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 />


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 />


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 />


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 />


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 />


Thomas L. Stephens<br />

Media Relations Specialist<br />

tstephens@maoi.org<br />

Dianne Teague<br />

Government and Donor Relations<br />


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 />



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 Wellness Center<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 />



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 />


Changing the Landscape of<br />

Rural Care<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 />



Serving the mind and the body<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 />



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 />


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 />


September 14, 2019<br />

Montgomery<br />

@MAOofAlabama<br />

maoofalabama<br />


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