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While the Affordable Care Act (ACA) and Medicaid expansion are vulnerable in America’s volatile political climate, for now the potential for increased healthcare coverage provided under “Obamacare” remains an important component of any EtE strategy. However, the ACA and the many Republican efforts at repealing the law can be confusing and complex. Below you’ll find some links to resources breaking down the ACA, the many challenges it faces, and the potential impact on people living with or vulnerable to HIV.

Knowing how to communicate with elected officials across the political spectrum is essential when trying to gain political support for an EtE initiative. Here we have provided some examples of key talking points from other EtE work as well as resources highlighting general communications strategies for engaging with elected officials.

Slide Deck on Communication and Advocacy

Increased healthcare access for marginalized communities through Medicaid expansion greatly improves the effectiveness of EtE efforts.[i][ii] With TasP, PrEP, and PEP—our most effective evidence-based tools for preventing new infections—comprehensive healthcare coverage is required; pills cannot be accessed without healthcare provider visits, labs, and medication coverage. Taking full advantage of federal funding for state Medicaid programs is likely essential for all communities to see drastic declines in new infections.

For EtE plans to succeed, they must centrally address social and structural barriers to care, treatment, and prevention. Here are some basics on social and structural determinants of health (SSDHs) from the Centers for Disease Control and Prevention (CDC):

 “The complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities. These social structures and economic systems include the social environment, physical environment, health services, and structural and societal factors.

The right timeline for an EtE planning process will change depending on location. Here are two examples from existing EtE plans: New York State (left) and Houston, Texas (right).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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While each EtE process may be different, there are many commonalities. Here are some examples and templates for agenda planning, invitation lists, event planning timelines, EtE action plans, etc. that may facilitate the formation of new community led EtE initiatives. Click below for resources for planning an initial meeting, community listening forums, online surveys, and drafting/launching EtE plans.

Planning a “kick off” meeting
Community listening forums
Online surveys
Drafting/Launching EtE Plans

Several cities, counties, and states have developed EtE plans that are in various stages of implementation. Click on the icons below to access the EtE plans for each jurisdiction, along with other related EtE resources from each location.

Cities/Counties

  • Houston, TX
  • Pittsburgh, PA
  • Washington, D.C.
  • Fulton County, GA (Atlanta Metro Region)
  • San Francisco, CA

States

  • Arizona
  • Colorado
  • Massachusetts
  • New York
  • Washington

 

 

There is no one-size-fits-all approach to EtE initiation and implementation, although there are some commonalities across plans. Successful planning usually involves partnership and shared leadership between community leaders, activists, service providers, representatives from academic institutions, and public health officials. Frequently, the first step is setting up an initial large planning meeting to establish community leadership, develop partnerships with other key stakeholders, and develop a plan of action for drafting a broader EtE plan.

TAG is working closely with community advocates and other key stakeholders in four different southern jurisdictions to develop EtE plans for their city or state. Each location was chosen based upon discussions with 45 advocates and key stakeholders from across the Deep South that TAG hosted in May of 2017.

For more on the information presented and findings of that meeting, you can find the meeting report here

Click on these icons for more information about each location and the work they’re doing to end their epidemics

Nashville, TN

Jackson, MS

Louisiana

Alabama

The context, planning, and implementation of each EtE initiative can vary tremendously depending on location. Here are four discussions with key community activists from four different EtE initiatives looking at how their plan was initiated, what the planning process looked like, and how their plans are being implemented:

(VIDEOS)
New York

Minnesota
Houston
Arizona

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