AIDS Institute Logo

HIV/AIDS

  • General Information
    • 1-800-541-AIDS
    • 1-800-233-7432 Spanish
  • AIDS Drug Assistance Program (ADAP)
    • 1-800-542-2437
  • HIV Confidentiality Hotline
    • 1-800-962-5065

CEI Program & Services for clinicians

  • (315) 477-8479 or visit www.ceitraining.org
    • Post-Exposure Prophylaxis Hotline (PEP Line)
      • 1-866-637-2342
  • HIV/Hepatitis C
    • 1-866-637-2342
  • STDs
    • 1-866-637-2342

Health Care Services

HIV Uninsured Care Programs (ADAP, ADAP PLUS, HIV Home Care, ADAP Plus Insurance Continuation, Pre-Exposure Prophylaxis Assistance Program)

The New York State Department of Health AIDS Institute has established five programs for HIV Uninsured Care -- ADAP, ADAP Plus, ADAP Plus Insurance Continuation, the HIV Home Care Program and the Pre-Exposure Prophylaxis Assistance Program (PrEP-AP).  The mission of these programs is to provide access to medical services and medications for all New York State residents with or at risk of acquiring HIV/AIDS.  The programs' dual goals are to empower individuals to seek, access, and receive medical care and prescription drugs without cost and to supply a stable and timely funding stream to health care providers, enabling them to use the revenues to develop program capacity to meet the needs of the uninsured HIV population.

The AIDS Drug Assistance Program (ADAP) began in 1987 as part of a national initiative to provide free HIV/AIDS drugs to low-income individuals not covered by Medicaid or without adequate third­-party insurance.  In November 1991, the HIV Home Care Program, modeled after ADAP, was implemented through a federal demonstration grant.  The ADAP Plus primary care initiative was developed with cooperative funding through a unique partnership between New York City and New York State and was implemented statewide in October 1992.  The ADAP Plus Insurance Continuation Program (APIC) began July 1, 2000.  PrEP-AP began in January 2015. All five programs are integrated, centrally administered, use a unified application form, and coordinate outreach activities.

The programs serve New York State residents who are HIV infected or at risk of acquiring HIV and are uninsured or under-insured and meet established residency, financial, and medical criteria.  The programs serve as a transition to Medicaid by providing interim assistance to individuals eligible for but not yet enrolled in Medicaid, or assistance in meeting spend-down requirements.  Individuals with third-party insurance who cannot meet the deductibles or co-payments are eligible to enroll in the programs.  Adolescents who do not have access to the financial or insurance resources of their parents/guardians are also eligible.

The programs' service benefit package has been restructured several times based on available funding.  As of February 2015, the ADAP formulary consists of more than 500 drugs, including:  antiretrovirals, antineoplastics, prophylaxis and treatments for opportunistic infections, and medications for related conditions.  ADAP Plus covers a full range of HIV primary care services, provided on an outpatient ambulatory basis, including:  annual comprehensive medical evaluation, clinical HIV disease monitoring, treatment of both HIV-related and non-HIV related illness, mental health and dental services, ambulatory surgery, laboratory services, and nutritional counseling and supplements.  Services covered through the Home Care Program include:  skilled nursing, personal care, homemaker and home health aide services, adult day health care, intravenous administration and supplies, and durable medical equipment.  APIC pays the premiums of individuals who lose their employment and are eligible to continue their insurance, or working individuals who cannot afford their insurance premiums. PrEP-AP provides reimbursement for necessary primary care services for eligible individuals seen by enrolled providers who are experienced providing services to HIV-negative, high-risk, individuals who are engaged in HIV Pre-Exposure Prophylaxis. Coverage of drugs and services is revised based on available funding and the changing clinical profile of the epidemic.

The HIV Uninsured Care Programs use the AIDS Institute's network of programs and providers and those of other New York State agencies as a comprehensive referral system and distribution network for applications and promotional materials.  The Programs provide Federal Ryan White Minority AIDS Initiative funding to ten community based organizations throughout New York State to support outreach and educational activities to increase minority participation in care and ADAP.  In cooperation with state, federal, and local corrections authorities, program applications and information are provided to HIV-positive inmates nearing release from correctional facilities.  The programs are coordinated with Medicaid to assure non-duplication of coverage, continuity of care and an easy transition to Medicaid when participants meet Medicaid eligibility criteria.  An advisory workgroup provides input, guidance, and recommendations to the programs from a wide variety of perspectives to recommend coverage elements and to ensure integration with other HIV services.  The workgroup is comprised of persons living with HIV/AIDS, representatives of Part A Planning Councils, local and state government officials, health care providers, agencies, associations, and clinicians.

The programs serve all populations affected by HIV in New York State, with participant demographics changing over the years to reflect changes in the epidemic.

New York State's ADAP/ADAP Plus has the most comprehensive drug and service coverage of any state in the country.  Utilization of combination antiretroviral therapy, drugs to treat side effects and toxicity, and ambulatory care services has consistently increased over time.

Contact:

Christine A. Rivera
Director, Office of HIV Uninsured Care Programs
HIV Health Care and Policy
(518) 459-1641 or 1-800-542-2437 (In New York State Only)
christine.rivera@health.ny.gov

Back to top of page

AIDS Nursing Facilities

The AIDS Nursing Facilities Initiative began in 1988 to provide appropriate nursing home care for people with HIV/AIDS.  The Department of Health issued regulations for the development of AIDS nursing facilities and an enhanced Medicaid reimbursement structure that allows for increases in nursing time, substance abuse counseling, AIDS medications, and medical care.

Nursing facilities providing services to residents with AIDS must ensure special services are provided including: medical services by a physician who has experience in the care and clinical management of persons with AIDS; sub-specialty physician services; nursing services supervised by a registered professional nurse with experience in the care and management of persons with AIDS; substance abuse services; HIV risk/harm reduction education; comprehensive case management; and pastoral care.

There are 13 facilities with the distinct AIDS Nursing Facility licensure designation with a total of 1079 beds, located primarily in New York City. One facility is located in Nassau County.  

An additional 12 facilities across New York State are approved for AIDS scatter beds.  These facilities have the ability to admit up to ten AIDS residents at any point in time. The AIDS Institute will continue to monitor the need for AIDS nursing home beds, and will encourage the development of AIDS Scatter beds in nursing facilities in Upstate New York as necessary to ensure sufficient access to nursing home care for persons with HIV/AIDS.  

Contact:

Joe Losowski
Director, Chronic Care Section
Office of Medicaid Policy and Programs
(518) 474-8162
joseph.losowski@health.ny.gov

Back to top of page

AIDS Adult Day Health Care Programs

AIDS Adult Day Health Care Programs (ADHPs) were originally designed for a frail population that required a greater range of comprehensive health care services than could be provided in any single ambulatory setting, but did not require the level of services provided in a hospital or a skilled nursing facility.  While the original intent of the program model -- to assist individuals with AIDS and HIV disease live more independently in the community and prolong or eliminate the need for residential health care services -- continues to be a major objective, ADHCPs have evolved over the years to meet the emerging needs of the population. Treatment advances have, in many cases, transformed HIV disease from a terminal illness to a chronic condition. As a result, the HIV infected population is living longer, and along with this trend has seen an increase in concomitant chronic medical conditions such as cardiovascular disease, hypertension, hepatitis and diabetes.

In order to achieve optimal results from the treatment advances that have occurred since the start of the HIV epidemic, it is critically important for individuals to be adherent to their treatment regimes. Clearly, medication adherence can be a major challenge associated with any disease. For individuals infected with HIV, adherence is often further compromised by the commonly occurring co-morbidities of substance use, mental illness, and other chronic conditions. This comprehensive care model has evolved to address the challenges and complexity of managing multiple comorbidities. 

The intent of the ADHCPs is to complement or enhance the existing continuum of medical services through on-going coordination with primary care providers and other service providers.  ADHCPs are designed to provide a comprehensive and integrated model of service delivery in a cost-effective manner by avoiding duplication of services and minimizing the need for patients to receive additional off-site services.

AIDS Adult Day Health Care Programs provide a comprehensive range of services in a community-based, non-institutional setting.  General medical care including treatment adherence support, nursing care, rehabilitative services, nutritional services, case management, HIV risk reduction, substance abuse, and mental health services are among the services provided.  Health maintenance/wellness activities such as supervised exercise and structured socialization are adjunct components of the program model, but cannot be the sole reason for admission/continued stay in the program.

ADHCP services are primarily located in the Greater New York Metropolitan area.  Services are also located in Monroe County in Upstate New York.
Currently, there are 13 licensed programs with a capacity to serve 867 clients per day.

Contact:

Joe Losowski
Director, Chronic Care Section
Office of Medicaid Policy and Programs
(518) 474-8162
joseph.losowski@health.ny.gov

Back to top of page

Community-Based HIV Prevention and Primary Care Services

The Community HIV Prevention and Primary Care Initiative was established in 1989 to meet the growing need for community-based HIV services. AIDS Institute grants were first offered to local health departments and community health centers willing to develop or expand on-site HIV prevention and primary care services for people living with HIV/AIDS and those at highest risk. Initially, seventeen facilities received grants. With the addition of federal and state funding to reduce health disparities, grant funding was targeted to underserved and disenfranchised communities and racial and ethnic minorities.  Community health centers, hospital ambulatory care clinics, and county health departments are currently funded through this initiative.

The goals of the initiative are to facilitate early access to coordinated, comprehensive and continuous care and develop provider capacity to deliver on-site quality HIV/STD/ HCV services.  Improved medical outcomes are directly linked to patient retention in care.  Sustained HIV viral load suppression is the key performance measure for assessing HIV primary care.  Facilities are funded to provide a wide range of prevention, supportive, and care services including:  partner services, peer support, and facilitated linkage to services unavailable on-site. The core funded activity is medical case management, which includes a range of client-centered services that link clients with medical, behavioral health and other services.  The coordination and follow-up of medical treatments are key components of medical case management.  

Key features of the initiative are: early access to care, access to patients at multiple points of care, retention in care, referral and linkage to care follow-up, and on-site care coordination by a multidisciplinary service team.  Services must be culturally and linguistically appropriate to the patient population and demonstrate effective interventions to support lesbian, gay, bisexual and transgender optimal health.  Emphasis is placed on the development of strategies to strengthen treatment adherence, the integration of health behavior counseling, and partner services.  In addition, all programs funded through this initiative are required to maintain mechanisms to integrate consumer feedback into the implementation and evaluation of care services and program activities. 

Linkages with other service providers offering services not provided on-site are important to ensuring access to the full continuum of HIV related care.  Grant funded programs are required to develop referral agreements with other service providers, including but not limited to: Designated AIDS Centers and other hospitals; community-based service organizations; community case management services (Medicaid Health Homes and grant funded programs); behavioral health (substance use and mental health) treatment programs; local Disease Intervention Specialist (DIS) programs to assist with partner notification and engagement efforts for clients that have fallen out of care; women and young adult service agencies; correctional services; anonymous counseling and testing programs; and appropriate social service agencies. 

Contact:

Jill Dingle
Initiative Director, Community Based Primary Care Services  
Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(212) 417-4764
jill.dingle@health.ny.gov

or

Marc Slifer
Director, Primary Care and Substance Use Section
Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(212) 417-4526
marc.slifer@health.ny.gov

Back to top of page

Designated AIDS Centers

Designated AIDS Centers (DACs) are State-certified, hospital-based programs that serve as the hubs for a continuum of hospital and community-based care for persons with HIV infection and AIDS.  AIDS Centers provide state-of-the-art, multi-disciplinary inpatient and outpatient care coordinated through hospital-based case management.  DACs with pediatric and obstetrical departments also provide specialized HIV care to infants, children, and pregnant women.

The AIDS Center program was developed and remains a patient-centered program model that can evolve with the needs of the patient in the changing health care environment.  AIDS Centers provide a primary care home for the person with HIV.  Patient outcomes improve when care is seamless, coordinated by a care manager utilizing multi-agency, multi-disciplinary health care teams.

HIV-specific care standards developed for DACs are intended to ensure uniformly high quality care for HIV patients.  AIDS Centers usually have a dedicated team and are required to provide or arrange for inpatient care; coordinated outpatient services including a broad array of subspecialty services; long-term care, as necessary; and counseling and testing services.  AIDS Centers must make arrangements for patients' personal or home care as required, and arrange for patients to participate in clinical trials.  AIDS Centers must enhance coordination with their community-based partners to identify patients at risk, help patients access and remain in care, and understand and adhere to their complicated regimens.

The quality of care is monitored and evaluated by the HIV Quality of Care Program described in a separate section of this document.  Each AIDS Center is required to have an active quality program including a broadly inclusive quality improvement committee as well as a consumer advisory group and other mechanisms to involve consumers in improving services for PLWHA.

With the Statewide implementation of Medicaid managed care plans for persons with HIV/AIDS over the last few years, AIDS Centers continue to maintain state-of-­the-art HIV treatment and serve geographic areas with the highest HIV/AIDS prevalence.

Currently, there are thirty-nine AIDS Centers statewide treating approximately 38,800 unique persons with HIV/AIDS as outpatients and inpatients.

Contact:

Carol DeLaMarter
Director, AIMS/Managed Care
Office of Medicaid Policy and Programs
(518) 486-1383
carol.delamarter@health.ny.gov

Back to top of page

HIV Special Needs Plans (SNPs) / Managed Care

HIV Special Needs Plans (SNPs), as defined in the New York State Medicaid Managed Care Act of 1996, are intended to provide an alternate source of capitated managed care to Medicaid-eligible persons with HIV infection.

Specialized managed care plans to address the health and medical needs of persons with HIV/AIDS first began to be explored by New York State in 1994 with the award of a Special Projects of National Significance (SPNS) grant from the federal Health Resources and Services Administration and concluded after a planning and study phase with passage of legislative language authorizing the creation and licensure of HIV SNPs. These activities culminated in federal approval of the Department of Health’s application to implement SNPs.

HIV SNPs, fully operational since 2003, provide an alternative option for managed care to Medicaid­ eligible persons in New York City with HIV/AIDS. In New York City approximately 25,000 HIV+ Medicaid individuals must choose either an HIV SNP or a mainstream managed care plan to receive their Medicaid benefits. Three SNPs are currently licensed and enrolling eligible individuals throughout New York City. In January, 2014 total SNP enrollment was 16,039.  In January, 2014 SNPs began to enroll homeless people who are HIV negative as a new population.  Homelessness is defined as those connected to NYC Department of Homeless Services at time of enrollment

HIV SNP networks include the full continuum of HIV services currently available in New York State. Inclusion of health and human service providers with experience in the provision of HIV services enables SNPs to meet the complex medical and psychosocial needs of enrollees, either through direct service provision or by referral. SNP experience with HIV population has helped them expand networks to support the new population of negative homeless members.  SNPs have well developed care and benefit coordination procedures and continue to develop relationships with newly organized health homes to support needs of members with complex medical, behavioral and psychosocial needs. Clinical care provided by SNPs is in accordance with AIDS Institute established standards for HIV care and assessed through continuous quality improvement techniques.

Because most Medicaid beneficiaries in NYS must enroll in a Medicaid managed care plan, the AIDS Institute is working to assure that all Medicaid-eligible persons with HIV infection have appropriate access to health care services delivered in a managed care setting. To assure that services offered by mainstream managed care plans assure access to quality HIV and other covered care, the AIDS Institute participates in the development of programmatic standards for mainstream managed care plans, conducts quality of care reviews, and participates in Article 44 surveys. The AIDS Institute also provides technical assistance to managed care plans regarding prevention activities and establishing coordinated systems of care that are appropriate to the specific health care needs of enrollees with HIV/AIDS.

Contact:

Carol DeLaMarter
Director, AIMS/Managed Care
Office of Medicaid Policy and Programs
(518) 486-1383
carol.delamarter@health.ny.gov

Back to top of page

HIV Enhanced Fees for Physicians Program

The Enhanced Fees for Physicians Program (EFP) was established in 1991 by the New York State Department of Health to give private practice physicians enhanced Medicaid rates for HIV Primary Care Visits. These visits include:

  • HIV Testing
  • HIV Post-test positive counseling
  • HIV monitoring

Physicians who participate in the HIV Enhanced Fees for Physicians Program must:

  • be in private practice and enrolled in the New York State Medicaid Program;
  • have active hospital admitting privileges;
  • be Board certified (preferably in infectious disease, internal medicine, family practice, pediatrics or obstetrics/gynecology);
  • provide 24 hour coverage; and
  • manage patient medical services, including hospital admissions, referrals for specialty care and social services.

Currently there are over 2,482 physicians enrolled in the HIV EFP program.

Contact:

Mundy Zullo
Program Administrator
Office of Medicaid Policy and Programs
(518) 486-1383
mundy.zullo@health.ny.gov

Back to top of page

HIV Primary Care Medicaid Program

The HIV Primary Care Medicaid Program (HPCMP) was established in 1989 by the New York State Department of Health to provide enhanced Medicaid rates to Article 28 facilities for HIV primary care and HIV testing visits.

Medicaid reimbursement methodology began a change in December 2008 that ultimately required 85% of the HPCMP providers to adopt new procedure-specific Ambulatory Patient Groups (APGs).  Since the full implementation of APGs, only Federally Qualified Health Centers (FQHC) that have NOT opted into the new APG methodology, continue access to the HPCMP rate structure. FQHCs who meet enrollment criteria can access enhanced reimbursement for HIV testing and HIV treatment.

Enrollment Criteria includes: 

  • The facility must be a FQHC (Article 28 facility hospital OR diagnostic and treatment center); and
  • The facility must sign an agreement with the New York State Department of Health to provide comprehensive services and coordination of care for persons with HIV.

Contact:

Mundy Zullo
Program Administrator
Office of Medicaid Policy and Programs
(518) 486-1383
mundy.zullo@health.ny.gov

Back to top of page

HIV Primary Care and Prevention Services for Substance Users

The Substance Use Initiative is designed to develop a co-located continuum of comprehensive HIV prevention and primary care services within substance abuse treatment settings throughout New York State.  At its core, the co-located model operates on the principles of integration of HIV services within the drug treatment environment and the seamless transition from testing to care.  Reaching active users not in treatment and responding to their complex needs is also integral work of the initiative.  For those actively using and willing, the program facilitates the transition and entry into addiction services, treatment and toward recovery.

The initiative was originally conceived and developed in 1989 through collaboration between the New York State Department of Health AIDS Institute and the New York State Office of Alcohol and Substance Abuse Services (OASAS) to respond to the companion epidemics of HIV and addiction.  Implemented in phases, the first phase was a comprehensive prevention program in drug treatment facilities to provide outreach, HIV education, counseling and testing, referral, partner notification, and individual and group supportive counseling.  In 1990, co-located HIV primary care was introduced to expand the continuum.  The Initiative has increased the availability and quality of HIV prevention and primary care services by incorporating the advances of the past decade into programming.  Those advances included:  behavioral-based prevention interventions, harm reduction, new testing technologies, comprehensive risk counseling and services, and new standards and best practices in the treatment of HIV/AIDS. 

In May 2010, the Substance Use Initiative funded agencies to provide medical case management services for their HIV+ clients. Medical case management is provided to patients who receive HIV medical care at the drug treatment program or by another medical provider.  Medical case management is a range of client-centered services that link clients with health care, psychosocial supports, and other services.  The coordination and follow-up of medical treatments are key components of medical case management.  The primary goals of medical case management are retention in care and viral load suppression. Medical case management services are provided at eight drug treatment programs in New York City and two community based health centers, one in Western New York and the other in Central New York.

Grant funds also support comprehensive outreach, information, testing, and referral services for active substance users in three upstate New York areas; Hudson Valley, Central New York and Western New York.  These services include:

  • Enhanced, evidence-based outreach;
  • Assisted referrals for detoxification and drug treatment services;
  • HIV testing using rapid test technology either on-site or by referral;
  • Assisted referrals to medical care, case management, and partner services for persons testing HIV positive;
  • Hepatitis information and referrals for testing, vaccination, and treatment;
  • Information on sexually transmitted infections and referrals for testing and treatment;
  • Facilitating client access to sterile syringes;
  • Education and skills training for clients, staff, and community members regarding opioid overdose prevention;
  • Follow-up to confirm the outcome of all referrals; and
  • Systems advocacy and transitional counseling to support clients in accessing services.

Contact:

Janice Bigler
Initiative Director, Substance Use Services  
Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(212) 417-4526
janice.bigler@health.ny.gov

or

Marc Slifer
Director, Primary Care and Substance Use Section
Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(212) 417-4526
marc.slifer@health.ny.gov

Back to top of page

Family-Focused HIV Health Care for Women

New York State (NYS) has the country’s largest population of women living with HIV/AIDS.New York City continues to be the epicenter of the HIV epidemic, as 79 percent of women living with HIV/AIDS in NYS reside there.  The epidemic has made further inroads into vulnerable populations already marginalized from health care systems, including women of color, immigrant women and females in New York State’s correctional system.

Women affected by HIV experience poverty, substance use, domestic violence, mental illness and family disruptions and are often survivors of trauma. The medical care of women with HIV is further complicated by cultural/gender inequality and family issues that are separate from those seen in their male counterparts. Traditionally, women have the primary responsibility for care of their children. Concerns regarding family and children often take precedence over their own health issues.  In addition to addressing their health care concerns, infected women often face compounding issues such as custody arrangements, daily child care, disclosure, elder care and discrimination.

Engaging and retaining HIV-positive pregnant women and women with dependent children in the health care system requires holistic, family-focused services that recognize the women’s role as primary caregivers and address the multiple needs of their children.  For women with HIV, gynecologic and reproductive health services, including family planning, must be coordinated with adult HIV primary care. The Family-Focused HIV Health Care for Women Initiative is a comprehensive model designed to meet the needs of the HIV-positive women. The initiative seeks improved access to care and a reduction to barriers within the health care system, with the overall goal of improving health outcomes through support and adherence to treatment regimens. In addition, a paramount outcome of this initiative is to reduce the risk of perinatal HIV transmission.

Family-Focused HIV Health Care for Women is an integrated model of service that coordinates HIV, primary care, women’s health services, and pediatric care for infants exposed to HIV.  Multicultural, multidisciplinary teams combine HIV specialty care, mental health counseling, prevention with positives, medical case management and other HIV-related support services to address the complex medical and social issues faced by women and HIV-affected families.  The Family-Focused HIV Health Care for Women Initiative includes active involvement of clinicians in the development and evaluation of the program model.  There is ongoing communication among all team members and community partners to ensure coordination of services and resources.  All efforts contribute to the goal of timely interventions - aggressive engagement and re-engagement, support for addressing family issues, optimal early treatment and continuous care.

As of 2014, a network of seven health care agencies, focused primarily in New York City, provide funded services.  Pregnant women diagnosed with HIV and women living with HIV who have dependent children in their household are eligible for program services.

Contact:

Beth Bonacci Yurchak
Section Director, Family and Youth Services
Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(518) 473-3435 
beth.yurchak@health.ny.gov

Back to top of page

Adolescent/Young Adult HIV Specialized Care Centers

As of December 2012, the total number of young people ages 13 to 24 years living with HIV/AIDS in New York State (NYS) was 5,020, of which 679 were newly diagnosed with HIV in 2012.  Although young people ages 13 - 24 only constituted 3.8% of the total living with HIV/AIDS population, this population represents 9% of all late newly diagnosed HIV cases in NYS in 2012 and 20.48% of all total newly diagnosed cases in NYS (2012). Adolescents/ young adults are therefore disproportionately affected when looking at HIV incidence in NYS.

A significant number of adolescents and young adults who were infected perinatally are served by the Specialized Care Centers (SCCs).  Many of these adolescents and young adults have significant developmental, mental health, risk reduction and self-management needs.  With a lifetime of medical monitoring, treatment regimens and potentially life threatening illnesses, this population is also confronted with the physical, cognitive, psychosocial and emotional challenges of adolescence. 

SCCs provide integrated, comprehensive health care and support services to address the needs of adolescents and young adults who have HIV.  Adolescents and young adults at risk for contracting HIV may also receive limited services.  The SCCs are responsible for developing linkage agreements to ensure the provision of a continuum of services needed by youth.  SCCs provide risk assessment and risk reduction services for:  HIV, sexually transmitted diseases (STDs), hepatitis, other chronic diseases, and substance use (e.g., drugs, alcohol and tobacco).  HIV counseling and testing, partner services, HIV primary care, reproductive health care and health promotion counseling are offered.  Also provided are domestic violence/trauma screening with referral to services as needed:  mental health services, medical case management, crisis intervention, transitional planning services, peer support groups, skills building/educational programs, and concrete supportive services.  Services are designed to be non-judgmental and adolescent/young adult focused.  SCCs provide innovative and tailored strategies that promote adherence with HIV medications and retention in care.

While SCCs primarily serve adolescents and young adults living with HIV infection, these programs may provide low-threshold clinical services (up to 6 months) to high-risk adolescents/young adults who are referred to the program either through inreach or outreach efforts.  Low-threshold clinical services include: HIV counseling/testing and risk reduction services; care for acute illness with immediate access to pharmaceuticals for uninsured youth; family planning and reproductive health care; STD screening and treatment; and screening and referral for treatment of tuberculosis and hepatitis A, B and C.  High-risk populations include young people of color, disenfranchised youth and those living in poverty.   Those at highest risk include young men who have sex with men; lesbian, bisexual, questioning or transgender youth; youth involved in “street economy;” substance users; homeless; adolescents/young adults who have experienced physical, mental, and/or sexual abuse; gang-involved youth; and/or those with a history with the criminal justice system. 

Intended outcomes of the SCCs are:

  • Improved engagement of  adolescents/young adults into systems of HIV prevention, health care, and supportive services;
  • Increased earlier identification of HIV, with provision of prompt support and linkage to care;
  • Improved disclosure of HIV status and improved partner notification;
  • Reduced transmission of HIV and STDs, as well as unintended pregnancies;
  • Improved provision of culturally relevant and client-focused services;
  • Strengthened client self-management skills, including health promotion skills (e.g., nutrition, physical activity, tobacco cessation) and eventual, successful transition to adult care;
  • Improved client ability to navigate complex health care and supportive services systems;
  • Enhanced retention in HIV care;
  • Improved adherence to treatment to stabilize or improve health status and suppress viral loads;
  • Improved care coordination between primary, HIV, obstetrics and gynecology (OB/GYN), pediatric/adolescent and other specialty care; and
  • Reduced disparities in health outcomes for communities of color.

Statewide, there are fourteen SCCs funded. 

Contact:

Beth Bonacci Yurchak
Section Director, Family and Youth Services
Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(518) 473-3435 
beth.yurchak@health.ny.gov

or

Timothy Doherty
Director, Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(518) 486-6048
timothy.doherty@health.ny.gov

Back to top of page

Adolescent and Young Adult Youth Access Programs

As of December 2012, the total number of young people ages 13 to 24 years living with HIV/AIDS in New York State (NYS) was 5,020 of which 679 were newly diagnosed with HIV in 2012. 

Sexually transmitted disease (STD) rates in the adolescent/young adult population are extremely high. One in four young people will have an STD during adolescence, and one in two sexually active young adults will have an STD by age 25, according to the Centers for Disease Control and Prevention. New York State’s teen pregnancy rate in 2012 for 15 to 19 year olds was 41.1 pregnancies per 1,000.

To compound the issues above, many youth experiment with drugs and alcohol which often leads to sexual risk-taking. For high-risk youth, the frequency and intensity of risk-taking behavior contribute to an increased potential for HIV, STDs and unintended pregnancy, necessitating integrated risk reduction efforts. Contributing factors related to high risk-taking behaviors may include multiple life stressors, such as poverty, chaotic/violent home situations, and/or physical or sexual abuse.

Youth, in general, are not high users of health care and frequently avoid health care settings that are unfamiliar or not youth-friendly. The stigma of HIV, possibly combined with mental illness, substance use, poverty, violence and other forms of trauma, may present further barriers to seeking help.

These statistics and trends emphasize the need to reach high-risk youth, identify those who are HIV-positive earlier in their disease course and connect them to care, and empower HIV-negative youth to remain HIV-negative.

The major goal of the Youth Access Program (YAP) is to reach HIV-positive adolescents/young adults whose status is unknown or who are not in care and connect them promptly to HIV/AIDS care.  Another important focus of this model is to connect high-risk youth to ongoing primary health care and to needed psychosocial and supportive services (e.g., child abuse and domestic violence intervention services, mental health, substance use treatment, etc.). 

YAPs provide low-threshold clinical services to high-risk youth (aged 13-24 years) in targeted and accessible community-based settings to meet their immediate health care and social service needs. In many cases, these needs must be met before or concurrent with addressing issues related to HIV testing and treatment.  Low threshold clinical services include: HIV counseling and testing and  risk reduction services; care for acute illness with immediate access to pharmaceuticals for uninsured youth; pregnancy testing, family planning and reproductive health care; STD screening and treatment; and screening and referral for treatment for tuberculosis and hepatitis A, B, and C.  A psychosocial assessment should be done to identify the unique needs of each adolescent/young adult and to offer appropriate services and referrals as needed.

Outreach is designed to reach the highest risk adolescents/young adults who may be socially isolated and marginalized. A community approach, which builds on partnerships with health providers, youth-serving organizations, the social networks of youth, and other community resources, facilitates access to the services that high-risk adolescents/young adults need at the point of entry into care.  It is imperative that YAP services be available at times when youth can access them, particularly evenings and/or weekend hours and at consistent community locations on a regular schedule (i.e., minimally weekly or bi-weekly). Over time, funded programs may need to adjust service locations as the community and population needs change.

Four Youth Access Programs were established in 2011, with three in New York City and one in the Lower Hudson Valley. 

Contact:

Beth Bonacci Yurchak
Section Director, Family and Youth Services
Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(518) 473-3435 
beth.yurchak@health.ny.gov

or

Timothy Doherty
Director, Bureau of HIV Ambulatory Care Services
Division of HIV and Hepatitis Health Care
(518) 486-6048
timothy.doherty@health.ny.gov

Back to top of page

Viral Hepatitis Section

The Viral Hepatitis Section is responsible for the development and maintenance of a comprehensive hepatitis C program. Program activities include hepatitis C prevention (including HCV screening), education, medical care and treatment and policy and planning activities. The overall program goals are to:

  • Prevent the acquisition and transmission of hepatitis C;
  • Build knowledge and awareness of hepatitis C disease, prevention, risk, treatment and medical management;
  • Develop and maintain an infrastructure to provide the highest quality of hepatitis C care and treatment;
  • Foster an effective policy and planning environment at the local, state and national levels and;
  • Conduct epidemiologic, program evaluation, and quality improvement studies to guide program and policy decisions.

The Viral Hepatitis Section collaborates and coordinates with the New York State Department of Health (NYSDOH) Bureau of Communicable Disease Control, which is responsible for hepatitis surveillance and outbreak activities; and the Bureau of Immunization, which is responsible for the coordination of the Adult Hepatitis Vaccination Program.

The Viral Hepatitis Section is responsible for the following activities:

Hepatitis C Care and Treatment Programs The Viral Hepatitis Section currently funds thirteen programs statewide to expand the capacity for hepatitis C care and treatment.  Five programs provide on-site hepatitis C medical care, care coordination, treatment and supportive services in a primary setting (i.e., community health centers, drug treatment programs and hospital based clinics) for HCV monoinfected persons.  An additional eight HIV primary care programs provide on-site hepatitis C medical care, care coordination, treatment and supportive services to HIV/HCV coinfected persons.

Hepatitis C Screening Program The Viral Hepatitis Section provides HCV rapid antibody test kits and controls to programs serving at-risk populations, such as syringe exchange programs, STD clinics and HIV counseling and testing sites.  Individuals screened for HCV are provided appropriate counseling messages and receive referrals for diagnostic testing, medical care and treatment. The Screening Program also covers the costs of HCV diagnostic testing (HCV RNA) for persons with a reactive HCV antibody test at prequalified agencies with the capacity to offer this service on-site.

Hepatitis C Continuity Program   The Hepatitis C Continuity Program makes it possible to initiate treatment for hepatitis C within New York State Department of Corrections and Community Supervision without regard to the incarceration time remaining.  It enables inmates who initiate treatment prior to release to receive timely referral to appropriate clinics for continuation of treatment following release.

Hepatitis C Epidemiologic and Research Studies  The Viral Hepatitis Section conducts epidemiologic, program evaluation, and quality improvement  studies to better understand the burden of hepatitis C and to evaluate programs overseen by the Section.  These studies support and promote the work done by the Section as well as other programs in the department.

Viral Hepatitis Strategic Plan The mission of the 2010-2015 New York State Viral Hepatitis Strategic Plan is to outline a coordinated, comprehensive and systematic approach that will decrease the incidence and reduce the morbidity and mortality of viral hepatitis.  The vision is to eliminate new hepatitis A, B and C infections and to improve the quality of life of those living with chronic hepatitis B and C.

Contact:

Colleen Flanigan, RN, MS
Director, Viral Hepatitis Section
Division of HIV and Hepatitis Health Care
518-486-6806
colleen.Flanigan@health.ny.gov

Back to top of page

Health Home Program/Legacy, HIV/AIDS Targeted Care Management (Formerly COBRA Case Management)

A product of New York State’s Medicaid Redesign and the Affordable Care Act, Health Homes were initiated across New York beginning in 2012 to provide comprehensive care management for Medicaid recipients with complex chronic illnesses and high needs. Medicaid recipients with HIV are eligible for these services if they also meet behavioral, medical or social risk criteria.

Each enrolled Health Home member is assigned a dedicated care manager to assess their needs and help navigate, coordinate, and integrate the individual’s behavioral health, medical health, and social services. The goals of the Health Home program are to improve the health of enrolled members, improve the delivery of health care services, and reduce health care costs (in particular by reducing unnecessary emergency room use and hospitalizations).

Health Homes are networks of providers administrated by a Lead agency. Networks include hospital systems, ambulatory care services (physical and behavioral), managed care plans, and community based organizations providing housing, nutrition, legal, and other social services. Agencies providing care management include 46 statewide AIDS Institute former (legacy) HIV Targeted Case Management providers, which in 2012 were converted to Health Home care management providers  when this initiative began.

Contact:

Lisa Tackley
Health Home Coordinator
Medicaid and Health Care Reform Policy and Analysis
518-473-3339
lisa.tackley@health.ny.gov