Integrating Peer Educators into Medical Care Teams
To train HIV+ community members as Peer Educators to work with medical staff connecting the most vulnerable HIV population to outpatient health services, increase medication adherence, and reduce ER visits and hospitalizations to save money and improve health outcomes for low income HIV+ men and women of color in NYC.
About You
Section 1: You
First Name
Anne
Last Name
West-Church
Website URL
Organization
AIDS Service Center NYC
Country
United States, NY
Section 2: Your Organization
Organization Name
AIDS Service Center NYC
Organization Website
http:// www.ascnyc.org
Organization Phone
212-645-0875, ext 373
Organization Address
41 East 11th Street, 5th Floor
Is your organization a
Non‐profit/NGO/citizen sector organization
Organization Country
United States, NY
Your idea
Name Your Project
Integrating Peer Educators into Medical Care Teams
Country and state your work focuses on
United States, NY
Describe Your Idea
To train HIV+ community members as Peer Educators to work with medical staff connecting the most vulnerable HIV population to outpatient health services, increase medication adherence, and reduce ER visits and hospitalizations to save money and improve health outcomes for low income HIV+ men and women of color in NYC.
Website URL
Innovation
What makes your idea unique?
A great majority of people living with HIV/AIDS in NYC have benefitted enormously from treatment advances, however, there is a large residual sub-population who, for myriad reasons, are unable to successfully engage in medical care. Many are homeless and at risk of progressive physical debilitation due to untreated HIV/AIDS, poverty, and/or concomitant mental health and substance abuse challenges. The continuing disproportionate AIDS morbidity and mortality concentrated among low income ethnic minority communities in NYC reflects a systemic failure to provide effective medical care. ASCNYC’s program, Integrating Peer Educators into Medical Care Teams will train, supervise and match Peer Educators with medical teams at Mt. Sinai, NY Presbyterian, and St. Vincent’s Hospitals, building upon existing agency partnerships. ASCNYC will provide Peers with advanced skills training and ongoing supervision on: Communicating with doctors, nurses and other clinic staff; HIPAA laws/ Confidentiality; Case Finding, Peer Coaching and Client Engagement to connect clients (and their partners) with HIV/STI and related medical care; Medication Adherence Strategies; Maintaining Boundaries; Cultural Competence; and Safety Issues. Peers will contribute to case finding, connection to HIV/STI testing and treatment, and maintenance in care, through peer coaching, accompaniment, and communication with medical partners.
Do you have a patent for this idea?
Impact
This Entry is about (Issues)
What impact have you had?
ASCNYC is proud to be growing our programs, service sites, and jobs, despite the current downturn in the economy. Since 1992, ASCNYC’s extensive Peer Education & Capacity Skills Training Program infuses every aspect of our programming and forms the “heart and soul” of our agency. The Peer Program provides skills, opportunities, and services for active and recovering substance users, women, ex-offenders, and other at-risk, underserved subpopulations.
Each year, through paid internships, mentoring, support groups, and other services, ASCNYC sponsors 40¬¬-50 trained Peer Educators who serve as inspiring examples of the possibility of change in communities at risk. Armed with skills and information, these Peer Educators provide high-risk communities throughout the city with outreach and prevention education on HIV, substance use, hepatitis, and sexually transmitted infections, along with other key services. Peers consistently attest to the program’s impact in helping them improve health, rebuild their self-esteem, and is a cost effective approach to the delivery of HIV healthcare services for people living with HIV/AIDS in NYC.
Key accomplishments:
• In 2009, ASCNYC Peer Educators conducted 3,577 community outreach initiatives reaching 14,691 New York City residents. More than 40,000 condoms and safer sex kits were distributed to men and women at risk during these outreach efforts.
• More than 25% of ASCNYC’s full-time staff are former clients or Peers, attesting to our success in helping to transform the lives of those we serve.
• Of the program’s more than 350 graduates, 75% have gone on to become ASCNYC volunteers, interns, or paid employees of ASCNYC or other agencies. Many have earned their GED; still others have gone back to college.
Problem
A great majority of people living with HIV/AIDS in NYC have benefitted enormously from treatment advances, however, there is a large residual sub-population who, for myriad reasons, are unable to successfully engage in medical care. Many are homeless and at risk of progressive physical debilitation due to untreated HIV/AIDS, poverty, and/or concomitant mental health and substance abuse challenges. The continuing disproportionate AIDS morbidity and mortality concentrated among low income ethnic minority communities in NYC reflects a systemic failure to provide effective medical care.
Research has demonstrated that HIV+ patients are more likely to take medication and stay connected to care when they have the support of those who have experienced the same challenges. In our new approach to healthcare, Peer Educators will connect these most vulnerable HIV populations to outpatient services, escorting them to medical appointments, helping them understand their doctors, increasing medication adherence, and reducing ER visits and hospitalizations.
Actions
ASC will provide advanced skills training and ongoing supervision/support groups to Peer Educators on: Communicating with doctors, nurses and other clinic staff; HIPAA laws/ Confidentiality; Case Finding, Peer Coaching and Client Engagement to connect clients (and their partners) with HIV/STI and related medical care; Medication Adherence Strategies; Maintaining Boundaries; Cultural Competence; and Safety Issues.
Key Steps:
Increase CONNECTION to quality HIV medical care by creating medical care teams, comprised of Physician, Case Manager, and Peer Educator, providing education and escorts to care appointments.
Enhance RETENTION by providing Peer support, medication adherence education, and escorts to medical appointments to alleviate participants’ barriers to establishing regular HIV care.
EMPOWER Peers and participants to establish and maintain healthy behavioral changes over time.
EVALUATE interventions and document project successes for replication.
Lack of funding and visibility are the main barriers to the success of this innovative program.
Results
Peer Educators will connect the most vulnerable HIV population to medical care. ASCNYC Peers consistently attest to the program’s impact in helping them improve their health, sustain long-term recovery, and rebuild their self-esteem. More than 25% of ASCNYC’s full-time staff are former clients or Peers, illustrating the program’s success in helping Peers to transform their lives. Peers are potent sources of hope, help, and support. This program is an investment in a cost effective approach to the delivery of HIV healthcare services, and will lead to long-term effective care, stability, and enhanced health outcomes for people living with HIV/AIDS in NYC.
What will it take for your project to be successful over the next three years? Please address each year separately, if possible.
YEAR 1 – Secure program funding and develop curriculum. ASCNYC will also begin the application process to select Peer Educators for the training. Collect data on program outcomes. After training is complete, match Peer Educators with doctors and hospitals and ASCNYC case management staff to ensure team-building and communication with the medical sites. Set up support system for the Peer Educators to address any recovery or issues that emerge. ASCNYC will secure office space near the various hospitals as a base for Peer Educators to work from.
YEAR 2 – Review successes/challenges and address in subsequent training cycles. Expand to other hospitals. Set up a calendar of trainings over the next 2 years. Increase the visibility of the program and its success using social media, website and personnel. Publish story and data in notable sources for maximum impact and exposure.
YEAR 3 – Continue to update training materials and leading efforts to replicate program nationally.
What would prevent your project from being a success?
Funding would be the major obstacle to this project’s success; however, we have reached out to multiple funding sources to support this program. In addition, ASCNYC is leveraging our over 18 years experience training community members as Peer Educators, but without funding for our innovative healthcare approach, we will not be able to implement a training program to integrate Peer Educators into medical care teams. To ensure program success, ASCNYC is seeking philanthropic support, as well as government program support to fund the total cost of the program. ASCNYC received a 5-year grant in 2009 from the Substance Abuse & Mental Health Services Administration with funding for ASCNYC’s Peer Education Program. ASCNYC has also submitted discretionary funding requests to New York City and State officials to support Peer Internship stipends for FY2011.
How many people will your project serve annually?
1001‐10,000
What is the average monthly household income in your target community, in US Dollars?
$100 ‐ 1000
Does your project seek to have an impact on public policy?
Yes
Sustainability
What stage is your project in?
Operating for more than 5 years
In what country?
United States, NY
Is your initiative connected to an established organization?
Yes
If yes, provide organization name.
AIDS Service Center NYC
How long has this organization been operating?
More than 5 years
Does your organization have a Board of Directors or an Advisory Board?
Yes
Does your organization have any non-monetary partnerships with NGOs?
Yes
Does your organization have any non-monetary partnerships with businesses?
Yes
Does your organization have any non-monetary partnerships with government?
No
Please tell us more about how these partnerships are critical to the success of your innovation.
ASCNYC has cultivated numerous partnerships and reciprocal referral relationships with medical providers, HIV Special Needs Plans, and service organizations across New York City that ensure an integrated care approach for people living with and at risk for HIV/AIDS.
ASCNYC facilitates expedited access to medical services to meet client needs ranging from primary medical care to HIV/STI screening. These “fast-track” medical referral partnerships enable ASCNYC clients to establish or renew connections to medical care and are particularly helpful for clients who otherwise would not access needed services. Through these expedited referral relationships with medical providers, ASCNYC clients—active and recovering substance users, women, ex-offenders, persons with HIV/AIDS, and other at-risk, underserved, “hard-to-reach” populations—benefit from being able to obtain same day appointments with medical providers. In order to further ensure maintenance in care, ASCNYC provides client escorts to these medical appointments.
What are the three most important actions needed to grow your initiative or organization?
Secure funding, finalize training/implementation, and replicate the program.
The Story
What was the defining moment that led you to this innovation?
ASC is one of only a handful of NYC community HIV service organizations to receive federal Ryan White funding through relationships with our three priority hospital partners. Through our unparalleled relationships with hospitals and our dedicated staff, many former clients themselves, we connect people living with HIV/AIDS to the best medical care and social programs that improve their health and advance their personal goals.
The culture of ASCNYC is nurturing and supportive. We have a diverse, cooperative team-based approach that is committed to a shared vision, with the discipline, creativity, tenacity and accountability to achieve our mission.
ASCNYC uses an approach called harm reduction to “meet clients where they are at” by providing culturally appropriate services. ASC’s experience mediating between HIV prevention, service goals, and the harsh realities of our clients’ lives has fostered an organizational value system that explicitly addresses the link between poverty, HIV/AIDS, substance use, and other poor health outcomes among low-income communities of color.
ASCNYC’s visionary Executive Director/CEO, Sharen Duke, identified a need to connect and maintain HIV+ New Yorkers into medical care and created a successful business model that defined roles for Peer Educators as a community provider in the context of medical service delivery for people living with HIV/AIDS. Our service plan not only benefits clients but also the hospitals treating them—it is a win-win partnership for health outcomes. From nationally acclaimed peer training to medical care coordination, substance abuse counseling to support groups, we treat the whole person—body, mind, and spirit—building community, connection, and stability for the thousands of New Yorkers we serve each year. Our innovative partnerships with medical providers help more people; make a bigger impact, save money, and saves lives.
Armed with skills and information, people living with HIV/AIDS are the most effective communicators on HIV prevention and health promotion messages. The Peer Educators are powerful role models of recovery from substance abuse, HIV risk reduction, and other health-enhancing behaviors—inspiring the individuals they reach with living examples of positive change.
Because HIV+ patients are more likely to stay connected to care when they have the support of those who have experienced the same challenges, we have created an approach to healthcare that combines our renowned Peer Education program and our successful collaborations with Medical Providers to connect the most vulnerable HIV populations to quality HIV care.
Tell us about the social innovator behind this idea.
Sharen Duke, founding Executive Director/CEO of AIDS Service Center NYC (ASC NYC), has more than 20 years of experience in the field of public health. Under her leadership since 1990, ASC has evolved from a three-person agency into a multiservice, multisite, multilingual, multimillion dollar community organization serving 3,700 New Yorkers affected by AIDS each year and reaching more than 14,000 people through peer education and community outreach initiatives.
ASC NYC is at the forefront of the fight against AIDS and the effort to ensure that all New Yorkers have access to HIV testing, treatment and care. As the daughter of a Holocaust survivor, Sharen has translated her father’s legacy of survival and hope into ASC’s mission: “Helping many, one by one.” ASC programs strive to transform challenge into positive change; build community, connection and stability; create and sustain hope; and provide a healing path for men, women, and families coping with HIV/AIDS.
Sharen has advocated on behalf of people living with HIV/AIDS in New York City through vigorous involvement in community planning processes in partnership with many government agencies. Currently she serves on the Priority Setting Resource Allocation Committee of the NYC HIV Health and Human Services Planning Council, the Member Advisory Council of the Federation of Protestant Welfare Agencies, and the Boards of Communities Advocating Emergency AIDS Resources and the New York AIDS Coalition.
How did you first hear about Changemakers?
Newsletter from Changemakers
If through another, please provide the name of the organization or company
50 words or fewer
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