Prevention Agenda 2019-2024: Prevent Communicable Diseases Action Plan

Prevent Communicable Diseases Action Plan (PDF, 901KB, 23pp.)

Table of Contents

Overview

A communicable disease is an illness or infection that can be spread from person to person, animal to person, animal to animal or person to animal. Communicable diseases contribute to sickness and death in New York State and are preventable. Additional information about the burden of communicable diseases, underlying risk factors and associated disparities can be found at: Link to the burden documents


Focus Area 1. Vaccine Preventable Diseases

Goal 1.1 Improve vaccination rates

Target 70.7%
Baseline 64.3%
Baseline Year 2018
Data Source New York State Immunization Information System (NYSIIS) and Citywide Immunization Registry (CIR)
Data Level NYS, county
Target 36.7%
Baseline 33.4%
Baseline Year 2018
Data Source NYSIIS and CIR
Data Level NYS, county
Target 54.8%
Baseline 49.8%
Baseline Year Influenza season 2016-2017
Data Source FluVaxView
Data Level Statewide
Target 76.2%
Baseline 69.3%
Baseline Year 2016
Data Source BRFSS
Data Level Statewide
Evidence and Resources
Age Range

May impact all ages, but primarily impacts:

    • Children up to age 12

    • Adolescents (13-21)

Social Determinants Addressed Education
Lead Sectors Governmental Public Health Agencies
Colleges and Universities
Schools (K-12)
Policy makers and elected officials
Contributing Sectors Healthcare Delivery system
Insurers
Media
Community or neighborhood residents
CBOs and Human service agencies
Intermediate-level Measure Example Increased annual school immunization coverage rates
Additional Intermediate-level Measure Example(s) Decreased annual school medical and religious exemption rates
Evidence and Resources


Age Range All ages
Social Determinants Addressed Health Care
Lead Sectors Governmental Public Health Agencies
Healthcare Delivery system
Policy makers and elected officials
Contributing Sectors Insurers
Media
Colleges and Universities
Schools (K-12)
CBOs and Human service agencies
Intermediate-level Measure Example Increased proportion of immunizations reported to NYSIIS within 14 days of administration
Additional Intermediate-level Measure Example(s) Increased number of reminder/recall reports run in NYSIIS each year
Evidence and Resources


Age Range All ages
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Contributing Sectors Governmental Public Health Agencies
Insurers
Colleges and Universities
CBOs and Human service agencies
Policy makers and elected officials
Intermediate-level Measure Example Increased number of clinics utilizing standing orders for vaccine administration
Additional Intermediate-level Measure Example(s) Increased proportion of vaccines administered by the clinic for which standing orders have been implemented

Goal 1.2 Reduce vaccination coverage disparities

Target 4.9%
Baseline 9.7%
Baseline Year 2016
Data Source National Immunization Survey
Data Level Statewide
Target 5.5%
Baseline 11.0%
Baseline Year 2016
Data Source National Immunization Survey - Teen
Data Level Statewide
Evidence and Resources

Age Range All ages
Social Determinants Addressed Economic Stability
Health Care
Lead Sectors Governmental Public Health Agencies
Healthcare Delivery system
Insurers
Policy makers and elected officials
Contributing Sectors Media
CBOs and Human service agencies
Intermediate-level Measure Example Increased number of no-cost or reduced-cost vaccine doses administered
Additional Intermediate-level Measure Example(s) Increased number of patients referred to health insurance navigators
Evidence and Resources Stinchfield PK. Practice-proven interventions to increase vaccination rates and broaden the immunization season. The American Journal of Medicine. 2008;121(7):S11-S21.
Age Range All ages, especially important for older adults.
Social Determinants Addressed Economic Stability
Education
Transportation
Health Care
Lead Sectors Healthcare Delivery system
Employers, businesses and unions
Contributing Sectors Governmental Public Health Agencies
Insurers
Media
Colleges and Universities
Schools (K-12)
CBOs and Human service agencies
Policy makers and elected officials
Intermediate-level Measure Example Improved patient/parent satisfaction with clinic locations and hours
Additional Intermediate-level Measure Example(s) Increased number of patients seen per clinic date and location

Focus Area 2. Human Immunodeficiency Virus (HIV)

Goal 2.1 Decrease HIV morbidity (new HIV diagnoses)

Target 1,020 diagnoses or 5.2 per 100,000 population
Baseline 3,391 diagnoses or 17.3 per 100,000 population
Baseline Year 2013
Data Source HIV Surveillance
Data Level OBJ targets will be Statewide only, but data will be presented by Statewide and county level
Target 13 new diagnoses per 100,000 population
Baseline 43 new diagnoses per 100,000 population
Baseline Year 2013
Data Source HIV Surveillance
Data Level Statewide
Target 10 new diagnoses per 100,000 population
Baseline 32 new diagnoses per 100,000 population
Baseline Year 2013
Data Source HIV Surveillance
Data Level Statewide
Evidence and Resources

Evidence Base: PrEP is a targeted biomedical intervention to facilitate "health care as prevention," a six-pronged intervention for people who are HIV-negative and at high risk for infection. The intervention includes a once daily pill; periodic HIV testing; periodic STD screening; counseling about the use of condoms to prevent STDs; education about harm reduction options; and, counseling to promote adherence to the once-a-day PrEP medication. PrEP has been studied in multiple randomized controlled and open-label trials in several populations, including MSM [Grant et al. 2010; McCormack et al. 2016], heterosexual serodiscordant couples [Baeten et al. 2012], heterosexual men and women [Thigpen et al. 2012; Van Damme et al. 2012; Marrazzo et al. 2015], transgender women [Grant et al. 2014], and PWID [Choopanya et al. 2013]. A recent meta-analysis suggests >70% protection across all studies in which >70% adherence was reported [Fonner et al. 2016].

Implementation Resources: NYS Medicaid, along with most insurance plans, covers the only currently FDA-approved PrEP medication, Truvada®. Uninsured individuals may receive Truvada® through the Gilead patient assistance program: ( https://start.truvada.com/). The NYS PrEP Assistance Program can also help to cover the costs of clinical visits and lab testing for uninsured and underinsured individuals who qualify: https://www.health.ny.gov/diseases/aids/general/prep/docs/prep_payment_options.pdf . The NYS DOH website on PrEP has useful information on PrEP and nPEP programming, as well as links to additional resources: https://www.health.ny.gov/diseases/aids/general/prep/consumers.htm

Age Range New Yorkers of all ages at highest risk for acquiring HIV
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
State and local health departments
STI service providers
Contributing Sectors Insurers
Colleges and Universities
Community or neighborhood residents
CBOs and Human service agencies
Intermediate-level Measure Example Number of New Yorkers prescribed PrEP, by patient demographic factors to ensure equal access.

Goal 2.2 Increase viral suppression

Target 95.0%
Baseline 81.0%
Baseline Year 2013
Data Source HIV Surveillance
Data Level Statewide
Target 95.0%
Baseline 77.0%
Baseline Year 2013
Data Source HIV Surveillance
Data Level Statewide
Target 95.0%
Baseline 81.0%
Baseline Year 2013
Data Source HIV Surveillance
Data Level Statewide
Evidence and Resources

Evidence Base: Clinical trials and cohort studies have long supported the fact that adherence to Antiretroviral Therapy (ART) reduces the risk of transmitting HIV. Today, treatment as prevention (TasP) has become a widely-accepted strategy for addressing the HIV epidemic and reducing new infections. Most recently, results from the HIV Prevention Trials Network 052 [Cohen et al. 2011] and PARTNER [Rodger et al. 2016] studies demonstrate that, not only does effective antiretroviral treatment improve the health of each person living with HIV, it also prevents transmission of HIV to sexual partners. Thus, individuals with a sustained undetectable viral load will not sexually transmit HIV, or "Undetectable equals Untransmittable" (U=U). Please visit https://health.ny.gov/endingtheepidemic to view a recent webinar on the topic of U=U and to receive updates as they become available.

Data to Care (D2C) is a public health strategy that uses HIV surveillance and other data to support the HIV Care Continuum, by identifying persons living with HIV who are in need of HIV medical care or other services and facilitating linkage to those services. Some examples of D2C activities include using HIV surveillance data to identify persons who are not in care (NIC) and then link or re-engage them in care; and identifying persons who are in care but are not virally suppressed and work with clients and their providers to support attaining viral suppression. D2C has been show to:

Implementation Resources: Strategies and Resources for Retention in Care resource has been posted to the NYSDOH website. It can be found at: http://www.health.ny.gov/diseases/aids/general/standards/docs/strategies_resources_retention_in_care.pdf

Age Range New Yorkers living with diagnosed HIV infection who are not virally suppressed (or who are risk of becoming unsuppressed)
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
State and local health departments
including partner services programs
MCOs
Contributing Sectors Colleges and Universities
Community or neighborhood residents
CBOs and Human service agencies
Intermediate-level Measure Example Viral suppression, by patient demographic factors to ensure equity across all groups

Focus Area 3. Sexually Transmitted Infections (STIs)

Goal 3.1 Reduce the annual rate of growth for STIs

Target 10.0%
Baseline 20.0%
Baseline Year 2012-2016 average 5 year percent change
Data Source STI surveillance
Data Level NYS, county
Target 4.0%
Baseline 8.0%
Baseline Year 2012-2016 average 5 year percent change
Data Source STI surveillance
Data Level NYS, county
Target 1.0%
Baseline 2.0%
Baseline Year 2012-2016 average 5 year percent change
Data Source STI surveillance
Data Level NYS, county
Target 240.9 per 100,000 population
Baseline 148.8 per 100,000 population
Baseline Year 2016
Data Source STI surveillance
Data Level NYS, county
Target 677.0 per 100,000 population
Baseline 567.1 per 100,000 population
Baseline Year 2016
Data Source STI surveillance
Data Level NYS, county
Target 79.3 per 100,000 population
Baseline 31.1 per 100,000 population
Baseline Year 2016
Data Source STI surveillance
Data Level NYS, county
Evidence and Resources

https://www.health.ny.gov/diseases/communicable/std/partner_services/index.htm

https://www.cdc.gov/std/program/partners.htm

https://nysptc.org/

https://www.health.ny.gov/diseases/aids/ending_the_epidemic/docs/std_workgroup_strategies.pdf

Age Range People of all ages
Social Determinants Addressed Health Care
Lead Sectors Governmental Public Health Agencies
Healthcare Delivery system
Not applicable
Contributing Sectors Insurers
Colleges and Universities
Community or neighborhood residents
CBOs and Human service agencies
Intermediate-level Measure Example number of patients offered and accepting Partner Services
Additional Intermediate-level Measure Example(s) number of patients naming at least one partner
number of partners linked to testing and treatment
Evidence and Resources https://www.cdc.gov/std/tg2015/screening-recommendations.htm
Age Range People of all ages
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Not applicable
Contributing Sectors Governmental Public Health Agencies
Insurers
Colleges and Universities
Schools (K-12)
CBOs and Human service agencies
Intermediate-level Measure Example number of patients testing for STIs;
Additional Intermediate-level Measure Example(s) number of patients positive for STIs
number of patients diagnosed with an STI who receive treatment
Evidence and Resources

https://www.cdc.gov/condomeffectiveness/index.html

https://www.health.ny.gov/diseases/aids/consumers/condoms/nyscondom.htm

https://www.health.ny.gov/diseases/aids/ending_the_epidemic/

https://www.health.ny.gov/diseases/aids/ending_the_epidemic/docs/std_workgroup_strategies.pdf

Age Range People of all ages
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Not applicable
Contributing Sectors Governmental Public Health Agencies
Insurers
Media
Colleges and Universities
Schools (K-12)
Community or neighborhood residents
CBOs and Human service agencies
Housing agencies
Intermediate-level Measure Example number of condoms distributed
Additional Intermediate-level Measure Example(s) percentage of sexually active people who report using condoms
Evidence and Resources

https://www.health.ny.gov/diseases/communicable/std/ept/

https://www.health.ny.gov/diseases/aids/ending_the_epidemic/docs/std_workgroup_strategies.pdf

Age Range People of all ages
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Not applicable
Contributing Sectors Governmental Public Health Agencies
Insurers
Media
Colleges and Universities
CBOs and Human service agencies
Policy makers and elected officials
Intermediate-level Measure Example number of providers who offer EPT
Additional Intermediate-level Measure Example(s) number of patients who receive an EPT prescription
number of EPT prescriptions filled

Focus Area 4. Hepatitis C Virus (HCV)

Goal 4.1 Increase the number of persons treated for Hepatitis C Virus (HCV)

Target 8,813
Baseline 8,012
Baseline Year 2016
Data Source NYS Medicaid
Data Level Statewide
Evidence and Resources

Evidence Base: CDC Know More Hepatitis Campaign

Implementation Resources: CDC Know More Hepatitis Campaign ; NYSDOH Hepatitis Web Site

Age Range People of all ages
Social Determinants Addressed Community Cohesion
Health Care
Lead Sectors Governmental Public Health Agencies
Healthcare Delivery system
Contributing Sectors Employers, businesses and unions
Insurers
Media
Colleges and Universities
Schools (K-12)
Community or neighborhood residents
CBOs and Human service agencies
Policy makers and elected officials
Transportation agencies
Housing agencies
Intermediate-level Measure Example Availability of HCV educational materials
Additional Intermediate-level Measure Example(s) Client awareness of Hepatitis C
Evidence and Resources

Evidence Base:

Implementation Resources : The New York State Department of Health AIDS Institute Clinical Education Initiative (CEI) enhances the capacity of New York's diverse health care workforce to deliver clinical services to improve health outcomes related to HIV, sexually transmitted diseases (STDs) and hepatitis C (HCV).

Age Range People of all ages
Social Determinants Addressed Community Cohesion
Health Care
Lead Sectors Governmental Public Health Agencies
Healthcare Delivery system
Contributing Sectors Employers, businesses and unions
Insurers
Media
Colleges and Universities
Schools (K-12)
Community or neighborhood residents
CBOs and Human service agencies
Policy makers and elected officials
Transportation agencies
Housing agencies
Intermediate-level Measure Example MOUs with HCV providers for timely linkage to care
Additional Intermediate-level Measure Example(s) Provider knowledge of HCV treatment

Goal 4.2 Reduce the number of new HCV cases among people who inject drugs

Target 33,781
Baseline 28,291 individuals with a syringe transaction at SEPS in 2018
Baseline Year 2018
Data Source AIDS Institute Reporting System (AIRS)
Data Level Statewide, ROS/NYC
Evidence and Resources

Evidence Base: Based on existing evidence, the U.S. Surgeon General has determined that Syringe Service Programs, when part of a comprehensive prevention strategy, can play a critical role in preventing HIV among persons who inject drugs (PWID); can facilitate entry into drug treatment and medical services; and do not increase the unsafe illegal injection of drugs. These programs have also been associated with reduced risk for infection with hepatitis C virus (HCV).

Implementation Resources: NYSDOH AIDS Institute Policies and Procedures for Syringe Exchange Program.

CDC Syringe Services Program Guidance and Resources

Syringe Services Program (SSP) Development and Implementation Guidelines for State and Local Health Departments, NASTAD.

Age Range New Yorkers of all ages
Social Determinants Addressed Community Cohesion
Health Care
Lead Sectors Governmental Public Health Agencies
Contributing Sectors Healthcare Delivery system
Employers, businesses and unions
Insurers
Media
Colleges and Universities
Schools (K-12)
Community or neighborhood residents
CBOs and Human service agencies
Policy makers and elected officials
Transportation agencies
Housing agencies
Intermediate-level Measure Example Increases in syringe distribution, provision of HCV screening and linkage to care.
Evidence and Resources Evidence Base:

Implementation Resources: NYSDOH Hepatitis C Rapid Testing Implementation Guide

Age Range All New Yorker with special focus on those < 30 years of age
Social Determinants Addressed Education
Health Care
Lead Sectors Governmental Public Health Agencies
Healthcare Delivery system
CBOs and Human service agencies
Contributing Sectors Employers, businesses and unions
Insurers
Media
Colleges and Universities
Schools (K-12)
Community or neighborhood residents
Policy makers and elected officials
Transportation agencies
Housing agencies
Intermediate-level Measure Example Establish MOU with agencies that conduct HCV screening.

Focus Area 5. Antibiotic Resistance and Healthcare-Associated Infections

Goal 5.1 Improve infection control in healthcare facilities

Target NA
Baseline NA
Baseline Year 2019
Data Source NYS Health Commerce System (HCS) survey
Data Level Statewide
Target 0.70 infections (CLABSI) per 1,000 central line days
Baseline 0.92 CLABSI per 1,000 central line days
Baseline Year 2017
Data Source National Healthcare Safety Network
Data Level Statewide
Evidence and Resources

Evidence Base and Resources:

Age Range All ages; however, given the focus on improved infection prevention and control and patient safety in hospitals and long-term care facilities, these interventions will measure progress related to healthy aging.
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Contributing Sectors Governmental Public Health Agencies
Insurers
Intermediate-level Measure Example Long-term care facilities with an Infection Preventionist in the HCS role.
Additional Intermediate-level Measure Example(s)
  • An Infection Preventionist with completed specialized training in infection prevention and control.

  • Number of infection prevention and control training and education materials provided to all staff in healthcare facility.

  • Number of hospitals flagged with CLABSI rates significantly higher than the state average submitting improvement plans to the NYSDOH Hospital Associated Infection Reporting Program reporting program in time recommended.


Goal 5.2 Reduce infections caused by multidrug resistant organisms and C. difficile

Target NA
Baseline NA
Baseline Year
Data Source NHSN
Data Level Statewide
Target 0.14 infections per 10,000 patient days
Baseline 0.18 infections per 10,000 patient days
Baseline Year 2017
Data Source NHSN
Data Level Statewide
Target 0.30 infections per 10,000 hospital admissions
Baseline 0.40 infections per 10,000 hospital admissions
Baseline Year 2017
Data Source NHSN
Data Level Statewide
Target 3.91 cases per 10,000 patient days
Baseline 5.21 cases per 10,000 patient days
Baseline Year 2017
Data Source NHSN
Data Level Statewide
Target 2.90 cases per 1,000 admissions
Baseline 3.87 cases per 1,000 admissions
Baseline Year 2017
Data Source NHSN
Data Level Statewide
Target NA
Baseline NA
Baseline Year 2020
Data Source NYS Electronic Clinical Laboratory Reporting System (ELCRS) and NHSN)
Data Level Statewide and County level
Target NA
Baseline NA
Baseline Year
Data Source
Data Level Statewide
Evidence and Resources

Evidence Base and Resources:

  1. The CDC NHSN: https://www.cdc.gov/nhsn/index.html

  2. The NYSDOH Hospital-Acquired Infection Rates in NYS Hospitals: https://www.health.ny.gov/statistics/facilities/hospital/hospital_acquired_infections/

Age Range All ages; however, given a higher prevalence of antimicrobial resistant infections found in individuals with comorbid conditions and exposure to healthcare, these interventions will measure progress related to healthy aging.
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Contributing Sectors Governmental Public Health Agencies
Insurers
Intermediate-level Measure Example Number of healthcare facilities using the NHSN MDRO module for expanded MDRO surveillance beyond CRE and CDI.
Additional Intermediate-level Measure Example(s)
  • Number of hospitals identified with hospital onset CDI rates significantly higher than the state average submitting improvement plans to the NYSDOH HAI reporting program in time recommended.

  • Number of clinical laboratories with a rapid test for C. auris.

Goal 5.3 Reduce inappropriate antibiotic use

Target 30.0%
Baseline 40.0% among adults 18 to 64 in Medicaid
Baseline Year 2016
Data Source NYS Medicaid https://health.data.ny.gov/Health/Potentially-Avoidable-Antibiotic-Prescribing-Rates/vg7a-h5ss)
Data Level Statewide and County level
Target 100.0%
Baseline 88.0%
Baseline Year 2017
Data Source Health Commerce System Survey
Data Level Statewide
Evidence and Resources

Evidence Base and Resources:

  1. The CDC Antibiotic Prescribing https://www.cdc.gov/antibiotic-use/community/improving-prescribing/evidence/systematic-reviews.html

  2. The CDC Core Elements of Outpatient Antibiotic Stewardship: https://www.cdc.gov/antibiotic-use/community/improving-prescribing/core-elements/core-outpatient-stewardship.html

  3. The CDC 6/18 Initiative https://www.cdc.gov/sixeighteen/

Age Range All ages; however, however, given higher rates of antimicrobial prescribing and use in older age groups, these interventions will measure progress related to healthy aging.
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Contributing Sectors Governmental Public Health Agencies
Insurers
Intermediate-level Measure Example Provision of antimicrobial prescribing data to all primary and acute care providers with comparison of their antibiotic prescribing patterns to benchmark.
Additional Intermediate-level Measure Example(s) Number of healthcare providers reached with education and tools on antimicrobial resistance.
Evidence and Resources
  1. The CDC 6/18 Initiative https://www.cdc.gov/sixeighteen/

  2. The CDC Core Elements of Hospital Antibiotic Stewardship Programs: https://www.cdc.gov/antibiotic-use/healthcare/implementation/core-elements.html

  3. The CDC Core Elements of Antibiotic Stewardship for Nursing Homes: https://www.cdc.gov/longtermcare/prevention/antibiotic-stewardship.html

The CDC NHSN:

https://www.cdc.gov/nhsn/index.html
Age Range All ages; however, however, given higher rates of antimicrobial prescribing and use in older age groups, these interventions will measure progress related to healthy aging.
Social Determinants Addressed Health Care
Lead Sectors Healthcare Delivery system
Contributing Sectors Governmental Public Health Agencies
Insurers
Intermediate-level Measure Example Number of hospitals reporting antibiotic use data through NHSN Antibiotic Use and Resistance (AUR) Module.