Title
Ratification of Four-Year Update of Fast-Track Cities Ad Hoc Committee Recommendations
Description
This item seeks City Council ratification of the recommendations discussed in the four-year update of the Fast-Track Cities Ad Hoc Committee presentation at the City Council Policy Session on Dec. 8, 2020. This item also responds to Councilmember questions at the Dec. 8, 2020 Policy Session regarding coverage for City employees in the City's health care plans.
Report
Summary
On Oct. 25, 2016, the Mayor and City Council authorized the City of Phoenix to join the Fast-Track Cities Initiative (FTCI) to establish the City of Phoenix as a model in addressing and ending HIV/AIDS in Phoenix. FTCI is a global partnership between the City of Paris, Joint United Nations Program on HIV/AIDS (UNIAIDS), United Nations Human Settlement Program (UN-Habitat), and the International Association of Providers of AIDS Care (IAPAC), in collaboration with the local, national, regional and international partners and stakeholders. There are currently 27 Fast-Track Cities (FTC) in North America, 25 of which are in the United States. Fast-Track Cities work towards ending AIDS as a public health threat by 2030 building upon, strengthening and leveraging HIV-related programs and resources. Fast-Track Cities agree to achieve the following 90-90-90-0 targets by 2020:
90 percent of people living with HIV (PLHIV) knowing their HIV status
90 percent of PLHIV who know their HIV-positive status on antiretroviral therapy (ART)
90 percent of PLHIV on ART achieving viral suppression
Zero discrimination and stigma against people living with HIV
In January 2017, a 23-member Ad Hoc Committee was created representing people living with HIV, medical providers, community-based organizations, local HIV advocacy groups, and government departments in the HIV field. Councilwoman Laura Pastor and Councilwoman Debra Stark currently serve as Co-Chairs.
FTCI is framed around a five-element implementation plan, supported by IAPAC which addresses key aspects necessary for a robust citywide AIDS response that promotes continuum of care from HIV diagnosis to viral suppression:
Process and Oversight
Monitoring and Evaluation
Program and Interventions
Communications
Resource Mobilization
Three subcommittees were created to reach these goals: 1) On HIV Medication and Virally Suppressed, 2) Knowing HIV Status, and 3) Zero Stigma. Below are highlights from the previous four years in each of the subcommittees:
On HIV Medication and Virally Suppressed Subcommittee
Developed the City of Phoenix Rapid Start Protocol in partnership with the Arizona Department of Health Services (ADHS) and local stakeholders. The created name of this process is "State of Arizona Rapid Treatment" (START) which is to have newly diagnosed HIV patients start on Antiretroviral Therapy (ART) within 0-5 days after diagnosis or after reengaging in care. This goal is being successfully met.
Created and distributed brochures on “Let’s End HIV”, “Medical Care” and “START” to the community.
In June 2019, FTC Ad Hoc Committee Member Dr. Thanes Vanig presented at the 14th International Conference on HIV Treatment and Prevention Adherence in Miami. The presentation was on "Implementation Strategies for Citywide Rapid Start Program: Collaboration Among Stakeholders Organized by the City of Phoenix Fast-Track Cities Initiative”.
In September 2019, FTC Ad Hoc Committee Member Dr. Thanes Vanig presented at the Global Fast-Track Cities Conference in London on the implementation and results of the START program.
Knowing HIV Status Subcommittee
Partnered with the ADHS HIV Prevention, Care and Surveillance program to implement a prevention and care needs assessment which included the ADHS Hispanic assessment completed in April 2018 and the ADHS African American assessment completed in September 2018.
In September 2018, the ADHS HIV Prevention, Care and Surveillance program released an interactive map which allows individuals to locate HIV incidence information from 1983 to present by zip code, customized using any combination of data including age, gender, ethnicity, risk factor, viral suppression rate, number of new and/or repeat HIV testing, location of HIV-specific providers and community-based services, hospitals and federally-qualified health centers and HIV pharmacies. Additionally, the ADHS HIV Prevention, Care and Surveillance program has developed specific HIV continuums of care for each target population quarterly with updated data.
In March 2019, FTC Ad Hoc Committee Members Kenja Hassan and Debbie Rubenstrunk coordinated a panel presentation on “HIV and the Faith Based Community" at the ADHS Fifth Annual HIV Integrated Symposium. A panel of local pastors/clergy discussed how faith leaders are working with the HIV community.
In June 2019, based upon a call to action by the FTC Ad Hoc Committee, the Arizona Christian Communities of Faith participated in the National HIV testing day with the theme “Oh Test and Know”. The purpose was to show support for those living with the HIV/AIDS virus, to raise awareness of the current epidemic in local communities, to reduce the numbers of the untested, and inspire the community to "know your status". An HIV/AIDS Resource Toolkit for Religious Leaders was created by the International Alliance for the Prevention of AIDS (IAPA) and Arizona State University. The toolkit contains links and resources to enable religious organizations to incorporate the topic of HIV/AIDS into messaging and outreach. Also highlighted in the toolkit are examples of how some churches are currently supporting their congregations in this effort.
As part of the HIV Training/Education goal, a 35-minute online course developed by IAPA, providing fact-based information on HIV/AIDS while addressing myths about the disease is offered to City of Phoenix employees. Since January 2019, 50 employees have taken this course.
In October 2019, the FTCI Dashboard was officially launched by the IAPAC, which is the global organization overseeing the Fast-Track Cities. This dashboard tracks the 90-90-90-0 data for the City of Phoenix.
Zero Stigma Subcommittee
Implemented Project HHHOME (Housing, HIV, Health Outcomes and EmployMEnt/Education), a program designed to improve housing, employment, education and health outcomes for people living with HIV. Administered through the Housing Department, this is a partnership with Ryan White HIV/AIDS Program, Maricopa Integrated Health System, Southwest Behavioral and Health Services, Area Agency on Aging and the City of Phoenix Housing, Human Services and Library departments.
During Spring 2018, Ad Hoc members from Arizona State University and Vital Insight Public Relations developed the “Undetectable = Untransmittable" or “U=U" campaign. Promoted locally and nationally using print, television and social media tools, this campaign was designed to reach those living with HIV, partners and friends, and health care professionals. U=U indicates that if a person with HIV is on HIV meds or (ART) with a consistently undetectable HIV viral load, the virus cannot be transmitted.
In early 2019, Arizona State University conducted a People Living with HIV (PLWHIV/AIDS) survey to identify issues relating to HIV stigma among individuals who reside in Maricopa County. The results of the survey are being used at conferences addressing the stigma of HIV/AIDS in the community. The report is available on the Fast-Track Cities website at Phoenix.gov/HIVPHX.
The Fast-Track Cities Ad Hoc Committee will continue to reach out to the private sector and the community in order to: (1) demonstrate the City's commitment to this issue, (2) garner media attention, (3) form collaborations to streamline and improve services for people diagnosed with HIV, and (4) enlist the community in ending stigma and changing attitudes toward HIV. It is this strategic combination of reforms and community action that will continue to make Phoenix a national leader in addressing this important issue.
The FTC Ad Hoc Committee requests the City Council adopt a declaration (Attachment A) called "Ending the Epidemic," which calls upon medical systems and providers throughout the city and health insurance providers to implement policies that will better enable the City of Phoenix to achieve the 90-90-90-0 goals.
In response to Councilmember questions at the Dec. 8, 2020 City Council Policy Session, staff researched City employee health care plan coverage related to HIV screening. Staff confirmed that City employee health care plans include policies that will better enable the City to achieve the 90-90-90-0 goals. Under the City’s current health care plans, HIV screening is covered as part of routine screening and all of the FDA approved therapies are included in the pharmacy plan approved formulary or medical plans, including the single-tablet HIV regimens. As new medications are developed and approved for treatment by the FDA, they will be added to the plans formulary. In addition to verifying coverage for these items, staff has worked with Banner Employer solutions to ensure that starting January 2021 HIV screening will be offered at all annual physical appointments conducted at the downtown employee health clinic.
Concurrence/Previous Council Action
The City Council heard the Four-Year Update of the Fast-Track Cities Ad Hoc Committee at the City Council Policy Session on Dec. 8, 2020 and in support of the declaration requested additional information related to health care plans available to City employees.
Department
Responsible Department
This item is submitted by Deputy City Manager Inger Erickson and the Human Services Department.