Track 3: Syringe Services
January - December 2016
Project Work Plan
Minnesota Department of Health
HIV/STD Prevention Projects
Agency name:
Project name: (If applicable)
PROJECT OVERVIEW
IMPORTANT: If your 2016 budget amount was reduced, include details of any and all
changes in your project caused by the funding reduction.
Number of participants you plan to serve (Jan-Dec):
Number of clean syringes out (Jan-Dec):
Number of used syringes returned (Jan-Dec):
ENGAGEMENT & RECRUITMENT
Complete the table below to describe a typical weekly exchange plan/schedule
Exchange Locations
Days of the week Time
(start to finish)
NEW MEDIA
List any new apps, websites and other new media in which activity will be implemented:
SYRINGE SERVICES ACTIVITIES
HIV/HCV prevention (including hormone use and sex work) will be conducted as described in your 2015
Project Work Plan:
Yes
No
If No, what changes were made and why did you make the change?
Overdose Prevention (specify materials/protocols used or developed) will be conducted as described in your
2015 Project Work Plan:
Yes
No
If No, what changes were made and why did you make the? (specify materials/protocols used or developed)
Educating clients about the MN Syringe Access Law (if applicable) will be conducted as described in your 2015
Project Work Plan:
Yes
No
If No, what changes were made and why did you make the change?
Working with area/neighborhood law enforcement will be conducted as described in your 2015 Project Work
Plan:
Yes
No
If No, what changes were made and why did you make the change?
Culturally appropriate services for MSM/IDU, whether on site or via referral will be ensured as described in
your 2015 Project Work Plan:
Yes
No
If No, what changes were made and why did you make the change?
HCV TESTING
Number of tests you plan to conduct (Jan-Dec):
HIV TESTING (if applicable)
Number of tests you plan to conduct (Jan-Dec):
CONNECTION TO CARE & REFERRALS
List clinics or providers you currently have a relationship with where clients testing positive for HIV or HCV will
be connected to care and services:
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
Name
List any staff paid through this project’s budget as of January 2016.
Title
FTE on project
(List title if position is unfilled)
(Must match FTE in
Budget Plan and
Narrative)
ADDITIONAL COMMENTS
Describe any additional information that you think is important for MDH to know:
Required Elements of Track 3 – Syringe Services Programs
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Needle Exchange and Disposal
HIV/HCV Prevention Education
HCV testing
Condom distribution
Overdose Prevention
Harm Reduction Education
Compliance with OSHA standards for blood borne pathogens, incl exposure control plan
Compliance with MN Communicable Disease Rule
Optional Activities:
o HIV Testing (follow all required elements of Track 1)
o Advocacy for the MN Syringe Access Law