As a New York State Department of Health Designated AIDS Center,
Montefiore's Moses Division provides a broad array of services for
adult patients living with AIDS. The current care model revolves around
a thoroughly integrated multidisciplinary AIDS Team known as the AIDS
Center. Regarded as experts in AIDS Care delivery, the team consists of
over 45 health care professionals including: physicians, social
workers, nurses, HIV Counselors, dietitians, clerical and
administrative staff. The major components of the AIDS Center are:
Structure of AIDS Care in the Hospital
Inpatient care is provided at the patient's bedside whether on
the designated 24 bed unit or scattered throughout the hospital.
Currently, the AIDS Center multidisciplinary team provides inpatient
care for an average daily census of approximately 30 patients and
facilitates approximately 100 admissions and discharges a month.
Through a combination of nursing and social work case management,
medical consults, and nutritional counseling comprehensive patient care
is made available to all adult AIDS patients admitted to the hospital.
Additionally, voluntary and confidential HIV Counseling and Testing is
available to all admitted patients upon request by either the patient
or physician.
To further insure continuity of care, the 8 Team physicians (4
Infectious Disease Specialists & 4 Internists), serve as attendings
of record for all
patients admitted to the Designated Unit and as primary care providers
in the Infectious Disease Clinic. Currently the average length of stay
for an
AIDS patient admitted to Montefiore is 9 days.
Outpatient Services
The AIDS Center Infectious Disease Clinic provides HIV comprehensive
primary care to HIV positive patients throughout the disease spectrum
(asymptomatic to full blown AIDS). The clinic has an active census of
approximately 1,400 patients. Hospitalized AIDS patients who have no
primary care provider are referred to the Infectious Disease Clinic
upon discharge. Additional referrals are accepted from the AIDS Center
HIV Counseling and Testing program and various community based
programs. The multidisciplinary model of care is continued in the
clinic as well. The clinic is open 5 days a week and is located in a
recently renovated wing of the hospital. After hours on-call physician
access is provided through a 1-800-number beeper with bilingual
voicemail.
As of July 1997 the HIV Counseling and Testing Service has provided
OraSure as an alternative to serologic HIV testing. Through a special
initiative of HRSA and the Bureau of Primary Health Care (Ryan White
Title III), Montefiore is offering OraSure HIV Testing and Counseling
on an outpatient basis free of charge until further notification.
The AIDS Center conforms to the New York State Department of Health 7 Tier and 5 Tier AIDS outpatient visit categories.
Additional Components
Ryan White Title IIIb
In 1989, the AIDS Center received grant support from the US Public
Health Service to further enhance and expand the HIV early intervention
services throughout Montefiore. This grant which is now in its fifth
year made possible a multigenerational care model serving adults,
adolescents and children through the AIDS Center, the Montefiore
Adolescent AIDS Program and the Family Immunology Clinic.
Tuberculosis Directly Observed Therapy Program
In 1994, Montefiore's Tuberculosis Directly Observed Therapy (DOT)
Program became part of the AIDS Center. This model program provides
home and site based directly observed therapy for patients who have
been diagnosed with tuberculosis. Through a coordinated initiative with
the New York City and State Departments of Health and other Bronx based
DOT programs, the Montefiore DOT program has played a fundamental role
in the prevention and cure of tuberculosis in the Bronx.
Adherence Initiative
In 1998, the AIDS Center recieved a grant to support the continued
development of adherence strategies for patients on combination
therapies. Montefiore has established in leadership in this effort
through a number of unique and promising projects: Mock Therapy for
Staff, Patient Binders,
MEM and the Patient Mentor/Buddy Program.
NYSDOH Special Needs Plan
In 1996, Montefiore Medical Center and Bronx Lebanon Hospital
received a planning grant from the New York State Department of Health
to propose a model of fully capitated HIV managed care. The completed
proposal describes a Bronx wide HIV managed care network coordinated by
both hospitals and including various community based organizations. The
NYSDOH is expected to release Requests for Proposals to license HIV
Special Needs Plans in the near future and approved plans are expected
to be operational sometime in the year 2000.
Visit our SNP web page dedicated to information and public discussion about HIV/AIDS Managed Care and SNPs.
Database Management and Development
The AIDS Center maintains a local area network which supports all
program database and document processing. This allows for the routine
reporting of utilization patterns and monitoring of quality of care
indicators.
AIDS Resource Center
The AIDS Center also serves as an AIDS clearinghouse and information
resource for Montefiore Medical Center. As the sponsor of the AIDS
Steering Council with representatives from all of the existing
Montefiore AIDS programs, the AIDS Center encourages and stimulates
multi program collaboration, coordinated grant and budget applications,
and a variety of administrative functions.
Contacts
Eli Camhi, CSW
Director for Bentley Services, AIDS Center
ecamhi@generes.com
718-920-2199
Gary Kalkut, MD
Medical Director, AIDS Center
gkalkut@aol.com
718-920-2809
Montefiore Medical Center
111 E. 210th Street
Bronx, New York 10467
718-920-5224
718-405-0610 fax
