Track 1: HIV Testing & HIV Testing Outreach
Project Work Plan
January - December 2016
Minnesota Department of Health
HIV/STD Prevention Projects
Agency name:
Project name (If applicable):
PROJECT OVERVIEW
Check all of the following activities for this project:
HIV Testing & Outreach (You do testing on-site and off-site.)
Outreach Only (You do not test. You connect clients to a test site.)
Condom Distribution
Check the target population(s) you will serve:
African Immigrant (HRH)
Young (HRH)
Latinos (HRH)
African Americans (HRH)
Greater MN
Native American (HRH)
Asian/Pacific Islander (HRH)
Adult MSM
Young MSM
List any sub populations within your selected target population that you are planning to focus on:
IMPORTANT: If your 2016 budget amount was reduced, include details of any and all
changes in your project caused by the funding reduction.
Provide the number of tests you plan to conduct in one year:
HIV Testing & Outreach
Number of Outreach Contacts (Jan-Dec):
Number of Tests (Jan-Dec):
(On-site and off-site total)
Outreach Only (You do not test. You connect clients to a test site.)
Number of Outreach Contacts (Jan-Dec):
Number of People Connected to Test (Jan-Dec):
ENGAGEMENT & RECRUITMENT
Complete the table below to describe a typical weekly outreach plan/schedule
Outreach location/setting
(Include Websites if applicable)
Time of Day
Days of the week (start to finish)
NEW MEDIA
List any new apps, websites and other new media in which activity will be implemented:
HIV TESTING
HIV testing will be implemented as described in your 2015 Project Work Plan:
If No, what changes were made and why did you make the change?
Yes
No
CONNECTION TO CARE & REFERRALS
How will persons testing positive (reactive) be linked to an HIV care clinic in 2016:
List clinics or providers you currently have a relationship with where clients will be connected to care:
What changes have you made in how you actively refer or link clients to appropriate prevention and/or
support services (other than HIV care)? What new agencies/providers are you connecting clients to? (e.g.,
housing, mental health, chemical dependency treatment, etc.)
CONDOM DISTRIBUTION
Targeted condom distribution will be implemented as described in your 2015 Project Work Plan:
Yes
No
If no, what changes were made and why did you make the changes?
PrEP
How will you integrate PrEP education and active referrals in your work in 2016?
What training or capacity building assistance do you need from MDH to accomplish this?
STD & HEPATITIS INTEGRATION
STD & Hepatitis will be integrated into your project as described in your 2015 Project Work Plan:
Yes
No
If no, what changes were made and why did you make the changes?
MONITORING & EVALUATION
List one specific project activity that will be evaluated this year. Include the type of data that will be collected
to evaluate the activity:
INCENTIVES
Check this box if you do not use incentives.
Incentives will be utilized as described in your 2015 Project Work Plan:
Yes
No
If no, what changes were made and why did you make the changes?
VOLUNTEERS
Number of volunteers in your program:
The role of volunteers is the same as described in your 2015 Project Work Plan:
Yes
No
If no, what changes were made and why did you make the changes?
STAFFING
Project staff List any staff paid through this project’s budget as of January 2016.
Name
Title
(List title if position is unfilled)
FTE on
project
Authorized to
use EvalWeb
(Must match
FTE in Budget
Plan and
Narrative)
Yes
No
Yes
No
Yes
No
Yes
No
ADDITIONAL COMMENTS
Describe any additional information that you think is important for MDH to know:
Required Elements of Track 1 – HIV Testing and Testing Outreach
HIV Testing:
 Data Collection
 Condom Distribution – Data entered into Evaluation Web
 Maintain an agency HIV testing protocol
 Standards of Practice
o Obtain client consent (incl Tennessen Warning), assess risk, give prevention
information, refer for other services
o Educate on the meaning of test results
o Provide HIV CTR Link to Care when applicable
o Follow local, state and federal regulations and guidelines
o Maintain staff testing proficiency
 Compliance with MN Communicable Disease Rule
 Compliance with OSHA standards for blood borne pathogens, incl exposure plan
Testing Outreach:
 Develop and use MDH approved Risk Assessment tool
 Directly connect clients identified at highest risk of infection to HIV Testing
 Confirm client connection to testing and track positivity rate
 Condom Distribution