Kentucky Rural Health Association in partnership with Kentucky Adult Viral Hepatitis Program and

the Kentucky Immunization Program

2018 Viral Hepatitis Conference Ending the Epidemic:

The Role of Professionals in Hepatitis Elimination Conference Brochure and Agenda

Lexington, KY July 31, 2018

2018 Viral Hepatitis Conference Ending the Epidemic:

The Role of Professionals in Hepatitis Elimination

Course Description The purpose of this conference is to provide the most up-to-date information on hepatitis A, B and C epidemiology, diagnosis, management, treatment and prevention, which will assist health service providers to offer the most effective care to persons infected with hepatitis A, B or C. By promoting collaborations and the sharing of knowledge, ideas and experience, we can continue to make advances and bridge the gap in the prevention and management of hepatitis infections throughout the Appalachia Region.

Course Objectives

1. Discuss the impact of a national strategy and the 2018 U.S. Viral Hepatitis Action Plan on

creating an effective HCV service delivery system and national strategy for creating an

effective HCV service delivery system.

2. Discuss the impact of the increases of hepatitis infection related to the growing opioid

epidemic in Kentucky and the U.S. Describe injection drug use and describe ways to

enhance access to health care services for substance users.

3. Discuss an understanding of Kentucky’s Opioid Response Effort (KORE).

4. Identify the procedures conducted during the pre-treatment evaluation of a patient with

HBV and HCV, best practices for screening, diagnosing, linkage to care. State the burden of

hepatitis B and hepatitis C disease in Kentucky and the Appalachia Region. Discuss new

screening strategies to identify persons infected with HBV and HCV. Describe the

infrastructure necessary to support hepatitis care and treatment in primary care settings.

5. Discuss novel interventions used in other jurisdictions throughout the US to address an

HAV outbreak. Summarize the status of the Louisville HAV Outbreak.

6. Discuss procedures conducted for screening on HCV, perinatal transmission; screening,

testing, and treatment of infants born to mothers with HCV and HBV.

7. Discuss the latest clinical drug trails for HCV treatment in children.

8. Discuss case management of perinatal HBV.

9. Discuss recent changes to Kentucky’s Medicaid Program and how these changes impact

viral hepatitis treatment in Kentucky.

10. Discuss viral hepatitis and opportunities to mobilize community action.

Kentucky 5th Annual Viral Hepatitis Conference

Griffin Gate Marriott Resort & Spa- Lexington, KY

Ending the Epidemic: The Role of Professionals in Hepatitis Elimination July 31, 2018

TIME PRESENTATION FACULTY 7:30 AM-8:00 AM Registration – Exhibit Viewing

Breakfast (provided)

8:00 AM-8:15 AM Welcome and Opening Remarks Kathy J. Sanders, RN MSN

8:15 AM-9:00 AM Plenary #1: Ending the Epidemic: U.S. Viral Hepatitis Action Plan

Corinna Dan, RN, MPH

9:00 AM-9:45 AM Plenary #2: Ending the Epidemic: Increases in Hepatitis Infection related to the Growing Opioid Epidemic

Jon E. Zibbell, PhD

9:45 AM-10:00 AM Morning Break and Exhibit Hall Viewing

10:00 AM- 10:30 AM Plenary #3: Ending the Epidemic: Kentucky’s Opioid Response Effort (KORE)

Allen J. Brenzel, MD, MBA

10:30 AM-11:30 AM Plenary #4: Ending the Epidemic: Best practices for screening, diagnosing, linking to care

Danielle Revert, ARNP Barbra Cave, MSN, ARNP, FNP-BC 11:30 AM-12:45 PM Working Lunch (Provided)

National Perspective: Novel Interventions to Address Hepatitis A Outbreaks in Jurisdictions; Louisville Hepatitis A Outbreak Update

Monique A. Foster, MD, MPH Lori Caloia, MD

12:45 PM-1:45 PM

Plenary #5: Ending the Epidemic: A Focus on HCV, Perinatal Transmission and Infants born to mothers Screening, Testing, and Treatment

Claudia Espinosa, MD, MSc William Balistreri, MD

1:45 PM- 2:00 PM Afternoon Break and Exhibit Hall Viewing

2:00 PM-3:00 PM

Plenary #6:Ending the Epidemic: Case Management of Perinatal HBV

John Stutts, MD, MPH

3:00 PM- 4:00 PM Plenary #7: Ending the Epidemic: Medicaid and Viral Hepatitis Treatment in Kentucky

Samantha McKinley, BS, JD, DC, PharmD

4:00 PM-4:50 PM Plenary #8: Ending the Epidemic: The Syndemic Involving HIV and Viral Hepatitis – Mobilizing Community Action!

Chris Taylor, BS

4:50 PM-5:00 PM Questions, Answers & Closing Remarks

MODERATOR Chris Taylor Senior Director

National Alliance of State and Territorial AIDS Directors

William F. Balistreri, MD Dorothy M.M. Kersten Professor of Pediatrics University of Cincinnati College of Medicine

Director Emeritus, Pediatric Liver Care Center Medical Director Emeritus, Liver Transplantation

Program Director Emeritus, Fellowship in Transplant Hepatology Division of Pediatric Gastroenterology, Hepatology, & Nutrition

Cincinnati Children’s Hospital Medical Center

Through more than 550 publications, Dr. Balistreri has helped to clarify the understanding of many aspects of liver diseases in children. His innovative research has addressed many aspects of hepatobiliary diseases in children, including neonatal cholestasis, metabolic liver disease, and viral hepatitis. Balistreri has been editor of The Journal of Pediatrics since 1995. He is the former editor-in-chief of the Journal of Pediatric Gastroenterology and Nutrition, and co-editor, associate editor, guest editor, reviewer and member of numerous editorial boards of several journals. He is co-editor of the prestigious text Liver Disease in Children. In 2000, Balistreri became the first pediatrician to serve as president of the American Association for the Study of Liver Diseases. In addition, he has received numerous awards. These include the Distinguished Leadership Award from the CCFA; the Andrew Sass-Kortsak Memorial Award from the Canadian Liver Foundation and the Canadian Association for the Study of Liver; The Distinguished Alumnus Award, University of Buffalo and The Distinguished Alumnus Award, University of Cincinnati, College of Medicine; the Distinguished Service Award from AASLD; and the Distinguished Educator Award from the American Gastroenterological Association. He received the Outstanding Pediatrician award from the Ohio Chapter of the American Academy of Pediatrics for distinguished achievements in pediatric care and in the education of patients and physicians. In 2012, NASPGHAN established the William F. Balistreri, MD, Prize for Excellence in Pediatric Gastroenterology, Hepatology and Nutrition. This award will recognize outstanding achievement in an area relevant to the field to be bestowed each year at the annual NASPGHAN meeting. Balistreri joined Cincinnati Children's in 1978. He served as division director of Pediatric Gastroenterology, Hepatology, and Nutrition for 25 years. Balistreri has been listed multiple times in Best Doctors in America.

Allen J. Brenzel, MD, MBA Associate Professor of Psychiatry and Pediatrics

Special Title Series University of Kentucky College of Medicine

In 2010 Dr. Brenzel was appointed the Medical Director for the Department of Behavioral Health and Developmental Disabilities (BHDID) with the Cabinet for Health and Families Services (CHFS) for the Commonwealth of Kentucky. Prior to 2010 he served as the Medical and Psychiatric Consultant for the Department of Community Based Services (DCBS) and as the Director of the Division of Child and Adolescent Psychiatry at the University of Kentucky. He attended the University of Louisville School of Medicine and completed a combined residency in Pediatrics, Adult Psychiatry and Child Psychiatry at the University of Kentucky. He also completed his Master in Business Administration in 2006. Dr. Brenzel has developed a breadth of knowledge and experience in mental health and substance abuse treatment. He frequently provides trainings and consultations across systems of care that have included Behavioral Health, Child Welfare, Juvenile Justice, Education and the Judiciary. Early identification of children and families at risk, and implementation of evidence based interventions across the lifespan have been the focus of his work. It is well known that he excels at working in multidisciplinary teams and building effective systems of care. Dr. Brenzel is actively involved in healthcare services reform in Kentucky. This has included working to modernize the State Medicaid Plan to include a full continuum of behavioral health substance abuse services including targeted case management, mobile and residential crisis and peer supports. In partnership with other state agencies, Dr. Brenzel has worked on reducing prescription drug abuse, addressing buprenorphine utilization and diversion, disseminating naloxone rescue kits, and developing guidelines for Kentucky’s recently approved Harm reduction and needle exchanges. He is also the CO-PI on the Kentucky MAT-PDOA grant which is providing coordinated care to woman with and opiate use disorder who are pregnant or parenting. In 2017, Dr. Brenzel was actively involved in the submission of Kentucky’s SAMHSA response to the Opioid STR grant. This will bring 10.5 million dollars to Kentucky for each of the next two years to address the opioid use disorder crisis in Kentucky.

Lori Caloia, MD

Medical Director Louisville Metro Department of Public Health and Wellness

Lori Caloia received her medical degree from Michigan State University, College of Human Medicine in 2004.

Following a transitional internship at San Antonio Uniformed Services Health Education Consortium from 2004-2005, she served in the U.S. Air Force as a flight surgeon for 5 years. She completed her Family Medicine Residency at Virginia Commonwealth University/Fairfax Family Practice and a Leadership Certificate in Public Health at Eastern Virginia Medical School in 2013 and is board certified in family medicine.

From 2013-2016, she was an Assistant Professor in Family Medicine at University of Louisville and she worked as a primary care provider at Norton Community Medical Associates from 2016-2017. She has been in her current position as Medical Director, Louisville Metro Department of Public Health and Wellness since November, 2017.

Barbra Cave, MSN, ARNP, FNP-BC

University of Louisville, Clinical Trials Unit Jewish Hospital Hepatitis C Clinic

Barbra Cave is a family nurse practitioner at the University of Louisville and serves as the Hepatitis C Program Lead for the University of Louisville Hospital Hepatitis C Center and participates in numerous clinical trials as co-investigator or sub-investigator. She was funded as a co-primary investigator alongside Dr. Claudia Espinosa to ensure all pregnant women delivering at University of Louisville Hospital are screened for hepatitis C, receive confirmatory testing, and both mother and baby are linked to care. She has a long-standing relationship with the Louisville Metro Department of Public Health and Wellness and their Syringe Exchange Program. Barbra plans to work with the program to learn more about the behaviors of people who inject drugs as she completes her PhD in nursing. She is an advocate for hepatitis C screening and access to treatment. Ms. Cave lead a team of volunteers for a large-scale free hepatitis C screening in Louisville and surrounding counties which helped test 488 people. This year, she and her team were able to test hundreds of people over a larger geographic area that included Louisville, its surrounding counties, and several sites in Southern Indiana.

Corinna Dan, RN, MPH

Viral Hepatitis Policy Advisor Office of HIV/AIDS and Infectious Disease Policy Office of the Assistant Secretary for Health U.S. Department of Health and Human Services

Ms. Corinna Dan, RN MPH, is with the Office of HIV/AIDS Policy (OHAP) at the US Department of Health and Human Services. Corinna is the Viral Hepatitis Policy Advisor working to implement the National Viral Hepatitis Action Plan. Prior to joining the OHAP, Corinna served as Hepatitis B Policy Fellow at the Association of Asian Pacific Community Health Organizations (AAPCHO). In this role, Corinna worked with community leaders and policy makers to promote improved prevention, diagnosis, treatment and care of viral hepatitis in Asian American communities across the United States. Before joining AAPCHO, Corinna held positions in the Hepatitis Foundation International (Chief Operating Officer) and the Chicago Department of Public Health (Hepatitis C Virus Program Coordinator). Corinna received a Bachelor of Arts degree from Connecticut College, a Bachelor of Science in Nursing from Rush University in Chicago and Masters in Public Health from the University of Illinois at Chicago.

Claudia Espinosa, MD, MSc

Division of Pediatric Infectious Diseases University of Louisville School of Medicine

Claudia Espinosa, M.D., M.Sc., earned her medical degree from the Universidad del Cauca, Colombia. She completed residency training at Kansas University Medical Center, Kansas City, KS, and fellowship training in pediatric infectious diseases at Motts Children’s Hospital Ann Arbor, MI. While in Michigan, she also earned a Master’s of Science in Health Services Research from the Michigan Institute for Clinical and Health Research Center at the University of Michigan. Dr. Espinosa is currently Assistant Professor of Pediatrics at the University of Louisville School of Medicine in the Division of Pediatric Infectious Diseases and Attending Physician at Norton Children’s, Norton Women and Children’s and University of Louisville Hospitals in Louisville, KY. She is a member of the Children’s Health Services Research Unit within the Department of Pediatrics and works with the resident Evidence Medicine Curriculum and Global Health Department. Her clinical and research interests are focused on the improvement of prevention and management of perinatally transmitted infections.

Monique A. Foster, MD, MPH

Medical Epidemiologist National Center for HIV/AIDS,

Viral Hepatitis, STD, and TB Prevention (NCHHSTP)

Dr. Foster serves as the epidemiology lead for hepatitis A in the Division of Viral Hepatitis.

She is a graduate of East Carolina University and Eastern Virginia Medical School and received her MPH from Vanderbilt University.

Dr. Foster completed her pediatric residency at the University of Tennessee Health Science Center and a pediatric infectious disease fellowship at Vanderbilt University before joining the CDC as an Epidemic Intelligence Service Officer with the Division of Viral Hepatitis in 2014.

Samantha McKinley, BS, JD, DC, PharmD Medicaid Pharmacy Director

Department for Medicaid Services Cabinet for Health & Family Services

Dr. McKinley attended the University of Florida and received her Bachelor of Science in Neuropsychology. She received her Juris Doctor at the Whittier College of Law in Santa Rosa California. She attended Northwestern Health Sciences University and received her Doctor of Chiropractic. The Doctor of Pharmacy was from the University of Kentucky College of Pharmacy. As Medicaid Pharmacy Director in the Kentucky Medicaid Program Dr. McKinley directs the Fee-for-Service population plus those covered through Managed Medicaid Care Organizations (approx. 1.4M covered lives). Kentucky Medicaid is a national leader in Medicaid program design. Her experience is utilized across departments to advance specific projects, investigations, policies, operations, and litigious matters. Dr. McKinley was the Utilization Management Manager & Strategic Consultant Pharmacist Director at the PharMerica Corporation. She managed the 2nd largest institutional long term care pharmacy company in America, operating more than 100 institutional pharmacies in over 40 states and servicing skilled nursing facilities caring for more than 350K patients. She focused on controlling pharmaceutical costs for customers while also supporting corporate preferred products and overall formulary for contract maximization. As Doctor of Chiropractic, Dr. McKinley was the Physician and Owner of Health Force Chiropractic & Rehabilitation Centre, Frankfort and Louisville, KY. Medically based trained Chiropractor and sole owner of a general family practice utilizing a variety of techniques; along with advanced spinal, arthritic and sports rehabilitation. As Legal Consultant Dr. McKinley will provide legal and legislative consultant by project only.

Danielle Revert, ARNP

Hepatitis C Treatment Center

Danielle Revert is a family nurse practitioner from Louisville, KY. She received her Master’s degree from Bellarmine University where she has also served as clinical and simulation faculty for the past 4 years. She works at the Hepatitis C Treatment Center where she primarily sees patients with viral hepatitis. The clinic is celebrating over 20 years of treating patients and curing over 2,100 people with HCV since the development of direct acting antivirals. She has given several talks across the region on HCV disease awareness and has been strong advocate for screening and treatment access.

Ms. Revert’s achievements include: Speaker for Gilead Sciences Inc., and AbbVie Pharmaceuticals, Gilead Sciences Inc. Advisory Board Member, Norton Better Care Award June 2013 and October 2013, Daisy Award Nominee 2013, Sigma Theta Tau International Nursing Honor Society Member, graduated magna cum laude from Bellarmine University 2012 and Graduated summa cum laude from University of Evansville 2010.

John T. Stutts, MD, MPH

Associate Director for Gastroenterology Core Curriculum and Residency Medical Education

Department of Pediatrics University of Louisville

Dr. Stutts is a native of Louisville, Kentucky. He received his Bachelor of Science degree from Purdue University. He earned his medical degree from the University of Louisville School of Medicine. He then completed his Pediatric Residency, Pediatric Gastroenterology Fellowship, as well as a Master of Public Health from Vanderbilt University. He returned to Louisville to join the University of Louisville faculty in the Department of Pediatrics in 2000. He is part of multiple research studies with the Kosair Charities Pediatric Clinic Research Unit. He serves as the Associate Director for Gastroenterology Core Curriculum and Residency Medical Education for the Department of Pediatrics. He is a member of the Public Education Committee for the North American Society for Pediatric Gastroenterology Hepatology and Nutrition (NASPGHAN) and has served as a member of the Professional Education Committee for NASPGHAN, as well.

Chris Taylor

Senior Director National Alliance of State and Territorial AIDS Directors

Mr. Taylor graduated from Mount Mercy College with a degree in Social Work, the University of Iowa College of Public Health and is currently attending John Hopkins University Bloomberg School of Public Health. He has worked on the Rapids AIDS Project/American Red Cross in Cedar Rapids, Iowa. He has also worked as an HIV Outreach Worker at the Johnson County Department of Public Health in Iowa City and was a Disease Prevention Specialist and a Hepatitis Program Coordinator at the Iowa Department of Public Health, Iowa City. He currently serves as the Senior Director of the National Alliance of State and Territorial AIDS Directors where he provides strategic leadership, staff management and partnership development for the hepatitis program. He is also a Trainer of Prevention Counseling & Partner Counseling and Referral Services courses for testing sites.

Jon E. Zibbell, PhD

Senior Public Health Scientist RTI International

Jon E. Zibbell, PhD. conducts behavioral and community-based epidemiological research on risk factors and health outcomes associated with the opioid epidemic and injection drug use. He is a Medical Anthropologist with two decades of field experience in the areas of injection drug use, opioid use disorder, and injection-related infectious disease. Previously, Dr. Zibbell worked as a CDC Health Scientist in the Division of Viral Hepatitis and Unintentional Injury Prevention, conducting epidemiological and surveillance research on viral injuries and infections caused by drug use behaviors. In addition to research, he has conducted rapid ethnographic needs assessments for community-based syringe service and overdose prevention programs and continues to assist states and community organizations to develop evidence-based approaches to reduce morbidity and mortality associated with opioid epidemic. Dr. Zibbell’s work has appeared in both academic and professional journals and he holds a joint adjunct appointment in the Center for the Study of Human Health and the Department of Anthropology at Emory University. Dr. Zibbell received a Bachelor of Science in Natural Resource Studies; a Master’s of Art in Anthropology and a PhD. in Anthropology (Medical) from the University of Massachusetts/Amherst.

2018 Viral Hepatitis Conference Ending the Epidemic:

The Role of Professionals in Hepatitis Elimination

Special thanks to the following Conference Committee Members:

Deborah Bolton-Plucknett, RN Kentucky Immunization Program Perinatal Hepatitis B Prevention Coordinator Sheri Erwin Kentucky Immunization Field Staff Kentucky Rural Health Association Laura Harrod, MS Kentucky Immunization Program Staff Assistant Margaret Jones, RN, BSN Kentucky Immunization Program Manager Tina McCormick Kentucky Rural Health Association Julie Miracle, RN, BSN Kentucky Immunization Program Adult and Hepatitis B Immunization Coordinator Rebecca Pearl, BA Kentucky Immunization Program Continuing Education Coordinator Kathy Sanders, RN MSN Adult Viral Hepatitis Prevention and Control Program Coordinator Raven Timmons, BS Adult Viral Hepatitis Prevention and Control Program Assistant Amanda Wilburn, MPH Adult Viral Hepatitis Prevention and Control Program Epidemiologist

NOTES:

NOTES: