We use collective impact strategies to accomplish our seven-fold mission. We find appropriate partners across different sectors with whom we establish shared common goals and specific action plans; we communicate regularly; we engage in mutually reinforcing activities; we share outcomes and measurements. We are focused and specific in our follow-up and follow-through with all partners; and we express respect and appreciation to our clients, volunteers and partners. Finally, we do not waste that most precious of commodities: time – ours, our clients’, volunteers’ or partners’.
These strategies are hardly new, but their consistent and disciplined application in our planning efforts enables us to operate within the constraints of our very tight budget on one end, and the lack of public funding to address the problem in Southern Nevada on the other.
Our specific activities are listed below.
I. Planning, organizing and setting up screening/vaccination events in culturally and linguistically friendly venues with our Community Partners.
II. Promoting the event through our Community and Media Partners.
III. Coordinating the delivery of services with our Medical Service Partners.
IV. Coordinating and scheduling native language speaking volunteers from Community Partners.
V. Ordering healthy snacks and lunches from our Food Partners for volunteers and medical service partner staff working the event.
VI. Managing the event in ways that minimize wait time for clients, that make it a hands-on learning experience for student volunteers and that ensure mutual reinforcement with our partners.
VII. Registering clients who complete three forms: registration form, consent to procedure & release form and authorization for release of protected health information form.
VIII. Communicating test results to clients screened within 14 working days of the screening date using letters A, B & C. These letters typically say, in both English and the primary language of the client:
- Letter A – You are not infected with the hepatitis B virus AND you are immune from the virus. If you gave us the name of your doctor at registration, a copy of this letter and your test results will be sent to him. If you did not give us his name, please share this letter with him at your next appointment. If you do not have a doctor, please see one if you have any questions about your test results. Enclosures are two items: a copy of the test results and the test guideline from page 2 of “Physician and Patient’s Guide to Hepatitis B” published by the Asian Liver Center at Stanford University.
- Letter B – You are not infected with the hepatitis B virus BUT you are not immune from the virus. If you gave us the name of your doctor at registration, a copy of this letter and your test results will be sent to him. If you did not give us his name, please share this letter and with him at your next appointment. If you do not have a doctor, please see one if you have any questions about your test results. Please talk to your doctor about the hepatitis B vaccine. If you would like its protection, you may receive the vaccine from SNHD. The vaccine is free if you do not have insurance, or if your insurance does not cover the cost of the vaccine. Enclosures are three items: a copy of the test results, the test guideline from page 2 of “Physician and Patient’s Guide to Hepatitis B” published by the Asian Liver Center at Stanford University, and the Hepatitis B Vaccine Information Statement from the Center for Disease Control in the client’s primary language if available, in English if not.
- Letter C-1– You tested positive for hepatitis B infection. You indicated at Registration that you have health insurance. Please see your medical provider immediately and give him this letter with enclosures. If you gave us his name at Registration, a copy of this letter and your test results will be mailed to him. If you did not give us his name, please share this letter and with him as soon as possible. If you don’t already have a doctor, please call us and we can provide you a list of Asian language speaking primary care physicians who we know treat chronic hepatitis B and you can see if any of them are in your provider network or HMO. Enclosures are a copy of the test results, the test interpretation guideline from page 2 of “Physician and Patient’s Guide to Hepatitis B” published by the Asian Liver Center at Stanford University and in-language patient education brochure about understanding and managing Chronic Hepatitis B if available, in English if not. This letter includes a disclaimer that HepBFreeLasVegas is not a medical provider, does not provide medical care and is not responsible for the treatment provided by any medical provider.
- Letter C-2 – You tested positive for hepatitis B infection. You indicated at Registration that you do not have health insurance. If this is true, we can work with you to find free or low cost medical care. There are independent, non-profit medical clinics that offer free and/or reduced-fee treatment to the uninsured and the underinsured. You do not have to use these clinics, but medical care may be available to you if you meet their eligibility or qualification requirements. Please call us immediately if you would like us to help you and we will meet with you as soon as possible. Enclosures are three items: a copy of the test results, the test interpretation guideline from page 2 of “Physician and Patient’s Guide to Hepatitis B” published by the Asian Liver Center at Stanford University and an in-language patient education brochure on understanding and managing Chronic Hepatitis B if available, in English if not. This letter includes the same disclaimer as in Letter C-1.
IX. Providing caseworker/client advocacy assistance to uninsured positive clients who ask us for help. Our services typically include:
- meeting face-to-face with the client to explain eligibility and qualification requirements;
- ensuring the client can provide the necessary documents to establish his eligibility and qualifications;
- expediting eligibility and qualification appointments with Clinic Partners Volunteers in Medicine of Southern Nevada and/or FirstMed Health & Wellness Center.
- accompanying the client to the eligibility and qualification appointment;
- providing a translator if the client in not able to bring an English-speaking family member or trusted friend to the eligibility and qualification appointment; and
- providing on-going assistance if requested by the clinic and agreed to by the patient, by way of in-language appointment scheduling and translation services during the medical appointments.
X. Facilitating vaccine for those who test not infected/not immune and want vaccine protection.
- Quick service at Southern Nevada Health District: When our clients who receive Letter B go to SNHD for hepatitis B vaccine, they present the letter with enclosures to the Information Desk. The staff calls the Immunization Department, who sends someone to the lobby to accompany the client to the nurse’s station for vaccine administration. All clients are required to pay the $16 administrative fee required by SNHD regardless of insurance status. Uninsured and underinsured clients are not charged for the cost of vaccine. Those whose insurance covers the cost of vaccine are required to pay for the vaccine. Clients can go anytime at their convenience to SNHD offices at 330 South Valley View Monday through Friday during business hours of 8:00am to 4:30pm.
- Confirmation of vaccine administration: We are registered with Nevada WebIZ, the state’s immunization information system, for read-only access. Prior to a combined screening and vaccination event, we check client vaccination status in WebIZ and we update our database with recent client immunization dates.
- In-language phone banking and reminder notices: We generate call lists by primary language spoken, of uninsured and underinsured clients due for a 1st, 2nd or 3rd vaccine. We call and invite them, in their language, to get their vaccine at the upcoming community vaccine clinic (see bullet below). If we are unable to reach an uninsured or underinsured client (non-working contact number) we mail a notice of the community vaccine clinic event to the client.
- Community vaccine clinics: We coordinate with SNHD to conduct vaccine clinics at our screening events as part of their community outreach. We notify them of the number of uninsured and underinsured clients who told us in our in-language phone banking that they would come for vaccine. This way, SNHD knows how much hepatitis B vaccine to bring. There is no waste of public resources because those who come for vaccine have already been tested and found to be not infected/not immune. SNHD may decide to bring other available vaccine, such as tetanus, diphtheria, pertussis vaccine and influenza vaccine to maximize access to these uninsured or underinsured at-risk, hard-to-reach APIs.
XI. Providing feedback to our partners on event outcomes and measurements.