10 Years of Collaboration on U S -Mexico

10 Years of Collaboration on U. S. -Mexico Border Training Center Collaborative

Panelists Tracee Belzle – Program Manager, Dallas PTC Mona Bernstein, MPH – Director, Pacific AETC Nicolé Mandel – Website Manager, AETC NRC Beth Rutkowski, MPH – Associate Director of Training, Pacific Southwest ATTC James Sederberg – Deputy Director, Curry International TB Center

Evolution of Border-Wide Efforts Border Feasibility Study and Planning Process: 2002 -2003 § End of year funding from HRSA to AETCs UMBAST: 2004 -2010 (U. S. -Mexico Border AETC Steering Team) § 2 cycles of MAI funding to AETCs Border FTC Collaborative: 2011 -2013 § MAI funding for AETCs, TB Centers, RTCs, PTCs, ATTCs

Collaborators California Arizona • • • Pacific AETC Curry TB Center Pacific SW ATTC California PTC Cardea – CA RTC Pacific AETC Pacific SW ATTC California PTC Cardea – CA RTC Heartland TB Center • • • New Mexico Texas • • • Mountain-Plains AETC California PTC Cardea – TX RTC Gulf Coast ATTC Heartland TB Center Texas/Oklahoma AETC Dallas PTC Cardea – TX RTC Gulf Coast ATTC Heartland TB Center National Partners: • • AETC NRC AETC NEC

Products of Collaboration Website: AETCBorder. Health. org Fact Sheets § Tips for Providers Working with Meth Users § Tips for HIV Patients Returning to Mexico § Antiretroviral Drugs Available in Mexico Directory § HIV Testing and Treatment Resources on the Border (print and online) Curricula § Continuity of Care for Patients Returning to Mexico § Engagement in Care on the Border National Trainings § AETC TOTs § U. S. ICE

Products of Collaboration Conference Presentations, Posters, & Institutes § § IAS Meetings: Toronto, Mexico City, Barcelona, Bangkok AGM Meetings: 2010, 2008, 2006 HRSA Border Meetings, Think Tank Binational Health Week Infectious Diseases Workshops Awards and Citations § AETC Leadership Award (Donohoe) § Human Rights Watch Publications § Journal of the Association of Nurses in AIDS Care § U. S. -Mexico Border Health Commission Newsletter § Impacto Transnacional

Training Center Perspectives Pacific AETC: Mona Bernstein § 10 Years of Collaborations on the U. S. -Mexico Border Curry International TB Center: James Sederberg Pacific Southwest ATTC: Beth Rutkowski AETC National Resource Center: Nicolé Mandel

Curry International Tuberculosis Center FTCC/UMBAST Collaborations James Sederberg Deputy Director

Program Collaboration and Service Integration (PCSI) • • Mechanism for organizing and blending interrelated health issues, activities, and prevention strategies to facilitate comprehensive delivery of services Initiated by CDC’s National Center for HIV/AIDS, Viral epatitis, STD, and TB Prevention Service delivery strategies begin with training of staff A “win-win” for all if implemented effectively

Border Training Collaborations • • Treatment of TB, STDs, HIV, Hep C and Substance Abuse on the Border: Keeping Border Patients in Care with Limited Resources ü ü Bisbee, AZ on November 18 -19, 2011 El Centro, CA, June 25 -25, 2010 Treatment of TB, STDs, HIV, Hep C and Substance Abuse on the Border: Managing Patients in the Border Region ü Rio Rico, AZ, June 12 -13, 2009 Treatment of TB, STDs, HIV, Hep C and Substance Abuse on the Border: Managing the Bi-national Patient ü San Ysidro, CA, June 6 -7, 2008 Treatment of TB, STDs, HIV, Hep C and Substance Abuse on the Border: Focus on Testing ü Imperial, CA, June 1 -2, 2007

Border Training Collaborations (2) • • • Addressing the Intersection of Multiple Health Concerns for Migrant Populations: Family Planning, STDs, HIV, TB, and Substance Abuse ü ü ü Fresno, CA, June 11 -12, 2010 Yakima, WA, July 9 -10, 2010 Supplemental MAI funding (CDC) HIV, TB, and Meth in 2011: What Border Clinicians Need to Know ü Sierra Vista, AZ, on May 25, 2011 Assisting HIV-Infected Patients Who Return to Mexico: What ICE Clinicians Need to Know ü San Diego, CA (phone conference), April 13

FTC Partners • • • Pacific AIDS Education and Training Center UCLA AIDS Education and Training Center San Francisco AIDS Education and Training Center Arizona AIDS Education and Training Center Northwest AIDS Education and Training Center California STD Prevention Training Center Pacific Southwest Addition Technology Transfer Center for Health Training Southeastern HIV/AIDS Consortium Heartland National Tuberculosis Center Etc…

Other Collaborative Activities • TB Prevention in the HIV-infected Patient: Screening, Testing, and Treatment of Latent TB Infection ü ü Online enduring product. Both a learning and teaching too. Provides information on how to screen, test, and treat human immunodeficiency virus (HIV)-infected patients for latent tuberculosis infection (LTBI) Faculty include Drs. Tulsky and Leutkemeyer (SF AETC)

• Other Collaborative Activities (2) Medical consultation ü ü ü 50 -year old patient, Mexican national in US, TB/HIV, psychiatric disorders Incarcerated, refusing meds, hospitalized but leaving care Huge financial burden on Arizona Department of Health Services and/or Arizona Corrections ADHS searched for options and contacted UCLA AETC to help coordinate: Ø Placement into a TB hospital (Heartland in San Antonio) Ø Funds to support TB, HIV treatment CITC, Heartland TB Centers, ADHS still working on solution

Pacific Southwest ATTC Beth Rutkowski, M. P. H. UCLA Integrated Substance Abuse Programs brutkowski@mednet. ucla. edu

When it all began…May 2004 • Initial topics included: – HIV and Substance Abuse on the Border: A Focus on Methamphetamine Abuse – HIV and Substance Abuse on the Border: A Focus on Women • Locations included: – CA: San Diego, El Centro – AZ: Nogales – NM: Las Cruces

More Folks got Involved and the Focus was Expanded beyond Meth • 2006 -Present – PAETC, Pacific Southwest ATTC, California STD/HIV Prevention Training Center, the Francis J. Curry National Tuberculosis Center, etc. – The Role of Addictions; A Focus on Testing; Managing the Bi-national Patient; Keeping Patients in Care

Most Recently, we have focused on… • Screening, Brief Intervention, and Referral to Treatment • Health Reform and Integration • NIATx Process Improvement Model (to increase client access, engagement and retention in SUD treatment)

The Most Powerful Collaboration Yet

The Benefits of Successful Cross-TC Border Collaboration… More Business! • Two Finalized Training Curricula (PPT presentation, trainer guide, 2 -page fact sheet) – Crack Cocaine and HIV – Prescription Opioids • Two More Curricula in Process (will be finalized by June 2012) – Alcohol and HIV – SUD and Primary Care Integration

U. S. -Mexico Border Project Texas FTCC Partnerships: Past and Future

en Th Original Southern Region FTCC Project : TX/OK AETC; Delta AETC, FL PTC, Dallas PTC, TX PTC; Center for Health Training (RTC)

ow N TX/OK AETC; Dallas, MS, CO PTC; Cardea Services (formally CHT), the RTC; Heartland RTMCC; Gulf Coast ATTC

UMBAST 2012 UMBAST provided us the opportunity to formally and specifically address common training and capacity issues of providers along the Texas-Mexico border.

UMBAST Meeting January, 2012 | S. Padre Island ü FTCC partners participated in-person/phone ü Planned inclusion of FTCC partner services in UMBAST “Continuum of Care” curriculum (e. g. , substance abuse, family planning, etc. ). ü Planning of a live, national webinar of updated “Continuum of Care” curriculum. ü Initiated planning of potential future crosscollaborative efforts across FTCC partners.

Collaborative Webcasts • HIV & Stigma – provided by RTC (Cardea Services) – March 23 • HIV, Stigma, and Prison – provided by RTC (Cardea Services) – March 29

Collaborative Webcasts • HIV Rapid Testing: A SAMHSA/NIDA Initiative to promote Adoption of an Evidence Based Practice in Substance Abuse Treatment Programs – provided by UT Austin, School of Social Work Research Center – May 3 • Diagnosis & Treatment of Tuberculosis in the HIV Patient – provided by Heartland National TB Center - June 21

ARTAS: Anti-Retroviral Treatment & Access to Services ARTAS is an individual-level, multi-session, timelimited strategy with the goal of linking recently diagnosed persons with HIV to medical care soon after receiving their positive test results. April 19 th – 20 th & May 24 th – El Paso June 7 th – 8 th – location TBD Provided by: Dallas PTC

AETCBorderhealth. org Nicolé Mandel AETC National Resource Center

UMBAST Home Online § Program information § Reports § Web links § Funding opportunities § Border Resource Directory June 2008

Search “Mexico border AIDS”

Border Resource Directory http: //www. AETCBorder. Health. org

Border Directory: The Next Phase

Using New Technology to Develop Collaborative Resources • Google Maps and Calendar • • Allow multiple editors Mobile friendly Easy to use Positions us for geolocation-savvy applications • AIDS. gov resource widgets

Looking Ahead • Sharing best practices & faculty across the border • Expanding use of technology & online training • Helping border providers with the big health care transitions ahead • More collaborations (e. g. Migrant Clinicians Network)

Collaboration Best Practices • • Funding helps Designated coordinator (rotating) Mission-driven participants Structured communication Dedicated Listserv Annual face-to-face meetings Shared successes (working on projects, joint trainings)