Prepared By:

Dolores Alvarado, Division Director,

Community Health Promotion

Submitted By: Guadalupe S. Olivas, PhD, Director,
Public Health Department

Date:

August 16, 2006

To:

Supervisor Liz Kniss, Chairperson
Supervisor Blanca Alvarado

From:

Kim Roberts, Acting Executive Director
Santa Clara Valley Health & Hospital System

Subject:

HIV/AIDS Testing Expansion Implementation Plan

RECOMMENDED ACTION

Accept and approve the Public Health Department’s HIV/AIDS Testing Expansion
Implementation Plan.
FISCAL IMPLICATIONS

No additional County General Funds are required as result of this action.
REASONS FOR RECOMMENDATION

On June 6,2006 the Board of Supervisors approved a one-time budget allocation of$375,000 for
FY 2006-07 for expansion of HIV testing and counseling sites for targeted at-risk populations in
Santa Clara County. Seventy-five thousand ($75,000)of this funding was set aside for the Public
Health Department to use for administrative and campaign marketing costs. The purpose of this
allocation is to expand HIV testing and counseling sites that 1) use Rapid Testing technologies;
2)are culturally and linguistically appropriate; 3)are provided at locations where, and during
hours when, populations most vulnerable and at-risk of acquiring HIV are accessible. The Public
Health Department was requested to submit an implementation plan for approval by the Health
and Hospital Committee.

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Process to Develop Plan

This implementation plan for alternative rapid HIV test sites reflects the use of epidemiological
estimates and reflects the voice of the community. Public Health has participated in several
meetings with representatives of the HIV Planning Council and the HIV Prevention Community
Planning Group. Their priorities and concerns are incorporated throughout this implementation
plan. It is also consistent with the Santa Clara County Comprehensive Planfor HIV/AIDS
Services 2006-2008 and the Santa Clara County HIV Prevention Plan 2006-2008.
BACKGROUND

Increasing rates of HIV infection in several identified populations are posing threat to the public
health of Santa Clara County. Both CDC and local estimates indicate about 25% of those living
with HIV/AIDS are unaware of their diagnosis. In Santa Clara County, there are at least 898
persons who are living with HIV/AIDS who are unaware of their diagnosis. The local
positive rate for all testing is 1.67%, while the local positive rate for MSM is 2.4-4.0%, and the
statewide MSM rate is 12-20%.

Purpose, Goals, and Parameters ofPlan

The overall purpose is to expand the rapid HIV testing and to connect this testing service with
existing HIV prevention and treatment programs and services.
The goals/objectivesfor the expansion ofHIV/AIDS testing are:

• Reduce the prevalence and incidence of HIV/AIDS through testing, counseling, referral
to care, and treatment to resident who are at risk of HIV/AIDS.

• Conduct a minimum of6,944 tests to targeted persons and achieve a seropositivity rate of
2% for HIV antibodies among test sites within Santa Clara County (including the Public
Health Department’s Crane Center) in order to reach a goal of approximately 140
positive results.

Priority Populationsfor Expanded HIV Alternative Testing Sites are:
•
•
•
•

Men who have sex with Men(MSM)
Female sexual partners of Men who have Sex with Men(FSMSM)
Transgender persons and Injection Drug Users(IDU)
(IDU) and MSM/IDU

Groups identified among priority populationsfor expanded HIV testing are:
• People of Color
•

Sex Workers

•

Youth

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Geographic Area Priorities are:

• The HIV/AIDS epidemic continues to be concentrated in the city of San Jose.
• North County residents (Sumiyvale, Mountain View, Palo Alto and Los Altos) make-up
the next highest percentage of reported HIV cases.
• South County residents make-up the smallest number of reported HIV cases to date.
• However, isolation and limited access to services create challenges that need special
attention.

Method to Expand HIV Testing

The Public Health Department will use a competitive RFP process to select 3 to 5 community
based organizations to provide HIV testing within the required standards stipulated by the
California Department of Health Services(CA DHS)and the Center for Disease Control(CDC).
These required standards have been incorporated as necessary “start-up” infrastructure
development that selected Community Based Organizations(CBO) will need to have in place
prior to beginning the testing. Accordingly, the contract period will be November 1, 2006 to
October 31,2007.

Attachment 1 outlines the timetable for implementing this plan. The specific work plan
activities are detailed in Attachment 2.

To maximize awareness of the availability of the expanded testing sites, the PHD will develop a

marketing campaign. To complement this new General Fund funding, the PHD has also been
able to restructure the availability of its internal testing services by assigning its County staff(2
FTE) during nontraditional hours. We are in the process of accomplishing this through the meet
and confer process with SEIU 715. In addition, to manage and monitor this expanded program,
the PHD will redirect HAP staff to undertake functions listed in Attachment 2.

Included in pages 3 and 4 of this work plan (Attaclrment 2) are the preferred capacities and
requirements for community based organizations.
The detailed activities and timeframe necessary to meet the CA DHS and CDC requirements are
delineated in pages 4 and 5.

Finally, the implementation of this program will include an evaluation of the degree to which the
outlined goals and objectives have been achieved. The detailed evaluation plan is included in
Attachment 3.

CONSEQUENCES OF NEGATIVE ACTION

Failure to accept this report and Implementation Plan will result in the Public Health
Department’s inability to expand HIV/AIDS testing sites in the community.

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c:

Supervisor Beall
Supervisor McHugh
Supervisor Gage
Peter Kutras

Phyllis Perez
Claudia Chan

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