Transcript Region V IPP PM UPdate

Region II
Infertility Prevention Project
Advisory Committee
May 16-17, 2007
New York, New York
Steven J. Shapiro
Infertility Prevention Project Coordinator
CDC/NCHHSTP/DSTDP/PTB (proposed)
Disclaimer: The findings and conclusions in this presentation are
those of the author and do not necessarily represent the views
of the Centers for Disease Control and Prevention.
Topics
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Budget Update
CSPS Update
Ongoing Projects
» Performance Measures Activities
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Performance Measures Data
Budget 2007
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Flat Funding for STD Prevention
– Funded at Final 2006 levels
» Approx. $107 million to grantees
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Infrastructure Funding
» Base Award
» Special Project
» STD Conference Travel Funds
» Data Systems Standardization
CSPS 2008
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CSPS 2008
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Continuation Application Due August 17, 2008
Program plans, reflective of regional activities, must be
developed with FP and Lab
– FP concurrence letter
CSPS Background, IPP plan and budget must be made
available to the regional coordinator with enough time for
inclusion of feedback into application
At least 50% used to support screening and treatment in
FP partner facilities
Local prevalence monitoring data should be used to
allocate resources
Application must include objectives related to the IPP
Performance Measures
CSPS 2009
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CSPS 2009
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5 year Cooperative Agreement
Possible increased flexibility in using awarded IPP funds
Integration Language
Better matching of CSPS and Infrastructure
Need for regional screening criteria
Emphasis on completing required IPP activities
– Ensure CT and GC screening and treatment
– Support laboratory testing
– Ensure collection of all CDC core data elements
– Program Management
– Provider Training
Ongoing Projects
Azithromycin Pricing
 Infertility Prevention Workgroup
 Performance Measures
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– CSPS
– Infrastructure
Azithromycin
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Off Patent 2006
» Contract (Pfizer) Sub-ceiling 340B pricing of
$95 per 10 doses of 1 gm sachet not longer
valid
» Available in various formulations and dosages
from three manufacturers and numerous
distributors nationwide
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Region II
» STD Programs $2.10-$15.52/dose
» FP Programs $2.24-$10.26/dose
» National Range $0.38 - $24.50/dose
Infertility Prevention Workgroup
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Summary of IPW Submission:
» Common theme:
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Should the Division support increased screening of
females under the age of 26 for Ct in public and private
sectors?
» Supporting Priorities
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Social Marketing
Monitoring of Screening Coverage
Current Activities
» Blueprint Development
» Staffing Plan
Performance Measures Activities
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NCSD Consultation (January 2006)
– Expansion of CSPS Performance
Measures
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Timeliness Treatment STD clinics
Gender of sex partner infectious syphilis
– Infrastructure Performance Measures
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NCSD Consultation (February 2007)
»
»
»
»
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Screening Coverage
Proportion of tests by age
Re-infection
Hepatitis B Vaccination in STD Clinics
Cost of partner services interventions
Congenital Syphilis
Performance Measures Learning Tours
Questions?
Performance Measures
Data Review
Region II and National Summary Data
 Data Verification
 Prevalence Monitoring and
Performance Measure Data

» Regional Summary
» Project Area Snapshot
100.0
90.0
80.0
70.0
60.0
50.0
40.0
30.0
20.0
10.0
0.0
Performance Measure
2
ES
1
ES
CS
2
CS
1
5
PS
4
PS
3
PS
2
PS
1
PS
1
2004-1
2005-1
2005-2
2006-1
LS
M
% Reporting
Grantees Reporting STD Performance Measures
Performance Measure
IPP CS1
Among clients of IPP Family
Planning clinics, the proportion of
women with positive chlamydia
tests treated within 14 and 30
days of the date of specimen
collection.
IPP CS 1 (Chlamydia) Results
Site
2004.1 2005.1 2005.2 2006.1
Region II- 14 Days (Average)
0.52
0.40
0.55
0.52
Region II- 30 Days (Average)
0.74
0.64
0.72
0.72
National- 14 Days (Average)
0.7
0.75
0.63
0.64
National- 30 Days (Average)
0.9
0.89
0.78
0.77
Index
CS1: Median proportion of positive female chlamydia cases
from Family Planning clinics treated within 14 days, by HHS
region
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
2004-1
2005-1
2005-2
2006-1
US
1
2
3
4
5
6
HHS Region
7
8
9
10
Performance Measure
IPP CS2
Among clients of IPP Family
Planning clinics, the proportion of
women with positive gonorhea
tests treated within 14 and 30
days of the date of specimen
collection.
IPP CS 2 (Gonorrhea) Results
Site
2004.1
2005.1
2005.2
2006.1
Region II- 14 Days (Average)
0.55
0.51
0.51
0.53
Region II- 30 Days (Average)
0.74
0.61
0.67
0.72
National- 14 Days (Average)
0.7
0.74
0.64
0.65
National- 30 Days (Average)
0.9
0.91
0.75
0.77
Index
CS2: Median proportion of positive female gonorrhea cases
from Family Planning clinics treated within 14 days, by HHS
region
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
2004-1
2005-1
2005-2
2006-1
US
1
2
3
4
5
6
HHS Region
7
8
9
10
Performance Measure
CSPS MLS1
Proportion of female admittees to large
juvenile detention centers tested for
chlamydia.
CSPS MLS1 (JDC Screening) Results
Site
Region II (Average)
National (Average)
2004.1 2005.1 2005.2 2006.1
0.69
0.63
0.87
0.60
0.54
0.50
0.48
0.59
Index
MLS1: Median proportion of female juvenile detention
center admittees that are tested for chlamydia, by HHS
region
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0.0
2004-1
2005-1
2005-2
2006-1
US
1
2
3
4
5
6
HHS Region
7
8
9
10
Data Verification
 Performance
Measures Guidance:
» IPP Family Planning Clinics: All family planning clinics that
report data as part of the Chlamydia Prevalence Monitoring
Project, regardless of whether they are integrated clinics or not.
» Denominator: Total number of women who tested positive for
chlamydia (at those family planning clinics)
– In other words: If ten FP clinics in a
jurisdiction report 500 CT positives and
9500 CT negatives to the prevalence
monitoring database, then the denominator
for the performance measure should be
500.
Prevalence Monitoring v. Performance Measure
Females in IPP Family Planning Clinics
Chlamydia and Gonorrhea 2005
Region II Summary
Region II
Prevalence
Monitoring Positives
7423 (4/5)
Performance
Measure
Denominator
9469
Chlamydia
Gonorrhea
Difference
2046 (28%)
721 (3/5)
1121
400 (55%)
Reasons for Differences
– 2005 data
– If Prev. Monitoring > Perf. Measures
» Prevalence Monitoring data includes only those clinics
who reported more than a total of 25 tests during the
year
» Not counting integrated clinics
– If Prev. Monitoring < Perf. Measures
» Non-prevalence monitoring FP sites submitting data for
performance measures
» Counting non-FP sites
– ???
Prevalence Monitoring v. Performance Measure
Females in IPP Family Planning Clinics
Chlamydia 2005
Grantee
Prevalence Monitoring Performance Measure
Positives
Denominator
3010
2761
New Jersey
Difference
249 (8%)
NYC
1352
1435
83 (6%)
NYS
2765
4830
2065 (75%)
Puerto Rico
296
443
147 (50%)
Virgin Islands
159
NR
n/a
Prevalence Monitoring v. Performance Measure
Females in IPP Family Planning Clinics
Gonorrhea 2005
Grantee
Prevalence Monitoring Performance Measure
Positives
Denominator
343
317
New Jersey
Difference
26 (8%)
NYC
70
298
228 (326%)
NYS
308
506
198 (64%)
Puerto Rico
14
NR
n/a
Virgin Islands
17
NR
n/a
Questions?