MAOInsightFallWinter2018
MAO In Sight is the community and supporter newsletter of Medical Advocacy and Outreach (MAO), a 501(c)3 not-for-profit organization.
MAO In Sight is the community and supporter newsletter of Medical Advocacy and Outreach (MAO), a 501(c)3 not-for-profit organization.
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a publication of Medical Advocacy & Outreach (MAO) Winter 2018/2019<br />
IN SIGHT<br />
Issue 1, Volume 1B - December 2018<br />
Compassion, care, and<br />
innovation for more than<br />
30 years<br />
Heath, wellness, and HIV, Hepatitis C,<br />
and diabetes prevention education<br />
Speciality medical and behavioral care,<br />
including pharmacy and dental services,<br />
and counseling<br />
Social services, case management,<br />
insurance, food, transportation, and<br />
housing assistance<br />
Professional development programs that<br />
build human capacity to save lives<br />
Provider assisted telemedicine<br />
integration<br />
(Left to right) Robert Forehand, Health Educator, Neice Danzey,<br />
Community Education Division Manager, and Thomas Stephens,<br />
Media Relations Specialist, show their support for National HIV/AIDS<br />
Testing Day and a partnership with Walgreens and Greater Than AIDS<br />
to encourage everyone to get tested for HIV.<br />
Removing Barriers to Rural Care<br />
Dr. Carlos Reyes-Sacin, MD, AAHIVS, one of MAO’s credentialed<br />
providers, demonstrating the effectiveness of using telemedicine<br />
technology to provide speciality care across vast distances with the<br />
assistance of another MAO Team Member.<br />
Changing the Landscape<br />
of Rural Care<br />
ALABAMA E-HEALTH & GROWING RECOGNITION<br />
One of MAO’s more ambitious and rewarding<br />
large-scale projects began in 2011 and continues<br />
to improve access to rural healthcare in Alabama -<br />
Alabama e-Health. In early 2011, MAO’s vision was<br />
to establish a network of partnering agencies and<br />
satellite clinics across an expanding geographic<br />
footprint; each site staffed with a nurse and<br />
equipped with state-of-the-art telemedicine<br />
equipment. HIV positive individuals living in rural<br />
areas of Alabama would have access to HIVspecific<br />
medical care without the burden of driving<br />
to the closest HIV-specific medical clinic. Simply<br />
put, through telemedicine a qualified physician or<br />
nurse practitioner could provide care to a rural<br />
client in real time from miles or even hours away.<br />
Continued on page 5.
A message from MAO<br />
Leadership<br />
Michael Murphree, LICSW<br />
Chief Executive Officer<br />
There has never been a better<br />
time to say how much we<br />
appreciate our supporters.<br />
Over the last few years, Medical<br />
Advocacy and Outreach (MAO) has<br />
not only continued to serve those<br />
who rely on us for life-saving<br />
care, but we have been able to<br />
expand our services based on the<br />
changing needs of South Alabama<br />
residents.<br />
My hope is that you will find the information in this issue of the new<br />
MAO IN SIGHT informative and inspiring. Take a moment to consider<br />
how you might get more involved. Everything that we have been<br />
able to do since 1987 has been a direct result of public support.<br />
Your support, whether that be in the form of donations, event<br />
sponsorships, volunteerism, professional introductions, or just<br />
attending activities and events hosted by MAO, helps us continue to<br />
save lives every day. THANK YOU!<br />
In addition to HIV, Hepatitis C, diabetes, and stigma are prevalent in<br />
South Alabama, there remain barriers for many needing care, and<br />
some segments of the population are being hit harder than others.<br />
Together, we can #GetToZero new HIV infections, and improve<br />
access to care and quality of life for everyone.<br />
STAFF LEADERSHIP<br />
Michael Murphree, LICSW<br />
Chief Executive Officer<br />
Ashley M. Tarrant, MPH<br />
Chief Operation Officer<br />
Tina Bush, CPA<br />
Chief Financial Officer<br />
Laurie Dill, MD, AAHIVS<br />
Medical Director<br />
DaQuentin Davis, MS, HRM<br />
Director of Human Resources<br />
Rozetta Roberts, MSN, RN<br />
Clinical Director<br />
KC Vick, MPH<br />
Director of Capacity Building<br />
Jamil Dawson<br />
Director of Support Services<br />
Alftan D. Dyson-Long, PharmD,<br />
BCACP, AAHIVP<br />
Director of Pharmacy Services<br />
Elana M. Parker Merriweather, Ed.S.,<br />
AADC, LPC, NCC<br />
Director of Behavioral Health<br />
Carl Shamburger, Jr., DMD<br />
Dominique Askew Shamburger, DDS<br />
Co-Directors of Dental Services<br />
MAO IN SIGHT RETURNS<br />
Increasing communication<br />
Over the past two years, MAO has made great strides in<br />
realizing a long-term plan to increase communication with<br />
those we serve through cost-effective means. The results to date have<br />
been most evident in the appearance of event-specific advertisements<br />
such as those used to promote the annual Tread Red Walk and Fun Run in<br />
Montgomery and the first Wiregrass Breaking Barriers Summit in Dothan;<br />
more comprehensive use of social media platforms; and ongoing work to<br />
improve the content and scope of the MAOI.ORG website.<br />
One staple of the early years of Montgomery AIDS Outreach, Inc., D.B.A.<br />
Medical Advocacy & Outreach (MAO), was the quarterly IN SIGHT newsletter.<br />
IN SIGHT was first concieved by those generous volunteers we honor as<br />
MAO’s founders and first published in the Fall of 1987. IN SIGHT provided<br />
updates about MAO and the HIV/AIDS pandemic. Although we continue to<br />
evaluate the frequency of producing the publication in today’s economy, we<br />
are thrilled to share the first issue of the new IN SIGHT with you. Feel free<br />
to share your thoughts.<br />
MAO INSIGHT - WINTER 2018/2019 - PAGE 2<br />
Billy Sample<br />
Telehealth Resource Center Program<br />
Manager<br />
Ashley F. Boaz, MBA, MHA, CMPE<br />
Clinical Practice Manager<br />
Pamela D. Holton<br />
Regional Coordinator (Wiregrass Area and<br />
Southwest Alabama)<br />
IN SIGHT PUBLICATION TEAM<br />
Thomas L. Stephens<br />
Media Relations Specialist<br />
tstephens@maoi.org<br />
Dianne Teague<br />
Government and Donor Relations<br />
dteague@maoi.org
Building and Maintaining a Holistic Care Model Requires Planning and Constant Examination<br />
of What Works and How We Can Do More<br />
MAO’s team of medical, dental, and behavioral health providers gathered with pharmacy services and operation personnel from<br />
Montgomery, Dothan, and Atmore in September 2018 to assess service delivery, changing patient needs, and potential barriers to care.<br />
NO ONE TURNED AWAY DUE TO AN<br />
INABILITY TO PAY<br />
Compassionate, quality, affordable care, and assistance still<br />
needed.<br />
Since the first cases of HIV were recorded, an estimated 77.3<br />
million people worldwide have contracted HIV and an estimated<br />
35.4 million have died of AIDS-related illnesses. Today, an<br />
estimated 36.7 million people are living with HIV worldwide.<br />
Thankfully, global efforts have resulted in 19.5 million people<br />
worldwide receiving lifesaving antiretroviral treatment. Since the<br />
peak of the epidemic in 2005, annual AIDS-related deaths have<br />
declined by 48%.<br />
Although we have finally started to see a decline in new<br />
diagnoses in the United States and across the globe, the fight<br />
is NOT over. New diagnosis remain in the thousands. In fact,<br />
an estimated 1.1 million people in the United States are living<br />
with HIV, and 1 in 7 still do not know they are infected. In<br />
2016, Southern states accounted for more than half of new HIV<br />
diagnoses in the U.S., despite making up just 38% of the overall<br />
population. There are high risk groups, but HIV does NOT<br />
discriminate regardless of belief, location, race, culture, gender,<br />
sexual orientation, or political views.<br />
According to the Alabama Department of Public Health, there<br />
were approximately 14,351 reported cases of HIV in Alabama as<br />
of September 2018, including 262 newly diagnosed.<br />
Continued on page 4 .<br />
MAO Dental Clinic<br />
After One Year<br />
In June of 2017, MAO opened the<br />
MAO Dental Clinic to provide oral<br />
health for clients living with HIV.<br />
The Clinic in Montgomery served<br />
more than 240 patients in its first<br />
two months. After one year, the<br />
Clinic now serves more than 100<br />
patients per week.<br />
Many patients had not visited a<br />
dentist for more than 15 years,<br />
In addition to financial concerns,<br />
“there are still a lot of places<br />
where people living with HIV<br />
are met with stigma,” observed<br />
Dominique Shamburger, DDS,<br />
Co-Director of MAO Dental<br />
Services and one of three<br />
licensed dentists at the MAO<br />
Dental Clinic. “They will not find<br />
that here!”<br />
MAO INSIGHT - WINTER 2018/2019 - PAGE 3
MAO Wellness Center<br />
EXPANDING OPTIONS FOR COMMUNITIES BEYOND HIV<br />
One of MAO’s more recent expansions is the MAO Wellness<br />
Center. The vision for the Center includes the development<br />
of specialized care and wellness activities for women, the<br />
LGBTQi communities, and others. Currently, the Center is<br />
home to MAO’s PrEP Clinic. PrEP is a one pill per day risk<br />
reduction option for people who test negative<br />
for HIV and would like to stay that way. More<br />
than 175 indviduals are now receiving PrEP<br />
through the Center with private insurance or<br />
as a result of available assistance programs.<br />
Rozetta Roberts, MSN, RN,<br />
Clinical Director, for MAO’s<br />
Copeland Care Clinic, and Billy<br />
Sample, Program Manager of<br />
MAO’s new Telehealth Resource<br />
Center, demonstrate for<br />
supporters at the MAO Learning<br />
Center in Montgomery how<br />
telemedicine allows a patient and<br />
their doctor to capture realtime<br />
patient vitals and examine<br />
physical anomalies.<br />
NO ONE TURNED AWAY DUE TO AN<br />
INABILITY TO PAY<br />
Compassionate, quality, affordable care, and assistance<br />
still needed. Continued from page 3.<br />
When combined with the number of those we have lost, the<br />
accumulative reported cases of HIV totals an estimated 20,185.<br />
Of course, the data was still subject to verification at the time<br />
of reporting, but the figures paint a very real picture. For MAO,<br />
this means a growing number of people living with HIV, many<br />
who are co-infected with other concerns like Hepatitis C and<br />
diabetes, who will need care.<br />
At the close of 2017, MAO was providing direct care to more<br />
than 1,800 spanning 28 counties in South Alabama. As of<br />
December 2018, MAO welcomed 192 new patients living<br />
with HIV into care. As the data below clearly shows, we have<br />
seen a steady flow of people entering treatment over the last<br />
five years. However, as a result of increased adherence to<br />
medication, more patients are able to visit their doctor less.<br />
Patient-focused use of telemedicine technology is playing<br />
a significant role in patient adherence. A research study<br />
about MAO’s success with telemedicine technology was<br />
published in the Journal<br />
of Telemedicine and<br />
Telecare in February<br />
2018. The study<br />
found that 96% of<br />
followed patients were<br />
retained in care, 97%<br />
used antiretroviral<br />
therapy and 93% had<br />
suppressed viral loads.<br />
“Before<br />
telemedicine,<br />
newly diagnosed<br />
patients had<br />
to wait weeks,<br />
sometimes<br />
months, to<br />
see a doctor.<br />
Now we can<br />
accommodate<br />
patients as<br />
soon as they<br />
are diagnosed.<br />
Telemedicine<br />
has been a life<br />
saver.”<br />
- Alabama Department<br />
of Public Health<br />
MAO INSIGHT - WINTER 2018/2019 - PAGE 4
Changing the Landscape of<br />
Rural Care<br />
ALABAMA E-HEALTH & RECOGNITION<br />
Continued from page 1.<br />
Thanks, in part, to a matching grant from AIDS United, MAO<br />
launched the Alabama e-Health Telemedicine Initiative and<br />
its first telemedicine clinic in Selma, Alabama in 2011. Over a<br />
few short years, MAO’s Initiative grew from one patient clinic<br />
and one provider location into a network that now canvases<br />
12 Alabama counties. As of<br />
2018, MAO’s Alabama e-Health<br />
network consisted of three<br />
provider locations and 10 rural<br />
satellite clinics. The MAO<br />
network of satellite clinics<br />
delivers not only HIV-specific<br />
specialized and primary care,<br />
but pharmacy consultations,<br />
mental health counseling, and<br />
social work support-services via<br />
telemedicine to underserved,<br />
disproportionately impacted<br />
communities.<br />
MAO’s efforts to integrate telemedicine<br />
technology informed and inspired a widescale<br />
effort by Alabama Department of Public<br />
Health (ADPH), which resulted in telemedicine<br />
technology being integrated at county health<br />
departments in 37 counties by April 2018.<br />
Twenty three more were expected to go online<br />
by August 2018. Furthermore, ADPH confirmed<br />
60 out of 66 counties “Bandwidth Ready”<br />
in 2018 to support the use of telemedicine<br />
technology. To quote an Alabama Department<br />
of Public Health HIV Program Coordinator from<br />
one of Alabama’s most rural areas, “Before<br />
telemedicine, newly diagnosed patients had to<br />
wait weeks, sometimes months, to see a doctor.<br />
Now we can accommodate patients as soon as<br />
they are diagnosed. Telemedicine has been a<br />
life saver.”<br />
Looking beyond HIV, the Alabama e-Health<br />
Initiative is proving the potential of telemedicine<br />
to address widespread health barriers and<br />
reduce disparities in rural Alabama. The initial<br />
success of Alabama e-Health earned MAO<br />
recognition from The White House resulting<br />
in an invitation to present at the What Works<br />
Showcase in 2014. Additionally, The White<br />
House’s national HIV strategy highlighted the<br />
Alabama e-Health model as a viable and costeffective<br />
means of reaching rural HIV patients.<br />
Having demonstrated that the success was as<br />
much about innovative technology as it was<br />
provider effectiveness, MAO providers were<br />
presented with The American Academy of HIV<br />
Medicine (AAHIVM)/Institute for Technology<br />
in Health Care HIV Practice Award in 2015 for<br />
their pioneering work. To help cement longterm<br />
sustainability of the Initiative, in December<br />
2015, MAO worked with Blue Cross Blue Shield<br />
of Alabama and reached an agreement to allow<br />
for insurance reimbursement of telemedicine<br />
visits through that provider.<br />
MAO INSIGHT - WINTER 2018/2019 - PAGE 5
BEHAVIORIAL HEALTH<br />
Serving the mind and the body<br />
MAO SUPPORTS NATIONAL DRUG TAKEBACK DAY<br />
More than 40 pounds of controlled and non-controlled prescriptions were<br />
collected and turned over to the DEA in April.<br />
Corp. Cedrick Leonard from the Montgomery County Sheriff’s Department<br />
pictured with Kirstie Tyson Cleveland, ALC, one MAO’s Behavioral Health<br />
Therapists, preparing the DEA submission.<br />
(1) medical and clinical operations through<br />
physician referrals and consultations;<br />
(2) capacity building through workforce<br />
development and staff training on specialized<br />
topics around behavioral health;<br />
(3) social services through the coordination of<br />
community resources and referral linkages;<br />
(4) administration through agency wide<br />
planning for Alabama Department of<br />
Mental Health substance abuse treatment<br />
certification;<br />
(5) marketing and social media through the<br />
use of multimodal dissemination of behavioral<br />
health information to staff and the community;<br />
(6) telehealth services through opportunities<br />
for substance abuse prevention and treatment<br />
opportunities in rural communities; and,<br />
(7) financial planning for future acquisition of<br />
state and federal behavioral health funding,<br />
private pay fee for services, and third party<br />
insurance billing.<br />
The Department of Behavioral Health<br />
continues to explore opportunities to address<br />
the opioid crisis in Alabama. In 2018, the<br />
following programs were implemented and<br />
MAO INSIGHT - WINTER 2018/2019 - PAGE 6<br />
MAO’s newest department,<br />
Behavioral Health, began<br />
expansion efforts in 2018. The<br />
primary goal of the ongoing<br />
expansion is to offer substance<br />
abuse and mental health<br />
counseling services to agency<br />
patients and clients who are<br />
accessing other services. The<br />
offering of these and other<br />
behavioral health services<br />
have been initiated through the<br />
integration of services into:<br />
funding initiatives were pursued respectively:<br />
• Intra departmental development and<br />
coordination of the OTAP Committee<br />
(Opioid Treatment Abuse and Prevention)<br />
including capacity building and pharmacy<br />
• Hosting the National Prescription Drug<br />
Take Back Observance on April 26 for the<br />
community, patients, and MAO staff<br />
• Hosting the 1st Annual Opioid Summit on<br />
October 18 for state and local community<br />
substance abuse and mental health<br />
providers<br />
• Naloxone 101 Training for clinical and social<br />
services staff on September 25 and October<br />
18<br />
• Integration of the SBIRT (Screening for<br />
Brief Intervention Referral to Treatment)<br />
and ASAM (American Society for Addiction<br />
Medicine) assessment tools to screen<br />
patients for opioid related disorders<br />
The integration of comprehensive behavioral<br />
health services into Ryan White Care<br />
programs at MAO is evolving and growing.<br />
Contributed by<br />
Elana M. Parker Merriweather, Ed.S., AADC, LPC, NCC<br />
Director of Behavioral Health
Building Human Capacity<br />
Community Education - Professional Development -<br />
Systems Outreach - Civic Health<br />
One of the fasted growing departments within MAO is the Department of Capacity Building. For<br />
some who remember the early years of MAO, education and helping South Alabama communities<br />
gain access to information and the tools that will improve overall health, quality of life, and<br />
remove stigma surrounding life-saving care is<br />
where it all began. Today, we have to go ever<br />
further to make a difference.<br />
During 2018, MAO’s Division of Community<br />
Education hosted multiple health fairs and<br />
wellness events, including the Wiregrass<br />
Wellness Expo in November, and exhibited at<br />
those hosted by partnering agencies. Additionally,<br />
MAO’s Health Educators continued to lead<br />
efforts to encourage the public to know their<br />
HIV and Hepatitis C status by offering free,<br />
fast, and confidential testing at MAO locations<br />
and throughout South Alabama. More than 200<br />
presentations were made in settings ranging from<br />
Preparing for community testing days in Dothan and<br />
Montgomery. Always a team effort at MAO!<br />
secondary schools to college and university campuses to private institutions of care or<br />
incarceration.<br />
Changing the Landscape<br />
of Rural Care<br />
- Continued from page 5.<br />
Over the past few years,<br />
the Alabama Governor’s<br />
Office turned to MAO for<br />
advice on addressing health<br />
disparities, nominating<br />
MAO’s CEO, Michael<br />
Murphree, to the State’s<br />
Healthcare Task Force.<br />
To date, Murphree has<br />
been invited to participate<br />
in three rural health<br />
conferences at The White<br />
House where he advocated<br />
for policies to bolster rural<br />
healthcare capabilities.<br />
Elsewhere, he has been<br />
invited to provide talks on<br />
a wealth of social service,<br />
HIV/AIDS, telemedicine and<br />
rural health topics.<br />
MAO’s Division of Professional Development was equally busy<br />
planning, hosting and/or facilitating training opportunties that<br />
expand the capabilities of doctors, nurses, social service<br />
workers, counselors, and others. Through in person and webbased<br />
training sessions, including the Breaking Barriers<br />
Summit andWiregrass Breaking Barriers Summit, operating<br />
alone or in partnership with the Alabama AIDS Education<br />
Training Center (AETC) and the Southeast AIDS Education<br />
Training Centers (SE AETC), more than 1,243 trainees reached<br />
new levels of understanding on a menu of topics.<br />
During 2018, the Capacity Building Team increased its focus on<br />
empowering people to become more active in issues impacting<br />
their lives by assisting with voter registration, offering voter right<br />
restoration training sessions, and hosting nonpartisan Town Hall<br />
Listening Sessions surrounding healthcare. Advancing into 2019,<br />
even more will be done in these areas as well as Civic Health<br />
and System Outreach, focusing on the<br />
benefits of PrEP and building community<br />
support partnerships.<br />
Consider how you might get involved.<br />
Lucero Sitz, MAO’s LatinX outreach professional<br />
and language interpretor pictured outside of the<br />
MAO Learning Center showing support for MAO’s<br />
#ivotebecause campaign.<br />
MAO INSIGHT - WINTER 2018/2019 - PAGE 7
YOUR DONATIONS COUNT<br />
Help South Alabama Residents<br />
Get Tested! Get Care & Support! Get Connected! Get Involved!<br />
Did you know MAO must raise nearly 30% of its annual budget from grants<br />
and public contributions? Given the uncertanty of government and private<br />
foundation grants recurring annually, the support of individuals and<br />
businesses play critical roles in sustaining afforable, quality care; expanding<br />
prevention efforts that save lives and lower healthcare costs; and responding<br />
to the changing needs of those living in the rural South.<br />
Please consider making a generous one time gift or smaller recurring gifts<br />
to Medical Advocacy & Outreach (MAO) today.<br />
No amount is too small, and most donations are tax-deductible to the extent<br />
permitted by law. Consider your donations as investments in the health of<br />
your family, friends, neighbors, and community. Use the enclosed envelope for<br />
check or cash donations, or donate online using a major credit card at: http://<br />
maoi.org/support-mao-save-a-life-today/donate/<br />
Questions! Contact Dianne Teague. Call (334) 315-5421 or e-mail<br />
dteague@maoi.org. Donate anonymously or in honor of a loved one.<br />
In the Next Issue<br />
Healthy Babies<br />
Preventing HIV transmission to<br />
newborns. Monitoring the child and the<br />
MOMS of MAO.<br />
New Atmore Location<br />
Developing MAO’s newest full service<br />
clinic and education center in an<br />
underserved region.<br />
Expanding Services<br />
Specialized care to address Hepatitis C,<br />
STIs/STDs, diabetes, Women’s Health,<br />
and the LGBTQi community.<br />
Copeland Care Pharmacy<br />
More than just medications.<br />
Consultations,assistance referrals,<br />
interdisciplinary approaches, and<br />
convenience.<br />
Telehealth Resource<br />
Center<br />
Helping providers and service workers<br />
connect with those in need<br />
across great distances.<br />
Breaking<br />
Barriers<br />
Summit 2019<br />
Jan. 23 - 25, 2019<br />
12.5 contact hours<br />
REGISTER TODAY!<br />
MAO INSIGHT - WINTER 2018/2019 - PAGE 8<br />
2900 McGehee Road<br />
Montgomery, Alabama 36111<br />
(800) 510-4704<br />
info@maoi.org<br />
MAOI.ORG<br />
SAVE THE DATE!<br />
September 14, 2019<br />
Montgomery<br />
@MAOofAlabama<br />
maoofalabama<br />
MAO