policy? How are confirmation laboratory tests for HIV and Hepatitis processed? Internally or externally? Who are the HIV, HCV, HBV linkages to care in the City of Detroit and specifically in the area surrounding your clinics or where your patients live? The face-to-face meetings set the platform for learning collaborative #2. The second learning collaborative allowed for each of the clinics to discuss their clinic flow, the EMR and labs they use. During this time we realized 2 of our partnering clinics used the same EMR, and our partnering substance abuse facility did not have an EMR system and were doing all of their medical examinations in paper files. From the discussions at our learning collaborative, clinic feedback, and through partnership support, the substance abuse facility purchased an EMR system that one of the other partners was already using. They went from paperless to electronic which made their clinic more efficient in all areas not just HIV and HCV. They were also able to get feedback and help from the clinic that was already using that EMR. We also noticed several of our clinics used the lab, Quest Diagnostics, to read their blood work. This presented an opportunity to negotiate the cost for testing. One of the clinics was using a different lab and paying a lot more than the clinics using Quest Diagnostics. They switched over to Quest Diagnostics, have been able to include more routine testing which they were not doing before, and it has saved their clinic a lot of money. To build our community partnership we had a guest speaker from Midwest AIDS Training and Education Center at our second learning collaborative. The have become great partners throughout the grant duration. They discussed a lot of the work they have been doing in the community and the partnerships they have built. They are a great HIV resource and always invite us to any HIV events that they know of in the community. We also discussed monthly data collection and how we are going to monitor our efforts to see the impact they have on our screening and testing efforts. DRAFT
MICHIGAN HIV CONSENT LAW By the third learning collaborative could discuss the monthly numbers and trends. We looked at where we were in regards to testing before the learning collaborative started and what strides we had made, via data. We also discussed the Michigan HIV testing consent law. Currently the Michigan HIV testing law is opt-in. Opt-in testing requires that the patient provide additional and separate written or verbal “informed consent� for the HIV test, and is a barrier to screening. Separate consent for HIV testing compromises the goal of routine screening. The providers shared at the learning collaborative that the opt-in consent deters patients from testing due to stigmatization. The collaborative became eager to learn about HIV consent laws in other states and learn strategies we could collectively work to change the Michigan HIV consent law and become an opt-out state. Opt-out testing, which is recommended by the CDC, indicates that the general consent is sufficient to notify patients that HIV testing may occur. We had a policy analyst guest speaker talk about the Michigan opt-in consent law in comparison to other states opt-out consent law and strategies the learning collaborative can incorporate in our initiative to make this possible. 19