <div> <B>4 - Southern States Summit on HIV/AIDS and STDs</B></div> <div> <B>5 - HHS Combines HIV/AIDS Advisory Bodies</B></div> <div> <B>5 - Latino Advisory Committee Meeting</B></div> <bR> <div> <B>PREVENTION AND SURVEILLANCE REPORTS</B></div> <div> <B>5 - IOM Request for Information on Surveillance Funding</B></div> <div> <B>6 - HIV/STD MSM Action Memo [memo added to document]</B></div> <div> <B>6 - Program Announcement and Community Planning Guidance Update 7 - CBO Program Announcement Update 7 - CDC Diffusion of Effective Interventions Project 7 - Update on Rapid Testing 8 - NASTAD CTR Technical Assistance 8 - In the Bulletin 8 - Prevention Work Group Update 9 - Youth CBA/NASTAD Survey Work 9 - 2003 HIV Prevention Conference</B></div> <bR> <div> <B>GLOBAL PROGRAM REPORTS</B></div> <div> <B>9 - CDC Global Program Partners Meeting</B></div> <div> <B>10 - CDC Global Program Leadership News</B></div> <div> <B>10 - December Global TA Provider Orientation</B></div> <div> <B>10 - NASTAD Collaboration with Tulane University</B></div> <bR> <div> <B>VIRAL HEPATITIS NEWS</B></div> <div> <B>11 - NASTAD Viral Hepatitis Program Update</B></div> <div> <B>11 - CDC Viral Hepatitis News</B></div> <bR> <div> <B>NASTAD MEMBER AND STAFF NEWS</B></div> <div> <B>12 - Staff News</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>NASTAD Prevention Bulletin - December 2002 (18 pages):</B></div> <bR> <div> <B>1 - Substance Abuse Treatment as HIV/Hepatitis Prevention</B></div> <div> <B>Overview: Substance Abuse Treatment as HIV and Hepatitis Prevention</B></div> <bR> <div> <B>2, 3 - Methadone Maintenance Treatment</B></div> <bR> <div> <B>4 - Regulation of Methadone Maintenance Treatment</B></div> <bR> <div> <B>5 - Buprenorphine: A New Option for Opiate Dependence</B></div> <bR> <div> <B>5 - Hepatitis Coordinators' Conference</B></div> <bR> <div> <B>6 - Jurisdiction Profile: New York State, AIDS Institute Linking HIV Prevention and Care with Substance Abuse Treatment</B></div> <bR> <div> <B>7, 8 - Jurisdiction Profile: D.C. Department of Health, Addiction Prevention and Recovery Administration From Outreach to Intake: Reaching D.C. Substance Abusers</B></div> <bR> <div> <B>9 - SAMHSA HIV/AIDS Initiatives</B></div> <div> <B>Early Intervention Services (EIS)</B></div> <div> <B>CSAT Minority HIV/AIDS Initiative -- TCE/HIV</B></div> <bR> <div> <B>10 - Update for NJ Substance Abuse Treatment Providers</B></div> <bR> <div> <B>11 - Resources on Substance Abuse and HIV</B></div> <bR> <div> <B>12 - FDA Approves OraQuick</B></div> <div> <B>Applying for a Clinical Laboratory Improvement Amendments Waiver Implementation of HIV Rapid Tests</B></div> <bR> <div> <B>13, 14 - Adolescent and School-Based Health</B></div> <div> <B>Presentation on Health and Student Achievement</B></div> <div> <B>Surveillance Information on Adolescents</B></div> <div> <B>Upcoming Ryan White National Youth Conference on HIV and AIDS</B></div> <bR> <div> <B>14, 15 - The Manager</B></div> <div> <B>Finding your "Genius"</B></div> <div> <B>Cultivating the faces of genius</B></div> <bR> <div> <B>15, 16 - Resources</B></div> <div> <B>National Black HIV/AIDS Awareness Day 2003</B></div> <div> <B>Capacity Building Assistance Training Calendar</B></div> <bR> <div> <B>16, 17 - Calendar</B></div> <div> <B>12/01/02 -- World AIDS Day 2002</B></div> <div> <B>12/01-03/02 - 2nd Int'l Conf.~Sub-Abuse/HIV, India</B></div> <div> <B>12/01-04/02 - 4th Nat'l Harm Reduction Conf., Seattle 01/27-29/03 - Rescheduling 11/02 CBO Consult.,Chicago 01/27-30/03 - Nat'l Hep Coord. Conf., San Antonio 02/14-17/03 - 10th RW Nat'l Youth Conf. HIV/AIDS, Dallas 03/02-08/03 - Black Church Week/Prayer For/Healing of AIDS 03/12-15/03 - CPLS for HIV Prevention, New York City 03/28-30/03 - RCAP National Conf., Bloomington, IN 03/30-04/02/03 - 15th Nat'l H/A Update Conf. (NAUC), Miami 04/04/03 - 3rd CAPS HIV Prevention Conf., San Francisco 04/6-10/03 - 14th Int'l Conf./Redux/Drug-Related Harm - Thailand 04/26-29/03 - 7th Comm. Campus Partnerships/Hlth Conf., San Diego 05/21-23/03 - Call 4 Abstracts: Nat'l Conf./Hlth Ed/Hlth Promotion 05/29-06/01/03 - 15th Nat'l Conf./Soc.Work~H/A, Albuq., NM</B></div> <div> <B>06/18-21/03- 13th Nat'l Conf./Soc.Mrktng/Pub.Hlth, ClrwtrBch, FL 07/27-30/03 - 2003 Nat'l HIV Prevention Conf., Atlanta, GA 09/18-21/03 - The US Conf. on AIDS (USCA), New Orleans, LA</B></div> <bR> <div> <B>18 - Info about "The Bulletin"</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>2 E-Mails regarding collection of data from other states relative to the work of the NC DHHS SCPG (approx. 3 pages)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>E-mail regarding NC DHHS SCPG Strategic Planning Process (aka "Road</B></div> <div> <B>Mapping) - approx. 1 page</B></div> <bR> <div> <B>and</B></div> <bR> <div> <B>2 E-Mails regarding Re: SCPG Strategic Planning Effort (combined) - approx. 2 pages</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>NOTICE: Re: Public Comment on the Comprehensive HIV Care Plan - Dec. 13, 2002 - 1 page</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>AIDS prevention saved up to 1.5 million [people] -US study [according to Dr. Holtgrave] 3 E-Mails</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>HHS Creates Unified HIV/AIDS and STD Advisory Committee to Strengthen Prevention and Treatment Efforts (1 page)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>Hotel Accommodations for World AIDS Day (1 page)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>SCPG Action Alert, Voting Members of the NC DHHS SCPG, NC DHHS Agenda Topics for Dec. 12, 2002 (approx. 3 pages)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>E-mail: SCPG ByLaws Contradiction? (1 page)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>E-mail: How prevention funds are distributed in NC (1 page)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>Not included in this document is: Prescription Drug Costs and Coverage:</B></div> <div> <B>What Can States Do? An Action Kit for State Advocates...   see:</B></div> <bR> <div> <A HREF="http://www.familiesusa.org/html/drugkit/drugkit.htm" TARGET="_top" TITLE="http://www.familiesusa.org/html/drugkit/"><U><B>http://www.familiesusa.org/html/drugkit/drugkit.htm</B></U></A></div> <bR> <div> <B>for further details.</B></div> <bR> <div> <B>respectfully submitted,</B></div> <bR> <div> <B>Kevin P. Nuttall - "NK0525611"</B></div> <div> <B>State & Federal Affairs Director</B></div> <div> <B>North Carolina AIDS Policy Center</B></div> <div> <B>81 Baird Street, Suite 105</B></div> <div> <B>Asheville, NC 28801-2093</B></div> <div> <B>p: 828.251.2229 / f: 828.285.0080 <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:retroart@buncombe.main.nc.us" TARGET="_top" TITLE="mailto:retroart@buncombe.main.nc.us"><U><B>mail to:retroart@buncombe.main.nc.us</B></U></A></FONT><B>></B></div> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <div> <B>Subject: [Fwd: NC SCPG Summary]</B></div> <div> <B>Date: Mon, 18 Nov 2002 15:41:10 -0500</B></div> <div> <B>From: Sarah Langer <sarah.langer@ncmail.net></B></div> <div> <B>Organization: N.C. Dept. of Health and Human Services</B></div> <div> <B>To: SCPG Road Mapping Committee Members</B></div> <bR> <bR> <div> <B>Here is a Consortia member perspective, as promised.</B></div> <bR> <div> <B>-Sarah</B></div> <bR> <div> <B>-------- Original Message --------</B></div> <div> <B>Subject: NC SCPG Summary</B></div> <div> <B>Date: Tue, 22 Oct 2002 13:37:06 -0400</B></div> <div> <B>From: Bengie.Hair@CareAlliance.com</B></div> <div> <B>To: maryann.chap@NCMail.net</B></div> <div> <B>CC: sarah.langer@NCMail.net, evelyn.foust@NCMail.net</B></div> <bR> <bR> <bR> <bR> <div> <B>Good Afternoon:</B></div> <bR> <div> <B>My thoughts are as follows:</B></div> <bR> <div> <B>1) 7 regional clusters has always been cumbersome ...due to geographic distances and lack of funds for coordination.  Sometimes, the travel time each way is 3 hours.</B></div> <bR> <div> <B>2)  13 consortia regions can be cumbersome, but it offers a more defined geographic area that relates to existing health care service delivery networks .....so, inclusion of prevention activities would not be too difficult to integrate into the existing consortium infrastructure.  The SCUP has never combined forces with the local AHED's in an effort to develop prevention initiatives.</B></div> <bR> <div> <B>3)  Consortia are already involved in some prevention activities in a smaller geographic area. For example, South Central Consortium supports the Richmond Co HIV Task Force at the Seaboard Festival in Hamlet, NC each year by selling food, beverages, etc.... the proceeds are used to pay for HIV prevention messages in Richmond County and support HIV and STD outreach services through the public health department.</B></div> <bR> <div> <B>4)  The prevailing lack of interest from public health departments is due to an effort to discourage their participation in the beginning of the SCUP process.  This was a subtle movement by Cob's to not include public health, because supposedly public health was not reaching those at greatest risk in the communities.  Now 7 years later, public health is still plugging away with no SCUP money, and the Cob's are no better organized to meet the challenge.  Thus, having money from the State to make community planning viable is not necessarily the answer.</B></div> <bR> <div> <B>5)  For the South Central Consortium, we have public health department/director participation because we "reached out" to them in the consortium formative years and have kept them informed on our development goals, which actually included prevention strategies. An example would be presentations at forums or booths at health fairs that included prevention and care information materials.  We have worked jointly with the public health departments for booths at county fairs.</B></div> <bR> <div> <B>6)  For community planning to produce an outcome there has to be "tasks" assigned.  Such as: 1) Develop a regional plan, with specific prevention strategies for each county, 2) determine a timetable for implementation,</B></div> <div> <B>3) define a reporting method for activities performed, 4) create a budget that reflects multiple sources of fiscal income and in-kind contributions (time and labor),</B></div> <bR> <div> <B>5) identify the participants, and 6) create a forum for information exchange on successes and failures.  For Ryan White [funded] Title II consortia, we have the infrastructure that have tasks and annual goals assigned by the AU and through our development activities we have identified needed services.  The process already exists within the consortia framework of operations.</B></div> <bR> <div> <B>7) And, the goal is PREVENTION, and not funding more money to organizations, creating hierarchies, promoting egos, giving awards, and disallowing "outcomes" as unachievable and unmeasurable.</B></div> <bR> <div> <B>At the most recent Emory Univ. sponsored Clinical Update on HIV in the Rural Southeast, a rep from CDC spoke and was very "focused" on how case/care management can play an integral role in HIV and STD prevention.  And, how program integration is the concept being explored and promoted with future cases being prevented through intense risk reduction/behavior modification support for those infected with HIV.</B></div> <bR> <div> <B>One of the best ways to let the public know about the issues is to create a public relations campaign.  America Responds to AIDS had the attention of the nation at one time.  IF the HIV/STD Prev & Care Branch would publish the STD issue in Moore County in The Pilot newspaper, it would get attention (let the Health Dept know first) .</B></div> <bR> <div> <B>Just some thoughts,</B></div> <div> <B>Bengie</B></div> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>National Alliance of State and Territorial AIDS Directors</B></div> <div> <B>444 North Capitol Street, NW, Suite 339</B></div> <div> <B>Washington, DC 20001-1512</B></div> <div> <B>FAX 202-434-8092</B></div> <div> <B>PHONE: 202-434-8090</B></div> <div> <A HREF="http://www.nastad.org" TARGET="_top" TITLE="http://www.nastad.org"><U><B>http://www.nastad.org</B></U></A></div> <bR> <bR> <div> <B>NASTAD News (December 2002)</B></div> <bR> <bR> <div> <B>Page 1 of 12</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Legislative and Policy Reports _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ FY2003 Appropriations Update _ _ _ _</B></div> <bR> <div> <B>Only two appropriations bills - Defense and Military Construction - were passed before Congress adjourned and the 107th Congress came to a close. During its lame duck session, Congress moved to enact the 5th continuing resolution (CR) since the beginning of the fiscal year, October 1, 2002. This CR will maintain non-defense spending at existing FY2002 fiscal levels through January 11, 2003. It was the goal of Congressional leadership to keep the lame duck session short and address the remaining appropriations bills when Congress convenes the 108th Congress in January.</B></div> <bR> <div> <B>It is difficult to predict at this point how the new Congress will approach the passage of the 11 remaining FY2002 appropriations bills. The White House and Congressional leadership have essentially agreed to stick with the overall spending level included in the President's FY2003 budget. In real terms, the Senate Appropriations Committee draft of the Labor-HHS-Education bill must be cut by $4 billion to be in compliance with the President's funding level. This puts the $100 million increase for ADAP and $17.6 million increase for Title II in serious jeopardy.</B></div> <bR> <div> <B>The long delay in receiving FY2003 funds will create difficulties for state and local health departments, as well as planning councils. HRSA has indicated that it is likely that Title I will receive abbreviated awards on March 1st. If Congress does not complete the Labor-HHS-Education appropriations bill by March, states will receive a partial award, about one-twelfth, on April 1, 2003.  CDC has indicated that they hope to make full prevention awards on January 1, 2003 but may be forced to make partial year awards. NASTAD will monitor this situation closely and share information as soon as it is available.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Election Impact _ _ _ _</B></div> <bR> <div> <B>Both the Congress and the Administration are now under Republican control. NASTAD staff and state AIDS directors must seek to enhance our existing relationships with Republican Representatives and Senators. There are 53 new members of the House of Representatives and 10 new Senators - to see list, please click on:</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/newmembers.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/newmember"><U><B>http://www.nastad.org/pdf/news/newmembers.pdf</B></U></A></div> <bR> <div> <B>NASTAD encourages state AIDS directors to reach out to these new members by introducing your state programs and offering yourself as a resource.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 2 of 12</B></div> <bR> <bR> <bR> <div> <B>[converted table follows]</B></div> <bR> <div> <B>* * * * Party Pre-election Post-election Gain/Loss * * * *</B></div> <bR> <bR> <div> <B>_ _ _ _ US Senate _ _ _ _</B></div> <bR> <div> <B>Party: Republican</B></div> <div> <B>Pre-election: 49</B></div> <div> <B>Post-election: 51</B></div> <div> <B>Gain/Loss: +2</B></div> <bR> <div> <B>Party: Democrat</B></div> <div> <B>Pre-election: 49</B></div> <div> <B>Post-election: 47*</B></div> <div> <B>Gain/Loss: -2</B></div> <bR> <div> <B>Party: Independent</B></div> <div> <B>Pre-election: 1</B></div> <div> <B>Post-election: 1</B></div> <div> <B>Gain/Loss: 0</B></div> <bR> <div> <B>*Mary Landrieu (D-LA) did not get 50% of the vote and must take part in a runoff on Dec. 7</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ US House _ _ _ _</B></div> <bR> <div> <B>Party: Republican</B></div> <div> <B>Pre-election: 223</B></div> <div> <B>Post-election: 231</B></div> <div> <B>Gain/Loss: +8</B></div> <bR> <div> <B>Party: Democrat</B></div> <div> <B>Pre-election: 211</B></div> <div> <B>Post-election: 203</B></div> <div> <B>Gain/Loss: -8</B></div> <bR> <div> <B>Party: Independent</B></div> <div> <B>Pre-election: 1</B></div> <div> <B>Post-election: 1</B></div> <div> <B>Gain/Loss: 0</B></div> <bR> <bR> <div> <B>_ _ _ _ State Governors _ _ _ _</B></div> <bR> <div> <B>Party: Republican</B></div> <div> <B>Pre-election: 27</B></div> <div> <B>Post-election: 26</B></div> <div> <B>Gain/Loss: -1</B></div> <bR> <div> <B>Party: Democrat</B></div> <div> <B>Pre-election: 21</B></div> <div> <B>Post-election: 24</B></div> <div> <B>Gain/Loss: +3</B></div> <bR> <div> <B>Party: Independent</B></div> <div> <B>Pre-election: 2</B></div> <div> <B>Post-election: 0</B></div> <div> <B>Gain/Loss: -**</B></div> <bR> <div> <B>**Independent Governors Ventura (MN) and King (ME) did not run for reelection</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Congressional Leadership _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ US Senate Leadership _ _ _ _</B></div> <bR> <div> <B>~ Republican</B></div> <bR> <div> <B>Majority Leader- Trent Lott (MS)</B></div> <div> <B>Asst. Majority Leader (whip)-</B></div> <div> <B>Mitch McConnell (KY)</B></div> <div> <B>Conference Chair- Rick Santorum (PA)</B></div> <div> <B>President Pro Tempore- Ted Stevens (AK)</B></div> <bR> <bR> <div> <B>~ Democrat</B></div> <bR> <div> <B>Minority Leader- Tom Daschle (SD)</B></div> <div> <B>Asst. Minority Leader- Harry Reid (NV)</B></div> <div> <B>Conference Chair- Tom Daschle (SD)</B></div> <bR> <div> <B>* Note: The Senate Democrats will hold leadership elections in December.</B></div> <bR> <bR> <bR> <bR> <div> <B>_ _ _ _ US House Leadership _ _ _ _</B></div> <bR> <div> <B>~ Republican</B></div> <bR> <div> <B>Speaker- Dennis Hastert (IL)</B></div> <div> <B>Majority Leader- Tom DeLay (TX)</B></div> <div> <B>Majority Whip- Roy Blunt (MO)</B></div> <div> <B>Conference Chair- Deborah Pryce (OH)</B></div> <bR> <bR> <div> <B>~ Democrat</B></div> <bR> <div> <B>Minority Leader- Nancy Pelosi (CA)</B></div> <div> <B>Minority Whip- Steny Hoyer (MD)</B></div> <div> <B>Conference Chair- Robert Menendez (NJ)</B></div> <bR> <bR> <div> <B>There are a number of committee changes that will have significant impact on federal funding for HIV/AIDS programs. There will be a new Chairman of the Senate Budget Committee, Senator Don Nickles (R-OK). On the House side, Appropriations Subcommittee chairs must receive the approval of the leadership-dominated GOP Steering Committee. This could result in moderate Subcommittee chairs being turned out of their chairmanships in favor of more conservative members.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 3 of 12</B></div> <bR> <bR> <bR> <div> <B>Senate Minority Leader Trent Lott (R-MS) has said that health care issues such as a Medicare prescription drug benefit, tax credits for the uninsured and limits on damages awarded in medical malpractice cases will have a high priority in the 108th Congress. We also expect that the pharmaceutical industry will have increased influence in Congress as they comprised the eighth-largest political contributor this election cycle, having donated $18 million as of late September.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ HIV/AIDS Community Meetings with Administration Officials _ _ _ _</B></div> <bR> <div> <B>Over the past six months, NASTAD has been involved in activities to reinvigorate national HIV/AIDS policy. As such, NASTAD is participating in an ad hoc national coalition of national and regional HIV/AIDS leaders engaged in national policy work. The Federal AIDS Advocacy Partnership, as it is now being called, has been meeting with key Administration officials to urge support for appropriate prevention services and access to care and treatment for HIV disease. Thus far, members of the partnership have met with White House Domestic Policy Council Chair Margaret Spellings, Director of the White House Office of National AIDS Policy Joseph O'Neill, HHS Secretary Tommy Thompson, HRSA Administrator Betty Duke, and CDC Director Julie Gerberding. The meetings have been intended as an opening of dialog between the Administration and the HIV/AIDS community.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Homeland Security _ _ _ _</B></div> <bR> <div> <B>The House and Senate approved legislation that creates a new Department of Homeland Security.  Under the legislation, the department will be responsible for domestic security protection, including training health care workers to respond to potential terrorist attacks. As part of the reorganization, some duties currently handled by HHS will shift to the new department, including chemical, biological, radiological and nuclear response programs and civilian bio-defense research. The homeland security bill also includes a provision that gives legal protection to health care workers who provide smallpox vaccinations. Under the provision, people or facilities that provide vaccinations would not face personal liability from lawsuits filed by those injured or killed by the vaccine. Public health experts applaud the effort to hold harmless medical workers but would prefer the development of a no-fault compensation fund.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Care and Treatment Reports _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ NASTAD Executive Committee Meeting with HRSA/HAB Staff _ _ _ _</B></div> <bR> <div> <B>The NASTAD Executive Committee met with representatives from the HRSA HIV/AIDS Bureau (HAB) on November 20 as part of their fall meeting. Discussions included the reorganization at HRSA, grant awards in the absence of a federal appropriation for the CARE Act, the ADAP funding crisis that is shaping up in many states, cooperation with Title III and IV programs (including Community Health Centers), NASTAD's quality management activities within the Cooperative Agreement, carryover funds, Emerging Communities, and the Integrated Services Project (ISP). Members expressed willingness to support HAB in its efforts to work within a challenging environment and HAB staff welcomed member input and support.</B></div> <bR> <bR> <bR> <bR> <div> <B>_ _ _ _ HRSA Reorganization _ _ _ _</B></div> <bR> <div> <B>NASTAD continues to provide input to HRSA</B></div> <div> <B>regarding proposed restructuring activities. A follow-up letter from NASTAD was recently sent to Dr. Elizabeth Duke, HRSA Administrator. The follow-up letter requests a response to concerns expressed in an original letter sent to Dr. Duke following a meeting with her during the Ryan White All-Titles meeting in August.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 4 of 12</B></div> <bR> <bR> <bR> <div> <B>In addition, members of the new Federal AIDS Advocacy Partnership met with Dr. Duke on November 14. She provided an update regarding restructuring activities. Participants expressed continued concern about the lack of consultation with various HIV/AIDS organizations concerning ongoing activities at HRSA, especially the reor-ganization efforts. Dr. Duke indicated that management recommendations were being completed and that reorganization should take place within several months.</B></div> <bR> <div> <B>Finally, NASTAD staff are meeting regularly with staff of the Association of Maternal and Child Health Programs (AMCHP) and National Association of Community Health Centers (NACHC) to determine common concerns with the reorganization. Planned activities include drafting of report language for appropriations bills as well as continued advocacy efforts with staff of House Appropriations Committee members concerning the HRSA reorganization.</B></div> <bR> <div> <B>For questions concerning HRSA reorganization, please contact Murray Penner at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:mpenner@nastad.org" TARGET="_top" TITLE="mailto:mpenner@nastad.org"><U><B>mail to:mpenner@nastad.org</B></U></A></FONT><B>> or Laura Hanen at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lhanen@nastad.org" TARGET="_top" TITLE="mailto:lhanen@nastad.org"><U><B>mail to:lhanen@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Title I and II "Opening Doors" Training _ _ _ _</B></div> <bR> <div> <B>As part of NASTAD's Cooperative Agreement with HRSAand in collaboration with the CAEAR Coalition, an advisory committee of Title I and II representatives has been established to guide the process of developing regional trainings for Title I and II grantees concerning topics of interest.  The first meeting of the advisory committee was held by teleconference on November 13. A copy of the minutes can be viewed at:</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/opendoors.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/opendoors"><U><B>http://www.nastad.org/pdf/news/opendoors.pdf</B></U></A></div> <bR> <div> <B>The next meeting will be a face-to-face meeting in Tampa, Florida on December 5. Following the advisory committee meeting, a training entitled "Opening Doors" is being conducted that will focus on linkages between Title I and II as well as other federal programs. For information on the training, please contact Danielle Davis at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:ddavis@nastad.org" TARGET="_top" TITLE="mailto:ddavis@nastad.org"><U><B>mail to:ddavis@nastad.org</B></U></A></FONT><B>> or Murray Penner at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:mpenner@nastad.org" TARGET="_top" TITLE="mailto:mpenner@nastad.org"><U><B>mail to:mpenner@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Quality Improvement Panel _ _ _ _</B></div> <bR> <div> <B>As another component of NASTAD's Cooperative Agreement with HRSA, NASTAD will be conducting a feasibility study to determine the effectiveness of initiating a quality improvement process using the Institute for Healthcare Improvement (IHI) "Collaborative" model. A "panel of experts" consisting of representatives from several states is being convened to guide the development of the feasibility study. The meeting will be January 15 and 16 in Washington, DC.  Travel reservations are due no later than December 12. For more information about the quality improvement panel or related activities, please contact Murray Penner at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:mpenner@nastad.org" TARGET="_top" TITLE="mailto:mpenner@nastad.org"><U><B>mail to:mpenner@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Across Care and Prevention _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _Southern States Summit on HIV/AIDS and STDs _ _ _ _</B></div> <bR> <div> <B>The Southern States Summit on HIV/AIDS and STDs: A Call to Action was held in Charlotte, North Carolina, November 13-15, 2002. The Summit was sponsored by the Kaiser Family Foundation, the National Alliance of State and Territorial AIDS Directors (NASTAD), and the Southern State AIDS Directors Work Group. The purpose of the Summit was to raise awareness of the HIV/AIDS and STD crisis in the south and to share the need to implement an urgent call to action with federal, state and community partners.  Dr. David Satcher, former U.S. Surgeon General, was the keynote speaker. State legislators, federal and community partners participated on interactive...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 5 of 12</B></div> <bR> <bR> <bR> <div> <B>...panels to discuss the unique issues related to health care in the South.</B></div> <bR> <div> <B>A comprehensive document, A Southern States Manifesto, HIV/AIDS and STDs in the South: A Call to Action will be released following the Summit. Written by southern state AIDS directors, the purpose of the document is to make recommendations to bring public awareness of the barriers to the provision of prevention and care services for individuals living with HIV/AIDS and STDs in the South and to provide a plan for alleviation of the barriers.</B></div> <bR> <div> <B>The Summit provided an opportunity to examine the unique barriers to providing HIV and STD prevention and care services, the current status of state and federal resources in the South, and successful efforts to promote awareness and mobilize communities of color in the South. Participants reviewed recommended strategies to create supportive community environments and improve prevention and care resources in order to effectively impact the health of families and communities in the South. In addition, participants were given the opportunity to provide feedback and suggested improvements to the draft Manifesto document.</B></div> <bR> <div> <B>More information and the webcast of the Summit are available on the Kaiser Family Foundation website at:</B></div> <bR> <div> <A HREF="http://www.kff.org" TARGET="_top" TITLE="http://www.kff.org"><U><B>http://www.kff.org</B></U></A><FONT SIZE="3" COLOR="#000000" FACE="Times New Roman" ><B>.</B></FONT></div> <bR> <bR> <bR> <div> <B>_ _ _ _ HHS Combines HIV/AIDS Advisory Bodies _ _ _ _</B></div> <bR> <div> <B>On November 14, HHS Secretary Tommy Thompson announced the merger of the CDC's Advisory Committee for HIV and STD Prevention and HRSA's AIDS Advisory Committee into a single advisory panel. Beginning in 2003, the newly chartered Advisory Committee will meet approximately twice a year. The decision to combine the advisory panels was made with neither consultation with the members of the advisory committees nor the HIV/AIDS community.</B></div> <bR> <div> <B>It is reported that the merger is intended to encourage even greater interagency synergy across the spectrum of HIV prevention and care. A copy of the press release announcing the creation of the new committee can be viewed at:</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/HHS.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/HHS.pdf"><U><B>http://www.nastad.org/pdf/news/HHS.pdf</B></U></A></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Latino Advisory Committee Meeting _ _ _ _</B></div> <bR> <div> <B>Last month's NEWS [which can be accessed at]</B></div> <bR> <div> <A HREF="http://www.nastad.org/login.asp" TARGET="_top" TITLE="http://www.nastad.org/login.asp"><U><B>http://www.nastad.org/login.asp</B></U></A></div> <bR> <div> <B>featured a short summary highlighting major themes that resonated during the Latino Advisory Committee meeting held in San Diego, CA on October 20 -23, 2002. Since then, NASTAD staff has completed a comprehensive meeting report that includes the PowerPoint presentations made at the meeting. The report can be viewed by clicking on</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news.latino.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news.latino.pd"><U><B>http://www.nastad.org/pdf/news.latino.pdf</B></U></A></div> <bR> <div> <B>For more information or to join the advisory committee, please contact Alberto M. Santana at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:asantana@nastad.org" TARGET="_top" TITLE="mailto:asantana@nastad.org"><U><B>mail to:asantana@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Prevention and Surveillance Updates _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ IOM Request for Information on Surveillance Funding _ _ _ _</B></div> <bR> <div> <B>As part of the Institute of Medicine's (IOM) study Data for Resource Allocation, Planning, and Evaluation, the IOM has asked NASTAD to request from states, territories, and the six CDC directly funded cities information regarding state/local funding of surveillance activities. The request also asks for information related to the impact the current fiscal environment in each state will have on state/local contributions as well as the successes and barriers each state has experienced in developing a HIV surveillance system. IOM will use the information in determining state and local capacity for HIV surveillance and the impact such capacity has on the quality of data.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 6 of 12</B></div> <bR> <bR> <bR> <div> <B>Congress mandated the study in the Ryan White CARE Act Amendments of 2000. The HHS Secretary will use the study to assess the accuracy of HIV prevalence data in determining resource allocations beginning in fiscal year 2005. The IOM study examines three primary areas:</B></div> <bR> <div> <B>* The accuracy of state surveillance systems in determining HIV prevalence within the state as a whole as well as for specific geographical areas and whether this data can be used to determine Title I and II resource allocations.</B></div> <bR> <div> <B>* The current and needed data and tools to determine severity of need and to help jurisdictions appropriately plan and allocate resources.</B></div> <bR> <div> <B>* The methods available for measuring outcomes of HIV care and treatment services and their relevance.</B></div> <bR> <div> <B>The IOM expects to publish the final report in Fall 2003. For more information on this request for information, contact Chris Aldridge at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:caldridge@nastad.org" TARGET="_top" TITLE="mailto:caldridge@nastad.org"><U><B>mailto:caldridge@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ HIV/STD MSM Action Memo _ _ _ _</B></div> <bR> <div> <B>CDC recently sent correspondence to HIV/STD directors [see document below**] recommending that they take several action steps to address the resurgence of unsafe sexual behaviors and syphilis outbreaks among various MSM communities across the country.  Ronald O. Valdiserri, Deputy Director, National Center for HIV, STD and TB Prevention signed</B></div> <div> <B>this letter, dated November 15, 2002.   Please click on</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/directorsletter.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/directors"><U><B>http://www.nastad.org/pdf/news/directorsletter.pdf</B></U></A></div> <bR> <div> <B>[see document below**] to access the letter.  Dr. Valdiserri attended NASTAD's Executive Committee meeting on November 20 and discussed the letter, as well as a proposed collaboration between CDC, NASTAD and NCSD to further explore strategies for addressing rising rates of HIV/STD infections among MSM. While the Executive Committee welcomed CDC's interest in working with NASTAD and the proposed collaboration with NCSD, they also expressed frustration that the CDC chose to send the letter without any prior consultation with NASTAD or health departments. NASTAD and jurisdictions across the country have worked extensively on this issue and have considerable expertise in this area. Dr. Valdiserri committed to working more closely with NASTAD and health departments in the future. Possible activities may include an initial conference call with CDC, NASTAD, NCSD and health department representatives, and a meeting in the near future to plan and coordinate joint activities. For more information, contact Leo Rennie at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lrennie@nastad.org" TARGET="_top" TITLE="mailto:lrennie@nastad.org"><U><B>mailto:lrennie@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>** ACTION MEMO</B></div> <bR> <div> <B>Centers for Disease Control and Prevention - Atlanta, Georgia</B></div> <bR> <div> <B>November 15, 2002</B></div> <bR> <div> <B>Dear HIV/STD Program Directors:</B></div> <bR> <div> <B>No doubt many of you are aware of CDC's recent report showing an increase in national syphilis rates for the first time in over a decade ("Primary and Secondary Syphilis - United States 2001" MMWR 2002 vol 51:971-973).  Also, you may be aware of the efforts CDC has undertaken over the past 24 months to alert the public health community to the resurgence  of STDs and high risk behaviors among various MSM communities across the United States.</B></div> <bR> <div> <B>Obviously, there is no one reason for this resurgence of unsafe behaviors -- nor is there a simple means of responding.  But it is imperative that we respond in a timely and competent manner.</B></div> <bR> <div> <B>Listed below are several action steps which we are recommending that you undertake immediately.  At the same time, CDC will work with the leadership of NASTAD and NCSD to explore further strategies for addressing this evolving public health challenge.</B></div> <bR> <div> <B>* Meet with the owners of gay bars / baths / businesses and other community leaders in your jurisdictions to inform them of resurgent STDs among MSM, to promote the availability of publicly funded STD diagnostic and treatment services and to encourage them to promote safer sex practices.</B></div> <bR> <div> <B>* Communicate with your state and county medical associations to inform them of national and local STD trends among MSM, to emphasize their important role in offering STD diagnostic and treatment services to sexually active MSM under care for HIV disease and to encourage them to promote safer sex practices.</B></div> <bR> <div> <B>* Ensure that Community Planning Groups (CPGs) have current epidemiologic information on HIV and STD trends in your jurisdictions.</B></div> <bR> <div> <B>* Ensure that the current HIV prevention community plans for your jurisdictions accurately reflect the burden of HIV transmission among MSM and that the state and federal HIV prevention funds are allocated in a manner consistent with the magnitude of the problem.</B></div> <bR> <div> <B>* Take active steps to ensure that the health department staff employed in STD clinics, HIV counseling and testing sites and other public venues serving MSM are aware of the recent national and local HIV/STD trends, provide counseling to reduce risk of HIV and other STDs, and offer, or refer, for HIV and STD services.</B></div> <bR> <div> <B>* Promote the use of STD diagnostic and treatment services among sexually active HIV (+) MSM.</B></div> <bR> <div> <B>* Improve the collection of information about gender of sex partners for persons reported with STDs.</B></div> <bR> <div> <B>Please contact your CDC project officer if you need technical assistance</B></div> <div> <B>to:  better characterize the HIV/STD trends among MSM populations in your jurisdictions, accurately assess the current level of HIV/STD service needs, or develop effective HIV/STD prevention approaches.</B></div> <bR> <div> <B>Your active support is essential to achieving improved health outcomes for these populations.  Should you wish to discuss this matter in further detail or if you have specific suggestions for the CDC, please do not hesitate to call me at 404-639-8002.</B></div> <bR> <div> <B>Sincerely,</B></div> <bR> <div> <B>Ronald O. Valdiserri, M.D., MPH</B></div> <div> <B>Deputy Director</B></div> <div> <B>National Center for HIV, STD, and TB Prevention</B></div> <bR> <div> <B>cc:</B></div> <div> <B>Dr. Sevgi Aral, CDC</B></div> <div> <B>Dr. Harold Jaffe, CDC</B></div> <div> <B>Dr. Robert Janssen, CDC</B></div> <div> <B>Ms. Candice Nowicki-Lehnherr, CDC</B></div> <div> <B>Ms. Teresa Raphael, NCSD</B></div> <div> <B>Ms. Julie Scofield, NASTAD</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Program Announcement and Community Planning Guidance Update _ _ _ _</B></div> <bR> <div> <B>CDC reported that the timeline for release of the health department program announcement and revised community planning guidance in the Federal Register has been pushed back from early to late December, with approximately a one month opportunity for final comments before both are finalized. The Prevention Work Group weighed in on these documents in October and November and the NASTAD Executive Committee reiterated work group concerns with CDC representatives during their meeting in mid-November.</B></div> <bR> <div> <B>Major outstanding concerns center on the community planning indicators and the program performance indicators, both of which will be developed through involvement of health departments and other stakeholders. CDC proposed to include a requirement around performance indicators in the program announcement and develop them over the first half of 2003. Jurisdictions would develop their own performance targets relative to these indicators. Also of concern is the client level evaluation used to measure the indicators for HERR activities (this is essentially what will be revised in the existing evaluation guidance). And, while...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 7 of 12</B></div> <bR> <bR> <bR> <div> <B>...there has been a stakeholder process in place to develop the community planning indicators, concern centers around ensuring the indicators that ultimately emerge do not lead to decreased flexibility in how planning takes place.</B></div> <bR> <div> <B>After the Executive Committee meeting, there remained lack of clarity around whether CDC would include performance indicators in the final program announcement released in February, rather than taking more time to develop them in early 2003. NASTAD staff will be following up with CDC in early December to ensure that health department representatives participate on external stakeholder working groups and consultations to develop these indicators. If you are interested in participating in the development of these indicators, please contact Lynne Greabell at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lgreabell@nastad.org" TARGET="_top" TITLE="mailto:lgreabell@nastad.org"><U><B>mailto:lgreabell@nastad.org</B></U></A></FONT><B>> as soon as possible. The NASTAD Executive Committee and Prevention Work Group will further discuss these issues and formally communicate concerns and recommendations to CDC. Please contact Lynne <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lgreabell@nastad.org" TARGET="_top" TITLE="mailto:lgreabell@nastad.org"><U><B>mailto:lgreabell@nastad.org</B></U></A></FONT><B>> if you have any questions or concerns about this process.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ CBO Program Announcement Update _ _ _ _</B></div> <bR> <div> <B>Please note that the directly-funded CBO consultations scheduled for December 2002 and January 2003 have been postponed until February and March 2003. CDC decided to move the dates because of the upcoming HIV Prevention Summit to be held in Atlanta on December 4 and 5. CDC expects that the summit will provide new directions for its HIV prevention activities, including the CBO program. It was believed that commencing the CBO consultations so quickly after the summit would not have allowed sufficient time to properly digest and process the new ideas from the summit.  New dates will be announced soon.</B></div> <bR> <div> <B>In preparation for this series of consultations, NASTAD has developed a</B></div> <div> <B>draft position statement on the directly funded CBO program.   Click on:</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/cboposition.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/cbopositi"><U><B>http://www.nastad.org/pdf/news/cboposition.pdf</B></U></A></div> <bR> <div> <B>to see the statement.  The Prevention Work Group, the African American Advisory Committee, the Latino Advisory Committee and the NASTAD Executive Committee are all in the process of reviewing the draft statement which will be given final consideration by the Executive Committee in mid-December. AIDS directors and HIV prevention staff are encouraged to review this statement.  For more information on the consultations or to make comments on the position statement, please contact Leo Rennie at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lrennie@nastad.org" TARGET="_top" TITLE="mailto:lrennie@nastad.org"><U><B>mailto:lrennie@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ CDC Diffusion of Effective Interventions Project _ _ _ _</B></div> <bR> <div> <B>At the beginning of November, the Academy for Educational Development</B></div> <div> <B>(AED) sent an interest survey for CDC's diffusion of effective interventions project to AIDS directors. AED mailed a hard copy of the survey, developed by CDC and AED, along with a cover letter from Julie Scofield. The survey assesses the interest of health departments and community based organizations in receiving training on eight prevention interventions proven to be effective. The survey also asks health departments to provide information on the number of individuals interested in becoming coaches/TA providers to increase the capacity of health departments to provide technical assistance for CBOs.  Trainings include such interventions as Popular Opinion Leader, Voices / Voces, Community Promise, and Sista. For more information regarding the survey or this project, contact Richard Sawyer from AED at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:rsawyer@aed.org" TARGET="_top" TITLE="mailto:rsawyer@aed.org"><U><B>mailto:rsawyer@aed.org</B></U></A></FONT><B>> or Chris Aldridge at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:caldridge@nastad.org" TARGET="_top" TITLE="mailto:caldridge@nastad.org"><U><B>mailto:caldridge@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Update on Rapid Testing _ _ _ _</B></div> <bR> <div> <B>On November 7th, FDA Approved OraQuick, made by OraSure Technologies, making it the first, second-generation rapid test to receive FDA approval.  FDA has initially classified the test as moderate complexity under the Clinical Laboratory Improvement Amendments (CLIA) since OraSure...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 8 of 12</B></div> <bR> <bR> <bR> <div> <B>...has not yet filed a waiver application. Currently, some ambiguity exists in terms of what guidelines OraSure must follow in developing their application.  Once FDA and OraSure agree on the guidelines, OraSure will likely complete all clinical studies quickly, allowing for filing of a waiver application in the near future.</B></div> <bR> <div> <B>It remains unclear how long FDA may take to rule on a waiver application, with some estimates indicating that a decision may not come before June 2003. However, in his remarks regarding OraQuick's approval, HHS Secretary Tommy Thompson voiced his support for a waiver. Given the support of HHS leadership, a waiver decision may come earlier than anticipated. Most data, including initial studies with untrained users, indicates that OraQuick will qualify for a waiver.  NASTAD continues to work with its ad-hoc Rapid Test Work Group, made up of health departments and community members, to maintain momentum around this issue and ensure a waiver decision is made as expeditiously as possible.</B></div> <bR> <div> <B>NASTAD also plans to work with FDA and manufacturers in order to bring other tests to the market.  With two, complimentary, waived rapid tests, results of a screening rapid could be immediately confirmed. At a November 4th meeting with Deputy Secretary Claude Allen, members of the Rapid Test Work Group discussed the need for FDA to issue revised guidelines for qualifying and applying for a waiver, as well as guidelines for approval of rapid tests. Clear guidelines from FDA would help manufacturers better determine whether their tests would be approved and waived. The Work Group may discuss this at a tentative future FDA meeting as well. The Work Group will also work with other manufacturers such as Abbott Laboratories, makers of one of the best HIV rapid tests, Determine, to encourage them to seek FDA approval for their products.</B></div> <bR> <div> <B>NASTAD has begun using results from its implementation survey to develop a technical assistance plan related to rapid test implementation and will work closely with CDC on providing TA. For more information regarding rapid tests, contact Chris Aldridge at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:caldridge@nastad.org" TARGET="_top" TITLE="mailto:caldridge@nastad.org"><U><B>mailto:caldridge@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ NASTAD CTR Technical Assistance _ _ _ _</B></div> <bR> <div> <B>NASTAD is working to develop its capacity to provide technical assistance on counseling, testing, and referral (CTR) activities. As part of these activities, NASTAD will be sending out a series of three information requests, through December and into January, to CTR/Prevention program managers to solicit models, tools, protocols, and best practices. The requests focus on quality assurance for CTR programs, routine versus targeted testing, prevention for positives, and partner counseling and referral services (PCRS). The requests are designed to take little time and will help NASTAD identify programs for further follow-up. NASTAD plans to publish the information in a series of compendiums early next year. For more information related to CTR technical assistance, contact Chris Aldridge at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:caldridge@nastad.org" TARGET="_top" TITLE="mailto:caldridge@nastad.org"><U><B>mailto:caldridge@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _In "The Bulletin" _ _ _ _</B></div> <bR> <div> <B>This Month's Bulletin</B></div> <bR> <div> <A HREF="http://www.nastad.org/pub_prevention.asp?publication_category_id=3&publication_subcategory_id=1" TARGET="_top" TITLE="http://www.nastad.org/pub_prevention.asp"><U><B>http://www.nastad.org/pub_prevention.asp?publication_category_id=3&publication_subcategory_id=1</B></U></A></div> <bR> <div> <B>focuses on substance abuse treatment as HIV and viral hepatitis prevention.  Stories from the field and a review of substance abuse treatment and its role in HIV prevention are included.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Prevention Work Group Update _ _ _ _</B></div> <bR> <div> <B>In November, the Prevention Work Group discussed via conference call the draft program announcement and revised community planning guidance, as well as leadership changes at the CDC Division of HIV/AIDS Prevention</B></div> <div> <B>(DHAP) and Center for HIV, STD, and TB Prevention (NCHSTP) and NASTAD's</B></div> <div> <B>draft statement on directly-funded CBOs.   Please click on</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/PWG.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/PWG.pdf"><U><B>http://www.nastad.org/pdf/news/PWG.pdf</B></U></A></div> <bR> <div> <B>to see...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 9 of 12</B></div> <bR> <bR> <bR> <div> <B>...minutes.) Comments on the program announcement and community planning guidance developed through these calls were shared with CDC in mid-November - click on</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/PWGcomm.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/PWGcomm.p"><U><B>http://www.nastad.org/pdf/news/PWGcomm.pdf</B></U></A></div> <bR> <div> <B>to see comments. Client level evaluation and the process for development of performance indicators as well as directly-funded CBOs are on the agenda for the December 13 work group call with CDC.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Youth CBA/NASTAD Survey Work _ _ _ _</B></div> <bR> <div> <B>In mid-November, NASTAD learned that the capacity building assistance providers (CBA providers) funded to build capacity around youth-focused HIV prevention, are conducting a survey of AIDS directors on priorities and capacity building needs of health departments and their grantees around youth. Through its CDC cooperative agreement, NASTAD conducts activities in the same arena, and was also preparing a short assessment to profile health department initiatives targeted to young people. To share information on health department initiatives and dispel myths that little youth-focused HIV prevention is supported through health departments, NASTAD plans to develop a report, entitled "Working For Our  Youth," modeled on the Bright Ideas framework.  Although the Youth CBA's survey is in process, NASTAD and the Youth CBAs will be conferring in December to devise a strategy for follow up with AIDS directors to obtain information that will be mutually beneficial and best share the health departments' response around youth-focused HIV prevention. For more information, contact Lynne Greabell <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lgreabell@nastad.org" TARGET="_top" TITLE="mailto:lgreabell@nastad.org"><U><B>mailto:lgreabell@nastad.org</B></U></A></FONT><B>> at NASTAD.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ 2003 HIV Prevention Conference _ _ _ _</B></div> <bR> <div> <B>The 2003 National HIV Prevention Conference will be held July 27-30, 2003, in Atlanta, Georgia.  The conference, which is held every two years, is noted for bringing together prevention programs and science - a blend not duplicated at other meetings.  Attendees include local, regional and national decision makers, researchers, policy makers, community leaders, and practitioners working to prevent the spread of HIV/AIDS. In 2001, this conference attracted over 2,500 participants from 47 states. Ronald O. Valdiserri, MD, MPH, of the Centers for Disease Control and Prevention and M. Valerie Mills, Ph.D., of the Substance Abuse and Mental Health Services Administration will serve as co-chairs of the 2003 National HIV Prevention Conference Planning Committee. The conference will offer over 100 sessions addressing a wide variety of topics, including the broad range of HIV interventions that promote safer behaviors, behavioral surveillance and epidemiological methods, biomedical interventions and other technological advances, and public policy challenges and solutions. More program details - including the Call for Abstracts and Registration information - are available on the conference website:</B></div> <bR> <div> <A HREF="http://www.2003HIVPrevConf.org" TARGET="_top" TITLE="http://www.2003HIVPrevConf.org"><U><B>http://www.2003HIVPrevConf.org</B></U></A><FONT SIZE="3" COLOR="#000000" FACE="Times New Roman" ><B>.</B></FONT></div> <bR> <div> <B>As a co-sponsor, NASTAD sits on the conference planning committee for the conference. CDC is seeking names of individuals interested in serving on abstract review committees. Please contact or forward names of potential reviewers to Leo Rennie at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lrennie@nastad.org" TARGET="_top" TITLE="mailto:lrennie@nastad.org"><U><B>mailto:lrennie@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Global Program Update _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ CDC Global Program Partners Meeting _ _ _ _</B></div> <bR> <div> <B>November 7-8, 2002, Lucy Slater, Minnesota AIDS/STD Prevention Services Planner, and Natasha Sakolsky, Director of the Gloabl AIDS Technical Assistance Program at NASTAD, traveled to Atlanta to participate in a CDC Global AIDS Program (GAP) Partners Meeting. Also in attendance were representatives from Advocates for Youth, CARE, Morehouse School of Medicine, Sister Love, Project Concern International, John Hopkins Center for Communication Programs,...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 10 of 12</B></div> <bR> <bR> <bR> <div> <B>...International Rescue Committee, Population Services International, International Medical Corps, The Balm in Gilead, the Association of Public Health Laboratories (APHL), American Red Cross and the Academy for Educational Development. The meeting was disappointing in that few CDC GAPrepresentatives (from the field or from Atlanta) were present and that it provided limited opportunity for true dialogue among partners or for questions to/from CDC. Meeting participants did generate a substantial list of recommendations to CDC GAP around communication and coordination, however, and CDC GAP committed verbally to follow up on these recommendations early next year. For more information on this meeting, please contact Natasha Sakolsky at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:nsakolsky@nastad.org" TARGET="_top" TITLE="mailto:nsakolsky@nastad.org"><U><B>mailto:nsakolsky@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ CDC Global Program Leadership News _ _ _ _</B></div> <bR> <div> <B>Gary West will be leaving his post as Deputy Director of the CDC Global AIDS Program in December 2002 to move to North Carolina where he will become Senior Vice President of Family Health International. While a positive move for Gary, this announcement has posed new challenges for CDC Atlanta, and promises a great loss for NASTAD advocacy in Atlanta.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ December Global TA Provider Orientation _ _ _ _</B></div> <bR> <div> <B>The Global AIDS Technical Assistance Program at NASTAD will host a two-day orientation for new TA providers on December 12 and 13. This orientation will provide participants an overview of the international AIDS epidemic, and will prepare them for working as technical assistance providers in a developing country. On the agenda for the first day is a presentation on the "Global AIDS Pandemic" by Sophia Mukasa Monico, Senior AIDS Program Officer at the Global Health Council. In addition, Lois Lux, Title II Administrator at the Washington State Department of Health, will present a session entitled "International Development 101."</B></div> <bR> <div> <B>The first day will conclude with a discussion of "Power and Privilege" as it relates to providing quality technical assistance in a foreign culture, which will be led by Dr. Denise Shervington. Dr. Shervington is the Regional Medical Director with the Louisiana Office of Mental Health and an Associate Professor at the Tulane University School of Public Health. On the second day of the orientation, participants will learn from representatives of Passport Health about ways of staying healthy and safe overseas. . They will also hear from Hamelmal Aklilu, who will speak about "Cross-Cultural Communication." Ms. Aklilu has worked as a consultant with major domestic and international organizations such as USAID, the United Nations Development Fund, the National Minority AIDS Council, and the Asia Foundation.  There will also be an informational session on "Safety & Security Issues for International Consultants" moderated by Michael O'Neill, Director of Security at Save the Children. For more information or to request a videotape of the orientation, please contact Natasha Sakolsky at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:nsakolsky@nastad.org" TARGET="_top" TITLE="mailto:nsakolsky@nastad.org"><U><B>mailto:nsakolsky@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ NASTAD Collaboration with Tulane University _ _ _ _</B></div> <bR> <div> <B>NASTAD and Tulane University's Payson Center</B></div> <bR> <div> <A HREF="http://www.payson.tulane.edu/" TARGET="_top" TITLE="http://www.payson.tulane.edu/"><U><B>http://www.payson.tulane.edu/</B></U></A></div> <bR> <div> <B>for International Development and Technology Transfer have begun collaboration on NASTAD's first technology transfer project. The Payson Center explores the impact of Information Technology (IT) on development and educational processes, particularly as they apply to lesser economically developed regions because of the great potential of IT in societies that use it strategically.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 11 of 12</B></div> <bR> <bR> <bR> <div> <B>Utilizing U.S. state AIDS directors' and NASTAD staffs extensive knowledge and experience in HIV/AIDS community planning materials, the goal of this collective effort is to package community planning resources in a digital library format for broad distribution within both the U.S. and sub-Saharan Africa. CDC GAP/Atlanta and field offices, USAID/Washington and missions, Ministries of Health and National AIDS Control Programs in sub-Saharan Africa, as well as peers and partners in the United States, will then have access to electronic training and tools for the design, implementation and evaluation of community planning processes using the internet, CDROMs, threaded discussions on list serves, and other e-tools. This technology will be a supplement to existing face-to-face community planning technical assistance and can be used for short-term technical assistance visits around the world. For more information, contact Rebecca Layton at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:rlayton@nastad.org" TARGET="_top" TITLE="mailto:rlayton@nastad.org"><U><B>mailto:rlayton@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Viral Hepatitis News _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ NASTAD Viral Hepatitis Program Update _ _ _ _</B></div> <bR> <div> <B>NASTAD is in the third and final year of its cooperative agreement with CDC's Division of Viral Hepatitis. The third year was funded at $200,000, which was an increase of $52,000 over the second budget period. Planned activities for the third year include completing NASTAD's, "Viral Hepatitis and HIV: A Resource Guide for HIV/AIDS Programs."  Three new modules for the Resource Guide have been developed and are available on NASTAD's website at:</B></div> <bR> <div> <A HREF="http://www.nastad.org/pro_viral_hepatitis.asp?menu=pro" TARGET="_top" TITLE="http://www.nastad.org/pro_viral_hepatiti"><U><B>http://www.nastad.org/pro_viral_hepatitis.asp?menu=pro</B></U></A></div> <bR> <div> <B>The modules address three areas. "Viral Hepatitis in the Correctional</B></div> <div> <B>Setting: The Role of State, Territorial, and Local HIV/AIDS Programs" provides an overview of the correctional system and of the issues that HIV/AIDS programs may encounter when working with Departments of Corrections (DoCs). "Viral Hepatitis and HIV: A Primer for Community Planning Groups (CPGs)" is designed to increase CPGs' understanding of viral hepatitis. The primer provides general information on viral hepatitis and offers a rationale for including viral hepatitis in the HIV community planning process. "Integrating Viral Hepatitis Services into HIV and STD Clinics" is an Issue Brief that describes six HIV and STD clinics that have successfully integrated viral hepatitis services into their existing clinic services. Hard copies of the new chapters have been mailed and should arrive in your jurisdiction within the week.</B></div> <bR> <div> <B>In addition, the module, "Viral Hepatitis and HIV: A Primer for Community Planning Groups (CPGs)," has been developed as a stand alone document and will be mailed it to all CPG co-chairs early next year.</B></div> <bR> <div> <B>Upcoming modules include an Issue Brief on HCV surveillance, an overview of viral hepatitis and HIV among IDUs, and a primer on hepatitis A and B vaccine for HIV/AIDS staff.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ CDC Viral Hepatitis News _ _ _ _</B></div> <bR> <div> <B>CDC's Division of Viral Hepatitis recently awarded four three-year cooperative agreements to integrate viral hepatitis education and services into programs reaching adolescents. Grantees include the Rhode Island Department of Health, Division of HIV/AIDS; Connecticut Department of Health; Miami School of Medicine; and San Diego Department of Health. The average award was $121,940.</B></div> <bR> <div> <B>The National Hepatitis Coordinators' Conference is scheduled for January 26-30 in San Antonio, Texas.  Conference topics include viral hepatitis prevention, treatment, counseling, testing, and surveillance.  Programs integrating viral hepatitis services into HIV, STD, corrections, and substance abuse settings...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 12 of 12</B></div> <bR> <bR> <bR> <div> <B>...will be highlighted. Staff from HIV/AIDS programs interested in learning how to integrate viral hepatitis services into HIV/STD services should attend. Conference information and registration is available at:</B></div> <bR> <div> <A HREF="http://www.cdc.gov/ncidod/diseases/hepatitis/coordinators/index.htm" TARGET="_top" TITLE="http://www.cdc.gov/ncidod/diseases/hepat"><U><B>http://www.cdc.gov/ncidod/diseases/hepatitis/coordinators/index.htm</B></U></A></div> <bR> <div> <B>For more information about NASTAD's Viral Hepatitis Program, please contact Laurie Schowalter at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lschowalter@nastad.org" TARGET="_top" TITLE="mailto:lschowalter@nastad.org"><U><B>mailto:lschowalter@nastad.org</B></U></A></FONT><B>></B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Staff News _ _ _ _ _ _ _ _ _ _</B></div> <bR> <div> <B>In December, Elena Soler will be joining the NASTAD staff in the position of program manager, HIV/STD prevention youth specialist. Elena is currently a project director for the National Alliance for Hispanic Health in Washington, DC.  Elena holds a MPH from Emory University.</B></div> <bR> <div> <B>Congratulations are in order for Stephanie Vasquez who has been promoted to the position of senior program manager with the global team at NASTAD. Stephanie will be transitioning to this new position by December 2. Stephanie will be taking on additional management and country lead responsibilities and will oversee the database evaluation activities for the program.</B></div> <bR> <bR> <bR> <div> <B>+ + +</B></div> <bR> <bR> <bR> <div> <B>The NASTAD News E-mail is distributed monthly to state and territorial HIV/AIDS programs. It is managed by staff of the National Alliance of State and Territorial AIDS Directors in Washington, DC. If you'd like to subscribe or unsubscribe, or if you have a question or comment, please contact NASTAD at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:nastad@nastad.org" TARGET="_top" TITLE="mailto:nastad@nastad.org"><U><B>mailto:nastad@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Inside the Bulletin (18 pages):</B></div> <bR> <div> <B>1 - Substance Abuse Treatment as HIV/Hepatitis Prevention</B></div> <div> <B>Overview: Substance Abuse Treatment as HIV and Hepatitis Prevention</B></div> <bR> <div> <B>2, 3 - Methadone Maintenance Treatment</B></div> <bR> <div> <B>4 - Regulation of Methadone Maintenance Treatment</B></div> <bR> <div> <B>5 - Buprenorphine: A New Option for Opiate Dependence</B></div> <bR> <div> <B>5 - Hepatitis Coordinators' Conference</B></div> <bR> <div> <B>6 - Jurisdiction Profile: New York State, AIDS Institute Linking HIV Prevention and Care with Substance Abuse Treatment</B></div> <bR> <div> <B>7, 8 - Jurisdiction Profile: D.C. Department of Health, Addiction Prevention and Recovery Administration From Outreach to Intake: Reaching D.C. Substance Abusers</B></div> <bR> <div> <B>9 - SAMHSA HIV/AIDS Initiatives</B></div> <div> <B>Early Intervention Services (EIS)</B></div> <div> <B>CSAT Minority HIV/AIDS Initiative -- TCE/HIV</B></div> <bR> <div> <B>10 - Update for NJ Substance Abuse Treatment Providers</B></div> <bR> <div> <B>11 - Resources on Substance Abuse and HIV</B></div> <bR> <div> <B>12 - FDA Approves OraQuick</B></div> <div> <B>Applying for a Clinical Laboratory Improvement Amendments Waiver Implementation of HIV Rapid Tests</B></div> <bR> <div> <B>13, 14 - Adolescent and School-Based Health</B></div> <div> <B>Presentation on Health and Student Achievement</B></div> <div> <B>Surveillance Information on Adolescents</B></div> <div> <B>Upcoming Ryan White National Youth Conference on HIV and AIDS</B></div> <bR> <div> <B>14, 15 - The Manager</B></div> <div> <B>Finding your "Genius"</B></div> <div> <B>Cultivating the faces of genius</B></div> <bR> <div> <B>15, 16 - Resources</B></div> <div> <B>National Black HIV/AIDS Awareness Day 2003</B></div> <div> <B>Capacity Building Assistance Training Calendar</B></div> <bR> <div> <B>16, 17 - Calendar</B></div> <div> <B>12/01/02 -- World AIDS Day 2002</B></div> <div> <B>12/01-03/02 - 2nd Int'l Conf.~Sub-Abuse/HIV, India</B></div> <div> <B>12/01-04/02 - 4th Nat'l Harm Reduction Conf., Seattle 01/27-29/03 - Rescheduling 11/02 CBO Consult.,Chicago 01/27-30/03 - Nat'l Hep Coord. Conf., San Antonio 02/14-17/03 - 10th RW Nat'l Youth Conf. HIV/AIDS, Dallas 03/02-08/03 - Black Church Week/Prayer For/Healing of AIDS 03/12-15/03 - CPLS for HIV Prevention, New York City 03/28-30/03 - RCAP National Conf., Bloomington, IN 03/30-04/02/03 - 15th Nat'l H/A Update Conf. (NAUC), Miami 04/04/03 - 3rd CAPS HIV Prevention Conf., San Francisco 04/6-10/03 - 14th Int'l Conf./Redux/Drug-Related Harm - Thailand 04/26-29/03 - 7th Comm. Campus Partnerships/Hlth Conf., San Diego 05/21-23/03 - Call 4 Abstracts: Nat'l Conf./Hlth Ed/Hlth Promotion 05/29-06/01/03 - 15th Nat'l Conf./Soc.Work~H/A, Albuq., NM</B></div> <div> <B>06/18-21/03- 13th Nat'l Conf./Soc.Mrktng/Pub.Hlth, ClrwtrBch, FL 07/27-30/03 - 2003 Nat'l HIV Prevention Conf., Atlanta, GA 09/18-21/03 - The US Conf. on AIDS (USCA), New Orleans, LA</B></div> <bR> <div> <B>18 - Info about "The Bulletin"</B></div> <bR> <div> <B>=-=-=-=-=-=-=</B></div> <bR> <div> <B>National Alliance of State and Territorial AIDS Directors</B></div> <div> <B>444 North Capitol Street, NW, Suite 339</B></div> <div> <B>Washington, DC 20001-1512</B></div> <div> <B>FAX 202-434-8092</B></div> <div> <B>PHONE: 202-434-8090</B></div> <div> <A HREF="http://www.nastad.org" TARGET="_top" TITLE="http://www.nastad.org"><U><B>http://www.nastad.org</B></U></A></div> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 1 of 18</B></div> <bR> <div> <B>NASTAD HIV PREVENTION BULLETIN</B></div> <div> <B>December 2002</B></div> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Substance Abuse Treatment and HIV/Hepatitis Prevention _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>The use and abuse of alcohol and other drugs can place individuals at risk for HIV and hepatitis through risky sexual behaviors and/or unsafe injection practices. This month's HIV Prevention Bulletin will provide an overview of the role of substance abuse treatment in HIV and hepatitis prevention; describe two opiate addiction treatment medications, methadone and buprenorphine; profile two jurisdictions integrating HIV and substance abuse treatment services; and offer resources for jurisdictions interested in understanding the intersection between substance abuse and infectious disease.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Overview: Substance Abuse Treatment as HIV and Hepatitis Prevention _ _ _ _</B></div> <bR> <div> <B>Since the emergence of AIDS over two decades ago, a strong link between substance abuse and HIV has been established. Over one-third of all reported AIDS cases are directly related to injection drug use (IDU) and sixty percent of hepatitis C virus (HCV) cases are attributed to IDU. IDUs, their sex partners, and their children are at risk for infection with HIV, hepatitis, and STDs through high-risk sexual and drug practices, such as sharing syringes, drugs, paraphernalia, and by practicing unsafe sex.</B></div> <bR> <div> <B>While the role of substance use and abuse in IDU-related HIV/AIDS is long recognized, other drugs, such as crack cocaine, club drugs, methamphetamine, and alcohol, also play a significant role in transmission of HIV and other infections. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), people with alcohol use disorders are more likely than the general population to contract HIV, and alcohol use is associated with high-risk sexual behaviors and injection drug use 1+. Research on methamphetamine use among men who have sex with men (MSM) has found that use of the drug is associated with increased risk for HIV infection, and that gay and bisexual men who use methamphetamine have a greater HIV prevalence than MSM who do not use the drug.</B></div> <bR> <div> <B>Numerous studies presented at the International AIDS Conference in Barcelona, Spain found that substance use is consistently associated with risky sexual behaviors by HIV positive and HIV negative MSM. The use of methamphetamine, club drugs, and other drugs may be an important risk factor in the recent resurgence of HIV, syphilis, and other STDs among MSMs. It is crucial for HIV/AIDS programs to understand the reasons for substance use and abuse, and incorporate substance abuse prevention and treatment information, education, and referrals into existing HIV prevention outreach programs.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 2 of 18</B></div> <bR> <bR> <bR> <div> <B>Individuals use and abuse drugs for a variety of reasons; an estimated 50% of persons with a substance abuse disorder also have a co-occurring mental health disorder. Users may be attempting to cope with psychological trauma, or to feel more relaxed socially. Users may experience significant benefits from alcohol and drug use, including increased confidence and improved sensation, and these benefits may outweigh potential negative consequences. Studies on alcohol indicate that it acts directly on the brain to reduce inhibitions and diminish risk perception, however, there is also evidence that expectations about the effects of alcohol can influence sexual behavior; individuals who believe alcohol enhances sexual arousal and performance are more likely to engage in unsafe sexual practices 1+.</B></div> <bR> <div> <B>While the motivations for drug use vary, the outcome of increased use and dependence on drugs is often addiction. Addiction is a brain disease; drug use causes changes in the brain structure and function, resulting in compulsive drug craving and use 3+.  It is a chronic disease, similar to diabetes or hypertension, and it is treatable. Drug abuse treatment can be conducted in a variety of settings (e.g., inpatient, outpatient, residential) and often involves various approaches, including behavioral therapy, medications, or a combination of both 2+.</B></div> <bR> <div> <B>Due to the role substance abuse plays in HIV risk behaviors, substance abuse treatment is one of the most important HIV prevention strategies. Drug users who enter and continue in treatment are more likely than those who remain out of treatment to reduce risky activities, such as sharing needles and injection equipment or engaging in unprotected sex</B></div> <div> <B>2+. Good drug abuse treatment programs offer HIV education, counseling</B></div> <div> <B>and testing, and other prevention services. Drug treatment programs may also provide counseling, psychiatric services, and other social services to help support the client.</B></div> <bR> <div> <B>Providing drug users with substance abuse treatment options is an important public health intervention. HIV, hepatitis, and STD programs should work closely with their counterparts in substance abuse and develop strong links between programs. Interventions for substance abusers that incorporate HIV and other infectious disease prevention strategies are critical, and HIV prevention programs must address the role of substance abuse in disease transmission.</B></div> <bR> <bR> <bR> <div> <B>~ ~ ~ ~ References:</B></div> <bR> <div> <B>1+ ... National Institute on Alcohol Abuse and Alcoholism, Alcohol</B></div> <div> <B>Alert, No. 57, July 2002.</B></div> <bR> <bR> <bR> <div> <B>2+ ... National Institute on Drug Abuse. Principles of HIV Prevention in</B></div> <div> <B>Drug Using Populations, March, 2002.  Available online at:</B></div> <bR> <div> <A HREF="http://drugabuse.gov/POHP/" TARGET="_top" TITLE="http://drugabuse.gov/POHP/"><U><B>http://drugabuse.gov/POHP/</B></U></A></div> <bR> <bR> <bR> <div> <B>3+ ... Academy for Educational Development. A Comprehensive Approach:</B></div> <div> <B>Preventing Blood-Borne Infections Among Injection Drug Users, December, 2000. Available online at:</B></div> <bR> <div> <A HREF="http://www.cdc.gov/idu" TARGET="_top" TITLE="http://www.cdc.gov/idu"><U><B>http://www.cdc.gov/idu</B></U></A></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Methadone Maintenance Treatment and HIV/AIDS Prevention _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>As persons working in HIV and hepatitis are acutely aware, injection drug users (IDUs) are at increased risk for contracting and transmitting HIV, hepatitis C, and other blood-borne infections through sharing syringes, drugs, and drug preparation and injection equipment. Injection drug use accounts for one-third of all HIV cases in the U.S. and 60% of hepatitis C cases. It is critical to reach IDUs with disease prevention strategies in order to decrease the transmission of HIV and hepatitis. The U.S. Centers for Disease Control and Prevention (CDC) recommends using a comprehensive approach to prevent blood-borne infections among IDUs; this approach includes, among others, community outreach, interventions to increase access to sterile syringes, HIV counseling and testing services, and substance abuse treatment 1+.</B></div> <bR> <div> <B>Substance abuse treatment plays a critical role in preventing the transmission of HIV and other blood-borne diseases among IDUs. Drug addiction is characterized by compulsive drug seeking behavior; finding and using drugs can soon become the primary motivation of the user. Users may practice risky sexual and drug using...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 3 of 18</B></div> <bR> <bR> <bR> <div> <B>...behaviors, including trading or selling sex for drugs or money to buy drugs. Limited access to sterile injection equipment is also problematic; safe injection practices are harder to follow when the user is fighting withdrawal and only has access to used injection equipment. Substance abuse treatment, then, is an important intervention that can provide individuals with the medical, psychological, and behavioral support they need to stop using drugs. 1+</B></div> <bR> <div> <B>In the U.S., one of the most commonly injected drugs is heroin. According to the Office of National Drug Control Policy (ONDCP) there are an estimated 980,000 heroin addicts in the U.S. 2+  Heroin is the most commonly abused opiate, which is a class of drugs whose use can cause euphoria, pain relief, decreased pain sensation, some sedation, and respiratory depression. 3+  Heroin is processed from morphine, a naturally occurring substance extracted from the seed pod of certain varieties of poppy plants. 4+  Other common opiates include morphine, opium, codeine, and oxycontin.  Heroin can be a white or brownish powder which is usually dissolved in water and then injected. Most street preparations of heroin are diluted, or "cut," with other substances such as sugar or quinine.</B></div> <bR> <div> <B>Heroin is a fast acting opiate; the effects of the drug are felt very soon after administration, and withdrawal symptoms can begin as soon as several hours after last use. Heroin can be injected, smoked, or snorted. Intravenous drug use provides the quickest high, and a typical user may inject up to four times a day. Withdrawal from opiates involves flu-like symptoms such as chills, shakes, sweating, nausea, vomiting, diarrhea, increased heart rate, insomnia, and increased sensitivity to pain. Users may develop a high tolerance and physical dependency to the drug and become addicted. For opiate addiction, medication assisted treatment is effective in reducing the harms of addiction and assisting users in gaining control of their lives.</B></div> <bR> <div> <B>Medication assisted treatment (MAT) is a form of treatment where opiate-dependent patients receive medication to block the effects of opiates. There are four medications used to treat opiate addiction: Levo-alpha-acetylmethadol (LAAM), naltrexone, buprenorphine, and methadone, which is the most commonly used medication. Methadone is a synthetic opiate that prevents withdrawal from opiates, decreases cravings for opiates, and blocks the euphoric effects of opiates. 3+  It has a half-life of approximately 24 hours and a slow onset of action, which blunts its euphoric effect and makes it unattractive as a drug of abuse. 3+  It is usually administered once per day. Methadone maintenance treatment (MMT) has been used for over thirty years as an effective medication assisted treatment for opiate addiction.</B></div> <bR> <div> <B>Research has found that the success of MMT may depend on whether an adequate dosage is given and whether there is continuity in treatment; most patients require continuous treatment over a period of years or even life. 3+  The National Institutes of Health Consensus Statement on Effective Treatment of Opiate Addiction recommends that patients receive at minimum twelve months of methadone. 5+  MMT is also more effective when coupled with psychiatric and counseling services, due to the high co-morbidity of addiction and mental health disorders. Until recently, methadone was only available in specially licensed clinics required to follow strict requirements; consequently, these clinics had little flexibility in providing individualized treatment, and patients were often not given adequate doses. These regulations have since changed (see "An Important Change in the Regulation of Methadone Maintenance</B></div> <div> <B>Treatment") [on page 4 of this document].</B></div> <bR> <div> <B>Over thirty years of extensive research has found that MMT reduces crime, improves health status, and helps opiate-dependent individuals attain productive lifestyles. 3+  Further, MMT significantly reduces the health risks associated with injection drug use. The risks for numerous infections, including HIV and hepatitis, are reduced by the reduction in intravenous drug use. Additionally, studies have found that HIV risk associated with sexual behavior is reduced, because methadone...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 4 of 18</B></div> <bR> <bR> <bR> <div> <B>...patients report a lower numbers of past-year sexual partners than do untreated opiate dependent persons; HIV positive methadone maintenance...</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ [begin] Side Bar ~ ~ ~ ~</B></div> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ An Important Change in the Regulation of Methadone Maintenance Treatment _ _ _ _ _ _ _ _ _ _</B></div> <bR> <div> <B>In March of 2001, the U.S. Department of Health and Human Services repealed the Food and Drug Administration (FDA)- enforced regulations for methadone maintenance treatment, and created a new accreditation program managed by the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT).</B></div> <bR> <div> <B>Programs administering methadone or levo-alpha-acetylmethadol (LAAM) are now accredited by non-federal agencies in accordance with standards established by CSAT. The standards emphasize improving the quality of care, such as individualized treatment planning, increased medical supervision, and assessment of patient outcomes, and are based on "best practice guidelines" developed by CSAT over the past 10 years.</B></div> <bR> <div> <B>This change from a federally regulated process to an accreditation process is significant: it gives patients and providers more control over their medical care, helps mainstream the medical treatment of opiate addiction, and will increase the number of health care providers who can administer MMT. Previously, specially licensed clinics only offered methadone; now, with the accreditation process, MMT can be offered at more settings and by more medical providers.  HIV/AIDS primary care clinics are encouraged to consider offering methadone to their clients. For more information about the accreditation process, please visit:</B></div> <bR> <div> <A HREF="http://www.samhsa.gov/centers/csat/content/dpt/accreditation.htm" TARGET="_top" TITLE="http://www.samhsa.gov/centers/csat/conte"><U><B>http://www.samhsa.gov/centers/csat/content/dpt/accreditation.htm</B></U></A></div> <bR> <div> <B>~ ~ ~ ~ [end] Side Bar ~ ~ ~ ~</B></div> <bR> <bR> <bR> <div> <B>...participants have a delayed onset of AIDS-related illnesses; and methadone treatment reduces the health risks, such as overdose, associated with using unregulated street drugs. 3+  According to SAMHSA's, Treatment for Alcohol and Other Drug Abuse: Opportunities for Coordination, methadone maintenance costs approximately $6.00 per day, or $2,190.00 per year, while the cost of medically treating an individual with AIDS is estimated at $100,000. The rates of new AIDS infections were four times higher in those heroin addicts on the street compared to similar former addicts who received treatment in methadone maintenance. 6+</B></div> <bR> <div> <B>Methadone has traditionally been controversial; many patients and critics alike have argued that MMT is simply replacing one substance with another. Patients may feel uncomfortable attending twelve step meetings because they are not "abstinent." These concerns are likely a result of the misunderstanding of addiction in our society; addiction is still considered by some to be a moral failing, rather than a chronic disease which requires medical management similar to other diseases, such as diabetes and high blood pressure. There has also been a strong "not in my backyard" sentiment towards methadone clinics, driven by the fear that the presence of methadone treatment will bring crime and drugs to the neighborhood.  The recent relaxing of the regulations on methadone may help reduce some of this stigma, and create a greater understanding among the public of the important role that MMT plays in addiction, disease transmission, and public health.</B></div> <bR> <bR> <bR> <div> <B>~ ~ ~ ~ References:</B></div> <bR> <div> <B>1+ ... Academy for Educational Development. A Comprehensive Approach:</B></div> <div> <B>Preventing Blood-Borne Infections Among Injection Drug Users, December, 2000. Available online at:</B></div> <bR> <div> <A HREF="http://www.cdc.gov/idu" TARGET="_top" TITLE="http://www.cdc.gov/idu"><U><B>http://www.cdc.gov/idu</B></U></A></div> <bR> <bR> <bR> <div> <B>2+ ... Substance Abuse and Mental Health Services Administration.</B></div> <div> <B>Training Begins for Accreditation of Methadone Programs, May 18, 2001. Available online at:</B></div> <bR> <div> <A HREF="http://www.samhsa.gov/news/news.html" TARGET="_top" TITLE="http://www.samhsa.gov/news/news.html"><U><B>http://www.samhsa.gov/news/news.html</B></U></A><FONT SIZE="3" COLOR="#000000" FACE="Times New Roman" ><B>.</B></FONT></div> <bR> <bR> <div> <B>3+ ... Marlatt, G.A. (1998). Basic principles and strategies of harm</B></div> <div> <B>reduction. In Marlatt, G.A. (Ed.), Harm reduction: Pragmatic strategies for managing high-risk behaviors (pp. 49-66). New York: The Guilford Press.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 5 of 18</B></div> <bR> <bR> <bR> <div> <B>4+ ... National Institute on Drug Abuse. Heroin: Abuse and Addiction.</B></div> <div> <B>NIDA Research Report Series, October 1997.  Available online at:</B></div> <bR> <div> <A HREF="http://www.drugabuse.gov/ResearchReports/Heroin/Heroin.html" TARGET="_top" TITLE="http://www.drugabuse.gov/ResearchReports"><U><B>http://www.drugabuse.gov/ResearchReports/Heroin/Heroin.html</B></U></A></div> <bR> <bR> <bR> <div> <B>5+ ... Effective Medical Treatment of Opiate Addiction. NIH Consensus</B></div> <div> <B>Statement 1997 Nov 17-19; 15(6): 1-38.</B></div> <bR> <bR> <bR> <div> <B>6+ ... Treatment for Alcohol and Other Drug Abuse: Opportunities for</B></div> <div> <B>Coordination, Treatment Assistance Publication Series 11.  Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment, Rockville, MD, 1994.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Buprenorphine: A New Option for Treating Opiate Dependence _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>In October 2002, the Food and Drug Administration (FDA) announced the approval of Buprenorphine for the treatment of heroin and other opiate addiction.</B></div> <bR> <div> <B>Buprenorphine is similar to methadone in that it reduces cravings for opiates, suppresses the opiate abstinence withdrawal syndrome, and provides cross tolerance to other opiates. It is considered to have lower abuse potential than methadone or LAAM (1-alpha-acetyl-methadol) [another common treatment for opiate addiction] and to have relatively mild withdrawal symptoms.</B></div> <bR> <div> <B>Under the Drug Addiction Treatment Act of 2000, physicians who meet certain qualifications will be able to prescribe Buprenorphine in an office setting. This is the first time a qualified physician has been able to provide anti-addiction medication from their own office and represents a significant advancement in drug addiction treatment policy in the U.S. Now, patients will be able to seek care from a trusted physician and get their prescription filled at a local pharmacy, as they would for other health conditions requiring medication. This is a major step forward in mainstreaming addiction treatment and giving patients more control in their treatment.</B></div> <bR> <div> <B>Buprenorphine is not meant to replace methadone, which will, along with other opiate treatments, still be dispensed in SAMHSA-accredited programs.  Rather, Buprenorphine will serve as an additional option for patients seeking opiate addiction treatment and will increase their options of where to seek treatment.</B></div> <bR> <div> <B>Physicians who are interested in offering Buprenorphine to their patients must complete an...</B></div> <bR> <bR> <bR> <div> <B>~ ~ ~ ~ [begin] Side Bar ~ ~ ~ ~</B></div> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Hepatitis C Coordinators' Conference _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <div> <B>January 26 - 30, 2003</B></div> <div> <B>San Antonio, Texas</B></div> <bR> <div> <B>Register for the Hepatitis Coordinators' Conference online at:</B></div> <bR> <div> <A HREF="http://www.cdc.gov/ncidod/diseases/hepatitis/coordinators/index.htm" TARGET="_top" TITLE="http://www.cdc.gov/ncidod/diseases/hepat"><U><B>http://www.cdc.gov/ncidod/diseases/hepatitis/coordinators/index.htm</B></U></A></div> <bR> <div> <B>Due to similar risks of transmission, men who have sex with men (MSM), injection drug users (IDUs), and incarcerated populations are at high-risk for infection with HIV, STDs, and viral hepatitis. Addressing these multiple disease risks requires a comprehensive, integrated, disease prevention program. The Hepatitis Coordinators' Conference, scheduled January 26-30 in San Antonio, Texas, is designed for public health professionals interested in integrating hepatitis prevention into their existing programs. The conference will provide training and networking opportunities to assist public health and other professionals working with clients at risk for viral hepatitis. Focus will be on prevention of perinatal, infant, childhood, adolescent and adult infections, and will include sessions on working with high-risk populations such as inmates, clients in HIV/STD clinics, substance abusers/IDUs, and MSM. Models of integrating hepatitis prevention services into STD, HIV, correctional health, and substance abuse treatment programs will be presented. Attendees will learn from health professionals working on the difficult and complex issues of collaboration with disparate professions, overlapping and converging epidemics, integration and coordination of medical services, cross training, and counseling. In-depth, extended workshops or 'institutes' will address the complex issues of providing services to high risk individuals including injection drug users and men who have sex with men.</B></div> <bR> <div> <B>~ ~ ~ ~ [end] Side Bar ~ ~ ~ ~</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 6 of 18</B></div> <bR> <bR> <bR> <div> <B>...eight hour training session to qualify for a waiver from the Controlled Substances Act 21, which restricts the use of methadone and other opiate drugs to federally licensed addiction treatment clinics. Information on current Buprenorphine trainings being offered, as well as general information on Buprenorphine, is available on SAMHSA's website</B></div> <div> <B>at:</B></div> <bR> <div> <A HREF="http://www.buprenorphine.samhsa.gov" TARGET="_top" TITLE="http://www.buprenorphine.samhsa.gov"><U><B>http://www.buprenorphine.samhsa.gov</B></U></A></div> <bR> <div> <B>Interested providers can get more information by calling the CSAT Buprenorphine Information Center at 866-BUP-CSAT from 8:30 A.M. to 5:00 P.M. , EST, or by emailing: <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:infor@buprenorphine.samhsa.gov" TARGET="_top" TITLE="mailto:infor@buprenorphine.samhsa.gov"><U><B>mailto:infor@buprenorphine.samhsa.gov</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Jurisdictional Profile: New York State, AIDS</B></div> <div> <B>Institute: _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Linking HIV Prevention and Care with Substance Abuse Treatment _ _ _ _</B></div> <bR> <div> <B>In 1990, in an effort to curb the HIV epidemic among injection drug users (IDUs) and other substance users, the New York State (NYS) AIDS Institute implemented a comprehensive model of HIV prevention and care services within drug treatment clinics throughout the state. The initial model, funded by CDC and implemented in collaboration with the New York Office of Alcoholism and Substance Abuse Services (OASAS), incorporated outreach, supportive education, HIV counseling and testing, partner notification and referral services into nine drug treatment programs and two community-based programs that reached out to active users and provided prevention services in smaller drug treatment programs.</B></div> <bR> <div> <B>Initial seroprevalence results found that 21.5% of clients tested were HIV positive. In response, the AIDS Institute pursued primary care funding from the state, and secured Ryan White Title I and II funding. The model quickly grew to include outreach, counseling and testing, supportive counseling, case management, and medical care.  Currently, the model includes twenty-eight drug treatment programs, and operates in a range of treatment settings, including methadone programs, drug free residential treatment and drug free outpatient programs.</B></div> <bR> <div> <B>In the early 1990's, this model of integrating HIV prevention services into drug treatment settings was revolutionary; traditionally, HIV and drug treatment programs were linked through referrals.  The AIDS Institute believed that integrating services within the drug treatment programs was the most effective way to make HIV prevention and care services accessible to drug users.  However, drug treatment programs were initially skeptical. Jeff Rothman, Assistant Director of the AIDS Institute's Bureau of HIV Ambulatory Care, said that there was initial resistance to the co-location model. Programs were concerned that HIV services would serve as a distraction to clients, and addiction counselors often felt that providing HIV services would negatively impact client progress towards recovery. Rothman noted that it is critical to obtain the support of administrators in order to effectively engage clinic staff in the service model. Often, implementing these services resulted in drastic changes within the drug treatment clinics. Entire teams of new personnel were hired to administer HIV services, and some drug treatment programs began a gradual shift towards a medical model.</B></div> <bR> <div> <B>The program has been extremely successful; from its inception through September 2001 the initiative conducted a total of 136,869 tests with 12,779 positives for a cumulative seroprevalence of 9.3%.  From 1990 through 2000, seroprevalence fell from 21.5% to 7.2% and the percent of IDUs from 57.4% to 26%.</B></div> <bR> <div> <B>Current challenges include reaching active drug users and working with treatment programs to enhance hepatitis services. In an effort to reach active drug users, the AIDS Institute has initiated a pilot project with several syringe exchange programs (SEPs). Intensive focus groups with syringe exchange programs including consumers and drug treatment programs found that SEPs and drug treatment programs often do not have established relationships, and a lack of understanding by both on the role each play in serving drug users hinders effective collaboration.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 7 of 18</B></div> <bR> <bR> <bR> <div> <B>The pilot project provides funding for transitional case management services at SEPs, which includes helping the user navigate his or her way into drug treatment. Interviews with clients and staff found that drug users often lack the documentation needed to enter treatment; the case managers will work with the client to gather all the information needed to facilitate entry into treatment.  Additionally, the case managers will take the lead in pursuing relationships with the drug treatment programs in order to achieve more effective collaboration.</B></div> <bR> <div> <B>The program does not currently provide funding for hepatitis services. Numerous sites are providing HCV testing and vaccinations for hepatitis A (HAV) and hepatitis B (HBV) virus out of their own funds. A recent survey of a sample of eighteen of the participating programs found that sixteen provided onsite screening for hepatitis C virus (HCV), and 13 and 10, respectively, vaccinate clients against HBV and HAV.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Jurisdictional Profile: D.C. Department of Health, Addiction Prevention and Recovery Administration: _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ From Outreach to Intake: Reaching D.C. Substance Abusers _ _ _ _</B></div> <bR> <div> <B>Substance abusers at risk for or infected with HIV, viral hepatitis, and other infections are often difficult to reach and difficult to engage in traditional drug treatment and primary care settings. Numerous barriers, including mistrust of the public health system; previous negative experiences attempting to navigate multiple, disparate, public health programs; diagnosis with a mental health or other co-occurring disorder; and often a lifetime of being medically underserved contribute to substance abusers' reluctance to access public health services. Due to the strong link between HIV, viral hepatitis, and substance abuse, it is critically important to address these barriers in order to reach substance abusers with disease prevention, medical care, and drug treatment services.</B></div> <bR> <div> <B>Perhaps nowhere is the need to reach substance abusers felt more strongly than in the District of Columbia (D.C.). The HIV/AIDS epidemic has devastated D.C.; it is estimated that one in twenty adults is HIV-infected, and D.C. ranks first among large U.S. cities in AIDS incidence, reporting 132 cases per 100,000. Substance abuse has played a major role in HIV transmission; from 1996 through 2000, approximately one-third (31.3%) of the reported AIDS cases were among heterosexuals with a history of injection drug use (IDU), and an additional 6.5% of the reported AIDS cases were among the sex partners or children of IDUs. It is also estimated that as many 60,000 people in the District are addicted to psychoactive substances.  The potential intersection between these two epidemics is frightening.</B></div> <bR> <div> <B>The D.C. Department of Health, Addiction Prevention and Recovery Administration (APRA) has responded to this challenge by developing and implementing a comprehensive program integrating outreach, intake, and clinical care for substance abusers living with or at risk for HIV infection in D.C. APRA is the D.C. single state agency for substance abuse prevention and treatment and the primary provider/ funder of substance abuse treatment for indigent (uninsured/under-insured) substance abusers. The program utilizes two main components: Project Orion, a mobile medical outreach and intake unit that targets substance abusers; and the First Street Health Care Center, a medical center offering numerous health services to APRA clients and specifically focusing on those infected with HIV.  While APRA has taken the lead in developing this project, its strength lies in the fact that several local public and private organizations are actively collaborating and contributing resources.</B></div> <bR> <div> <B>Project Orion serves as the first point of entry into the program, targeting street-based substance abusers; this mobile clinic regularly travels to several different locations in D.C. with a high prevalence of substance abuse. With funds from the Substance Abuse and Mental Health Services...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 8 of 18</B></div> <bR> <bR> <bR> <div> <B>...Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT), Project Orion provides disease prevention education and information; infectious disease screening for HIV, sexually transmitted diseases (STDs), tuberculosis (TB), hepatitis B (HBV) virus, and hepatitis C (HCV) virus; basic primary medical care; intake and referrals to substance abuse treatment; case management; and ongoing primary health care services. Project partners include Unity Health Care, Inc., a community based organization and the main community health care provider in D.C.; the HIV/AIDS Administration (HAA) within the D.C.  Department of Health; and Family and Medical Counseling Services, Inc., a community based organization contracted to provide outreach services.</B></div> <bR> <div> <B>Kevin Shipman, Project Director of Project Orion and Chief of the APRA Office of Special Populations Services (OSPS), notes that one of the strengths of Project Orion is that it succeeds in providing substance abusers with a safe, accessible place to access an array of services. He says, "the central philosophy of the project is 'curbside service'; in order to engage the highest risk substance abusers, it is essential to bring the services to them. This helps eliminate some of the major barriers that may prevent them from otherwise seeking medical care, prevention services, and substance abuse treatment."</B></div> <bR> <div> <B>Shipman further notes that the value of Project Orion is that the outreach workers and staff are able to build connections with active substance abusers who many not be ready for treatment, but are interested in some of the other services offered on the mobile unit. Engaging active substance abusers by addressing their current needs and concerns is crucial to establishing trust. Once there is a relationship, clients will know where to go to get information about treatment if they are ready, and staff can intake them into the APRA system while on the medical outreach unit. The staff of Project Orion are also very visible and respected outreach workers in the community and this is an invaluable strength.</B></div> <bR> <div> <B>Once a client has entered into the APRA system, they are able to access an array of health services at the First Street Health Center. The Department of Health's HAA (the primary funder of the HIV medical care) and Unity Health Care, Inc. (the primary care partner), collaborate with APRA to provide the First Street Health Center, which is co-located with the APRA central intake center. There is a special emphasis at the Center on providing services to patients living with HIV/AIDS. Other medical services offered include adult internal medicine, OB/GYN services, laboratory, pharmacy, social services, and psychiatric services.  The significance of the First Street Health Center is that the medical services are integrated with substance abuse treatment; clients' providers understand addiction, and understand that their patients are in substance abuse treatment, and can appropriately tailor their care and work in tandem with the substance abuse treatment provider. This integrated system is extremely beneficial to clients, who are often suffering from multiple disorders and need their provider to understand all aspects of their health care. Without an integrated system, clients often receive fragmented health care and conflicting recommendations from their providers, and consequently have difficulty remaining in care.</B></div> <bR> <div> <B>Shipman stresses that the success of these two projects is due to "partnership mathematics." He notes that, "in regular mathematics, 1 plus 1 equals 2, but in partnership mathematics 1 plus 1 equals 4. Working with partners offers the potential to gain exponentially. When you establish relationships with other programs, you may find that there are multiple opportunities, beyond what you intended, to collaborate and combine resources."</B></div> <bR> <div> <B>Future goals for the program are to integrate mental health services into Project Orion, enabling staff to screen for mental health disorders on the mobile unit. Shipman would also like to have more case management services available. He plans an expansion of the First Street Health Center to include an adjacent program for co-occurring mental illness.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 9 of 18</B></div> <bR> <bR> <bR> <div> <B>The program has been quite successful; currently, the APRA twelve month follow-up rate for Project Orion is nearly 70%, and in FY 2002 they reported over 31,000 outreach contacts.</B></div> <bR> <div> <B>For more information, please contact Kevin Shipman, MHS, LPC, D.C. Department of Heath/ Addiction Prevention and Recovery Administration</B></div> <div> <B>(APRA) at (202) 442-9216 or <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:kevin.shipman@dc.gov" TARGET="_top" TITLE="mailto:kevin.shipman@dc.gov"><U><B>mailto:kevin.shipman@dc.gov</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ SAMHSA HIV/AIDS Initiatives _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>The Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT) is responsible for developing and ensuring access to effective substance abuse treatment services for individuals who abuse alcohol and other drugs. CSAT also identifies and disseminates information on best practices for substance use/abuse treatment and intervention. CSAT administers the treatment funding aspects of the Substance Abuse Prevention and Treatment (SAPT) Block Grant program, which is an annual formula grant awarded to states and territories to finance local substance abuse prevention and treatment services, and is administered by a single state authority for substance abuse. The SAPT Block Grant provides for approximately 40 percent of public funds expended on substance prevention activities and treatment services. SAPT Block Grant places a special emphasis on the provision of treatment and primary prevention services to injecting drug users, and to substance abusing women who are pregnant or with dependent children. States and territories can spend up to 35 percent of SAPT for alcohol prevention and/or treatment activities, 35 percent for prevention and treatment of other drugs, 20 percent for primary prevention activities and services and up to 5 percent on administrative expenses.</B></div> <bR> <div> <B>The President's FY 2003 budget includes a $60 million increase in SAPT Block Grant funds. This will raise the total SAPT Block Grant to almost 1.8 billion for 2003 and serve nearly 1.9 million clients.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Early Intervention Services (EIS) _ _ _ _</B></div> <bR> <div> <B>States with a minimum annual AIDS case rate of 10/100,000 are required to set aside a portion of their SAPT Block Grant for early intervention services. This is called the HIV Set Aside. They are required to expend between 2 percent and 5 percent of the SAPT block grant on HIV EIS. This provided an estimated $57.9 million from total block grant funding in FY 2002. Projects funded by EIS are to reduce transmission of HIV among substance abusers, their sex and needle sharing partners, and their children. They do this through the provision of HIV testing and counseling and provide services in the geographic areas of the state in the greatest need. A major challenge of the HIV Set Aside is that due to the fluctuations in AIDS case rates, states may not consistently be required to set aside, challenging the sustainability of programs. This requirement is now waivable by request from the state to the Secretary. Should no waivers be approved, the FY 2003 block grant HIV/AIDS Set Aside would be approximately $62.1 million.</B></div> <bR> <div> <B>The Center for Substance Abuse Treatment's (CSAT) primary discretionary grant activity, Programs of Regional and National Significance (PRNS), consists of the following three components: best practices; training and technical assistance; and targeted capacity expansion (TCE), under which the HIV/AIDS minority initiative is funded.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ CSAT Minority HIV/AIDS Initiative -- TCE/HIV _ _ _ _</B></div> <bR> <div> <B>In FY 1999, CSAT received $16 million from the Congressional Black Caucus Initiative (CBC) to address HIV/AIDS; these funds were earmarked to provide substance abuse treatment programs for substance abusing African American and Hispanic populations at risk of contracting HIV. CSAT awarded 35 Targeted Capacity Expansion/HIV grants to community-based organizations to supplement and expand substance abuse treatment, HIV/AIDS, and infectious disease services. CSAT also funded 25 HIV Outreach Projects that targeted...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 10 of 18</B></div> <bR> <bR> <bR> <div> <B>...hard-to-reach, high-risk substance abusers with prevention, risk information, and opportunities to enter substance abuse treatment. Metropolitan areas with AIDS case rates of 20 per 100,000 or higher and states with AIDS case rates of 10 or more per 100,000 were eligible for funding.</B></div> <bR> <div> <B>CSAT awarded an additional 43 grants in FY 2000.  Expansion of the HIV/AIDS outreach and treatment activities continued in FY 2001 with the award of 14 new grants for $6 million. Eleven grants were also funded using funds from the Department. In FY 2001, a total of $53 million was spent on TCE/HIV activities which included 92 grants and 3 contracts. In FY 2003, approximately $21 million will be available for new 38-42 new/competing awards for a total program level of $62.2 million.</B></div> <bR> <div> <B>The CSAT TCE/HIV initiative has provided a significant investment in increasing the capacity of minority community-based organizations to address HIV/AIDS and other infectious diseases among substance abuses. Grantees are enhancing their ability to provide comprehensive substance abuse, infectious disease, and mental health services through linkages with other community organizations. State HIV and hepatitis programs would do well to partner with CSAT grantees and other community-based organizations working with substance abusers at high-risk for HIV and hepatitis infection.</B></div> <bR> <div> <B>For more information, please visit:</B></div> <bR> <div> <A HREF="http://www.samhsa.gov" TARGET="_top" TITLE="http://www.samhsa.gov"><U><B>http://www.samhsa.gov</B></U></A></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ HIV and Hepatitis Update for New Jersey Substance Abuse Treatment Providers _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>While the link between HIV and substance abuse has long been recognized, hepatitis C virus (HCV), has emerged as a significant threat to substance abusers, particularly intravenous drug users (IDUs). Research demonstrates that IDUs rapidly acquire hepatitis C after the initiation of injection drug use, and between 60% and 90% of persons who have been injecting drugs for over 12 months are infected with hepatitis C. The prevention and treatment of substance use is a critical component of hepatitis prevention and control efforts .  Providing education, training and supportive resources for substance abuse treatment professionals is the primary step in addressing these prevention needs.</B></div> <bR> <div> <B>In response to this need, the New Jersey AIDS Education and Training Center (AETC); New Jersey Department of Health and Senior Services, Department of Addiction Services and Division of AIDS Prevention and Control; Centers for Disease Control and Prevention; and the Academy for Educational Development (AED) sponsored a meeting this past October entitled, "The Dual Epidemics of Hepatitis and HIV: An Update for Substance Abuse Treatment Providers." The meeting provided a forum for substance abuse treatment providers to discuss the link between substance abuse, HIV, and hepatitis in New Jersey.</B></div> <bR> <div> <B>The purpose of the meeting was to increase the awareness and understanding of substance abuse treatment providers on the epidemiology, transmission, and prevention of hepatitis A, B and C. Participants could choose between a counselor, clinician, and administrator tracks; these three tracks were designed to specifically tailor information to the needs of the different substance abuse professionals.</B></div> <bR> <div> <B>Presentations highlighted HIV/STD programs that have integrated viral hepatitis services into their existing infrastructures; discussed the challenges that addiction counselors face in educating and providing services to clients at risk for or infected with a type of viral hepatitis; and provided an overview of the hepatitis screening, diagnostic and treatment protocols. Participants had the opportunity to network with their colleagues throughout the state, and learn how different programs are addressing the challenges of integrating viral hepatitis.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 11 of 18</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Resources on Substance Abuse and HIV _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>~ ~ ~ ~ A Comprehensive Approach: Preventing Blood-Borne Infections Among IDUs</B></div> <bR> <div> <B>A technical assistance document developed by CDC which describes eight complementary strategies that when used together, can make a difference for HIV prevention among IDUs.  Available at:</B></div> <bR> <div> <A HREF="http://www.cdc.gov/idu/pubs/ca/forword.htm" TARGET="_top" TITLE="http://www.cdc.gov/idu/pubs/ca/forword.h"><U><B>http://www.cdc.gov/idu/pubs/ca/forword.htm</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ CSAT/CDC/HRSA cross-training initiative</B></div> <bR> <div> <B>A CSAT, CDC and HRSA training and technical assistance initiative available to state and local public health programs (e.g. corrections, substance abuse, mental health) on cross training and collaboration across multiple programs. Information is available at:</B></div> <bR> <div> <A HREF="http://www.treatment.org/Topics/infectious.html" TARGET="_top" TITLE="http://www.treatment.org/Topics/infectio"><U><B>http://www.treatment.org/Topics/infectious.html</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ CSAT Treatment Improvement Protocols (TIPs)</B></div> <bR> <div> <B>Best practice guidelines for the treatment of substance abuse developed by CSAT. Relevant TIPs include Tip 37: Substance Abuse Treatment for Persons with HIV/AIDS, among others. Up to five free hard copies of TIPs can be ordered from the National Clearinghouse for Drug and Alcohol Information (NCADI) by accessing its electronic catalog at:</B></div> <bR> <div> <A HREF="http://www.health.org/about/Questions.htm" TARGET="_top" TITLE="http://www.health.org/about/Questions.ht"><U><B>http://www.health.org/about/Questions.htm</B></U></A></div> <bR> <div> <B>or by calling 1-800-729-6686. A brief description of each TIP and its NCADI order number is available at:</B></div> <bR> <div> <A HREF="http://www.treatment.org/Externals/tips.html" TARGET="_top" TITLE="http://www.treatment.org/Externals/tips."><U><B>http://www.treatment.org/Externals/tips.html</B></U></A></div> <bR> <div> <B>and many TIPS are available online for download.</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ The NIDA Community-Based Outreach Model</B></div> <bR> <div> <B>A Manual to Reduce the Risks of HIV and other Blood-Borne Infections in Drug Users Provides principles for HIV prevention to out of treatment drug users. Available at:</B></div> <bR> <div> <A HREF="http://drugabuse.gov/CBOM/index.html" TARGET="_top" TITLE="http://drugabuse.gov/CBOM/index.html"><U><B>http://drugabuse.gov/CBOM/index.html</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ Principles of HIV Prevention in Drug-Using Populations</B></div> <bR> <div> <B>This guide developed by the National Institute on Drug Abuse (NIDA) summarizes the basic overarching principles that characterize effective HIV/AIDS prevention in drug-using populations.  The guide is available</B></div> <div> <B>at:</B></div> <bR> <div> <A HREF="http://drugabuse.gov/POHP/" TARGET="_top" TITLE="http://drugabuse.gov/POHP/"><U><B>http://drugabuse.gov/POHP/</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ Principles of Drug Addiction Treatment</B></div> <bR> <div> <B>This guide developed by the National Institute on Drug Abuse (NIDA) summarizes the basic principles of drug treatment and describes different treatment options. Available at:</B></div> <bR> <div> <A HREF="http://drugabuse.gov/PODAT/PODATindex.html" TARGET="_top" TITLE="http://drugabuse.gov/PODAT/PODATindex.ht"><U><B>http://drugabuse.gov/PODAT/PODATindex.html</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ Web sites</B></div> <bR> <div> <B>Addiction Technology Transfer Centers:</B></div> <div> <A HREF="http://www.nattc.org/" TARGET="_top" TITLE="http://www.nattc.org/"><U><B>http://www.nattc.org/</B></U></A></div> <bR> <div> <B>American Society of Addiction Medicine:</B></div> <div> <A HREF="http://www.asam.org/" TARGET="_top" TITLE="http://www.asam.org/"><U><B>http://www.asam.org/</B></U></A></div> <bR> <div> <B>Centers for Disease Control and Prevention, HIV Prevention Among Injection Drug Users: </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.cdc.gov/idu" TARGET="_top" TITLE="http://www.cdc.gov/idu"><U><B>http://www.cdc.gov/idu</B></U></A></FONT></div> <bR> <div> <B>Crystal NEON, a project in Seattle, Washington, that provides information on methamphetamine use: </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.crystalneon.org/html/index.html" TARGET="_top" TITLE="http://www.crystalneon.org/html/index.ht"><U><B>http://www.crystalneon.org/html/index.html</B></U></A></FONT></div> <bR> <div> <B>The Harm Reduction Coalition:</B></div> <div> <A HREF="http://www.harmreduction.org" TARGET="_top" TITLE="http://www.harmreduction.org"><U><B>http://www.harmreduction.org</B></U></A></div> <bR> <div> <B>National Association of State Alcohol/Drug Abuse Directors: </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.nasadad.org" TARGET="_top" TITLE="http://www.nasadad.org"><U><B>http://www.nasadad.org</B></U></A></FONT></div> <bR> <div> <B>National Center on Addiction and Substance Abuse at Columbia University:</B></div> <bR> <div> <A HREF="http://www.casacolumbia.org/" TARGET="_top" TITLE="http://www.casacolumbia.org/"><U><B>http://www.casacolumbia.org/</B></U></A></div> <bR> <div> <B>National Clearinghouse for Alcohol and Drug Information: </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.health.org/" TARGET="_top" TITLE="http://www.health.org/"><U><B>http://www.health.org/</B></U></A></FONT></div> <bR> <div> <B>National Institute on Alcohol Abuse and Alcoholism </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.niaaa.nih.gov/publications/publications.htm" TARGET="_top" TITLE="http://www.niaaa.nih.gov/publications/pu"><U><B>http://www.niaaa.nih.gov/publications/publications.htm</B></U></A></FONT></div> <bR> <div> <B>National Institute on Drug Addiction:</B></div> <div> <A HREF="http://www.nida.nih.gov/" TARGET="_top" TITLE="http://www.nida.nih.gov/"><U><B>http://www.nida.nih.gov/</B></U></A></div> <bR> <div> <B>SAMHSA Center for Substance Abuse Treatment: </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.samhsa.gov/centers/csat2002/csat_frame.html" TARGET="_top" TITLE="http://www.samhsa.gov/centers/csat2002/c"><U><B>http://www.samhsa.gov/centers/csat2002/csat_frame.html</B></U></A></FONT></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 12 of 18</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ The Food and Drug Administration Approves OraQuick _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>On Thursday, November 7th, the Food and Drug Administration (FDA) approved OraQuick, making it the first second-generation rapid test to receive approval for marketing in the U.S. Many second-generation tests are already used worldwide, but none have been available here until now. The first generation Sudden Use Diagnostic System (SUDS), manufactured by Abbott Laboratories, is the only other rapid test currently available in the U.S. SUDS is a complicated test requiring a laboratory and trained laboratory personnel to run and interpret. Unlike SUDS, OraQuick, manufactured by OraSure Technologies, is a simple test to administer and interpret, making it ideal for use in non-clinical settings where a lab is not readily available.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Applying for a Clinical Laboratory Improvement Amendments Waiver _ _ _ _</B></div> <bR> <div> <B>Whether OraQuick will receive a waiver under the Clinical Laboratory Improvement Amendments (CLIA) remains a concern. CLIA, passed by Congress in 1988, regulates medical testing to ensure quality results. Under CLIA, tests can be classified as high or moderate complexity, which determines what laboratories may run certain tests. The higher a tests complexity, the higher the standards in terms of personnel, etc., required for a lab to run the test. The Centers for Medicare and Medicaid Services (CMS) has responsibility for ensuring laboratories meet CLIA standards as well as interpreting the CLIA statute.</B></div> <bR> <div> <B>Manufacturers with accurate, simple to use tests may apply for a waiver under CLIA. A waiver removes the test from much of the oversight required by CLIA because of the small chance such a test would be administered incorrectly by untrained users, resulting in an erroneous result.  With a waiver, the test can be more readily performed without the auspices of a laboratory.  OraSure designed OraQuick specifically to qualify for a waiver, and initial data indicates that the test could meet potential waiver criteria. Secretary of Health and Human Services Tommy Thompson indicated his support for a waiver at the press conference announcing OraQuick's approval.</B></div> <bR> <div> <B>Some confusion exists regarding the guidelines to qualify and apply for a waiver. Although CLIA gives authority for making waiver decisions to FDA, decisions for classifying all previously approved tests fell to the Centers for Disease Control and Prevention. FDA only recently took back responsibility for making waiver decisions and developed draft revised waiver guidelines.  However, FDA withdrew these guidelines last year and began developing new ones with input from CDC and CMS. At this point, it remains unclear exactly what guidelines FDA will use in determining whether OraQuick receives a waiver.  FDA and OraSure are expected to discuss what standards FDA will use in determining a waiver and the data necessary to demonstrate whether OraQuick meets the standards. OraSure will likely file a waiver application sometime thereafter.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Implementation of HIV Rapid Tests _ _ _ _</B></div> <bR> <div> <B>Much of the attention on rapid tests has focused on receiving FDA approval and on a waiver under CLIA. Because a waiver will determine what settings can use rapid tests and what roles AIDS programs and laboratories will play in providing oversight and quality assurance, discussions related to the waiver will likely continue to be the focus of much attention. Yet CDC and health department AIDS programs are beginning to examine implementation issues beyond a waiver under CLIA.</B></div> <bR> <div> <B>Some states have been re-examining state laws that could pose a barrier for rapid tests such as laws that prohibit providing preliminary HIV results from a screening test. OraQuick only screens for HIV; positive results require confirmation. A second, complimentary rapid test could be used to confirm the results of OraQuick, but such a test will not be available in the near future. Many states have laws that prohibit providing clients with preliminary results. Health department regulations may allow some states to circumvent these laws while others...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 13 of 18</B></div> <bR> <bR> <bR> <div> <B>...may need to approach their state's legislature for a change. Many advocates raise concerns that opening up laws relating to HIV testing may allow some legislatures to add mandatory testing or other undesirable laws.</B></div> <bR> <div> <B>AIDS programs have also begun assessing their counseling, testing, and referral (CTR) programs to begin deciding how rapid tests will fit. Rapid tests will not be appropriate in all settings. In general, they are recommended for settings with high prevalence (which reduces the likelihood of receiving a false negative) where return rates for results are low. Sights chosen must have the capacity to handle any additional demand for rapid testing that some pilot sites have seen. Counselors will require training on administering and interpreting the test and providing appropriate information regarding results. Counselors must also be trained to provide positive results and be prepared to provide clients with such results within a short time frame. Clear linkages to confirmatory testing must be in place, and health departments must determine how best to provide quality assurance for rapid tests.</B></div> <bR> <div> <B>Through a recent NASTAD survey on rapid test implementation, health departments identified several clear technical assistance needs. These needs included:</B></div> <bR> <div> <B>* Adapting and implementing new counseling models.</B></div> <bR> <div> <B>* Training curriculum on the new technology.</B></div> <bR> <div> <B>* Adapting/developing revised training programs for counselors.</B></div> <bR> <div> <B>* Working with CBOs to build their capacity to offer rapid tests.</B></div> <bR> <div> <B>NASTAD will work with health departments, CDC, community planning groups and other key stakeholders to meet these technical assistance needs. Given these needs, roll out of OraQuick may begin slowly over the next year, with many states starting with small pilot projects.</B></div> <bR> <div> <B>NASTAD will also work with FDA and manufacturers to bring other rapid tests to market.  As noted above, a second, complimentary rapid test could provide confirmation of test results, eliminating the need for follow-up testing.  NASTAD and other key stakeholders encourage FDA to issue the revised guidelines on qualifying and applying for a waiver, as well as guidelines providing standards rapid tests must achieve to receive FDA approval. Manufacturers will also be encouraged to seek FDA approval for many of the other tests already available internationally. FDA's approval of OraQuick represents a significant step forward in ensuring people infected with HIV learn their status and are linked with care. However, it is only the first step in a process that will ultimately change how people are tested for HIV in the U.S.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Adolescent and School-Based Health: Resources on School Health _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Presentation on Health and Student Achievement _ _ _ _</B></div> <bR> <div> <B>The Society of State Directors of Health, Physical Education and Recreation (SSDHPER) and the Association of State and Territorial Health Officials (ASTHO) recently announced that the presentation, "Making the</B></div> <div> <B>Connection: Health and Student Achievement," will soon be available on CD-ROM. This PowerPoint presentation makes a compelling case for school health programs by outlining the major research that links the components of coordinated school health programs with student success. SSDHPER and ASTHO encourage education and health professionals to use this presentation in collaboration to show the importance of state and local partnerships in improving health and educational outcomes.</B></div> <bR> <div> <B>This presentation was developed with support from a cooperative agreement from the Centers for Disease Control and Prevention, Division of Adolescent and School Health. There is no cost to receive this resource.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 14 of 18</B></div> <bR> <bR> <bR> <div> <B>An order form that you may fax or email back to SSDHPER to get your CD-ROM is accessible at:</B></div> <bR> <div> <A HREF="http://www.thesociety.org/pdf/connections.pdf" TARGET="_top" TITLE="http://www.thesociety.org/pdf/connection"><U><B>http://www.thesociety.org/pdf/connections.pdf</B></U></A></div> <bR> <div> <B>CD-ROMs will be mailed out as soon as they are ready.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Surveillance Information on Adolescents _ _ _ _</B></div> <bR> <div> <B>CDC has made available via web a set of slides profiling the HIV/AIDS epidemic through 2001.  Included in the slide set are AIDS cases among 13-19 year olds and 20-24 year olds by sex and year of report, estimated male and female incidence by exposure category and AIDS cases by race/ethnicity. These slide sets can be accessed at:</B></div> <bR> <div> <A HREF="http://www.cdc.gov/hiv/graphics/adolesnt.htm" TARGET="_top" TITLE="http://www.cdc.gov/hiv/graphics/adolesnt"><U><B>http://www.cdc.gov/hiv/graphics/adolesnt.htm</B></U></A></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Upcoming Ryan White National Youth Conference on HIV and AIDS _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>On February 14-17, 2003, the Ryan White National Youth Conference on HIV and AIDS (RWNYC) will convene in Dallas, TX. The RWNYC is the only national conference dedicated to building the HIV prevention health services skills of young AIDS activists, youth peer educators and HIV positive youth and those who work in support of young people. Over 600 youth and adults who work with youth from around the nation will attend to identify and share effective resources for HIV prevention among young people; present models of care, leadership and support services for HIV positive young people; present models of youth appropriate, culturally competent services to those infected, affected or at risk; develop leadership and advocacy skills; and strengthen youth leadership in the fight against HIV/AIDS.</B></div> <bR> <div> <B>For more information, including registration form, visit the conference</B></div> <div> <B>website:</B></div> <bR> <div> <A HREF="http://www.rwnyc.org" TARGET="_top" TITLE="http://www.rwnyc.org"><U><B>http://www.rwnyc.org</B></U></A></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ The Manager _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Finding your "Genius" _ _ _ _</B></div> <bR> <div> <B>When we hear the word genius, we are likely to think of those few who have entered the history books for great works of art or major breakthroughs in scientific discovery. But while a Leonardo DaVinci or an Albert Einstein are classic geniuses, some believe that everyone can cultivate "genius" in their own lives.</B></div> <bR> <div> <B>One of the most important steps to doing so is knowing where to look, according to Annette Moser-Wellman, author of The Five Faces of Genius: Creative Thinking Styles to Succeed at Work (Penguin Publishers, 2001). "Most of us believe that geniuses are in a league of their own.  What we don't realize is that these highly creative people use skills we all can learn." Moser uses five metaphorical "faces" to identify the major thinking styles, each with their own unique strengths and particular contributions to make:</B></div> <bR> <div> <B>* The Seer: Seers throughout history have had the ability to make prophecies. In this usage, a seer has "the power to image." Seers can visualize new possibilities and expand existing frameworks.</B></div> <bR> <div> <B>* The Observer: While seemingly playing a passive role, one who observes has the "power to notice detail." Observers can then connect seemingly diverse points of information to draw new conclusions.</B></div> <bR> <div> <B>* The Alchemist : Alchemy is the science of combining different ingredients to make a new substance, hence the Alchemist has "the power to connect domains." By bringing together different ideas, disciplines or systems of thought they can achieve an entirely new product.</B></div> <bR> <div> <B>* The Fool: In the Middle Ages, the Fool was the only one in a King's Court who could speak the truth. In this context, the fool has "the power to celebrate weakness."  They can take existing structures and turn them upside down and inside out, sometimes leading to fortuitous new combinations or novel approaches.</B></div> <bR> <div> <B>* The Sage: The greatest wisdom can sometimes be found in the most modest proverb or most uncomplicated insight. The Seer has "the power to...</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 15 of 18</B></div> <bR> <bR> <bR> <div> <B>...simplify" and in the process to look at a situation and identify its essence -- and thus its most important part.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Cultivating the faces of genius _ _ _ _</B></div> <bR> <div> <B>Most people will have one "face" with which they most closely identify, and even these simple descriptions may be enough for you to figure out your dominant face. But unlike many management books of this type, the author encourages readers not to specialize on one area but rather to cultivate all five of the faces. Indeed, she warns against simply relying on the one face that comes most naturally or has worked best in the past and regards the least developed face not as a weakness but as a "growth opportunity." At different times we may all be called upon to use each of the thinking styles.</B></div> <bR> <div> <B>To develop the skills of The Seer, focus on your powers of visualization. Ask yourself: "What solutions do I see in my mind's eye?" Try to "see" possibilities and cultivate a vision of the future, then think about what the implications would be of different futures. Because it sees "the big picture," The Seer needs to work in combination with other styles that are more detail-oriented.</B></div> <bR> <div> <B>To strengthen your powers of observation, encourage your sense of curiosity and try to draw new ideas out of collections of details. Ask</B></div> <div> <B>yourself: "What do I see around me that leads to a solution?"  The Observer excels in conceptual thinking that is rooted in real issues, but must guard against drawing wrong inferences from details.</B></div> <bR> <div> <B>To become a better Alchemist, focus on the possible connections between seemingly disparate domains. Ask yourself:  "What does this situation remind me of?"  The Alchemist develops insights through analogies but also runs the risk of relying too heavily on others for the stimulus for new ideas.</B></div> <bR> <div> <B>To play The Fool, ask yourself: "What happens if I invert the situation? Come up with an absurd conclusion? What if I persevered?" By inverting, toying with the absurd, and persevering in the face of tough odds, The Fool can create ideas that break through barriers -- but must be careful not to persevere beyond what's reasonable.</B></div> <bR> <div> <B>To enhance your qualities as The Sage, ask yourself:  "What simple solution could I create?  What can I rekindle from the past?" By drawing on the lessons of the past, The Seer can create streamlined new ideas and develop insights into the issues that are truly key and essential. The danger here is oversimplification, and eliminating too many of the 'messy edges' that spawn good ideas.</B></div> <bR> <div> <B>Moving forward, consider drawing on your strength as The Alchemist to enable each of your thinking styles to enhance the other thinking styles.  Let your Fool challenge the certainty of The Sage.  Let the Observer ground The Seer while The Seer broadens the perspective of The Observer. As the author notes, "We live in an age of change. Don't be the person who responds to change. Be the person who creates it."</B></div> <bR> <div> <B>Recognizing the need to support HIV/AIDS program staff members in their management challenges, the NASTAD HIV Prevention Bulletin offers "The Manager" column to bring to our readers' attention key works by professionals in the field of management. "The Manager" encourages readers to send in ideas for topics to be covered in this column. Please e-mail suggestions to <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:nastad@nastad.org" TARGET="_top" TITLE="mailto:nastad@nastad.org"><U><B>mailto:nastad@nastad.org</B></U></A></FONT><B>> , fax them to 202-484-8092, or mail them to "The Manager," NASTAD, 444 N. Capitol St., NW, Washington DC 20001.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Resources _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ National Black HIV/AIDS Awareness Day 2003 _ _ _ _</B></div> <bR> <div> <B>National Black HIV/AIDS Awareness Day (NBHAAD) is a community mobilization initiative that focuses on building effective leadership within the African American community around HIV/AIDS prevention. NBHAAD is a project of the Community Capacity Building Coalition (CCBC) which is a coalition of national organizations funded by the Centers for Disease Control and Prevention through the National Minority AIDS Initiative.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 16 of 18</B></div> <bR> <bR> <bR> <div> <B>National Black HIV/AIDS Awareness Day is an annual event that will take place on February 7, 2003. There have been 16 targeted cities identified (Philadelphia, Los Angeles, Washington, DC, Chicago, New York, Atlanta, Dallas, Raleigh-Durham, New Orleans, Houston, Miami, Baltimore, Cleveland, Detroit, New York and Trenton) and lead community-based organizations (CBOs) within each of these cities will plan and organize local events and activities.</B></div> <bR> <div> <B>Please click on:</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/BlackAIDS.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/BlackAIDS"><U><B>http://www.nastad.org/pdf/news/BlackAIDS.pdf</B></U></A></div> <bR> <div> <B>for information on lead CBOs for each of the targeted cities. Health departments and CBOs are encouraged to get involved in NBHAAD activities being planned within their jurisdiction.  There are also many activities that can be initiated around National Black HIV/AIDS Awareness Day for health departments and CBOs that do not reside in one of the 16 targeted cities. Please refer to the official NBHAAD website for ideas on how you can get involved.</B></div> <bR> <div> <B>The CCBC has established a toll free number (877) 867-1446 and website:</B></div> <bR> <div> <A HREF="http://www.BLACKAIDSDAY.org" TARGET="_top" TITLE="http://www.BLACKAIDSDAY.org"><U><B>http://www.BLACKAIDSDAY.org</B></U></A></div> <bR> <div> <B>to provide and collect additional information related to National Black HIV/AIDS Awareness Day.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Capacity Building Assistance Training Calendar _ _ _ _</B></div> <bR> <div> <B>Please click on:</B></div> <bR> <div> <A HREF="http://www.nastad.org/pdf/news/calendar.pdf" TARGET="_top" TITLE="http://www.nastad.org/pdf/news/calendar."><U><B>http://www.nastad.org/pdf/news/calendar.pdf</B></U></A></div> <bR> <div> <B>to see information on Capacity Building Assistance Trainings being offered through January 2003:</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Community Planning Calendar _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>Following are listings of meetings, conferences and other key dates that may be of interest to those working on HIV prevention or community planning. Their inclusion does not necessarily indicate endorsement by NASTAD; please see contact information for additional details about each activity.</B></div> <bR> <bR> <bR> <div> <B>~ ~ ~ ~ December 1, 2002</B></div> <bR> <div> <B>World AIDS Day 2002. Please visit The Balm In Gilead website:</B></div> <bR> <div> <A HREF="http://www.balmingilead.org/wad02/contents.asp" TARGET="_top" TITLE="http://www.balmingilead.org/wad02/conten"><U><B>http://www.balmingilead.org/wad02/contents.asp</B></U></A></div> <bR> <div> <B>for information on the World AIDS Day community mobilization campaign</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ December 1-3, 2002</B></div> <bR> <div> <B>2nd International Conference on Substance Abuse and HIV, Mumbai, India. Sponsored by United Nations AIDS. For more information, contact The Hope 2002 Secretariat at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:info@hopeconference.org" TARGET="_top" TITLE="mailto:info@hopeconference.org"><U><B>mailto:info@hopeconference.org</B></U></A></FONT><B>> or visit:</B></div> <bR> <div> <A HREF="http://www.hopeconference.org/hope2002main.html" TARGET="_top" TITLE="http://www.hopeconference.org/hope2002ma"><U><B>http://www.hopeconference.org/hope2002main.html</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ December 1-4, 2002</B></div> <bR> <div> <B>4th National Harm Reduction Conference, "Taking Drug Users Seriously," Seattle, WA. For more information, visit:</B></div> <bR> <div> <A HREF="http://harmreduction.org/conference/4thnatlconf.html" TARGET="_top" TITLE="http://harmreduction.org/conference/4thn"><U><B>http://harmreduction.org/conference/4thnatlconf.html</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ January 27- January 29, 2003</B></div> <bR> <div> <B>Rescheduling of the November CBO Consultation in Chicago -- Due to unexpected logistical problems, the Regional Chicago CBO Consultation originally scheduled for November 13-16, 2002 has been rescheduled to January 2003. For more information, contact <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:cboconsultation@cdc.gov" TARGET="_top" TITLE="mailto:cboconsultation@cdc.gov"><U><B>mailto:cboconsultation@cdc.gov</B></U></A></FONT><B>> or visit:</B></div> <bR> <div> <A HREF="http://www.cdc.gov/hiv/cboconsultation.html" TARGET="_top" TITLE="http://www.cdc.gov/hiv/cboconsultation.h"><U><B>http://www.cdc.gov/hiv/cboconsultation.html</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ January 27-30, 2003</B></div> <bR> <div> <B>National Hepatitis Coordinator Conference, San Antonio, TX.</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ February 14-17, 2003</B></div> <bR> <div> <B>10th Annual Ryan White National Youth Conference on HIV/AIDS, Dallas, TX. Sponsored by the National Association of People With AIDS (NAPWA). For more information, please call NAPWA at (202) 898-0414 or visit:</B></div> <bR> <div> <A HREF="http://www.napwa.org" TARGET="_top" TITLE="http://www.napwa.org"><U><B>http://www.napwa.org</B></U></A></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 17 of 18</B></div> <bR> <bR> <bR> <div> <B>~ ~ ~ ~ March 2-8, 2003</B></div> <bR> <div> <B>The Black Church Week of Prayer For the Healing of AIDS, sponsored by The Balm in Gilead, Inc. For more information, visit:</B></div> <bR> <div> <A HREF="http://www.balmingilead.org/home.asp" TARGET="_top" TITLE="http://www.balmingilead.org/home.asp"><U><B>http://www.balmingilead.org/home.asp</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ March 12-15, 2003</B></div> <bR> <div> <B>Community Planning Leadership Summit for HIV Prevention, New York City. Sponsored by AED, CDC, NASTAD and NMAC. For more information, visit:</B></div> <bR> <div> <A HREF="http://www.nmac.org" TARGET="_top" TITLE="http://www.nmac.org"><U><B>http://www.nmac.org</B></U></A></div> <bR> <div> <B>and click on the CPLS button.</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ March 28-30, 2003</B></div> <bR> <div> <B>RCAP National Conference, "HIV/STD Prevention in Rural Communities: Sharing Successful Strategies III", Bloomington, IN. Co-sponsored by the Rural Center for AIDS/STD Prevention (RCAP) and the National Rural Health Association (NRHA). For more information, visit the RCAP website:</B></div> <bR> <div> <A HREF="http://www.indiana.edu/~aids" TARGET="_top" TITLE="http://www.indiana.edu/~aids"><U><B>http://www.indiana.edu/~aids</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ March 30- April 2, 2003</B></div> <bR> <div> <B>15th National HIV/AIDS Update Conference (NAUC), Miami, FL. Sponsored by the American Foundation for AIDS Research (AmFAR). For more information, contact Jennifer Attonito, Conference Director at (212) 805-1631 or</B></div> <div> <B>visit:</B></div> <bR> <div> <A HREF="http://www.amfar.org/cgi-bin/iowa/nauc/index.html" TARGET="_top" TITLE="http://www.amfar.org/cgi-bin/iowa/nauc/i"><U><B>http://www.amfar.org/cgi-bin/iowa/nauc/index.html</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ April 4, 2003</B></div> <bR> <div> <B>3rd Annual CAPS HIV Prevention Conference, "Many Voices… One Mission", San Francisco, CA. Sponsored by the Center for AIDS Prevention Studies (CAPS).</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ April 6-10, 2003</B></div> <bR> <div> <B>14th International Conference on the Reduction of Drug-Related Harm -- Chiang Mai, Thailand -- For more information, visit:</B></div> <bR> <div> <A HREF="http://www.ihrc2003.net" TARGET="_top" TITLE="http://www.ihrc2003.net"><U><B>http://www.ihrc2003.net</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ April 26-29, 2003</B></div> <bR> <div> <B>Community-Campus Partnerships for Health (CCPH) 7th Annual Conference, San Diego, CA, "Taking Partnerships to a New Level: Achieving Outcomes, Sustaining Change". For more information, please call (415) 476-7081 or</B></div> <div> <B>visit:</B></div> <bR> <div> <A HREF="http://www.ccph.info" TARGET="_top" TITLE="http://www.ccph.info"><U><B>http://www.ccph.info</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ May 21-23, 2003</B></div> <bR> <div> <B>Call for Abstracts: National Conference on Health Education and Health Promotion, "Emerging Opportunities for Health Promotion and Health</B></div> <div> <B>Education: Sailing into New Waters", San Diego, CA. Sponsored by The Association of State and Territorial Directors of Health Promotion and Public Health Education (ASTDHPPHE). For more information on abstract submission, contact Sara Riedal at (202) 659-2230 x102 or <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:sriedel@astdhpphe.org" TARGET="_top" TITLE="mailto:sriedel@astdhpphe.org"><U><B>mailto:sriedel@astdhpphe.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ May 29 - June 1, 2003</B></div> <bR> <div> <B>The Fifteenth Annual National Conference on Social Work and HIV/AIDS, Albuquerque, NM, "HIV/AIDS 2003: The Social Work Response."  For more information, please contact the Conference Chair at (617) 552-4038 or email at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:lynchv@bc.edu" TARGET="_top" TITLE="mailto:lynchv@bc.edu"><U><B>mailto:lynchv@bc.edu</B></U></A></FONT><B>> or <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:andertje@bc.edu" TARGET="_top" TITLE="mailto:andertje@bc.edu"><U><B>mailto:andertje@bc.edu</B></U></A></FONT><B>>.</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ June 18-21, 2003</B></div> <bR> <div> <B>13th Annual National Conference of Social Marketing in Public Health, Clearwater Beach, FL. Sponsored by the University of South Florida, College of Public Health. For more information, please call (888) USF-COPH and press '2' for the Continuing Education Office or call directly at (813) 974-6695.</B></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ July 27-30, 2003</B></div> <bR> <div> <B>2003 National HIV Prevention Conference, Atlanta, GA.  Sponsored by CDC and other governmental and non-governmental partners. For more information, visit:</B></div> <bR> <div> <A HREF="http://www.2003HIVPrevConf.org" TARGET="_top" TITLE="http://www.2003HIVPrevConf.org"><U><B>http://www.2003HIVPrevConf.org</B></U></A></div> <bR> <bR> <div> <B>=+=+=+=+=+=+=+=+=+=</B></div> <bR> <bR> <div> <B>~ ~ ~ ~ September 18-21, 2003</B></div> <bR> <div> <B>The United States Conference on AIDS (USCA), New Orleans, LA. Sponsored by the National Minority AIDS Council (NMAC). For more information and abstract submission deadlines, please contact NMAC's Conferences and Meeting Services Department between 9 a.m. and 5 p.m. (EST) at (202) 483-6622.</B></div> <bR> <bR> <bR> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <div> <B>*-*-*- page break -*-*-*</B></div> <div> <B>-*-*-*-*-*-*-*-*-*-*-*-*-</B></div> <bR> <div> <B>Page 18 of 18</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ _ _ _ _ _ _ Info about "The Bulletin" _ _ _ _ _ _ _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>If you have an idea or program relative to any of these topics that you would like to include in the Bulletin, please contact Nyedra Booker -</B></div> <div> <B>e-mail: <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:nbooker@nastad.org" TARGET="_top" TITLE="mailto:nbooker@nastad.org"><U><B>mailto:nbooker@nastad.org</B></U></A></FONT><B>>, phone: 202/434-8090).</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ LET US KNOW WHAT YOU THINK! _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>NASTAD welcomes feedback to issues presented in our newsletter. To submit commentary, please e-mail us at <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:nastad@nastad.org" TARGET="_top" TITLE="mailto:nastad@nastad.org"><U><B>mailto:nastad@nastad.org</B></U></A></FONT><B>>.</B></div> <bR> <bR> <bR> <div> <B>_ _ _ _ Visit our Web page! _ _ _ _</B></div> <bR> <bR> <bR> <div> <B>Electronic versions of the Bulletin are posted, along with other information on both NASTAD's prevention and care projects.</B></div> <bR> <div> <A HREF="http://www.nastad.org" TARGET="_top" TITLE="http://www.nastad.org"><U><B>http://www.nastad.org</B></U></A></div> <bR> <bR> <bR> <div> <B>The NASTAD HIV Prevention Bulletin is written and edited by NASTAD staff and participants of community planning and prevention efforts around the country. NASTAD's production of the Bulletin is made possible through funding provided by CDC's Division of HIV/AIDS Prevention (DHAP) in the National Center for HIV, STD, and TB Prevention.</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: Re: as promised:</B></div> <div> <B>Date: Tue, 19 Nov 2002 10:51:21 -0500</B></div> <div> <B>From: Phyllis Gray <phyllis.gray@ncmail.net></B></div> <div> <B>Organization: N.C. Dept. of Health and Human Services</B></div> <div> <B>To: retroart@buncombe.main.nc.us</B></div> <div> <B>CC: Evelyn Foust <Evelyn.Foust@ncmail.net>, Myra Allen <Myra.Allen@ncmail.net>, Kimberly Burnett-hoke <Kimberly.Burnett-hoke@ncmail.net></B></div> <div> <B>References: 1 , 2</B></div> <bR> <div> <B>Kevin,</B></div> <bR> <div> <B>Thanks a million for doing the research you promised [shown in following document]! While I have read the majority of these documents, there are some I am not familiar with, but will be shortly (smile).</B></div> <bR> <div> <B>Please know, we will do our best to get as many of these documents as possible before the December meeting so that they may be distributed on the 12th.</B></div> <bR> <div> <B>As always I am hungry to read any information that might help us do our job better or we can pass along to others. There is no point in reinventing the wheel if someone has already tried out a process and found it successful.  So feel free to send me other references that you come across. A summary like this is very, very, helpful.</B></div> <bR> <div> <B>Again.....THANKS!</B></div> <bR> <div> <B>pag</B></div> <bR> <bR> <div> <B>----- original message -----</B></div> <div> <B>Subject: as promised:</B></div> <div> <B>Date: Tue, 19 Nov 2002 10:27:46 -0500</B></div> <div> <B>From: retroart@buncombe.main.nc.us</B></div> <div> <B>To: Phyllis.gray@ncmail.net</B></div> <div> <B>CC: "7.9 - epi staff" <epi.hivstd.prevstaff@ncmail.net></B></div> <div> <B>References: 1</B></div> <bR> <div> <B>Phyllis:</B></div> <bR> <div> <B>Here is the list of the documents the Branch should request, compile and distribute (to respective committees or the full membership of the SCPG) as deemed appropriate. kpn</B></div> <bR> <div> <B>---</B></div> <bR> <div> <B>Assessing the Need for HIV Prevention Services: A Guide for Community Planning Groups (August 1999)</B></div> <bR> <div> <B>Facilitating Meetings: A Guide for Community Planning Groups (August</B></div> <div> <B>2001)</B></div> <bR> <div> <B>HIV Prevention Community Planning: An Orientation Guide (January 1999)</B></div> <bR> <div> <B>NASTAD Issue Brief: Technical Assistance and Capacity Building (March</B></div> <div> <B>2000)</B></div> <bR> <div> <B>NASTAD HIV Prevention Update and Community Planning Bulletin</B></div> <bR> <div> <B>NASTAD TA Report: Youth of Color TA Report</B></div> <bR> <div> <B>Self-Assessment Tool for HIV Prevention Community Planning (May 1995)</B></div> <bR> <div> <B>What Intervention Studies Say About Effectiveness: A Resource for HIV Prevention Community Planning Groups (May 1996)</B></div> <bR> <div> <B>Compendium of HIV Prevention Interventions with Evidence of Effectiveness (November 1999)</B></div> <bR> <div> <B>Connecticut Community Planning Group Policy & Procedures Manual</B></div> <bR> <div> <B>Connecticut CPG summary of frequently used Robert's Rules of Order.</B></div> <bR> <div> <B>Iowa's Membership /Orientation /Bylaws Committee compiled a short booklet designed to help new members understand the community planning process.</B></div> <bR> <div> <B>Maryland developed an Exit Interview to gauge the experience of former CPG members.</B></div> <bR> <div> <B>Michigan PLWH/A Task Force and HAPIS/DHAS collaborated in conducting a statewide needs assessment of primary prevention needs of HIV-infected individuals.</B></div> <bR> <div> <B>The Rules and Membership committee of the New York City HIV Prevention Planning Group (PPG) has developed an objective process for the recruitment and selection of new members.</B></div> <bR> <div> <B>Ohio HIV Prevention Regional Advisory Group Reference Manual</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: SCPG Strategic Planning Effort</B></div> <div> <B>Date: Tue, 19 Nov 2002 11:42:26 -0500</B></div> <div> <B>From: Phyllis Gray <phyllis.gray@ncmail.net></B></div> <div> <B>Organization: N.C. Dept. of Health and Human Services</B></div> <div> <B>To: Myra Allen <Myra.Allen@ncmail.net>, sarah langer <sarah.langer@ncmail.net>, Eloise Hicks <ehhicks@uwcentralcarolinas.org>, Evelyn Foust <Evelyn.Foust@ncmail.net>, Rickie Rouse <cCdream@weblnk.net>, Andy Sturdy <asturdy@tcchc.com>, Kevin Nuttall <retroart@buncombe.main.nc.us>, Jesse Duncan <jduncan@triadhealthproject.com></B></div> <div> <B>CC: Kimberly Burnett-hoke <Kimberly.Burnett-hoke@ncmail.net>, Leslie Brown <Leslie.Brown@ncmail.net></B></div> <bR> <div> <B>Just wanted to express my personal thanks for your willingness to assist with this strategic planning process. Yes it is tedious and we are moving slowing......but we are moving! We in fact have done the following as of today:</B></div> <bR> <div> <B>* Completed a modified SWOT analysis, focusing on the identification of strengthens, weaknesses, and opportunities for clusters and SCPG</B></div> <bR> <div> <B>* Created an opportunity for clusters to discuss the issue of community participation. This opportunity - opened discussion and deliberation for clusters -  if you recall at least allowed two clusters - II and V - to have focused discussions about this issues. I see this as a win win for them and SCPG if we heed what they say!</B></div> <bR> <div> <B>* Have reviewed cluster and SCPG member thoughts and begun to prioritize what is of critical importance and what can wait. We begun the next step of assigning priority issues to SCPG Standing Committees for further development. We also have identified some resources that would be helpful for SCPG members to have as they continue deliberations.</B></div> <bR> <div> <B>* At yesterday's meeting, we identified additional action steps (e.g. how to eliminate mistrust of the State).</B></div> <bR> <div> <B>* Have outlined a process to bring closure to the strategic planning process. If you recalled we began assigning issues & recommendations of priority to Standing committees with the request that these committees...... identify strategies, develop time frame for accomplishment and determine responsibility for achievement).</B></div> <bR> <div> <B>* Assigned ourselves the responsibility of pulling a draft report together for SCPG and hopefully Cluster approval!</B></div> <bR> <div> <B>I know, upon reviewing the meeting evaluation, that some think that yesterday was a waste...we didn't accomplish anything. I fully believe we have indeed made headway....review the list above. I really believe you will be surprised when you review the minutes from yesterday what has been done!</B></div> <bR> <div> <B>I also want to apologize for the 30 minute start delay. As I explained, we were predicting that people would arrive late, therefore everyone was told 11:00 AM when we did not really intend to start until 11:30 AM. BIG MISTAKE WITH THIS GROUP! Please, please for give this error in think! It will not happen again. Time is valuable, especially those who give it freely! So again my apology for the misstep.</B></div> <bR> <div> <B>So I plea with you all to forgive and forget missteps......SCPG needs you, the members of this think tank to help this process along! While closure is good I am hopeful that SCPG members and clusters alike will think creatively about the task at hand to make even a good thing better. I think I am up to the challenge and KNOW you are.</B></div> <bR> <div> <B>Thanks again for your brain power, your commitment, effort and TIME!</B></div> <bR> <div> <B>Phyllis Gray</B></div> <bR> <div> <B>PS Standing Committees will meet on Dec 12 and will begin this process then!</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: Re: SCPG Strategic Planning Effort</B></div> <div> <B>Date: Tue, 19 Nov 2002 13:10:28 -0500</B></div> <div> <B>From: retroart@buncombe.main.nc.us</B></div> <div> <B>To: Phyllis Gray <phyllis.gray@ncmail.net></B></div> <bR> <div> <B>and...</B></div> <bR> <div> <B>Subject: Re: SCPG Strategic Planning Effort</B></div> <div> <B>Date: Tue, 19 Nov 2002 14:58:37 -0500</B></div> <div> <B>From: Phyllis Gray <phyllis.gray@ncmail.net></B></div> <bR> <div> <B>combined...</B></div> <bR> <bR> <div> <B>Phyllis Gray wrote: SWOT analysis</B></div> <bR> <div> <B>kpn wrote: please define "SWOT"</B></div> <bR> <div> <B>Phyllis Gray replied: Definition for SWOT analysis.  A SWOT assessment is a process to identify an organization's strengthens, weaknesses, opportunities, and threats. On those occasions when I have engaged in strategic planning before, SWOT is the 1st step in moving forward with plan development. Are we finished with SWOT? A resounding NO. As both you and Eloise pointed out yesterday, there are external opportunities and threats that will need to be rolled into this thinking process as we push it along.</B></div> <bR> <div> <B>===</B></div> <bR> <div> <B>Phyllis Gray wrote: Have outlined a process to bring closure to the strategic planning process.</B></div> <bR> <div> <B>kpn wrote: Have we ?!?!  This was not my understanding.  As I understood the situation, we would re-convene later in the FY, at which time we could choose to continue or dissolve the WorkGroup.</B></div> <bR> <div> <B>Phyllis Gray replied: Have outlined a process to bring closure to the strategic planning process. As I understood it, the work group had agreed not to meet again immediately, but instead to forward the product of our thinking thus far to the Standing Committees. To me bringing closure to this process would mean that we, the strategic work group, are thinking about how to get a product from all this effort to the clusters. It would mean that we are taking responsibility to making certain the process does not die for lack of action.</B></div> <bR> <div> <B>===</B></div> <bR> <div> <B>Phyllis Gray wrote: Assigned ourselves the responsibility of pulling a draft report together for SCPG and hopefully Cluster approval!</B></div> <bR> <div> <B>kpn wrote: Can you explain this assignment (briefly)?</B></div> <bR> <div> <B>Phyllis Gray replied: Assigned ourselves the responsibility of pulling a draft report together for SCPG and hopefully Cluster approval! - Perhaps I misunderstood what the Work group was saying when folks agreed to reassemble "later in the year". My  interrupted was that with the collective nod agreeing to come back together we were agreeing to serve as the steering committee making certain that there was a draft document, a review process, and a final document. To me this means that by the next time we meet one or two things would have happened: 1.We would receive and review all the work of the Standing Committees and assembly it into a draft produce that would give SCPG as well as Clusters something to react to.  [2 was not included in the response]</B></div> <bR> <div> <B>===</B></div> <bR> <div> <B>Phyllis Gray wrote:  Standing Committees will meet on Dec 12 and will begin this process then!</B></div> <bR> <div> <B>kpn wrote: Which committee(s) will meet on 12/12/02, and when will the TA committee convene?</B></div> <bR> <div> <B>Standing Committees will meet on Dec 12 and will begin this process then! -- ALL STANDING COMMITTEES will meet on the 12th. These are organizational meeting for all committees. At a minimal they need to set up meeting dates to proceed with the assignments we just handed off to them in addition to other pressing SCPG business.</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: [Public Comment on the] Comprehensive HIV Care Plan</B></div> <div> <B>Date: Tue, 19 Nov 2002 15:09:02 -0500</B></div> <div> <B>From: Arthur Okrent <arthur.okrent@ncmail.net></B></div> <div> <B>Organization: N.C. Dept. of Health and Human Services</B></div> <div> <B>To: list removed</B></div> <bR> <div> <B>This is a reminder that we are still accepting suggestions for inclusion in the State's Comprehensive Care Plan, to be submitted as part of our FY 2003 RW application.</B></div> <bR> <div> <B>Please provide us with a synopsis of your proposed ideas for possible inclusion by this Friday, November 22, 2002. A fleshed out version of this synopsis should be submitted by Wed., December 11, 2002, so that these ideas may be considered prior to the public hearing on December 13, 2002 . All proposed changes will be given careful consideration.</B></div> <bR> <div> <B>This will also serve as a reminder that the public hearing will be held on :</B></div> <bR> <div> <B>Friday, December 13, 2002</B></div> <div> <B>10 am to 1 pm</B></div> <div> <B>at the Branch offices,</B></div> <div> <B>Cooper Building, 5th floor</B></div> <div> <B>225 N. McDowell St., Raleigh,</B></div> <bR> <div> <B>All submissions may be made to</B></div> <bR> <div> <B>Arthur Okrent, AIDS Care Branch</B></div> <div> <B>1902 Mail Service Center</B></div> <div> <B>Raleigh, NC 27699-1902</B></div> <div> <B><</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:arthur.okrent@ncmail.net" TARGET="_top" TITLE="mailto:arthur.okrent@ncmail.net"><U><B>mailto:arthur.okrent@ncmail.net</B></U></A></FONT><B>> (preferred)</B></div> <div> <B>(919) 715-3118</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: CDC Funded Prevention: US success rate is about 1:600 ? (NC = 1:12,800 ?)</B></div> <div> <B>Date: Tue, 26 Nov 2002 11:00:36 -0500</B></div> <div> <B>From: retroart@buncombe.main.nc.us</B></div> <div> <B>To: 8 - Phyllis Gray <phyllis.gray@ncmail.net>, "7.9 - epi staff" <epi.hivstd.prevstaff@ncmail.net></B></div> <div> <B>CC: "7.9 - epi.hivstd.scpg" <epi.hivstd.scpg@ncmail.net></B></div> <bR> <bR> <div> <B>Phyllis:</B></div> <bR> <div> <B>Last night I sent this article (attached) to the NC SCPG members, absent commentary.  David Holtgrave, who is referred to as a former AIDS expert at the U.S. Centers for Disease Control and Prevention (CDC), who now teaches health policy at Emory University in Atlanta, appears to be the external spokesperson for the CDCs objective to obtain another $300 million for a four year grant cycle ($1.2 billion).</B></div> <bR> <div> <B>It's an interesting number ($300 million per year), but the articles' claims are peculiar to be polite.  Of course, Mr. Holtgrave doesn't currently work for the CDC, so holding that agency responsible for the claims isn't possible - that's bureaucracy at its best.  And of course, comparing the epidemic in Africa (mostly 3rd world countries) to the epidemic in the west, simply isn't sensible, as most 3rd world countries have a minimal health infrastructure.</B></div> <bR> <div> <B>Now here's some other mathematical modeling.  If Mr. Holtgrave were correct in some of his assumptions...</B></div> <bR> <div> <B>"$300 million a year for four years" --- How would he propose to fund the rest of the epidemic, which will probably last a hundred years? (Until 2075 that is.)  The cost projections for increased funding from 2007 through 2075 (68 years) would be approximately $20,400,000,000.00, if one doesn't account for inflation.</B></div> <bR> <div> <B>"cost per infection prevented would be around $6,400" --- At $6,400, Mr. Holtgrave's estimate would seem to imply that the $65,000 (+ or -) our local ASO receives each year only prevents roughly 10 new infections. That's a poor return on about 6,000 contacts (+ or -) during the same time frame.  It would seem to imply that the success rate is about 1:600.</B></div> <bR> <div> <B>"He came up with four different scenarios for the course of the AIDS epidemic in the United States" --- This quote speaks for itself.</B></div> <bR> <div> <B>These are just a few examples of why you can't believe everything you read in the funny papers.  I make this point because I would like to caution the NC DHHS AIDS Care & Prevention Branch, that any legislation presented to the NC House or Senate in the upcoming year, should be scrutinized by the SCPG for its mathematical modeling.</B></div> <bR> <div> <B>The last legislation that was presented to fund prevention with state revenues ($300,000 for 600,000 contacts), proposed that the cost per contact was to be about 50 cents per person, which left me to question the credibility of an Elder SCPG member who was supporting the Bill.  At 50 cents per person, with an average cost of $6,400 per successful intervention, using Mr. Holtgrave's math, we might say that the proposed success rate for state funded prevention, was more likely to be in the arena of 1:12,800.</B></div> <bR> <div> <B>kpn</B></div> <bR> <div> <B>--- page break ---</B></div> <bR> <div> <B>Subject: Nov 22 (Reuters) - Re: AIDS prevention efforts</B></div> <div> <B>Date: Mon, 25 Nov 2002 21:12:08 -0500</B></div> <div> <B>From: retroart@buncombe.main.nc.us</B></div> <div> <B>To: "7.9 - epi staff" <epi.hivstd.prevstaff@ncmail.net></B></div> <div> <B>CC: "7.9 - epi.hivstd.scpg" <epi.hivstd.scpg@ncmail.net></B></div> <bR> <div> <B>AIDS prevention saved up to 1.5 million -US study</B></div> <div> <B>By Maggie Fox, Health and Science Correspondent</B></div> <bR> <div> <B>WASHINGTON, Nov 22 (Reuters) - AIDS prevention efforts across the United States, including programs to promote the use of condoms and focus groups aimed at drug users, have saved hundreds of thousands of lives, researchers said on Friday.</B></div> <bR> <div> <B>Although the number of new infections has stayed level at about 40,000 a year for the past decade, many more people would have become infected with the AIDS virus if prevention programs had not been in place, the researchers said.</B></div> <bR> <div> <B>"We have prevented enough HIV infections to be the equivalent of the population of a small to large U.S. city,'' David Holtgrave, a former AIDS expert at the U.S. Centers for Disease Control and Prevention who now teaches health policy at Emory University in Atlanta, said in a telephone interview.</B></div> <bR> <div> <B>It was not hard to find out what would happen without AIDS prevention efforts. Most HIV cases are in Africa, in countries too poor to do much at all to control the deadly and incurable virus.</B></div> <bR> <div> <B>Holtgrave looked at infection rates in those countries and also looked at theoretical scientific models of epidemics. He came up with four different scenarios for the course of the AIDS epidemic in the United States. The number of potential infections prevented ranged from 200,000 to more than 1.5 million, he wrote in his report, published in the journal AIDS.</B></div> <bR> <div> <B>"That's a broad range, but it reflects that there is no certainty,'' he said.</B></div> <bR> <div> <B>An estimated 5 million Americans are at risk of getting HIV -- 1 million drug users, who can be infected from shared needles, and 4 million men and women at risk of being infected sexually.</B></div> <bR> <div> <B>Most prevention programs target these groups. "They include HIV counseling and testing, risk reduction counseling and small group risk reduction interventions,'' Holtgrave said.</B></div> <bR> <div> <B>"For example, you get six or so people together and talk about how HIV is transmitted and how people can protect themselves.''</B></div> <bR> <bR> <div> <B>GOVERNMENT NOT SPENDING MORE</B></div> <bR> <div> <B>To keep up this level of effort would require more money, but the government is not spending more, Holtgrave said. "To really give everybody at risk of HIV infection in the United States really state-of-the-science prevention services, you would probably need to increase prevention efforts by $300 million a year for four years,'' he said.</B></div> <bR> <div> <B>"We're not seeing that kind of expansion.''</B></div> <bR> <div> <B>The current budget provides no more money than last year for HIV prevention efforts, Holtgrave said.</B></div> <bR> <div> <B>This makes little sense as it costs much less to prevent HIV than to treat it, Holtgrave and other experts say. If 200,000 deaths have been prevented, Holtgrave estimates it costs about $50,000 to prevent each infection, versus $150,000 to $195,000 to treat someone for HIV for the rest of his or her life.</B></div> <bR> <div> <B>If the actual number of infections prevented were closer to his top estimate of 1.5 million, then the cost per infection prevented would be around $6,400.</B></div> <bR> <div> <B>"These analyses do not include other real benefits of prevented HIV infections such as increased worker productivity and decreased pain and suffering,'' Holtgrave said.</B></div> <bR> <div> <B>Worldwide 25 million people have died of AIDS. In the United States 450,000 have died of AIDS since the epidemic began in the early 1980s.</B></div> <bR> <div> <B>Reuters, 11-25-02</B></div> <bR> <div> <B>+-+-+-+-+</B></div> <bR> <div> <B>Subject: Re: CDC Funded Prevention: US success rate is about 1:600 ? (NC = 1:12,800 ?)]</B></div> <div> <B>Date: Wed, 27 Nov 2002 10:24:44 -0500</B></div> <div> <B>From: "Charles Lee" <chlee101@charter.net></B></div> <div> <B>To: <retroart@buncombe.main.nc.us></B></div> <div> <B> References: 1</B></div> <bR> <div> <B>I am still amused by the 1.5 million claim. There are too many uncontrolled and/or uncontrollable variables involved. Lack of a health care infrastructure, as you point out, literacy levels, psycho-sexual-religious-social values and attitudes, communications</B></div> <div> <B>infrastructure, economics, etc....   A basic question might be asking</B></div> <div> <B>why USA prevention efforts and HIV rates haven't been compared to countries in the developed world. That comparison might be more revealing. CHL</B></div> <bR> <div> <B>+-+-+-+-+</B></div> <bR> <div> <B>Subject: Re: CDC Funded Prevention: US success rate is about 1:600 ? (NC = 1:12,800 ?)</B></div> <div> <B>Date: Tue, 26 Nov 2002 17:44:27 -0500</B></div> <div> <B>From: Phyllis Gray <phyllis.gray@ncmail.net></B></div> <div> <B>Organization: N.C. Dept. of Health and Human Services</B></div> <div> <B>To: retroart@buncombe.main.nc.us</B></div> <div> <B>References: 1</B></div> <bR> <div> <B>Very Interesting.............There is one thing to be said about funding for prevention, I bet it will even be more difficult to get out of the General Assembly given what is projected....2 billion shortfall! And yes, SCPG should take an active role in advocating for prevention funding...be it state or federal. See ya!</B></div> <bR> <div> <B>Phyllis G</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>HHS News</B></div> <bR> <div> <B>US Department of Health and Human Services </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.hhs.gov/news" TARGET="_top" TITLE="http://www.hhs.gov/news"><U><B>http://www.hhs.gov/news</B></U></A></FONT></div> <bR> <div> <B>FOR IMMEDIATE RELEASE</B></div> <div> <B>Thursday, November 14, 2002</B></div> <div> <B>Contact: HRSA Press Office</B></div> <div> <B>(301) 443-3376</B></div> <bR> <div> <B>HHS Creates Unified HIV/AIDS and STD Advisory Committee to Strengthen Prevention and Treatment Efforts</B></div> <bR> <div> <B> HHS Secretary Tommy G. Thompson today announced the creation of a new, unified HIV/AIDS and STD prevention and treatment advisory committee to strengthen collaboration in these activities throughout the department.</B></div> <bR> <div> <B> The new committee merges the Centers for Disease Control and Prevention's Advisory Committee for HIV and STD Prevention (ACHSP) and the Health Resources and Services Administration's AIDS Advisory Committee (HAAC) into a single advisory panel. All current members of both committees will become members of the new committee. Both committees advise HHS on AIDS and STD prevention, care and treatment issues and have occasionally met jointly over the past two years.</B></div> <bR> <div> <B> "This merger puts the best of both worlds - prevention and treatment - together for the benefit of all who are affected by this illness," Secretary Thompson said. "Uniting the top people from both fields in a one committee will spark greater ingenuity and improved coordination as we continue our war against the national and global menace of HIV and AIDS."</B></div> <bR> <div> <B> The merged committee will advise the Secretary, CDC, and HRSA on the full range of issues addressed by the existing committees. This will include identifying objectives, strategies, policies and priorities for HIV/AIDS and STD prevention, care and treatment efforts. The merger is intended to encourage even greater inter-agency synergy across the spectrum of prevention and care.</B></div> <bR> <div> <B> "Combining these committees will make us more efficient, more innovative, and more accurate in targeting our efforts against HIV/AIDS," said Elizabeth M. James Duke, Ph.D, Administrator of the Health Resources and Services Administration (HRSA). "We applaud the Secretary's decision and are delighted to join CDC in this enterprise."</B></div> <bR> <div> <B> "It makes perfect sense to integrate these two important committees. As a former AIDS clinician, I fully appreciate the close interrelationship between prevention and treatment," said Dr. Julie Gerberding, Director of the Centers for Disease Control and Prevention (CDC).</B></div> <bR> <div> <B> As the merger begins, each of the existing HRSA and CDC committees will meet one last time. Then, beginning in 2003, the newly chartered Advisory Committee will meet approximately twice per year.</B></div> <bR> <div> <B> The CDC/HRSA Advisory Committee on HIV and STD Prevention and Treatment will continue to consist of members knowledgeable in the fields of public health, epidemiology, laboratory practice, immunology, infectious disease treatment, drug abuse, behavioral science, health education, health care delivery, and community health center management.</B></div> <bR> <bR> <div> <B>Note: All HHS press releases, fact sheets and other press materials are available at </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://www.hhs.gov/news" TARGET="_top" TITLE="http://www.hhs.gov/news"><U><B>http://www.hhs.gov/news</B></U></A></FONT></div> <bR> <bR> <div> <B>LCDR Jeff Bosshart, MSW, MPHHIV/AIDS</B></div> <div> <B>Coordinator & Title II Project Officer</B></div> <div> <B>HRSA Atlanta Field Office</B></div> <div> <B>61 Forsyth St., SW, #3M60</B></div> <div> <B>Atlanta, GA 30303</B></div> <div> <B>Phone: 404-562-4195</B></div> <div> <B>Fax: 404-562-7974</B></div> <div> <B>EMail: <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:jbosshart@hrsa.gov" TARGET="_top" TITLE="mailto:jbosshart@hrsa.gov"><U><B>mailto:jbosshart@hrsa.gov</B></U></A></FONT><B>></B></div> <bR> <div> <B>HRSA Southeast Field Office: Serving the States of AL, FL, GA, KY, MS, NC, SC and TN.</B></div> <bR> <div> <B>To learn more about HIV/AIDS Bureau programs and funding opportunities see our website at: </B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="http://hab.hrsa.gov" TARGET="_top" TITLE="http://hab.hrsa.gov"><U><B>http://hab.hrsa.gov</B></U></A></FONT></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: Hotel Accomodations for World AIDS Day</B></div> <div> <B>Date: Mon, 02 Dec 2002 15:19:26 -0500</B></div> <div> <B>From:  Laura Parrish <laura.parrish@ncmail.net></B></div> <div> <B>Organization: N.C. Dept. of Health and Human Services</B></div> <div> <B>To: list removed</B></div> <bR> <bR> <div> <B>Hello all!  This is to let you know that your accommodations for World AIDS Day have been made at the Ameri-Suites on Wake Forest Rd. behind Bahama Breeze right off the beltline.  Their phone number is (919) 877-9997 in case you get lost or need to make specific arrangements (i.e., smoking room, double beds, etc)  You will not need a credit card or other form of payment for this room, they are direct billing the Branch.  If you have any questions or problems please call me ASAP and let me know what I can do for you.  Directions follow.</B></div> <bR> <div> <B>~misslaura</B></div> <bR> <div> <B>From points West</B></div> <div> <B>Get on I-40E</B></div> <div> <B>Exit onto I-540 (right after Miami Blvd)</B></div> <div> <B>Exit onto Falls of the Neuse Rd. (this will turn into Wake Forest Rd) Go past BoJangles, Wendy's, then the North Raleigh Hilton Bahama Breeze is right there on the right TURN RIGHT AT THE LIGHT ON NAVAHO DR Ameri-Suites is at the top of the hill on the right</B></div> <bR> <bR> <div> <B>From Points East</B></div> <div> <B>Take I-40 West to the beltline exit that says "440 Raleigh NORTH  -</B></div> <div> <B>EAST)</B></div> <div> <B>Get off on Wake Forest Rd Exit</B></div> <div> <B>Turn Right at bottom of exit</B></div> <div> <B>Turn left at first light on Navaho Dr</B></div> <div> <B>Ameri-Suites is at the top of the hill on the right.</B></div> <bR> <bR> <div> <B>TO WORLD AIDS DAY FROM THE HOTEL</B></div> <div> <B>Go right on Wake Forest Rd.</B></div> <div> <B>Once you pass Miami Subs get in the right lane and continue to drive forward the road will split (stay to the right going DOWNTOWN) go into downtown turn left at the first light (Jones St.) go to the 2nd light and turn right onto Salisbury The Sheraton is approx 6 lights down on the left.</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: SCPG Action Alert</B></div> <div> <B>Date: Wed, 04 Dec 2002 14:05:52 -0500</B></div> <div> <B>From: Sarah Langer <sarah.langer@ncmail.net></B></div> <div> <B>Organization: N.C. Dept. of Health and Human Services</B></div> <div> <B>To: retroart@buncombe.main.nc.us</B></div> <bR> <bR> <div> <B>Kevin,</B></div> <bR> <div> <B>Here are your plain text requests:</B></div> <bR> <bR> <div> <B>[Voting Members of the NC DHHS SCPG]</B></div> <bR> <div> <B>Phyllis Gray, State Chair</B></div> <div> <B>Rick Rouse, State Chair</B></div> <div> <B>Verb Abraham, Region I Chair</B></div> <div> <B>Kevin Nuttall, Region 1 Chair</B></div> <div> <B>Lizzi Torrone, Region II Chair</B></div> <div> <B>Arvelle Isbell, Region II Chair</B></div> <div> <B>Caroline Moseley, Region III Chair</B></div> <div> <B>Thomas Clarke, Region III Chair</B></div> <div> <B>Pat Amaechi, Region IV Chair</B></div> <div> <B>James Bagley, Region IV Chair</B></div> <div> <B>Mima Allende, Region V Chair</B></div> <div> <B>Anthony Daniels, Region V Chair</B></div> <div> <B>Edwin Cutler, Region VI Chair</B></div> <div> <B>Yvonne Early, Elder</B></div> <div> <B>Eloise Hicks, Elder</B></div> <div> <B>Pastor EL White, Elder</B></div> <div> <B>Pastor Gwen Curry, Elder</B></div> <div> <B>Kathy Norcott, Regional At Large III</B></div> <div> <B>Jacqueline Clymore, Regional At Large IV</B></div> <div> <B>Brenda L Hunt, State At Large</B></div> <div> <B>Reggie Silver, State At Large (Faith)</B></div> <div> <B>Sherry Lehman, State At Large (DPI)</B></div> <div> <B>Amaka Flynn, State At Large (Care Unit)</B></div> <div> <B>Dr. Bert Bennett, State At Large (Mental Health)</B></div> <div> <B>Melissa Green, State At Large (OMH/HD)</B></div> <bR> <div> <B>Vacant (12/4/02)</B></div> <div> <B>Region VI Co-Chair</B></div> <div> <B>Region VII Co-Chairs</B></div> <div> <B>Regional At Large for Regions I-II & V-VII</B></div> <div> <B>State At Large (Youth)</B></div> <bR> <div> <B>***</B></div> <bR> <div> <B>December 4, 2002</B></div> <bR> <div> <B>AN ACTION ALERT FROM YOUR CO-CHAIRS</B></div> <bR> <div> <B>We call your attention to the items below. Please make note and respond to those needing immediate attention as soon as possible. Thank you!</B></div> <bR> <bR> <bR> <div> <B>*Next SCPG meeting On December 12th, 2002</B></div> <bR> <div> <B>The next SCPG meeting is scheduled for December 12, from 10:00 AM - 3:00 PM at the Cooper Building, 5th floor conference room. Only half of the SCPG members RSVP'd by the November 31st date.  If you are planning to attend, please contact Laura Parrish at 919.733.9568.</B></div> <bR> <bR> <bR> <div> <B>Attached is the draft agenda for the SCPG meeting.  It is a full schedule, so please be on time so the meeting can begin promptly. SCPG members wishing to add to the agenda may do so prior to the meeting or at the time the agenda is reviewed.  Additionally, please review the October 22, 2002 meeting minutes prior to the meeting.</B></div> <bR> <div> <B>For those attending the Governor's World AIDS Day Event (WAD) and requested a hotel room the evening of December 11th, you will be staying at the Ameri-Suites on Wake Forest Road, behind Bahama Breeze, right off the beltline. Please call Ms. Parrish if you are unsure of your hotel status, as only a small number of members reserved a room. If you need to make a special arrangement, or reserve a room on your own, please call the hotel at (919) 877-9997.</B></div> <bR> <bR> <bR> <div> <B>* Strategic Planning Meeting</B></div> <bR> <div> <B>The Strategic Planning Work Group convened on November 18th. A draft report from this meeting is being finalized by the Work Group members and will be e-mailed to you prior to the December 12th meeting.  Copies will also be available at the meeting.</B></div> <bR> <bR> <bR> <div> <B>* Public Forum on NC Ryan White Title II Comprehensive Plan on December</B></div> <div> <B>13th:</B></div> <bR> <div> <B>HRSA (Health Resources and Services Administration) has required all states receiving Ryan White Title II funding to develop and submit as part of their annual application a comprehensive plan for HIV services. The plan is to be updated every three years and is to be for each state "a road map for the incremental development of a system of care over the longer term." The SCPG did not submit any comments on the Plan. However, if you would still like to provide input on the application and plan, there will be a Public Hearing on December 13th, from 10:00 AM-1:00 PM, at the Cooper Building, 5th Floor Conference Room, in Raleigh.</B></div> <bR> <bR> <bR> <bR> <div> <B>* Meeting Schedules Requested For Regional Clusters</B></div> <bR> <div> <B>As a reminder, the SCPG co-chairs would like to meet with each Cluster at least once during FY 2002-03. This request is part of the strategic planning process with a goal of increasing community participation in the SCPG planning process. If you have not done so already, please bring your calendars to the December 12th meeting.</B></div> <bR> <bR> <bR> <bR> <div> <B>DRAFT NC HIV Statewide Community Planning Group</B></div> <bR> <div> <B>12/12/2002</B></div> <div> <B>9:30 AM to 3:00 PM</B></div> <div> <B>Cooper Building, 225 North McDowell St</B></div> <div> <B>5th Floor Conference Room</B></div> <div> <B>Raleigh, NC</B></div> <bR> <bR> <div> <B>Please read: Minutes from 10/22/02, 2nd Report from Strategic Planning Workgroup</B></div> <bR> <div> <B>----- Agenda Topics -----</B></div> <bR> <div> <B>* Call To Order, Welcome/Introductions, Agenda Review  Co-Chair 10:00 am</B></div> <bR> <div> <B>* Special Presentations  10:15AM - 11:15AM</B></div> <bR> <div> <B>* Resources Available From National AIDS Education & Services for Minorities (NAESM) Robert Scott</B></div> <bR> <div> <B>* Epid Profile 2003 Overview Bill Jones</B></div> <bR> <div> <B>* Report from the Road Mapping/Strategic Planning Workgroup  11:15 AM</B></div> <bR> <div> <B>* Lunch: Sub-Committees are asked to sit together for lunch  12:00 Noon</B></div> <bR> <div> <B>* Reading & Approval of the Minutes</B></div> <bR> <div> <B>* Resolution of Remaining Parking Lot Issues  12:45 PM</B></div> <bR> <div> <B>* Report From the Clusters  1:00 PM</B></div> <bR> <div> <B>* Report From the Branch & Prevention Unit  1:45 PM</B></div> <bR> <div> <B>* Nominations to NCAAC  2:00 PM</B></div> <bR> <div> <B>* New Business  2:15 PM</B></div> <bR> <div> <B>* Announcements  2:45 PM</B></div> <bR> <div> <B>* Adjourn  3:00 PM</B></div> <bR> <div> <B>Other Information</B></div> <bR> <bR> <div> <B>Sarah Langer</B></div> <div> <B>Public Health Program Consultant</B></div> <div> <B>HIV/STD Prevention & Care Unit</B></div> <div> <B>North Carolina Department of Health and Human Services <</B><FONT SIZE="3" COLOR="#0000FF" FACE="Times New Roman" ><A HREF="mailto:sarah.langer@ncmail.net" TARGET="_top" TITLE="mailto:sarah.langer@ncmail.net"><U><B>mailto:sarah.langer@ncmail.net</B></U></A></FONT><B>> 225 N. McDowell Street 1902 Mail Service Center Raleigh, NC 27699-1902</B></div> <div> <B>Fax: 919-733-1020</B></div> <div> <B>Work: 919-733-9558</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: [Fwd: SCPG ByLaws Contradiction?]</B></div> <div> <B>Date: Fri, 29 Nov 2002 20:21:03 -0500</B></div> <div> <B>From: retroart@buncombe.main.nc.us</B></div> <div> <B>To: "8.88 - Evelyn Foust" <evelyn.foust@ncmail.net></B></div> <div> <B>CC: "8.8 - Steve Sherman" <steve.sherman@ncmail.net></B></div> <bR> <bR> <bR> <bR> <div> <B>fyi</B></div> <bR> <div> <B>----- original message -----</B></div> <div> <B>Subject: Re: SCPG ByLaws Contradiction?</B></div> <div> <B>Date: Fri, 29 Nov 2002 20:18:33 -0500</B></div> <div> <B>From: retroart@buncombe.main.nc.us</B></div> <div> <B>To: 8 - Phyllis Gray <phyllis.gray@ncmail.net></B></div> <div> <B>CC: "7.9 - epi staff" <epi.hivstd.prevstaff@ncmail.net>, "7.9 - epi.hivstd.scpg" <epi.hivstd.scpg@ncmail.net>, "7.1 - Vern L. Abraham" <mjhmeach@aol.com></B></div> <bR> <bR> <bR> <div> <B>Phyllis et al:</B></div> <bR> <div> <B>In stating the following concern, for consideration by the full body of the SCPG, I will assume that the version of the ByLaws (aka Charter) distributed at the 8/19-8/20, 2002 SCPG Training Summit, were current at the time of disbursement, and to date, remain so.</B></div> <bR> <div> <B>--- page break ---</B></div> <bR> <div> <B>Article III.   Roles and Responsibilities</B></div> <div> <B>     Section 3.  Shared responsibility</B></div> <div> <B>          [item] 2.  Determine the distribution of planning funds to support  a) SCPG and RCPG meetings...</B></div> <bR> <div> <B>My concern in reference to this subparagraph (III. 3. 2.), is that the Branch does not appear to have "shared" their responsibility with the SCPG when choosing to de-fund "clusters" (aka RCPG).  Therefore, please prepare an explanation for the general membership of the SCPG on December 12, 2002, as to if/how the Branch has contradicted this ByLaw, and if so, what corrective measures might occur in response.</B></div> <bR> <bR> <div> <B>respectfully submitted,</B></div> <bR> <div> <B>Kevin P. Nuttall - "NK0525611"</B></div> <div> <B>State & Federal Affairs Director</B></div> <div> <B>North Carolina AIDS Policy Center</B></div> <div> <B>81 Baird Street, Suite 105</B></div> <div> <B>Asheville, NC 28801-2093</B></div> <div> <B>p: 828.251.2229 / f: 828.285.0080</B></div> <div> <B>retroart@buncombe.main.nc.us</B></div> <bR> <bR> <bR> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <div> <B>>>> Document Separator <<<</B></div> <div> <B>>>>>>>>>>>><<<<<<<<<<<</B></div> <bR> <bR> <bR> <div> <B>Subject: How prevention funds are distributed in NC</B></div> <div> <B>Date: Wed, 27 Nov 2002 10:17:58 -0500</B></div> <div> <B>From: retroart@buncombe.main.nc.us</B></div> <div> <B>To: 8 - Phyllis Gray <phyllis.gray@ncmail.net>, "7.9 - epi.hivstd.scpg" <epi.hivstd.scpg@ncmail.net></B></div> <div> <B>BCC: "7.1 - Vern L. Abraham" <mjhmeach@aol.com></B></div> <bR> <div> <B>Phyllis:</B></div> <bR> <div> <B>As you recall, I had asked in August for a detailed report (line item) on how NC spends down the funds it receives for HIV prevention each year from the CDC.  In a report distributed by NASTAD on 11/13/02 in Charlotte, NC, it details that NC received $5,676,572 for FY 2001.  Of this sum, $4,332,890 was received through the Prevention Cooperative Agreement.  Another $295,635 was received through the Surveillance Cooperative Agreement.</B></div> <bR> <div> <B>These are the funding streams which I and others on SCPG would be interested in reviewing, with exacting detail - the line item please?</B></div> <bR> <div> <B>thanks in advance,</B></div> <div> <B>kpn</B></div> </td> </tr></table></body>