Dr. Jose Montero, associate professor in the Division of Infectious Disease, and Dr. Marela Velez, a division fellow, are two of 14 USF infectious disease physicians who treat patients at the Hillsborough County Health Department’s Specialty Care Center.

It was a gray morning when officials from the Duval County Health Department recently arrived for a day at the Hillsborough County Health Department. Inside the building, the atmosphere was bright and full of energy as representatives of the two health departments began discussing innovative ideas. Sharing knowledge about designing and refining programs, infrastructure, technology, and research in order to create the most effective public health care for Florida’s residents was the call of the day.

As a peer county, with similar demographics to Hillsborough, Duval County will strive to make improvements based on what has worked in Tampa Bay. One program that has worked exceptionally well is the HIV Clinical Research Unit, a long-term partnership between the USF Division of Infectious Disease and International Medicine and the HCHD. The unit operates in conjunction with the county’s Specialty Care Center and conducts clinical research relevant to the HIV community it serves.

“We realize that Hillsborough’s Disease Control Program is recognized as one of the best in the state. We are here to obtain information about the clinics: HIV, STD, TB, as well as the Immunization program so that we can model our programs after their programs,” said Aaron Hilliard, PhD, assistant director of Environmental Health and Disease Control for the Duval County Health Department. “We see there has been an increase in quality and efficiencies here. We can go back to Duval and make it happen.”

L to R: Mike Kilcomons, RN, BSN, MPH, Public Health Officer, HCHD; Fayshonda Cooks, RN, BSN, CAPPM, Disease Control Program Administrator, Duval County Health Department; Aaron Hilliard, PhD, Assistant Director, Environmental Health and Disease Control, Duval County Health Department; and Mike Wagner, Health Center Administrator, HCHD

Advances in HIV Research

The USF HIV Clinical Research Unit operates out of the HCHD in downtown Tampa. This unit has been designed to facilitate access to innovative experimental therapies before they are widely available to the greatest number of patients. The physicians, supplied by the USF Division of Infectious Diseases, and care providers have been contributors to evidence-based medicine for over 13 years. Their efforts have been instrumental in bringing more than 20 HIV medications to market. The research team has conducted more than 110 HIV research studies, including Phase I-IV pharmaceutical studies, investigational device and testing evaluations, epidemiologic, health services, and outcomes research. Four to eight studies are ongoing at any time, with approximately 50 patients participating in studies each year.

“The HIV Clinical Research Unit serves as an exceptional study and trial environment with a highly qualified staff and an excellent performance record,” said Charurut Somboonwit, MD, assistant professor of medicine in the USF Division of Infectious Disease and director of communicable diseases for HCHD.

This unique partnership with USF benefits HCHD and the community by offsetting approximately $300,000 a year for care and medications that would otherwise be billed to the Hillsborough County Health Plan, Medicaid, Medicare, and other indigent funds. Enhancing their professional growth, Health Department professionals gain experience with new agents and laboratory tests before their general availability. This experience facilitates HCHD’s leading role as a community education resource. Additionally, the research unit works to improve the public image and the prestige of public sector healthcare through its association with a facility that offers state-of-the-art diagnosis and management.

Providing Specialized, Comprehensive Care

A reported 8,732 people live with HIV/AIDS in Pinellas and Hillsborough counties, according to the HCHD’s Epidemiology and Public Health Surveillance Department. The Specialty Care Center at HCHD provides the comprehensive primary healthcare services to HIV/AIDS patients and operates a STD clinic for the county. Through Ryan White CARE Act funding, the Center provides comprehensive HIV care to any HIV-infected patient desiring services, regardless of ability to pay. It is not the clinic’s accessibility, however, that attracts patients from all over Florida. It is the superior quality of care. In addition to providing excellent care from HIV-trained disease clinicians, the center addresses the myriad of social issues of HIV care. Social workers and on-site ADAP representatives assist patients in obtaining health care coverage, medications, and links to other community resources. The center also provides dental care, an often neglected, but integral part of comprehensive HIV/AIDS care.

“We call it a center, not a clinic, because the patient is at the center of our care. We give them whatever they need, when they need it,” said Debbie Morgan, a dental professional at the Specialty Care Center. Morgan provides dental care to HIV-positive patients, and is passionate about her contribution. The dental services are extensive: “We do everything from fillings to extractions; probably the only level of dentistry that we do not do is cosmetic.”

She explains: “The mouth is the closest portal to the heart for infection. We try to keep patients with compromised immune systems from any type of infection that may get into the lymph system or the circulatory system and filter into the heart causing other cardiac problems. We are really promoting wellness. When the mouth looks healthy, generally we know the person is eating correctly and being compliant with their medication.”

Touch-screen customer service satisfaction surveys are available at kiosks throughout the HCHD.

Continuous Quality Improvements

As patients leave the HCHD they are asked to complete an anonymous electronic customer service survey available at computer kiosks throughout the facility. The survey helps the clinic continuously improve the quality of care provided.
“The only constant is that everything is always changing and being improved upon at the Hillsborough County Health Department,” said Mike Kilcommons, RN, BSN, MPH, public health officer.

– Story by Kaeley Hamilton, Julian Corvin, Dr. Jennifer Logan/Division of Infectious Disease & International Medicine

– Photos by Kaeley Hamilton